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Biomedical subjects

J K Laitung

Publications and source records attributed to J K Laitung.

18 recordsLinked to original sources
PubMed1998

Nipple-bearing inferior flap mammaplasty: a new technique for reducing massive breasts.

Patients with massive breasts may also suffer from concurrent obesity and preexisting cardiac and respiratory problems, thus presenting significant anesthetic and surgical risk. A modified new technique, evaluated by means of three cases, is described. Preliminary findings show a rapid surgical operating time, little blood loss, acceptable aesthetic appearance, and high patient satisfaction.

Humans↗
PubMed1993

A computer-aided method of measuring nasal symmetry in the cleft lip nose.

Objective assessment of the results of cleft lip and nose surgery is necessary to quantify differences between alternative surgical techniques. A previously described method of measuring facial asymmetry has been modified to allow a comparison of differently treated cleft noses (radical nasal correction versus no nasal correction). Standardised, inferior view photographs of 10-year-olds were obtained from patient records. These were projected, traced, digitised and analysed using a BBC microcomputer. A method of excluding the ill-defined nasal baseline by obtaining a mirror-image of the upper nasal perimeter is described. The method has a high degree of inter and intra observer reproducibility.

Child↗
PubMed1993

A comparison of computer versus panel assessment of two groups of patients with cleft lip and palate.

A computer-based system of assessing asymmetry was used to compare standardised photographs of primarily corrected cleft noses, uncorrected cleft noses and control (normal) noses. A significant difference was found between control and cleft groups for both upper nasal perimeter (p < 0.001) and nostril outline (p = 0.001), and between uncorrected and corrected noses for upper nasal perimeter (p = 0.03) but not for nostril outline (p = 0.99). Comparing the results achieved by panel assessment (Cussons et al., 1992) with this of the same patients revealed some discordance related to the influence of extraneous factors on panel decisions. Panel assessment is needed in the evaluation of overall appearance, whilst the computer method is able to assess the results of different techniques, and from different centres, on specific features where symmetry is a major objective of surgical technique.

Attitude of Health Personnel↗
PubMed1991

Effectiveness of burns resuscitation using two different formulae.

Prior to 1989 burns were resuscitated at the Burns Unit Frenchay Hospital according to the Mount Vernon formula. In 1989 a 33 per cent modification was introduced as suggested by Watson, Walker and Sanders. The aim of this study was to examine retrospectively the effects of the resuscitation protocols on morbidity and mortality. The total numbers of burns admitted to Frenchay in 1988 were 93 adults and 58 children. This compares with 82 adults and 55 children admitted in 1989. Of these, approximately one-fifth required intravenous resuscitation. No statistical difference was found between the two groups for age, body weight, distribution of burn, or delay in arriving at the burns unit (taken from the time of burn). In both years the volume of albumin used in resuscitation exceeded the calculated requirement after the third period (P less than 0.05). The 1989 patients were transfused with greater volumes, resulting in increased urine output (P less than 0.001). No difference in morbidity or mortality was shown. However, the investigation did show that the 1989 patients achieved urine outputs indicative of overtransfusion. It is concluded that the Watson-Walker modification is unnecessary and possibly undesirable.

Adolescent↗
PubMed1990

Successful preexpansion of a free scapular flap.

The use of pretransfer tissue expansion of a free scapular flap is described. This technique allows coverage of large defects with good quality skin and tensionless closure of the donor site.

Adolescent↗
PubMed1989

The lower posterolateral thigh flap.

The vascular basis of a new distally based flap in the distal third of the posterolateral thigh has been studied in 30 cadaver limbs. This flap is supplied mainly by direct cutaneous branches of the popliteal artery and of the lateral superior genicular artery. Its use as a distally based fasciocutaneous flap for defects of the knee is illustrated and its potential as a free flap is discussed. A classification of various flaps from the posterolateral region of the thigh is also proposed. In the light of the anatomical studies, the cutaneous blood supply of the distal posterolateral region and other regions of the thigh is reviewed.

