Biomedical subjects
Publications and source records attributed to P R Layman.
Bilateral amputations were performed without analgesia on a patient with congenital insensitivity to pain (congenital analgesia). Positioning, vasomotor control and possible sensitivity to anaesthetic drugs are discussed.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
A case of cancrum oris is described. Airway control was difficult at three different stages of treatment. The use of transtracheal ventilation allowed the problem airway to be bypassed on each occasion, avoiding the dangers of blind nasal intubation, tracheostomy and guided intubation techniques.
The use of transtracheal ventilation as a routine method of ventilation during anaesthesia for 60 patients with gross pathology requiring oral surgery is reported. Theoretical hazards of the technique and protection of the airway are discussed. There were no serious complications in this series. The technique is recommended as a simple and safe alternative to blind nasal intubation.
Twenty patients with melanocytoma of the optic disc underwent Goldmann perimetry and pupillary evaluation. Two patients (10%) had normal visual fields. Three (15%) had minimal blind spot enlargement. Fifteen patients (75%) had a greatly enlarged blind spot, of which ten had concomitant nerve fiber bundle field defects. These consisted of a nasal step in two cases (10%), relative nerve fiber bundle defects in four cases (20%), and an absolute arcuate defect in four cases (20%). The blind spot enlargement relates to the pigmented tumor extended beyond the disc boundary, thereby shading the peripapillary retina. The nerve fiber bundle defects result from injury to the visual axons passing through the nerve head, although the mechanism is uncertain. A Marcus Gunn pupillary sign produced by the melanocytoma was found in six patients (30%), all of whom had a substantial relative or absolute nerve fiber bundle defect.
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