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Biomedical subjects

D Buckley

Publications and source records attributed to D Buckley.

79 records · Page 5Linked to original sources

Case report: combined hand access with laparoscopic pneumoperitoneum in intraperitoneal adhesiolysis.

Previous abdominal surgery is one of the relative contraindications to safe induction of pneumoperitoneum with a Veress needle. Similarly visual inspection with a telescope may be limited and instrumental manipulation difficult. The manual ability to distract bowel loops and finger dissect greatly facilitates adhesiolysis and this is lost with conventional laparoscopy. A novel hand-access port is described which combines manual tactile ability with minimally invasive laparoscopic adhesiolysis.

Aged↗

Contact allergy to isoeugenol and its derivatives: problems with allergen substitution.

A total of 2261 (808 male, 1453 female) consecutive patients attending contact dermatitis clinics were patch tested to isoeugenol and its derivatives listed in the EU Inventory of Fragrance Ingredients. Positive reactions were found to isoeugenol in 40, transisoeugenol in 40, isoeugenyl acetate in 19, isoeugenyl benzoate in 4, isoeugenyl phenylacetate in 16, isoeugenyl methyl ether in 6 and benzyl isoeugenyl ether in 2 patients. There was a concomitant reaction to isoeugenol in 36/40 of those positive to transisoeugenol, 13/19 of those to isoeugenyl acetate, 3/4 of those to isoeugenyl benzoate and 15/16 of those to isoeugenyl phenylacetate but in none of those 6 positive to isoeugenyl methyl ether and in neither of those 2 positive to benzyl isoeugenyl ether. Concomitant contact allergy between isoeugenol and its derivatives may occur through chemical cross-reactivity or local skin metabolism of the derivatives. It is more commonly observed with the esters rather than the ethers. Isoeugenyl acetate has been proposed as an alternative to isoeugenol, but there is a high degree of concomitant reactivity with isoeugenol.

Allergens↗

Cryosurgery treatment of plantar warts.

Plantar warts are common, painful and contagious. Because of their dept of penetration, self treatment with topical creams and gels is often very slow and commonly unsuccessful. Surgical excision or cautery are very painful, can leave permanent tender scars and often lead to relapse because of the Koebner phenomenon. 100 consecutive patients with plantar warts treated by one General Practitioner over a sixteen month period were analysed. Patients were followed up to assess success and relapse rates and the development of any complications. The number, type, size and position of plantar warts were also recorded and analysed. A total of 514 plantar warts presented for treatment. 505 Plantar Warts in 96 patients were considered suitable for treatment using liquid nitrogen cryosurgery via a Byrmill cryogun. Patients were treated by the open spray technique after debulking the plantar wart using a surgical blade. 421 plantar warts (83.5%) cleared completely with one single treatment of cryosurgery. A further 30 (6%) cleared with two treatments and another 15 (3%) cleared with three treatments. In total, 467 plantar warts (92.5%) cleared completely using cryosurgery and 90% of these cleared with one treatment. Of the remaining 38 plantar warts, 23 (4.5%) were lost to follow up and 12 (2.4%) were managed using other techniques after initially being treated with cryosurgery. Only 3 (0.6%) plantar warts failed to clear. However, all three were smaller and less painful after treatment. No patient had to be referred to hospital for treatment of their plantar warts. There were no serious complications of treatment. This study highlights the advantages of cryosurgery for treating plantar warts in general practice. This technique is quick, safe, highly successful, has a low relapse rate and leaves little or no scars.

Adolescent↗

Seasonal differences in serum vitamin D binding protein in exclusively breast-fed infants: negative relationship to sunshine exposure and 25-hydroxyvitamin D.

Vitamin D binding protein (DBP) is the major carrier for vitamin D and its metabolites in serum. DBP increases in pregnancy and decreases in cirrhosis; no seasonal variation has been reported in adults. We observed significant seasonal differences in 41 exclusively breast-fed infants who were less than 6 months of age. Winter DBP concentrations exceeded summer DBP concentrations: 398 +/- 22 versus 297 +/- 20 micrograms/ml (mean +/- SEM). The mean concentration for spring and fall was 329 +/- 25 micrograms/ml. Maternal DBP concentrations did not differ by season. A sunshine exposure score, previously verified, was used to document time and body surface exposed to the sun. DBP was inversely related to sun exposure (r = -0.46, p = 0.005). Infant DBP was significantly and negatively correlated with 25-hydroxyvitamin D concentrations (r = - 0.38, p = 0.02). We speculate that serum DBP fluctuations are a response to varying vitamin D needs: increased serum DBP occurs in low vitamin D status to maximize uptake of vitamin D from skin.

Breast Feeding↗

Unusual manifestations of type 1 autoimmune polyendocrinopathy.

We present a family with five members affected by Type 1 autoimmune polyendocrinopathy. All patients had chronic mucocutaneous candidiasis and dental abnormalities. Four patients had ocular abnormalities, four had hypoparathyroidism, and three had Addison's disease. The family was unusual in that all four affected females had premature ovarian failure. The ocular abnormalities included two patients with subcapsular lens opacities, one patient with asymptomatic corneal opacities, and one patient with severe bilateral iridocyclitis with cataract formation. One patient had pernicious anaemia and one had insulin dependent diabetes mellitus. All patients were negative on repeated occasions for organ specific and non-organ specific autoantibodies. Lymphocyte studies were performed in four patients. A deficiency of T suppressor cells was found in three and low normal levels were present in the fourth suggesting that the syndrome may be due to a defect in suppressor T cells.

Adolescent↗