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Biomedical subjects

C M Lewis

Publications and source records attributed to C M Lewis.

At least 109 records · Page 6Linked to original sources
PubMed1985

Management of the recovering alcoholic who seeks cosmetic surgery.

Plastic surgeons are likely to see patients who have successfully completed alcohol or drug abusers' rehabilitation programs. These patients are seeking to improve their appearance and, hence, their self-image. Unless special care is given to the recovering alcoholic, he or she is at risk of readdiction to alcohol or to drugs after surgery. Recommendations are made regarding the timing of elective operations, the use of drugs during and after the procedure, and reliance on a dependable third party to dispense drugs postoperatively.

Alcoholism↗
PubMed1985

Lipoplasty of the neck.

Lipoplasty provides a new method of removing subcutaneous fat and contouring the neck. This author reports his experience in 50 cases. A total of 35 patients were done in conjunction with a rhytidoplasty, and 15 patients had lipoplasty as an isolated procedure. The series could be divided into halves. After 25 cases, several undesirable results were noted, including discomfort (15 of 25), nodularity (6 of 25), and contour irregularities (3 of 25). Modifications were made in the technique and postoperative treatment, including a smaller-diameter cannula, more extensive dissection with feathering, multiple incisions and cross-tunnels, and the postoperative use of massage and ultrasound and an elastic head garment. Subsequent patients had reduced morbidity and improved operative results. A detailed account of the operative procedure is discussed. Photographic documentation of results is given. This author's initial experience with lipoplasty of the neck indicates early problems, solutions, and results. The technique is viewed as a useful addition to the armamentarium of the plastic surgeon.

Adipose Tissue↗
PubMed1984

Preservation of the female sideburn.

Routine face-lift incisions in the temporal hair line may be unsatisfactory because of one or all of the following reasons: Production of an area of baldness immediately in front of the ear; presence of wide unsightly scar in the temporal hairline; loss of hair in the temporal area; and disfigurement of the temporal hair and sideburn. In order to conceal the deformity, the patient is limited to certain hairstyles. The problem is exaggerated in patients with sparse hair or who undergo a secondary rhytidectomy. A solution is an incision at or in the edge of the hairline in the temporal hairline. The technique has been used in over 200 patients during the past 3 years with excellent results. Specific points including location of incision, caveats in technique, and pre- and postoperative results are discussed.

Face↗
PubMed1984

Seasonal persistence of resting cyst toxicity in the dinoflagellate Gonyaulax tamarensis var. excavata.

Resting cysts collected in the autumn from bottom sediments were stored in the laboratory, in the dark at 4 degrees C, through the winter. Over a six month period, toxicity of the stored resting cysts was compared with toxicity of cysts from freshly-collected sediments. Resting cysts retained toxin over the winter months. Toxin levels show an apparent rise. Toxicity measurements of cysts from sediment samples kept in the laboratory reflect in situ levels.

Animals↗
PubMed1984

SAFE: a practical guide to psychological factors in selecting patients for facial cosmetic surgery.

Selecting appropriate patients for facial cosmetic surgery can reduce patient management problems as well as increase the number of patients satisfied with their treatment and with the aesthetic result. In addition to medical considerations, the psychological make-up of a particular patient should play an important role in the decision to operate. Research with 55 patients undergoing aesthetic regenerative facial surgery has produced data which indicate particular personality characteristics to consider in the selection process. These four characteristics--self-evaluation of attractiveness, anxiety, fear, and expectation--are represented by the acronym SAFE; they are presented in this article along with the techniques for a surgeon to use when evaluating a patient for each characteristic. This method aids in selecting SAFE patients for surgery.

Anxiety↗
PubMed1983

Detection of HLA antigens on lymphoblastoid and epithelial cell lines and cross-reactivity of HLA-Cw5 and HLA-Cw8.

