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Biomedical subjects

N F Jones

Publications and source records attributed to N F Jones.

At least 19 recordsLinked to original sources
PubMed1992

Intraoperative and postoperative monitoring of microsurgical free tissue transfers.

Numerous techniques have been described for monitoring the postoperative viability of microsurgical free tissue transfers, and their sensitivity and reliability continue to be evaluated in animal experiments and clinical trials. Relative advantages and disadvantages of these various postoperative monitoring techniques are discussed. The concept of intraoperative monitoring of the microsurgical anastomoses during closure and inset of a free flap is introduced because many free flaps may fail on the operating table, but this only becomes clinically apparent several hours later in the early postoperative period.

Animals↗
PubMed1992

Microvascular free tissue transfer for reconstruction of head and neck cancer defects.

Over the last 10 years, microvascular free tissue transfer techniques have broadened the range of the head and neck surgeon, allowing for successful reconstruction of extensive curative extirpations in one operation with minimal morbidity. Success rates of more than 90% are now being achieved consistently. This article provides an overview of these revolutionary techniques for oral cavity, mandibular, and hypopharyngeal reconstructions. Patients are selected for microvascular free tissue transfer because of the large size of their defect, its location (eg, anterior mandibular loss), or complexity (circumferential defects of the hypopharynx). Others may be good candidates for this surgery because of previous radiotherapy or failed reconstructive surgery. Donor sites range from the radial forearm to the jejunum.

Follow-Up Studies↗
PubMed1991

The effect of postoperative radiation therapy on pharyngoesophageal reconstruction with free jejunal interposition.

Free tissue transfer of a jejunal segment was undertaken for laryngopharyngoesophageal reconstruction in 20 patients who received postoperative irradiation therapy. Treatment consisted of 1.8- to 2-Gy-fractions, the average total dose was 55.57 Gy (range, 40 to 66 Gy). Anastomotic strictures (six) were encountered early in the series and associated with stapled anastomoses. Hand-sewing the jejunoesophagostomy eliminated the problem. Enteric cutaneous fistula, bowel necrosis, and hemorrhagic enteritis were not observed. We conclude that the application of postoperative irradiation therapy to patients requiring jejunal interposition grafts is feasible.

Adolescent↗
PubMed1991

Acute and chronic ischemia of the hand: pathophysiology, treatment, and prognosis.

Fifty consecutive patients with acute and chronic ischemia of the hand were investigated by Allen testing, Doppler ultrasound, digital plethysmography, and angiography over a 4-year period. The pathophysiologic mechanism responsible for the ischemia was determined to be emboli in 6%, vasospasm in 10%, thrombosis or "sludging" in 28%, occlusive disease in 26%, and occlusive disease associated with either vasospasm or external compression in 30%. Ten patients required emergency medical treatment with intraarterial streptokinase, intravenous heparin, or dextran 40 and continuous stellate ganglion blocks, and three patients required emergency microsurgical revascularization because of radial artery thrombosis. Patients with chronic ischemia of the hand were maintained on nifedipine, 30 to 60 mg daily, and pentoxifylline, 1200 mg daily. Seven patients underwent digital sympathectomy and 14 patients underwent microsurgical revascularization as prophylactic procedures for chronic digital ischemia. Amputations were required in 18 patients because of end-stage gangrene. Long-term follow-up revealed a 20% incidence of recurrent digital ulcerations. There have been six deaths during follow-up, five of them due to myocardial infarction; this reflects the underlying systemic arteriopathy in many of these patients.

Acute Disease↗
PubMed1991

Pacinian corpuscle hyperplasia in the hand.

Proliferation of pacinian corpuscles adjacent to the digital nerves in the hand is very rare. Patients are usually seen initially with a history of previous trauma and severe localized pain. The symptoms, signs, and surgical treatment of previously reported cases are reviewed and histological criteria from this case are proposed to define this condition. In addition to a neuroma or glomus tumor, pacinian corpuscle hyperplasia should be considered in the differential diagnosis of digital or palmar pain.

Diagnosis, Differential↗
PubMed1979

Psychological contributions to chronicity in asthma: patient response styles influencing medical treatment and its outcome.

