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Biomedical subjects

M J Concannon

Publications and source records attributed to M J Concannon.

32 records · Page 2Linked to original sources
PubMed1993

Computer-generated slide graphics: an exciting advancement or a problem?

Computer-generated slide graphics have significantly altered the face of audiovisual presentations. However, it remains to be determined if dramatic effects enhance presentation clarity and increase information retrieval. This study compared color combination and print type graphics. Ninety medical students were shown a 29-minute, 45-slide presentation addressing aspects of plastic surgery. Each slide represented one of 15 color combinations and one of 3 fonts. The students studied each slide for 10 seconds and then in 25 seconds recorded all information they could recall. Statistical analysis (using ANOVA) revealed a significant difference in information retrieval among slides and a significant interaction between color and font. The "best" was orange block print on a raspberry background. The "worst" was yellow cursive print on a black background. This study demonstrated that (1) color influences information gleaned from a slide presentation and (2) font type simplicity may result in improved retention.

Audiovisual Aids↗
PubMed1993

Social improvement after the Wilke procedure for excessive drooling.

The child with an excessive drooling problem often faces similar social deprivation to those with severe craniofacial malformations. Many of these children have other "strikes against them" (such as cerebral palsy) that, when coupled with drooling, isolate them from social interaction. Many methods have been employed to control drooling but surgery has been most consistently successful. The most popular of these has been the Wilke procedure or a modification of it. Several series have been reported, but a detailed correlation of mechanical success with the effects on social activity has not been reported. We reviewed a series of 23 cases of Wilke-type surgery. Analysis of the results showed a convincing improvement in social activity after successful surgery. The Wilke procedure enjoys a relatively high rate of success in preventing excessive drooling, which seems to offer a dramatic improvement in social contact enjoyment.

Adolescent↗
PubMed1993

Application of maxillofacial miniplating and microplating systems to the hand.

During the past several years, a profound change in our approach to bone stabilization in the hand has occurred. Today, standard management of almost any fracture requiring open reduction as well as most arthrodeses and osteotomies will incorporate rigid fixation employing one of the maxillofacial systems. Many of the early concerns, such as increased complexity of the procedure, the need for extensive periosteal stripping, bulkiness of the plates (with potential palpation, tenderness, and the impingement on tendon and joint motion), and the anticipated frequent need for removal, have been allayed. Thinner plates, the smallest screws from the miniplating systems, and the introduction of the microplating systems (Luhr and Synthes) have obviated much of the anticipated difficulty with tendon gliding and have made the necessity for subsequent plate removal a rarity in our practice. The use of these systems allows much earlier mobilization postoperatively, reducing the incidence of joint stiffness and tendon adhesion. This paper discusses our series of 143 patients (average follow-up time over 18 months) and the application of miniplating and microplating systems for a variety of fractures, osteotomies, and arthrodeses in the hand.

Adolescent↗
PubMed1993

The impact of the media on women with breast implants.

Because of the considerable attention given to breast implants by the media, these two surveys were conducted to evaluate how women with breast implants think and feel about the current issues. A telephone questionnaire was administered to 60 women prior to the Food and Drug Administration's moratorium and again following the advisory panel recommendation. The second survey revealed that most subjects felt the media information was accurate, a significant (p = 0.02) change from the first survey responses. The most frequently cited concern about breast implants on the first survey was silicone leakage. It continued to be a major concern on the follow-up survey but was replaced by mammography concerns in the women with augmentation. Concern regarding autoimmune disease increased significantly on the follow-up survey (p = 0.0001). Satisfaction with the decision to have implants changed from 98 percent of the sample before the moratorium to 71 percent of augmentation patients and 79 percent of reconstruction patients after. Women willing to choose the procedure again also declined from 72 percent of reconstructive patients and 58 percent of augmentation patients before to 59 and 52 percent, respectively, after (p = 0.01). The majority (67 percent) acknowledged that the moratorium had an effect on their feelings about breast implants. Negative media information appears to have been a persuasive influence on patients' opinions regarding their implants.