Antibody-dependent cell-mediated cytotoxicity was used to detect HLA antigens on tissue cultured lymphoblastoid cells (phytohemagglutin blasts and Epstein-Barr virus lines) and transitional cell carcinomas. The results agreed with those obtained on fresh peripheral blood lymphocytes by conventional HLA typing. The same HLA antigens were detected on cells from an individual irrespective of their tissue origin or length of time in vitro. Antibody-dependent cell-mediated cytotoxicity (ADCC) showed that HLA-Cw5 and HLA-Cw8 were cross-reactive. An HLA-Cw5 antiserum that was negative for HLA-Cw8 positive cells in complement-mediated lymphocytotoxicity reacted strongly with HLA-Cw8 donor cells in ADCC. Similarly HLA-Cw8 antibodies were detected in HLA-B14 antisera, which reacted on all HLA-Cw5-positive donor cells. Absorption of sera with HLA-Cw5-positive lymphoid cells removed HLA-Cw5 and HLA-Cw8 specificities but spared HLA-B14. Absorption of HLA-B14 antisera with HLA-B14/Cw8-positive cells removed HLA-Cw5, HLA-Cw8, and HLA-B14 reactivities. Sequential immune precipitation and gel electrophoresis confirmed that HLA-Cw5 and HLA-Cw8 were cross-reactive and that HLA-B14 was physically separable from HLA-Cw8.

Antibody-Dependent Cell Cytotoxicity↗
PubMed1983

The reliability of the carbon dioxide-rebreathing, indirect Fick method of cardiac output determination in patients with pulmonary disease.

1. The CO2-rebreathing indirect Fick method of cardiac-output measurement was compared with the standard invasive direct Fick method for oxygen during rest and treadmill exercise in 15 patients with pulmonary disease characterized by the common feature of expiratory-airflow limitation. 2. The correlation coefficient for all 37 determinations was 0.94 (P less than 0.01); in patients who had a Pa-ETCO2 (arterial end-tidal PCO2 gradient) of greater than 5 mmHg, the coefficient was 0.69 (P less than 0.05), and in the remainder, with a normal Pa-ETCO2, 0.98 (P less than 0.01). 3. The difference in correlation between these two latter groups is statistically significant. 4. It is concluded that the indirect method is valid in most patients with pulmonary disease, but that the correlation with the direct Fick method is significantly worse when the Pa-ETCO2 exceeds 5 mmHg.

Carbon Dioxide↗
PubMed1983

Functional classification of chronic airflow limitation based on flow-volume and single-breath nitrogen washout criteria.

A simple means of functional classification of the individual patient has been devised. The performance of a forced flow-volume manoeuvre in concert with a single-breath nitrogen washout procedure in 54 comprehensively investigated patients with chronic airflow limitation yielded two parameters which could be employed in classification. A normalized alveolar nitrogen slope (FEV1/FVC X delta N2%) greater than 4.0% per litre clearly delineated emphysema. The peak flow ratio (PEFR/PIFR%) categorized other subgroupings: a value in excess of 100% strongly suggests primary bronchial disease, while a lower value almost certainly indicates a mixed functional disorder.

Forced Expiratory Flow Rates↗
PubMed1983

Apparent alteration in MHC antigens in K36.16, an AKR thymoma, does not result in genetic rearrangement.

An 'alien' MHC antigen has been previously described in the AKR tumour K36.16. We have attempted to establish the nature of this antigen by immunochemical techniques. Sequential immunoprecipitation and affinity purification of the 'alien' and regular antigens show that the same molecular entity is involved, the H-2Kd molecule being precipitated by anti H-2Dd sera. Absorption of the sera used to define this 'alien' antigen suggests that an interaction between endogenous viral antigens and H-2 is responsible. Genetic rearrangement within the MHC may well be a facet of tumour immunology but the AKR tumour K36.16 does not appear to be a suitable example for further study.

Animals↗
PubMed1983

Patient selection and patient satisfaction.

Patient selection is difficult. Modern-day plastic surgeons are becoming increasingly aware that patient selection is an important aspect of a successful surgical practice. Evaluation of the patient as a whole rather than just the deformity is necessary to avoid dissatisfied patients. Surgeons should, during the initial interview, consider the acronym SAFE, asking open-ended questions and evaluating the patient. Patient selection rules for outpatient facilities are an extension of patient selection in general. Either patient or surgeon may have reasons for choosing the hospital over the outpatient facility for the procedure. The importance of patient selection extends to patient management as a whole. Appropriate management is even more important in the office-based setting because the stress may have more of an impact on the patient than for hospitalized procedures. Awareness of the stress state in surgery and the patient's personality style allows for a knowledgeable surgeon and staff to anticipate behaviors and emotions and use appropriately their power and nurturance to lead the patient to the ultimate goal, a feeling of satisfaction with the surgical result.

