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Biomedical subjects

J T Wee

Publications and source records attributed to J T Wee.

12 recordsLinked to original sources
PubMed1992

Objective assessment of research performance.

Research output in academic institutions need critical and objective assessment. Publications are an important avenue by which research by an academic can be evaluated. Journals in which such publications appear may be ranked and weight age given to publications in highly ranked journals. The number of citations of an academic's work by peers is another assessment of quality of research output. Firstly subjective peer assessment although flawed by interpersonal bias has its merits especially when evaluation is by an outsider of the institution.

Humans↗
PubMed1992

The dropped big toe.

Surgical procedures for exposure of the upper third of the fibula have been known to cause weakness of the long extensor of the big toe post-operatively. The authors present three representative cases of surgically induced dropped big toe. From cadaveric dissection, an anatomic basis was found for this phenomenon. The tibialis anterior and extensor digitorum longus muscles have their origin at the proximal end of the leg and receive their first motor innervation from a branch that arises from the common peroneal or deep peroneal nerve at about the level of the neck of the fibula. However, the extensor hallucis longus muscle originates in the middle one-third of the leg and the nerves innervating this muscle run a long course in close proximity to the fibula for up to ten centimeters from a level below the neck of the fibula before entering the muscle. Surgical intervention in the proximal one-third of the fibula just distal to the origin of the first motor branch to the tibialis anterior and extensor digitorum longus muscles carries a risk of injury to the nerves innervating the extensor hallucis longus.

Adolescent↗
PubMed1989

Glutaraldehyde-tanned microvascular grafts.

In this study the efficacy of preserving microvascular heterografts with glutaraldehyde tanning was investigated. These were compared with glutaraldehyde-tanned autografts. Previous studies have found that untreated autograft veins maintain a 95% patency rate, whilst untreated heterograft veins (Group 1) had a 15% patency rate at 4 weeks in this study. Autogenous glutaraldehyde-tanned rabbit carotid arterial grafts (Group 2) and glutaraldehyde-tanned human chorionic veins (Group 3) were interposed in rabbit femoral or carotid arteries. Fifty per cent and 75% patency rates were achieved respectively at 4 weeks. The low patency rate of the autogenous group suggests that the glutaraldehyde tanning technique itself is largely responsible for the low patency of glutaraldehyde-tanned human chorionic veins rather than any immunological response. Therefore if human chorionic veins are to be used as a readily available preserved microvascular graft, further investigation is required to develop another technique which will reduce antigenicity without promoting thrombosis.

Animals↗
PubMed1989

A new technique of vaginal reconstruction using neurovascular pudendal-thigh flaps: a preliminary report.

The blood supply to the skin of the perineum, medial groin, and upper thigh was studied in fresh female cadavers. The pudendal-thigh flap was designed as a result to reconstruct the vagina. The flaps are raised bilaterally in the groin crease just lateral to the labia majora and then are transposed toward the midline and sutured together to form a skin-lined cul-de-sac which opens at the introitus. The technique has been used successfully in three patients to reconstruct the vagina. The first patient, an adult, was reconstructed after total pelvic exenteration for malignancy, while two children had reconstructions for congenital vaginal anomalies. This technique is superior to currently available methods because it is simple and reliable. No stents or dilators are needed. It is safe technique without complications in our hands. The reconstructed vagina has a natural angle for intercourse and is sensate. The donor scars in the groin are well hidden.

Adult↗
PubMed1988

Reversed venous flow in the distally pedicled radial forearm flap: surgical implications.

In recent years the distally pedicled radial forearm flap has proved to be a versatile technique for resurfacing the hand. The venous drainage of this flap, however, has remained a puzzle. Various explanations have been suggested, including bypass of the valves by collateral veins and by crossover between the venae comitantes. However, venous drainage must be against the direction of the valves in at least one segment of the veins. The question of reversed venous flow and how it may be achieved reliably is addressed in this study. Timmons has postulated three criteria which all must be satisfied for reversal of venous flow. These criteria, namely higher proximal venous pressure, denervation of the valves, and the filling of the venous segments may be achieved satisfactorily if a few precautions are taken and certain technical manoeuvres performed. The criteria were re-examined in the light of known physiological phenomena. In addition, certain pertinent anatomical facts which arose from our cadaveric studies and which may be exploited to advantage are discussed. Our studies have led to greater understanding of reversed venous flow and to greater success with this flap in our clinical practice.

Forearm↗
PubMed1986

Reconstruction of the lower leg and foot with the reverse-pedicled anterior tibial flap: preliminary report of a new fasciocutaneous flap.

The blood supply to the skin of the anterior leg was studied in 10 fresh cadavers. Particular attention was paid to the intermuscular septal blood vessels, which emerge in the cleft between tibialis anterior and extensor hallucis longus and extensor digitorum longus muscles. With this anatomical knowledge, the reverse-pedicled anterior tibial fasciocutaneous flap was designed and transferred clinically to cover lower leg and foot defects in 6 patients. Three case reports are detailed. The factors which allow a distally based flap to be raised in the lower leg against the direction of venous valves are also described. The versatility of this new flap in the reconstruction of defects of the lower leg and foot is discussed.

Adult↗