Adult↗
PubMed1992

Nipple reconstruction using the "inchworm" flap.

A new method of nipple reconstruction called the "inchworm" flap is described. The name comes from the manipulation method used to position the flap for nipple projection. Experience with over 50 patients and including 58 breasts has been reviewed. There was adequate followup for 36 breasts in which overall maintenance of projection was 78% for this technique. When used after submuscular expansion for breast reconstruction, maintenance of projection reached 89%. The technique of flap manipulation is described in detail. This flap appears to be a reliable method for obtaining moderate nipple projection, particularly in the submuscular expansion breast reconstruction cases. It is not recommended for use in TRAM flap cases.

Female↗
PubMed1992

Patterns of free-radical production after tourniquet ischemia: implications for the hand surgeon.

Since use of the pneumatic tourniquet is standard procedure for the hand surgeon, ischemic and reperfusion injury is a risk. To determine optimal periods of ischemia, 100 rabbit hindlimbs were subjected to various ischemic insults and analyzed for malondialdehyde (an indicator of free-radical production). Group 1 (3 hours of continuous ischemia) had 12.5 percent more reperfusion damage than controls (p less than 0.05). Group 2 (three 1-hour ischemic insults) had 10 percent more damage than controls (p less than 0.05). Group 3 (two 90-minute ischemic episodes) had 21 percent more damage than controls (p = 0.0001). Group 4 (4 1/2 hours of continuous ischemia) had 14.5 percent more damage than controls (p less than 0.01). Group 5 (three 90-minute ischemic episodes) had 10.8 percent more damage than controls (p less than 0.01). Group 6 (6 hours of continuous ischemia) had 17.5 percent more damage than controls (p less than 0.002). Group 7 (four 90-minute ischemic episodes) had 14 percent more damage than controls (p less than 0.01). Group 8 (three 2-hour ischemic episodes) had 22.5 percent more damage than controls (p less than 0.003). And group 9 (two 3-hour ischemic episodes) had 42 percent more damage than controls (p less than 0.0001). These results suggest a direct correlation in reperfusion injury with duration of tourniquet ischemia. Additionally, allowing specific reperfusion periods in some groups ultimately increased the amount of reperfusion injury.

Animals↗
PubMed1992

Skin expansion as preparation for an opening wedge osteotomy of the mid-foot in arthrogryposis.

A case report is presented in which tissue expansion is used to provide the additional skin needed during an opening wedge mid-foot osteotomy to correct a varus foot deformity in a patient with arthrogryposis multiplex congenita. Tissue expansion is a relatively new method of acquiring coverage for wounds which may have advantages over previous techniques. The risks and drawbacks of this technique will be described in detail.

Arthrogryposis↗
PubMed1991

Improved survival in a replantation model containing ischemic muscle.

The effectiveness of superoxide dismutase and allopurinol was evaluated in preventing reperfusion injury in Sprague-Dawley rats utilizing a limb replantation model after 6 hours of warm ischemia. Immediately prior to reperfusion of the replanted limb the animals received (intravenously) either a single bolus of superoxide dismutase (16,000 units/kg), a single bolus of allopurinol (45 mg/kg), both agents, or only control solutions. In the rats that received only control solutions, 30% of the limbs survived the ischemic insult. The group that received both superoxide dismutase and allopurinol had a 75% limb survival (P = 0.005). The animals that had only superoxide dismutase or allopurinol had 58% and 60% of the replanted limbs survive, respectively. This study suggests that the administration of superoxide dismutase and allopurinol may be helpful in the prevention of reperfusion injury in skeletal muscle in an acute injury setting (without pretreatment) and may thereby improve limb salvage after a significant ischemic period.

Allopurinol↗
PubMed1991

Impedance plethysmography: a new method for continuous muscle perfusion monitoring.

