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Biomedical subjects

M Siddins

Publications and source records attributed to M Siddins.

10 recordsLinked to original sources
PubMed2001

Laser photoirradiation in digital flexor tendon repair.

This study evaluates tendon coaptation using Nd:YAG laser photoirradiation in an in vivo cockerel model. Using the intervinculum segments of the flexor profundus tendons, experimental transactions were performed. Tendon coaptation was then attempted using laser photoirradiation. Tendons were immediately examined for evidence of stable coaptation. After this assessment, specimens were excised and processed for electron microscopic examination and exposure to trypsin digestion. Despite varying multiple laser parameters, tissue welding was not observed. The subsequent functional and ultrastructural observations of irradiated tendon suggest that these changes are those of simple thermal denaturation. The results of this study suggest that when successful tissue welding has been observed in other tissue types, the mechanism is unlikely to be because of formation of intermolecular collagen bonds as hypothesized. An alternative hypothesis is that laser welding reflects photothermal coagulation of cytoplasmic peptides or nucleic acids liberated at the coaptation interface. This may explain the successful welding of cell-rich tissues such as bowel, vas deferens, and arteries and the observed failure of laser welding in collagen-rich but relatively hypocellular tendon.

Animals↗
PubMed2001

Intraoperative vascular localization to facilitate endopyelotomy after renal transplantation.

BACKGROUND: Pelviureteric junction (PUJ) obstruction after renal transplantation is uncommon. Surgical correction can be technically challenging due to dense perinephric adhesions and variable hilar vascular anatomy. Endopyelotomy is well established in the treatment of PUJ obstruction in native kidneys. METHODS: The present paper reports the first experience of antegrade visual cold-knife endopyelotmy performed in a renal allograft. In orientating the incision at the PUJ, preoperative imaging was supplemented by intrarenal Doppler ultrasound, using a probe designed for transoesophageal cardiac monitoring. To the authors' knowledge this approach has not previously been reported. RESULTS: Renal vascular relationships were readily indentified by identifying arterial and venous waveforms. CONCLUSIONS: For this uncommon procedure the use of intrarenal Doppler ultrasound provides greater security in avoiding inadvertent vascular injury.

Cold Temperature↗
PubMed1995

Bilateral renal oncocytoma: case report and implications in renal tumour management.

Renal oncocytomas are uncommon benign tumours that have recently been recognized as a unique pathological entity. These lesions may attain considerable size; however, most present as an asymptomatic incidental finding. Although usually solitary, these tumours are occasionally multicentric or bilateral at presentation. Retrospective studies suggest that oncocytoma may account for up to 5% of tumours previously classified as well-differentiated renal cell carcinoma. At present, conservative management is hampered by difficulty in establishing a confident pre-operative or intra-operative diagnosis. A case of bilateral asymptomatic renal oncocytoma is presented, and the implications of this lesion for the management of renal tumours is discussed.

Adenoma, Oxyphilic↗
PubMed1994

A comparison of amiodarone and digoxin for treatment of supraventricular arrhythmias after cardiac surgery.

Despite the widespread use of amiodarone in non-surgical patients, its role in the management of supraventricular tachyarrhythmias after cardiac surgery is not clear. We set out to compare the relative efficacy of amiodarone and digoxin in the management of atrial fibrillation and flutter in the early postoperative period. This prospective randomised trial comprised 30 patients, previously in sinus rhythm, who developed sustained atrial fibrillation or flutter following myocardial revascularisation, valve surgery or combined procedures. Amiodarone was administered as an intravenous loading dose followed by a continuous infusion. Digoxin was given as an intravenous loading dose followed by oral maintenance therapy. Electrocardiographic and haemodynamic monitoring was continued for 24 h after the commencement of treatment. There was a marked reduction in heart rate in both groups, mainly in the first 6 h, from 146 to 89 beats per minute in the amiodarone group and from 144 to 95 in the digoxin group. At the end of the 24 h, one of the 15 patients in the amiodarone group and 3 of the 15 patients in the digoxin group remained in atrial fibrillation. No patient in either group developed adverse reactions. We conclude that intravenous amiodarone therapy is safe and at least as effective as digoxin in the initial management of arrhythmias after cardiac surgery.

Aged↗
PubMed1991

Fibrovascular polyp of the oesophagus.

Fibrovascular polyps of the oesophagus are rare. Despite this, they provoke considerable interest because of their often dramatic presentation, and their potential for lethal complications. When the diagnosis is entertained, endoscopic or radiological confirmation is usually easily obtained and local excision is curative. An adult patient is described who presented after partial regurgitation of a 10 cm polyp. In view of the size of the lesion and its proximal attachment, endoscopic polypectomy was undertaken. The diagnostic pitfalls and therapeutic options in this unusual condition are discussed.

Esophageal Neoplasms↗
PubMed1990

Prophylaxis against postsplenectomy pneumococcal infection.

An excess risk of overwhelming sepsis following splenectomy is well established. In view of this, surgical responsibility must embrace the administration of pneumococcal prophylaxis. Current recommendations vary, but routine pneumococcal vaccination, together with penicillin prophylaxis in selected patients, is advocated widely. This retrospective review of 75 patients undergoing splenectomy was undertaken in order to evaluate the extent to which current practice complies with these recommendations. Among surviving patients, the incidence of vaccination with polyvalent pneumococcal vaccine (PPV) was found to vary according to operative indication. All haematological patients received pre-operative PPV. Two-thirds of multitrauma patients were vaccinated, while 42% of patients who required splenectomy following accidental intra-operative trauma received PPV. Only 11% of patients who underwent incidental splenectomy were vaccinated. Long-term antibiotic prophylaxis was commenced in 33% of surviving patients under 20 years of age, and in 8% with underlying malignancy. These results highlight a need for greater vigilance in the administration of pneumococcal prophylaxis, particularly following accidental or incidental splenectomy.

Adult↗