Search PubMed⌕ Search

Biomedical subjects

D M Walker

Publications and source records attributed to D M Walker.

152 records · Page 9Linked to original sources
PubMedDate not supplied

Hexetidine mouthrinse in the management of minor aphthous ulceration and as an adjunct to oral hygiene.

A number of compounds have been used in the management of recurrent oral ulceration, including antimicrobials. This was a double-blind placebo-controlled cross-over study to assess the value of a 0.1% hexetidine mouthwash in the management of minor aphthous ulceration and as an adjunct to oral hygiene. Forty patients with a catalogued history of ulceration took part. Patients were randomly allocated to active/placebo or vice versa order of mouthwashes, which were used as 15 ml volumes three times a day. Treatment periods were 6 weeks with a 3 week washout. During each period patients kept daily records of the number, site, and duration of ulcers, together with pain scores. Plaque and gingivitis were scored at baseline and end of treatment periods. Thirty-eight patients completed the study, with no significant treatment differences between active and placebo rinses on any ulcer parameter. Additionally, the hexetidine rinse provided no significant benefit to oral hygiene or gingival health. However, there was a significant period effect, with considerable ulcer improvements during the second period, irrespective of treatment. In conclusion, the hexetidine rinse appeared to offer no benefits to these patients, but professional supervision of ulcer treatment does appear to result in a worthwhile placebo effect.

Adolescent↗
PubMedDate not supplied

Occult knee ligament injuries associated with femoral shaft fractures.

Recognition of ligamentous injuries of the knee in the acute phase is essential for optimum treatment and prognosis. A multitraumatized patient with a fractured femur and occult knee ligament damage presents a difficult diagnostic challenge. This paper retrospectively reviews 52 patients with 54 midshaft femoral fractures. The high incidence (48%) of ipsilateral knee ligament damage, particularly of a severe nature (30%) evident at followup (mean 24.5 months) is alarming. In the 26 cases of knee ligament damage, the mean time from injury to documentation of instability is 12.8 months. Motor vehicle and athletic injuries and falls account for all of the injuries. The majority are dashboard impacts treated in balanced traction with subsequent case bracing. The anterior cruciate ligament (50%) is most often injured followed by the medial collateral ligament (31%), lateral collateral ligament (13%), and posterior cruciate ligament (6%). A Lachman test, aspiration of the effusions, examinations under anesthesia including stress films, and arthroscopy are recommended as diagnostic procedures. Acute ipsilateral knee instability is a strong relative indication for primary rigid immobilization of the fracture femur to allow early ligamentous repair.

Accidents, Traffic↗
PubMedDate not supplied

Haemolysis following mitral valve repair.

We report the unusual occurrence of severe intra-vascular haemolysis following mitral valve repair. Mild to moderate mitral regurgitation was detected after repair, but severe haemolysis was the only indication for re-operation. Following prosthetic valve replacement there was an immediate cessation of haemolysis. We postulate that a small regurgitant jet directed against the teflon pledgets used in the repair was the reason for the haemolysis.

Aged↗
PubMedDate not supplied

Intranuclear post-transcriptional down-regulation responsible for loss of a keratin differentiation marker in tumour progression.

Apparent loss of differentiation markers characterizes advanced malignant neoplasms. Post-transcriptional down-regulation of keratin message to levels undetectable with a partial cDNA probe to rat keratin K5 had been observed in anaplastic cells (T952/F7) derived from benign keratin-producing cells (A5P/B10) (1). The entire fifth introns of both the K5 and K6 genes were generated from rat genomic DNA by PCR to define expression of these closely related proteins. Sequencing of the PCR products revealed 84% homology in the K5 and K6 exon regions included, but absence of any homology in the introns. Active transcription of K5 could be demonstrated in the anaplastic cells with reverse transcription of nuclear RNA (RTn-PCR) by the presence of PCR-generated products confirmed by sequencing as unspliced and spliced transcripts of rat K5. In situ hybridization with ssDNA probes for the spliced message from this region of the K5 gene demonstrated a punctuate distribution in the cytoplasm of the benign cells and absence of any detectable message in the anaplastic derivatives, ssDNA probes for the unspliced transcript containing intron 5 and the same flanking exon sequences as the spliced probe detected transcription of hnRNA in the anaplastic cells as discrete signals confined to the nuclear compartment. These results show that failure to express mRNA for a differentiation marker in the cytoplasm of anaplastic cells can be due to a mechanism operating in the nuclear compartment after gene transcription and indicate that the mechanism functions shortly after splicing of the transcript.

Animals↗