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Biomedical subjects

M I James

Publications and source records attributed to M I James.

9 recordsLinked to original sources
PubMed2006

A simple method for linear burn debridement.

Debridement of linear burns especially on the trunk and abdomen can be challenging. Some currently used methods are technically difficult and potentially hazardous to the surgeon or the assistant. We propose a simple and effective method of linear burn debridement using towel clips. A pair of strong towel clips can be used to grasp the area of the burn at either end producing a tenting effect and therefore facilitating debridement of difficult areas. This technique provides a simple, precise and safe method of linear burn debridement.

Burns↗
PubMed2006

The flaming gypsy skirt injury.

On review of admissions over a 12-month period, we noted a significant number of women presenting with gypsy skirt burns. We describe all six cases to highlight the unique distribution of the wounds and the circumstances in which the accidents occurred. Four skirts were ignited by open fire heaters: two skirts ignited whilst the women were standing nearby, distracted with a telephone conversation; one brushed over the flame as she was walking past the heater; other whilst dancing in the lounge. One skirt was ignited by decorative candles placed on the floor during a social gathering. Another skirt was set alight by cigarette ember, whilst smoking in the toilet. Percentage surface area burned, estimated according to the rule of nines, showed that gypsy skirt burns were significant ranging from 7 to 14% total body surface area (TBSA) and averaging 9% TBSA. Two patients required allogenic split-skin grafts. Common sense care with proximity to naked flame is all that is needed to prevent this injury.

Adolescent↗
PubMed2003

Clinical decision guidelines for NHS cosmetic surgery: analysis of current limitations and recommendations for future development.

Because of increasing demand for publicly funded elective cosmetic surgery, clinical decision guidelines have been developed to select those patients who should receive it. The aims of this study were to identify: the main characteristics of such guidelines; whether and how they influence clinical decision making; and ways in which they should be improved. UK health authorities were asked for their current guidelines for elective cosmetic surgery and, in a single plastic surgery unit, we examined the impact of its guidelines by observing consultations and interviewing surgeons and managers. Of 115 authorities approached, 32 reported using guidelines and provided sufficient information for analysis. Guidelines mostly concerned arbitrary sets of cosmetic procedures and lacked reference to an evidence base. They allowed surgery for specified anatomical, functional or symptomatic reasons, but these indications varied between guidelines. Most guidelines also permitted surgery 'exceptionally' for psychological reasons. The guidelines that were studied in detail did not appreciably influence surgeons' decisions, which reflected criteria that were not cited in the guidelines, including cost of the procedure and whether patients sought restoration or improvement of their appearance. Decision guidelines in this area have several limitations. Future guidelines should: include all cosmetic procedures; be informed by a broad range of evidence; and, arguably, include several nonclinical criteria that currently inform surgeons' decision-making.

Cosmetics↗
PubMed2001

Deep dermal burn due to contact with stomach contents.

A patient sustained deep dermal burns from contact with gastric contents following disconnection of his percutaneous endoscopic gastrostomy (PEG) tube. We discuss the complications of gastrostomies and add this as a rare complication, which may be prevented by a modification to the outlet control of a PEG tube.

Aged↗
PubMed1985

Delayed exposed skin grafting: a 10 year experience of the technique.

We describe the routine use of the technique of delayed exposed skin grafting in 2062 patients over a 10 year period. Points of technique have been reviewed and tested in a prospective trial. Delayed graft application requires some 20 minutes (range 5-90 minutes) of nursing time, and daily care of 10 to 20 minutes. Wound healing was achieved in all patients in this series even when a second application of stored skin was applied, without the need for a further operation. Take was achieved in 75% of patients by 8 days after application. The technique offers a saving in theatre time for the patient and the surgeon, although hospital in-patient time is increased.

Graft Rejection↗
PubMed1983

The metabolism and biosynthesis of (+/-)-o-octopamine and (+/-)-o-synephrine in the rat.

The metabolism of (+/-)-o-octopamine and (+/-)-o-synephrine by rats was studied quantitatively by a gas chromatography-mass spectrometry-selected ion monitoring (g.c.-m.s.-s.i.m.) method using deuterated internal standards. When o-octopamine was injected intraperitoneally into rats four metabolites were excreted in the urine: (i) unconjugated o-hydroxymandelic acid (OHMA) (16%), (ii) unconjugated o-hydroxyphenylglycol (OHPG) (4.5%), (iii) an acid-hydrolysable conjugate of OHPG (28%) and (iv) unconjugated o-octopamine (10%). When o-synephrine benzoate was similarly administered six metabolites were excreted in urine: (i) unconjugated OHMA (13.5%), (ii) unconjugated OHPG (3.3%), (iii) an acid-hydrolysable conjugate of OHPG (15.6%), (iv) unconjugated o-synephrine (10%), (v) an acid-hydrolysable conjugate of o-synephrine (8.5%) and (vi) unconjugated o-octopamine (0.3%). Adult rats normally excreted OHMA (1.0 micrograms day-1) but OHPG, o-octopamine and o-synephrine could not be detected in urine. After the administration of a monoamine oxidase inhibitor, unconjugated o-octopamine (0.3 micrograms day-1) was excreted in urine but OHPG and o-synephrine could not be detected. o-Tyramine given to rats afforded urinary o-octopamine (75 ng day-1) and this was increased 10-fold upon co-administration of a monoamine oxidase inhibitor and o-tyramine.

Animals↗
PubMed1982

Identification and quantitative determination of m-hydroxyphenylglycol in mammalian urine.

m-Hydroxyphenylglycol (MHPG) has been identified in mammalian urine by gas chromatography mass spectrometry selected ion monitoring. (2H0) MHPG and (2H5) MHPG were synthesized for use as authentic sample and internal standard, respectively. After acid hydrolysis or treatment with sulfatase, the glycol was extracted from urine with ethyl acetate, converted to its tris-pentafluoropropionyl (PFP) derivative and identified by comparison of the retention times and relative intensities of the characteristic ions, m/z 592, m/z 428 and m/z 415, with those from the authentic sample. Using the internal standard the following quantitative results were obtained: 10 normal human adults excreted 7 ng MHPG mg-1 creatinine (range 2-18) as a sulfate conjugate. Ten rats excreted 0.8 micrograms day-1 (range 0.5-1.1) of MHPG also in the conjugated form. Urinary m-hydroxymandelic acid (MHMA) was also measured quantitatively. The ratio MHMA:MHPG was 1:1 in the rat and 6:1 in the human. This indicates that the overall reductive pathway of m-octopamine and m-synephrine metabolism is more important in the rat than in the human. o-Hydroxyphenylglycol (OHPG) and the three isomeric monomethoxy phenylglycols could not be detected in human or rat urine by these techniques.

2-Hydroxyphenethylamine↗