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Biomedical subjects

N W Law

Publications and source records attributed to N W Law.

At least 19 recordsLinked to original sources
PubMed1994

Diagnostic features and management of bacterial arteritis with false aneurysm formation.

Primary bacterial arteritis with false aneurysm formation is an uncommon condition. This report presents seven patients admitted to one unit over a 5-year period. Interesting aspects of the clinical presentation are discussed. The importance of surgical debridement, extra-anatomic bypass, antibiotic therapy and antibiotic irrigation of the infected aneurysm cavity is stressed. The relative merits of extra-anatomic bypass and in situ grafting for aortic infection are discussed. By following these principles, this series of patients have had a successful surgical outcome and all the signs of infection have been eradicated.

Aged↗
PubMed1993

Mycotic aneurysm of left subclavian artery.

Bacterial endarteritis is rare and usually affects the abdominal aorta. A case of bacterial left subclavian arteritis complicated by mycotic aneurysm is presented. An early diagnosis of infective arteritis was made based on a history of fever, sweats, rigors, and a progressive macular rash, polyarthralgia splinter haemorrhage (limited to the left arm), and a loud left subclavian bruit on admission. A mycotic aneurysm was diagnosed by computed tomography and treated surgically. In cases of endarteritis the possibility of a mycotic aneurysm should be borne in mind even when there is no evidence of endocarditis.

Aneurysm, Infected↗
PubMed1991

A comparison of polypropylene mesh and expanded polytetrafluoroethylene patch for the repair of contaminated abdominal wall defects--an experimental study.

Abdominal wall defects created in Sprague-Dawley rats were repaired with either polypropylene mesh (PPM) or expanded polytetrafluoroethylene patch (PTFE). Tensiometric studies of abdominal wall strength showed that PPM and expanded PTFE provided a strong repair in uninfected wounds. Wounds reconstructed with expanded PTFE and contaminated with Staphylococcus aureus had a weak interface between the patch and the abdominal wall fascia. The strength of the interface was inadequate because collagen ingrowth in the material was inhibited. In contrast, the wound strength of PPM was unaffected by the presence of bacterial contamination.

Abdominal Muscles↗
PubMed1990

The effect of parenteral nutrition on the healing of abdominal wall wounds and colonic anastomoses in protein-malnourished rats.

The effect of postoperative parenteral nutrition on the healing of abdominal wall wounds and colonic anastomoses in protein-malnourished rats was studied. The healing of laparotomy wounds and colonic anastomoses was assessed by bursting pressure measurement on the fifth postoperative day. Compared with control animals on a normal diet (group A), rats on a low-protein diet given postoperative dextrose-saline solution (group B) had significantly lower abdominal wall and colonic anastomotic bursting strengths. The detrimental effects of protein malnutrition could be completely reversed for abdominal wall wounds and partially reversed for colonic anastomoses in rats on a low-protein diet given postoperative parenteral nutrition (group C). Autoradiographic studies showed a marked decrease in the activity of wound fibroblasts that was restored by the administration of postoperative parenteral nutrition. Serum protein measurements showed a closer correlation of colonic anastomotic healing to serum albumin than to serum transferrin values but showed no correlation with abdominal wall wound healing.

Abdominal Muscles↗
PubMed1990

The influence of prosthetic materials on the growth of Walker 256 tumour in the rat.

Polypropylene mesh and expanded polytetrafluoroethylene patches implanted into abdominal wall defects did not affect the rate of growth of Walker 256 experimental tumour in the rat. The tumour invaded through the interstices of the polypropylene mesh to involve the peritoneal surface, whereas the expanded polytetrafluoroethylene patch acted as a physical barrier to the spread of the tumour to the parietal peritoneum. These findings will be of help in the choice of replacement material following wide resection of the abdominal wall for malignant disease.

Abdominal Muscles↗
PubMed1990

Preliminary results for the repair of difficult recurrent inguinal hernias using expanded PTFE patch.

The repair of recurrent inguinal hernias can be a complex problem. This study examines the results of 52 difficult recurrent inguinal hernias repaired with an expanded PTFE patch. Patients were selected because the hernia had either multiple defects, a single large defect that could only be repaired with excessive tension, or the surrounding tissues were unable to support a sutured repair. The number of previous hernia repairs ranged from 1 to 7 with a mean of 2.5 repairs. Hernias recurred in 5 patients (10%) after a mean follow up of almost 2 years. Three of these recurrences were inguinal, around the patch, and 2 were through the femoral canal. There was no association between postoperative wound complications and hernia recurrence.

Adult↗
PubMed1990

Drainage or suture of the cavity after breast biopsy.

An initial series of 105 women who underwent excision biopsy of the breast were entered into a controlled randomised trial to determine the effect on postoperative morbidity of drainage of the cavity with a soft rubber Penrose drain. The use of this drain had no effect on the incidence of postoperative wound complications (drain 11 of 40 (28%), no drain 10 of 58 (17%]. A second series of 202 women were entered into a randomised controlled trial to determine the effect of closed suction drainage and suture of the cavity after breast biopsy. The use of this drain significantly reduced the incidence of postoperative wound complications (drain 9 of 93 (10%), no drain 22 of 105 (21%], but although suture of the cavity halved the number of wound complications (suture 11 of 97 (11%), no suture 20 of 101 (20%], this did not reach statistical significance. Wound complications were more frequent with large wounds (28%) than with smaller ones (15%), and with less experienced operators (registrar 21%, senior registrar/consultant 10%). We conclude that a closed suction drain will reduce the incidence of wound haematomas after breast biopsy but that a Penrose drain is ineffective in the prevention of wound complications.

Biopsy↗
PubMed1989

Revised model for the study of colonic anastomotic healing in protein malnourished rats.

The effect of a low-protein diet on the healing of colonic anastomoses in the rat was studied. The low-protein diet given for 2 weeks caused a weight loss of 11.9%. The healing of colonic anastomoses was assessed by bursting pressure measurement performance sequentially in the postoperative period. Compared to control animals, rats on a low-protein diet had significantly lower bursting pressures from the 4th to the 7th postoperative day. There was no difference in the hydroxyproline concentration at the anastomoses of the two groups of rats. These results suggest that the 5th postoperative day is the most appropriate time to investigate the effects of protein malnutrition on colonic healing in the rat.

Anastomosis, Surgical↗
PubMed1989

Transthoracic sympathectomy for palmar hyperhidrosis in children under 16 years of age.

Palmar hyperhidrosis can be a disabling condition in children. We report the results of transthoracic sympathectomy in 18 children aged 16 years or under. Follow-up, 1 to 11 years after surgery, revealed a high incidence of late sequelae, but these were not significant when compared to the primary condition. Transthoracic sympathectomy is recommended for children with severe palmar hyperhidrosis.

Adolescent↗
PubMed1987

Bilateral submandibular gland lymphoma in Sjögren's syndrome.

Salivary gland lymphoma is associated with Sjögren's syndrome. A case of bilateral submandibular gland and sublingual gland lymphoma, arising in Sjögren's syndrome, is presented. A lymphoma involving more than one salivary gland may occur in Sjögren's syndrome, and there is an increased risk of developing an extrasalivary lymphoma.

Female↗