Aged↗
PubMed1988

Isolated penile burns: a plea for early excision.

We report our experience of eight cases of isolated full thickness burns of the penis. Early excision of burns of the penile shaft and repair with a preputial flap or mesh split skin graft produces excellent results, with a reduction in complications and an early re-establishment of sexual function. Conservative treatment of burns of the glans, on the other hand, is appropriate and results in minimal scarring.

Burns↗
PubMed1987

The fibrous capsules around static and dynamic implants: their biochemical, histological, and ultrastructural characteristics.

In this article, we report the findings of a small study comparing the histological, ultrastructural, and biochemical features of fibrous capsules formed around tissue-expanding devices (dynamic implants) and simple prostheses (static implants) in the human. Histologically and biochemically, the dynamic fibrous capsule appears to represent an early phase of scar tissue formation around an expanding foreign body, the dominant feature being increased cellularity caused by myofibroblasts. In view of the marked presence of these contractile elements, it is paradoxical that a lower capsular contracture rate should be reported to occur in breast reconstruction using a temporary expander. This lower rate presumably is because these myofibroblasts undergo modulation once the expansion process has ceased and the final prosthesis is in place. One may also assume that the fibrous capsule would retain features of early scar tissue if the expansion process is maintained indefinitely. This hypothesis can be evaluated by a long-term study in the animal.

Cicatrix↗
PubMed1986

Scalp expansion flaps.

A mean 5 year review of 20 patients who had surgery for localised alopecia of the scalp is presented. The technique of using scalp expansion flaps is described and evaluated: it is associated with a low morbidity and high patient satisfaction rate; it provides an excellent one-stage procedure for intermediate size defects and, in the frontal area, for larger defects. Particular emphasis is laid on making incision lines at right angles to the direction of hair growth in order to cover stretched scars, and in performing Z-plasties when closing small scalp defects. Finally, a rationale for the treatment of localised areas of baldness according to their size is put forward.

Adolescent↗
PubMed1985

Shoulder function following the loss of the latissimus dorsi muscle.

A study of shoulder function was carried out in a group of 19 male patients who had their latissimus dorsi muscle removed as a free flap. A control group was examined to obtain data for the normal range of movement and power at the shoulder. Only a few patients had any subjective impairment of shoulder function; 13 of our 19 patients had a complete range of movement at the shoulder. There was no significant difference in power between the patient group and the control group when dominant and non-dominant sides were considered separately (p greater than 0.05). Patients who had surgery carried out more recently and patients with a scar contracture had a significantly higher disability score. The latter group also had a greater deficit in range of movement at the shoulder (p less than 0.05). Most patients encountered no difficulty whatever with their occupational and sporting activities. Our results support the view that the latissimus dorsi muscle is totally expendable and that there is no significant functional loss at the shoulder, either in casual or in forceful activities.

Adolescent↗
PubMed1984

The role of surgery in chromic acid burns: our experience with two patients.

Two patients with chromic acid burns are described, one having a 10 per cent body surface area (BSA) burn, the other a 70 per cent BSA burn. Hexavalent chromium, being more mobile physiologically, is more toxic than trivalent chromium. Both, however, are readily absorbed through burned skin, and cause renal failure. For this reason, emergency excision of burned areas has been advocated as first line treatment. However, this is not always feasible as, for instance, when the size of the burn is large, and is of uncertain value when patients are referred late.

Adult↗
PubMed1983

Manganese absorption through a burn.

A case of manganese absorption occurring in association with a burn is presented. We maintain that acute manganese toxicity was a likely cause of liver dysfunction in our patient.

Adult↗
PubMedDate not supplied

A simple method of securing a dressing on scalp wounds.

A method of securing a dressing on scalp wounds, using silastic foam, is described. This method has the advantage of leaving the rest of the scalp uncovered and is particularly effective in the unco-operative patient.

Bandages↗