Biomedical subjects
Publications and source records attributed to W M Hopkins.
A retrospective review of both mesh classic inguinal hernia repairs performed under the guidance of a single surgeon showed that Mersilene mesh is safe to use and that the recurrence rate is significantly improved by using the mesh for repair. Mersilene mesh is easier to use than other types of mesh and should be used routinely in the repair of inguinal and femoral hernias.
Nonoperative management of blunt splenic injury has been infrequently selected for adults. Nonoperative management was initially utilized in seven adult patients (23%) with blunt splenic injury during a 6-year period. Two patients eventually failed nonoperative management and required surgical intervention. No morbidity or mortality has been recorded in the remaining five patients (16%) successfully followed after 32.6 months. No added morbidity was sustained by the two patients who failed nonoperative management during the delay of surgical intervention. Hospitalization was briefer in the nonoperative group. Our experience indicates that blunt splenic injury can be successfully nonoperatively managed in an adult population seen at a community hospital.
Twenty patients with gallstone ileus were treated over a 20-year period. The demographics were typical: mean age 76, female to male ratio of 5:1, and 60 per cent incidence of concomitant medical ailments. An 85 per cent preoperative diagnostic rate was unusually high. An analysis of the study halves demonstrated a stable preoperative diagnostic rate, decrease in preoperative delay (7.5 vs. 4.7 days), and a rise in mortality rate (0 vs. 11%) without an unfavorable effect from a 26 per cent incidence of single-stage procedures (0% mortality). Gallstone ileus still carries a mortality rate of five to ten times that of all other nonmalignant mechanical small bowel obstructions. Anticipated improvements related to augmented preoperative diagnostic yields shortened preoperative delays, and selective surgical management have not been substantiated. Improved mortality rates may await refinements in resuscitation, monitoring, and surgical skills.
1. The effects of insulin-induced hypoglycaemia on pupil size, parotid salivary secretion and sweating were studied in seven normal volunteers. 2. Hypoglycaemia was associated with an acute stimulation of parotid salivary secretion and of sweating, synchronous in onset with the rise in heart rate. There was no clear evidence of concurrent pupillary constriction.