Ambulatory Surgical Procedures↗
PubMed1982

Dominant allele-specific regulation of expression of H-2Kk gene products revealed by somatic cell hybridization.

A study has been made of the H-2 profiles of the AKR thymoma K36 and two series of somatic cell hybrids derived from it. Despite expressing good amounts of the H-2Dk product, the H-2Kk antigen was barely detectable in this tumor, approximately only 1% of that expressed by a comparable AKR lymphoma, 339. The isoelectric focusing profile of the H-2kk product immunoprecipitated from K36 was found to be identical to that from normal AKR lymphocytes. The phenotype of K36 therefore results from regulatory constraints. Fusion of K36 with normal K-2k lymphocytes resulted in hybrids expressing the H-2Kk product. Fusion of K36 with normal H-2b lymphocytes resulted in good expression of the H-2Dk and H-2Db alleles in addition to good expression of the H-2Kb products. The expression of the H-2Kk antigen remained marginal. The data suggest a suppressive mechanism which is trans-acting and dominant and specific for the H-2Kk allele.

Alleles↗
PubMed1982

Interactions between folate and ascorbic acid in the guinea pig.

Possible interactions between folic acid (folate) and ascorbic acid (AA) have been suspected because megaloblastic anemia is occasionally observed in scorbutic patients, and it may or may not respond to folate treatment. Male weanling guinea pigs were fed diets containing high levels of folate and AA or diets deficient in one or both vitamins. A total of 36 animals, including 9 controls, were studied. When anorexia began to appear in the deficient groups, all animals were killed by exsanguination, and tissue samples (blood, liver, adrenal, kidney, spleen, and intestinal mucosa) were removed for AA and folate analyses. Folate and AA deficiency lowered tissue folate and AA levels, respectively. AA deficiency, either alone or in combination with folate restriction, did not affect tissue folate levels, nor did AA deficiency significantly exacerbate the anemia and leukopenia caused by folate deficiency. However, there was an unexpected decrease in AA levels in the liver and adrenal glands with folate deficiency. Although AA does not appear to be needed for normal folate metabolism, the lower AA levels associated with a folate deficiency are indicative of an interaction between the two vitamins.

Anemia, Megaloblastic↗
PubMed1982

Method for immediate measurement of skin removed during rhytidectomies.

A method for measuring skin removed during rhytidectomy is presented based on analysis of 50 female patients. More skin was removed in primary rhytidectomies than in subsequent ones. Younger patients, aged 30 to 39 years, had measurably more skin removed than any other group between 40 and 69. The amounts of skin removed from the two sides of each patient's face were nearly equal in most cases. In those few cases where the skin excisions were unequal, there were still no significant differences between the two sides. The method described for measuring skin excisions is easy, rapid, and convenient.

Adult↗
PubMed1981

[A non-invasive approach to pulmonary hemodynamics].

Currently available investigative methods employed in the evaluation of the pulmonary circulation involve cardiac catheterization and, in respect of exercise determinations, only supine data have been recorded. Consequent upon a 3-year study of pulmonary haemodynamics and gas exchange at rest and during exercise on the treadmill in patients with chronic hypoxaemic lung disease, correlations have been established which accurately characterize the venous admixture (QVA/Qt, the quantitative expression of hypoxaemia), cardiac output and pulmonary artery pressure (PA), permitting the prediction of these variables in the erect posture. The employment of fibre-optic oximetry obviates the need for arterial cannulation. The relevant regression formulae are as follows: QVA/Qt = 8,85 x ln (Hb (100 - SaO2) x heart rate/VO2) - 3,66 (r = 0,97; SEE = 2,43) PAm (resting) = 0,4516 (QVA/Qt) + 8,2 (r = 0,90; SEE = 2,7) PAm (exercise) = 1,453 (QVA/Qt) + 3,8 (r = 0,96; SEE = 4,0) Cardiac output may be derived directly from VO2 and the known components of QVA/Qt, and total pulmonary vascular resistance in turn from Qt and PAm. Direct comparison of the predicted values derived by this means with actual determinations yielded no systematic differences. The clinical application of these principles ensures reliable estimates of haemodynamic variables, without resort to invasive techniques, during free movement and graded exercise testing.

Adolescent↗