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Biomedical subjects

M P Wall

Publications and source records attributed to M P Wall.

7 recordsLinked to original sources

Effects of dimethylthiourea, melatonin, and hyperbaric oxygen therapy on the survival of reimplanted rabbit auricular composite grafts.

Microvascular reconstruction currently offers the best chance of survival for an ear segment reimplanted after amputation. Unfortunately, this technique is possible only when ear and scalp vessels remain intact. Direct reattachment of the amputated segment as a composite graft is less reliable because survival is poor for grafts larger than 2 cm in diameter. However, if survival could be improved, direct reattachment would be an attractive alternative in situations in which microsurgical revascularization is not possible. Certain pharmacologic agents have been shown to enhance the survival of composite grafts. This study demonstrated that hyperbaric oxygen, dimethylthiourea, and melatonin significantly affected the survival of reimplanted auricular composite grafts at day 7. However, by day 21 the average percentage of survival for all groups approached 13% to 14%. Dimethylthiourea had the most beneficial effect on survival early in the postoperative period, whereas the hyperbaric oxygen group demonstrated the poorest survival.

Animals↗

Prescription-type drug misuse and workplace access among nurses.

Access to prescription-type substances in the workplace is a unique feature of the practice of health professionals. Empirical data on the relation between workplace access to substances and prescription-type drug misuse among nurses are limited. Using an anonymous mailed survey, data were collected on three dimensions of access: perceived availability, frequency of administration, and degree of workplace control over storage and dispensing of substances. Each dimension was independently associated with increased use. When these dimensions were combined into an index, nurses with very easy access were most likely to have misused prescription-type drugs (adjusted Odds Ratio = 4.18; 95% Confidence Interval: 1.70-10.30). Level of knowledge of controlled substances was also associated with use, but did not explain the relation between access and use.

Adult↗

The vascular anatomy and angiosome of the posterior auricular artery. A cadaver study.

BACKGROUND: Pedicled flaps based on the posterior auricular artery have been used for small auricular and mastoid cavity defects. OBJECTIVE: To precisely define the vascular anatomy and angiosome (cutaneous distribution) of the posterior auricular artery. METHODS: A fresh cadaver model was used for 3 separate investigations, studying the posterior auricular artery. Intra-arterial ink injections defined the angiosome, and subtraction angiography and latex injection defined the vascular anatomy in relation to bony and soft tissue landmarks. SUBJECTS: Eight fresh cadavers, 6 men and 2 women, were used, varying in age from 58 to 85 years. RESULTS: The posterior auricular artery has a predictable course in the posterior auricular sulcus. The branching pattern over the auricle and temporal bone and the artery's relationship to bony and soft tissue landmarks were consistent. The angiosome includes the anterior and posterior surfaces of the auricle and the periauricular skin superiorly, posteriorly, and inferiorly. CONCLUSIONS: The investigation documented the consistent vascular anatomy and angiosome of the posterior auricular artery. The cutaneous distribution suggests that a large pedicled or island flap based on the posterior auricular artery may be raised safely as a myocutaneous or myofasciocutaneous flap with temporalis fascia and/or periosteum, extending previously published dimensions. Further studies may extend the clinical application to include free flaps based on the posterior auricular artery.

Aged↗

Septal replacement for severe anterior septal deviation.

PURPOSE: To introduce a novel surgical technique for treatment of severe anterior septal deviation. MATERIALS AND METHODS: Retrospective case series set in a tertiary-care hospital. Ten patients were treated over an 18-month period. External septorhinoplasty and septal replacement for severe anterior septal deviation. Postoperative clinical nasal examination and photographic comparison. RESULTS: Ten patients were treated with septal replacement for severe anterior septal deviation over an 18-month period. All patients were followed for a minimum of 1 year. No postoperative complications were seen. All patients reported a subjective improvement in their nasal airway and nasal appearance. This was confirmed with clinical examination and photographic comparison. CONCLUSION: Septal replacement for severe anterior septal deviation is a viable option for select patients who can not be successfully treated with conventional techniques.

Adult↗