Search PubMed⌕ Search

Biomedical subjects

H G Lewis

Publications and source records attributed to H G Lewis.

10 recordsLinked to original sources
PubMed2000

A review of 100 consecutive free tissue transfers.

Following the introduction of microsurgical techniques the availability of free tissue transfer has radically transformed reconstructive possibilities for both oncological and surgical defects. This study is a review of 100 consecutive free tissue transfers (free flaps), carried out in 96 patients over a period of 25 months in our unit. The indications for surgery in this series mainly resulted from malignancy, trauma, chronic osteomyelitis, burns and congenital abnormalities. The tissues transferred included various combinations of skin, fat, fascia, muscle, bone and several free digits. Fourteen cases required re-exploration, of which 12 were salvaged, and the overall success rate was 96%.

Anastomosis, Surgical↗
PubMed1999

Intramucosal acidosis and the inflammatory response in acute pancreatitis.

OBJECTIVE: The aim of this study was to assess the host response and diminished bowel perfusion during acute pancreatitis. METHODS: A total of 19 patients admitted with established diagnoses of acute pancreatitis on the basis of clinical findings, elevated serum amylase to more than four times the upper limit or by contrast radiology. Patients were stratified into mild and severe pancreatitis using the Atlanta criteria. Blood samples were obtained from in-dwelling lines or direct venipuncture within 12 h of admission and 24 hourly thereafter for measurements of plasma endotoxin, EndoCab immunoglobulin (Ig)G and IgM antibodies, tumor necrosis factor (TNF), p55 TNF receptor, and IL-6. A gastric tonometer was inserted in place of a nasogastric tube for intramucosal pH evaluation. RESULTS: Episodes of endotoxaemia were more common and endotoxin concentration significantly higher at presentation in the severe group compared to the mild group of patients. A greater consumption of IgM antibody was found in those with severe disease. The decrease in IgM antibody concentration was shown to be a specific host response, as a fall in concentration of antibodies to a neutral antigen, tetanus toxoid, was not observed. Significantly greater elevations were found in p55 TNF receptor and IL-6 concentrations in the severe group in comparison to those suffering mild pancreatitis. Significant correlations were found between gastric intramucosal pH and EndoCab IgM antibody, p55 TNF receptor, and IL-6. CONCLUSIONS: These results suggest that endotoxemia, an acute inflammatory response, and a reduction in bowel perfusion may occur in severe acute pancreatitis. The endotoxemia and inflammatory response may be due to the permeation of bacteria and their breakdown products across a disrupted bowel mucosal barrier.

Acute Disease↗
PubMed1998

A 10-year review of high-pressure injection injuries to the hand.

High-pressure injection injuries to the hand are uncommon, but often result in poor outcome or even amputation. We report a review of the 28 cases treated surgically in our department over the last 10 years and have examined the factors leading to increased morbidity. The severity of these injuries was related to the nature of the injected material, involvement of the tendon sheath and proximal spread of the injected substance. All cases in which the digit was noted to be poorly perfused from the outset resulted in amputation. We conclude that early amputation should be considered in cases in which the affected digit is initially cool or poorly perfused.

Accidents, Occupational↗
PubMed1982

Some aspects of orthodontic specialist practice in the United Kingdom.

A questionnaire sent to orthodontic specialist practitioners provided information about the nature of specialist practice, the training of specialist practitioners and the patterns of treatment within orthodontic practices. Specialists are now undergoing more extensive postgraduate training and the use of fixed appliances is increasing. General dental practitioners are referring larger numbers of patients to orthodontic specialist practitioners. Several factors will soon be operating to encourage a raising of treatment standards in British orthodontics, namely a falling birth rate, an increased interest in dentistry by the general public and the availability of an increased number of well-trained orthodontic specialist practitioners. Some form of official recognition for the specialist practitioner role is now desirable whilst the historical model for delivery of orthodontic care defined at the inception of the National Health Service in in urgent need of revision.

Humans↗
PubMed1981

Changes in orthodontic treatment patterns within one orthodontic practice over a 15 year period.

Fifty consecutive treatment case records were analysed for each of the years 1964, 1971, 1974, 1976 and 1978. The following variables were examined: sex distribution, age at start of treatment, extractions undertaken (if any), type of appliance used, completeness or incompleteness of treatment, treatment duration and one final category termed "other clinical procedures' dealing with cephalometry, photography and surgery. The sex distribution fluctuated only slightly with a predominance of females throughout. The age of onset of treatment was fairly constant at around 12 years. Over the 15 years a rise in number of non-extraction cases was noted and the number of patients treated by extraction only, fell. The use of fixed appliances increased steadily and in 1978 55 per cent of cases received some form of fixed appliance therapy. The mean number of incomplete cases was 17 per cent for all years with no rise latterly despite the use of more complex appliances. The treatment duration time showed a steady decrease over the 15 year period. Few referrals for oral surgery were made, although the use of precision following rotation correction has increased.

Adolescent↗