Vigilant postoperative monitoring of the buried muscle flap is critical after free transfer because early diagnosis of vascular insufficiency is essential to allow prompt correction. We have identified a monitoring method utilizing needle electrodes and impedance plethysmography that gives a beat-to-beat representation of muscular perfusion. In 25 New Zealand White rabbits the gastrocnemius muscle was isolated on its vascular pedicle, and two intramuscular needle electrodes were placed. The instantaneous impedance changes of the muscle (corresponding to the pulsatile volume changes of perfusion) were measured and recorded. Using this representation of perfusion, an independent judge was able to correctly diagnose muscular ischemia 100 percent of the time (n = 25). Further, the judge was able to correctly distinguish the ischemia as arterial (n = 10) or venous (n = 10) in origin 100 percent of the time. Additionally, we monitored muscle perfusion transcutaneously in five free muscle flaps and demonstrated a reliable impedance signal that correlated with perfusion.

Animals↗
PubMed1987

A critical look at capsule contracture in subglandular versus subpectoral mammary augmentation.

A critical comparison of the contracture rate in subglandular versus subpectoral augmentations was done in a personal series (senior author's) of 100 consecutive augmentation patients, 50 with subglandular augmentation and 50 with subpectoral augmentation. The average followup for the series was 27 months. Baker's classification of capsule contracture was utilized. Overall contracture rate in the subglandular group was 58% (29 of 50 patients) while in the subpectoral group it was 22% (11 of 50 patients), p less than 0.0002. Considering only the more severe contractures (Baker III & IV), the subglandular patients had 48% (24/50) while the subpectoral patients had 14% (7/50), p less than 0.0002. Comparing the more severe contractures in individual breasts, the subglandular group had 41% and the subpectoral group had 8%, p less than 0.0001. We conclude that in this personal series of patients, subpectoral placement of the prosthesis has significantly reduced but not eliminated the occurrence of capsule contracture without sacrificing a normal breast appearance.

Adult↗
PubMedDate not supplied

Management of a metacarpophalangeal joint fracture using a dynamic traction splint and early motion.

Dynamic traction and early motion have been used by hand therapists to treat proximal interphalangeal joint fractures with good results. However, metacarpophalangeal joint fractures have been neglected, perhaps because of their relative infrequency. The purpose of this case study is to report the authors' experience using dynamic traction in conjunction with early motion to treat a construction worker who fell from scaffolding and sustained a complex fracture of the left smallfinger proximal phalanx with involvement of the metacarpophalangeal joint. Range of motion of the patient's left small finger at discharge from therapy, approximately 22 weeks postoperatively, was as follows: metacarpophalangeal joint, hyperextension/65 (85 degrees passive flexion); proximal interphalangeal joint, 20/80 (5/90 passively); and distal interphalangeal joint, 0/50 (65 degrees passive flexion). The patient made a successful return to full-time construction work. The results of this case appear to support consideration of the use of dynamic traction and early motion for management of selected metacarpophalangeal joint fractures.

Adult↗
PubMedDate not supplied

The inhibition of fibroblast proliferation by a novel monokine: an in vitro and in vivo study.

We have identified a product of rabbit macrophages that inhibits fibroblast proliferation. Tested in vitro against several fibroblast populations, this monokine inhibited rabbit conjunctival fibroblast proliferation by 85% (p = 0.005), human conjunctival fibroblast proliferation by 88% (p = 0.005), human hypertrophic scar fibroblast proliferation by 85% (p = 0.005), and human keloid fibroblast proliferation by 79% (p = 0.005). Additionally (in an in vivo model), this monokine was injected into healing rabbit wounds and inhibited fibroblast proliferation by 33% after 7 days (p = 0.0001) and by 27% after 2 weeks (p < 0.0001). Preliminary analysis of the active factor demonstrates that it is not species-specific, has a molecular weight less than 3000 d, is resistant to degradation by trypsin and carboxypeptidase A, is heat-stable, and is produced by macrophages largely in the first 3 days of culture.

Animals↗