Research is reviewed relating to two aspects of response styles among asthmatic patients, neither of which is a mere derivative of the patient's medical condition. One aspect, indexed by panic-fear symptomatology, appears to be associated with the level of attention directed at breathing difficulties, ranging from symptom disregard (low panic-fear symptomatology) to symptom vigilance (high panic-fear symptomatology). A second aspect, indexed by a derived personality dimension, appears to be associated with the quality of the patient's reactions to acknowledged breathing difficulties, ranging from extreme independence (low panic-fear personality) to helpless and ineffective dependency (high panic-fear personality). Simply, these aspects of patient response styles refer both to the attention directed toward breathing difficulties and to the quality of the patient's reactions in response to acknowledged breathing difficulties. Their importance derives from 1) their interaction with the severity of asthma to influence medical decisions about the intensity of prescribed medications and length of hospitalization during medical treatment and 2) their effect on long-term medical outcome. Awareness of these two aspects of patient response styles should enable differential approaches to be adopted by physicians seeking to counteract psychological contributions to chronicity in asthma.

Asthma↗
PubMed1979

Psychosexual aspects of the panic-fear personality types in asthma.

Numerous earlier studies have demonstrated the close relationship between MMPI Panic-Fear categories and various medical outcome measures in asthma. The present study relates MMPI Panic-Fear categories to psychosexual development. Specifically, High Panic-Fear patients demonstrate oral preoccupations, Low Panic-Fear patients demonstrate anal preoccupations, while Moderate Panic-Fear patients do not demonstrate pre-Oedipal preoccupations. Thus, MMPI Panic-Fear categories, useful in predicting medical outcome measures, have now been related to developmental levels, with the explanatory power of developmental concepts as well as their implications for psychological treatment.

Adolescent↗
PubMed1978

N-acetyl-beta-D-glucosaminidase: A new approach to the screening of hypertensive patients for renal disease.

Urinary activity of the enzyme, N-acetyl-beta-D-glucosaminidase (N.A.G.) was examined as a screening test for renal disease in patients with hypertension. Renal disease was present in 64% of patients with increased N.A.G., compared with only 14% of patients with normal N.A.G. The measurement of N.A.G. is cheap and convenient and this simple test warrants further assessment in hypertension as a guide to the need for further investigation.

Acetylglucosamine↗
PubMed1978

Zinc and the sodium pump in uremia.

A defect in sodium transport is known to exist in the leucocytes of uremic patients. Recent work has shown changes in cation flux rates associated with alterations of extracellular zinc concentration. As plasma zinc is known to be low in uremia, the possibility that this might be the cause of the defect in membrane transport was investigated. Plasma zinc was shown to be lower in uremic patients than in normal controls but this was not matched by alterations in leucocyte zinc content. Leucocytes from normal subjects and from patients with uremia have similar increases in the sodium efflux rate constant when exposed to elevated extracellular zinc concentrations. However, the abnormality in leucocyte sodium transport in uremia was not completely corrected by elevation of the extracellular zinc, when compared with normal cells in the same zinc concentrations. Although extracellular zinc is a factor that must be controlled in studies of cellular membrane transport, a low plasma zinc is not the explanation for the defect of sodium transport seen in uremia.

Biological Transport↗
PubMed1978

Attitudes toward respiratory illness and hospitalization in asthma. Relationships with personality, symptomatology, and treatment response.

A previous study described the development of the Respiratory Illness Opinion Survey (RIOS) which measures six categories describing attitudes toward respiratory illness and its treatment: Optimism, Negative Staff Regard, Specific Internal Awareness, External Control, Psychological Stigma, and Authoritarian Attitudes. In the present study these attitudes were found: a) to relate more clearly to general personality characteristics than to illness-specific subjective symptomatology; b) to enable types of asthmatic patients to be described on the basis of the patterns of attitude category scores; and c) to provide some information about treatment outcome in asthma as indexed by length of hospitalization during long term, intensive therapy, the need for prescribed oral corticosteroids, and rates of rehospitalization and judged severity following discharge from treatment.

Adaptation, Psychological↗
PubMed1978

Panic-fear in asthma: rehospitalization following intensive long-term treatment.

The panic-fear personality scale related to rehospitalization rates of asthmatics during two successive 6-month periods following intensive long-term treatment. High and Low Panic-Fear patients were nearly twice as likely as Moderates to be rehospitalized. Neither longitudinal pulmonary function measurements, physicians' judgments about the medical severity of the asthma during treatment, nor the presence or absence of maintenance oral corticosteroids at discharge were related to rehospitalization. The available information suggests that High Panic-Fear patients react to asthma with symptom exaggeration and helplessness, while Low Panic-Fear patients employ an equally maladaptive strategy best characterized as symptom minimization and denial. It is possible that both of these extreme response styles may affect adherence to prescribed medical regimens and are equally detrimental as indicated by rehospitalization following intensive long-term treatment.

Adolescent↗