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Biomedical subjects

D W Man

Publications and source records attributed to D W Man.

At least 19 recordsLinked to original sources
PubMed2001

A preliminary study to investigate the empowerment factors of survivors who have experienced brain damage in rehabilitation.

BACKGROUND: This study was an extension of previous studies on the empowering of families caring for a relative who had experienced brain damage. The demand to adopt a similar empowerment concept in the direct rehabilitation of people with brain damage was proposed. OBJECTIVE: The development of a theory-driven instrument, in the form of a person-administered empowerment questionnaire, so as to establish the empowerment factors of people with brain damage during their rehabilitation process. RESEARCH DESIGN: A kind of methodological study was used to develop, validate and evaluate research tools. This study concentrated on the development of a questionnaire that accurately measures empowerment in people with brain damage. METHODS AND PROCEDURE: This questionnaire derived items from both the existing literature on brain damage rehabilitation and related studies on people coping with brain damage. Open-ended questions were also included to investigate how patients may be encouraged to achieve successful rehabilitation (such as degree of acceptance, learning of adaptive skills and community re-entry). A structural empowerment model has been constructed by both content validity analysis and construct validity through an explorative factor analysis of 112 people with brain damage. MAIN OUTCOME AND RESULTS: A 42-item questionnaire has been developed, constructing four interpretable factors: Support (13 items), Skill (14 items), Aspiration (nine items), and Knowledge (six items), which accounted for 49.99% of the total variance. Analyses of open-ended questions showed that they generally lack external resources and support in the coping process. They did not have sufficient information to face their problems in a variety of areas, although they were quite aware of their importance. They could rely only on personal assets and families, and less on friends, work-mates, and external social resources. CONCLUSION: It is suggested that the results of this initial empowerment framework can either guide ways to improve the case management of patients with brain damage (in terms of structure, methods, and evaluation mechanisms) or assist in the research and design (R&D) of rehabilitation programmes with better efficacy and effectiveness. Further research using Rasch Analysis is suggested to establish item difficulties, and using the findings as an outcome measure in rehabilitation is recommended.

Adaptation, Psychological↗
PubMed1998

The empowering of Hong Kong Chinese families with a brain damaged member: its investigation and measurement.

This is an increasing recognition of the influential roles played by the families of brain damaged persons in rehabilitation. Although these families are expected to take up the burden of care, they are usually ill-prepared to face this long-term process. This preliminary study of empowerment is aimed at helping Hong Kong Chinese families with a brain damaged member to regain a sense of mastery over the brain damage, their environment and their lives. The impact of brain damage on families was explored in order to propose a model to guide the development of assessment and intervention, as well as for the justification of practice by health care professionals. A 52-item instrument, the empowerment questionnaire, was developed through explorative factor analysis of responses of 211 families that included a brain damaged member. This analysis yielded four interpretable factors: efficacy: knowledge: support and aspiration and they demonstrated high validity reliability.

Adaptation, Psychological↗
PubMed1988

Multifocal leiomyosarcoma of the small intestine in childhood.

We recently observed a 4-year-old Chinese boy with multifocal leiomyosarcoma of the small intestine with evidence of dissemination. Complete surgical excision was not possible and the response to postoperative chemotherapy was poor. The patient died 3 months after diagnosis. The prognosis for disseminated intestinal leiomyosarcoma in childhood appears to be poor.

Child, Preschool↗
PubMed1988

Thyroid abscess caused by Eikenella corrodens.

To our knowledge, this is only the fourth case recorded of thyroid abscess due to Eikenella corrodens and the first in which the causative organism has been isolated in pure culture from the site of infection. E. corrodens may be the cause of apparently sterile thyroid abscesses encountered in head and neck surgery and should be considered in their differential aetiology.

Abscess↗
PubMed1988

End-to-end oesophageal anastomosis: an experimental study in the rat.

To study the effects of suture material, calibre and tension on the end-to-end oesophageal anastomosis, the cervical oesophagus of the rat was resected for 2.5 mm, 7.5 mm and 12.5 mm respectively in three groups of 60 rats each. End-to-end anastomosis was performed with either 6/0 silk, 6/0 polypropylene or 9/0 polypropylene sutures. There was no postoperative leakage. Mortality was mainly due to hair bolus obstruction at the site of anastomosis. There was no difference in mortality and anastomotic stenosis between groups with different resection lengths. Within each group, however, mortality and anastomotic stenosis were significantly higher in the subgroup of rats with 6/0 silk suture than that in the subgroup with 6/0 polypropylene sutures, which also had significantly higher mortality and anastomotic stenosis than the subgroup with 9/0 polypropylene sutures. Histological examination of the stenosed anastomosis showed disruption of muscle layers and submucosal thickening. It is concluded that the use of fine calibre sutures of biologically inert material would be preferred for the end-to-end anastomosis of the oesophagus.

Anastomosis, Surgical↗
PubMed1988

Malrotation of midgut in adult polycystic kidney disease.

A case of malrotation of the midgut and adult polycystic kidney disease is reported. The patient had a stillborn son who had congenital heart disease and adult type of polycystic kidney disease. These findings support the notion that cystic disease of the kidney, gastrointestinal and cardiovascular anomalies are genetically linked.

Adult↗
PubMed1987

Primary hypospadias repair with single stage techniques.

Our experience with primary hypospadias repair by single stage technique is reviewed. The transverse preputial island flap is most versatile and can be used for hypospadias varying in severity from the subcoronal to the perineal types. In this study, this technique carried a fistula rate of 14%. Glanular and coronal hypospadias were corrected by the technique of meatal advancement and glanuloplasty (MAGPI) which had a zero fistula rate. An overall fistula rate of 7.5% is considered acceptable. Single stage repair should be considered standard practice in the management of hypospadias repair. A brief description is given of the procedure of transverse preputial island flap repair.

Adolescent↗
PubMed1986

Experience with single stage hypospadias reconstruction.

Our experience with single stage primary hypospadias repair in 96 patients over a 12-month period is reviewed. The ages ranged from 7 months to 14 years with an average of 3.5 years. Seventeen patients were 18 months or younger at the time of operation. Meatal advancement and glanuloplasty (MAGPI) was performed in 46 patients mainly with coronal and glanular hypospadias. There was a fistula rate of 4%. The modified Mathieu and Mustarde operations were used for subcoronal and distal hypospadias. The transverse preputial island flap technique was found to be very versatile and was employed in 33 patients. The fistula rate was 18% and proximal urethral stricture rate 9%. These complication rates are considered quite acceptable in busy centers where surgeons in training are involved in these operations. It is concluded that by mastering a relatively limited number of techniques, single stage hypospadias reconstruction can be undertaken in almost all cases at the optimal time.

Adolescent↗
PubMed1986

Histochemical changes in intestinal atresia and its implications on surgical management: a preliminary report.

Histochemical studies of the intestine were performed on five neonates, three with intestinal atresia and two as normal controls. In this preliminary report, changes secondary to ischemia and obstruction were defined. It was shown that the ischemic changes were limited in extent both proximally and distally, and the obstructive changes were reversible. A conservative approach to resection in the management of intestinal atresia is suggested. Limited resection of the dilated proximal bowel together with the use of total parenteral nutrition will allow for a safe waiting period for the pathological changes to reverse themselves and effective peristalsis to return.

Acetylcholinesterase↗
PubMed1986

Massive upper gastrointestinal bleeding from haemorrhagic gastritis in the newborn.

A case is reported of massive upper gastrointestinal bleeding in a newborn on the second day. Failure to control the bleeding by conservative measures necessitated an exploration. Haemorrhagic gastritis was found to be the cause of bleeding. Vagotomy and pyloroplasty was performed with satisfactory results. Management of this condition in the newborn is discussed.

Gastritis↗
PubMed1986

An unusual laryngeal foreign body in an infant.

A case is presented of laryngeal impaction in an infant by a cervical vertebra of a toad. Symptoms were mild initially but became progressive later with secondary laryngeal edema. Early diagnosis was not made, which resulted in considerable difficulty in management. Computerized tomography (CT) scan was found to be useful in identifying the foreign body and thereby facilitating management. CT is recommended for suspected foreign bodies in the air and food passages where more conventional methods fail to make a diagnosis.

Animals↗
PubMed1985

Choledocholithiasis in infancy.

Three cases of choledocholithiasis presenting with obstructive jaundice in infancy are reported. Ultrasonography demonstrated a grossly dilated common bile duct in all three cases. It failed, however, to demonstrate the calculi that were situated at the distal end of the common duct. Percutaneous transhepatic cholangiography was valuable in one patient in outlining the biliary tract and in identifying the cause of the obstruction. Endoscopic retrograde cholangiopancreatography (ERCP) was employed in a child, aged three years, in whom it was possible to proceed to endoscopic sphincterotomy with clearance of the common duct. In small infants, transduodenal sphincteroplasty would appear to be the procedure of choice.

Cholangiography↗
PubMed1985

The management of chylous ascites in children.

The results of surgical treatment of four children with chylous ascites unresponsive to medical management are presented. Peritoneovenous shunts were inserted in three patients, two of whom had the ascites resolved. The third patient was a 4-year-old girl with widespread mucin-secreting carcinomatosis, the first reported case in the literature combined with chylous ascites, whose shunt failed to relieve the ascites. A review of the literature comprising 92 cases of chylous ascites in children and a proposed scheme of management is presented.

Child, Preschool↗
PubMed1984

Epididymal abnormalities associated with maldescent of the testis.

A prospective series of 118 consecutive patients admitted for exploration of the groin is reviewed. Seven patients were excluded from the study; the remaining 111 patients had among them a total of 132 maldescended testes. These were classified as either truly undescended testes associated with a complete hernial sac, undescended testes with no hernial sac, or ectopic testes. All testes were examined at operation and the incidence of associated epididymal abnormalities was noted. Four main types of epididymal abnormality are described and a classification is suggested. These abnormalities may contribute to impaired fertility despite orchidopexy, particularly in the group of patients with truly undescended testes associated with a hernial sac where the incidence of epididymal abnormalities was high (75%) compared with an incidence of 20% in the other two groups.

Adolescent↗
PubMed1984

Percutaneous antegrade pyelography in children.

We report our experience with 107 percutaneous antegrade pyelograms in 79 children aged between 3 days and 14 years. The main indications for the procedure are outlined, together with a note on the technique. Puncture of the pelvicaliceal system failed in 10% of cases. The procedure is simple to perform and is preferred to retrograde urography, which carries significant morbidity and is impracticable in the male infant. Antegrade pyelography provides the definitive anatomical diagnosis of obstruction of the upper urinary tract. It is particularly useful in megaureters after reimplantation and in grossly dilated and/or poorly functioning systems where diagnosis of obstruction by radionuclide renal scan could be difficult. The procedure has been found to be safe and complications are minimal.

Adolescent↗