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Biomedical subjects

J H Palmer

Publications and source records attributed to J H Palmer.

At least 19 recordsLinked to original sources
PubMed2001

Control of brittleness in butyl-methylmethacrylate resin embedding mixtures to facilitate their use in immunofluorescence microscopy.

Butyl-methylmethacrylate resin mixtures were tested for brittleness-inducing factors in polymerised resin using a rapid quantitative scoring technique. The major source of brittleness was identified as the reducing agent dithiothreitol, which is commonly included in resin mixtures at 10 mM, to protect against tissue oxidation. Lowering the dithiothreitol content to 5 mM substantially reduced brittleness. Changing the 4:1 ratio of butyl- to methylmethacrylate to 9:1 or 3:2, and reducing the concentration of the catalyst, benzoin ethyl ether, to 0.25% also reduced dithiothreitol-induced brittleness. Polymerisation at temperatures close to 0 degrees C increased dithiothreitol-induced brittleness, but this was controlled in the 4:1 and 9:1 resin mixtures by lowering the catalyst concentration from 0.5 to 0.25%. Degassing the resin mixture with nitrogen gas prior to polymerisation did not reduce brittleness. Immunolabelled onion roots which were embedded using the 3:2 resin mixture ratio, 5 mM dithiothreitol and the 0.25% catalyst concentration, showed excellent preservation of cortical microtubule arrays.

Dithiothreitol↗
PubMed2000

Awake tracheal intubation with the intubating laryngeal mask in a patient with diffuse idiopathic skeletal hyperostosis.

Diffuse idiopathic skeletal hyperostosis, otherwise known as Forestier's disease or ankylosing hyperostosis, is a relatively common condition that is distinguished from ankylosing spondylitis by the relative preservation of spinal function and the characteristic 'candle flame' lipping of the vertebrae. We report a patient with this condition and a well-recorded history of impossible intubation who presented for emergency laparotomy. The patient was intubated awake using the intubating laryngeal mask and sedation and anaesthesia were provided by a target-controlled infusion of propofol.

Anesthesia, Intravenous↗
PubMed2000

A call for unity.

Explore the source record for details and available documents.

Equipment Safety↗
PubMed1999

Reducing non-attendance at outpatient clinics.

Outpatient non-attendance is a common source of inefficiency in a health service, wasting time and resources and potentially lengthening waiting lists. A prospective audit of plastic surgery outpatient clinics was conducted during the six months from January to June 1997, to determine the clinical and demographic profile of non-attenders. Of 6095 appointments 16% were not kept. Using the demographic information, we changed our follow-up guidelines to reflect risk factors for multiple non-attendances, and a self-referral clinic was introduced to replace routine follow-up for high risk non-attenders. After these changes, a second audit in the same six months of 1998 revealed a non-attendance rate of 11%--i.e. 30% lower than before. Many follow-up appointments are sent inappropriately to patients who do not want further attention. This study, indicating how risk factor analysis can identify a group of patients who are unlikely to attend again after one missed appointment, may be a useful model for the reduction of outpatient non-attendance in other specialties.

Appointments and Schedules↗
PubMed1997

Long-term clinical results and quality of life after insertion of a self-expanding flexible endourethral prosthesis.

OBJECTIVE: To evaluate the safety and efficacy of the Urolume self-expanding flexible endourethral stent, based on a long-term follow-up, and to determine its role amongst the various modalities of treatment available for the relief of bladder outlet obstruction (BOO) arising from benign prostatic hyperplasia (BPH). PATIENTS AND METHODS: From January 1991 to April 1992, the Urolume wallstent (American Medical Systems, USA) was placed successfully in each of 62 patients (aged 50-89 years) who had significant subjective and objective evidence of BOO. The stent was placed as a daycase procedure under general anaesthesia. Pre-operatively, each patient was assessed fully in an out-patient clinic by symptoms, a flow rate measurement and a rectal examination. Post-operatively, patients were assessed using transrectal ultrasonography, cystoscopy, symptoms and flow rate measurement, and after 5 years, the International Prostate Symptom Score and satisfaction score were obtained. RESULTS: After 5 years, 27 (39%) patients survived and 10 (14%) died with their Urolume stent intact; 22 (32%) completed the follow-up and five refused or were lost to follow-up. Day and night-time frequencies and flow rates improved continuously. Complete epithelialization occurred in 16 of the 22 patients assessed. Of those in whom the Urolume was removed, 20 are alive and five dead. CONCLUSION: The effectiveness of the Urolume in improving symptoms and flow rates in patients with BPH was confirmed. However, the high failure rate arose largely from inexperience in selection and deployment. There are no absolute criteria to predict a successful outcome. This study confirms the Urolume as a safe device. Most patients whose symptoms settled in the first year maintained a good flow rate and a significant improvement in symptoms for 5 years; their quality of life at the last follow-up was good.

Aged↗
PubMed1997

Lumbovertebral syndrome after repeat extradural blood patch.

We describe an obstetric patient who developed incapacitating headache after inadvertent dural tap and was treated with repeated blood patching. She subsequently developed severe lumbar back pain which, after exclusion of suspected extradural abscess, was treated successfully with simple analgesics and physiotherapy. Two possible explanations are offered to account for her symptoms. We compare this case with others in the literature.

Adult↗
PubMed1994

The Urolume as a means of treating urinary outflow obstruction and its impact on waiting lists.

OBJECTIVE: To evaluate the effectiveness of the prostatic stenting device--the Urolume--both in terms of relief from urinary outflow obstruction and as a means of reducing waiting lists. PATIENTS AND METHODS: A group of 70 men from the long-term waiting list were chosen for this study. The Urolume, a mesh tube of biomedical superalloy, was successfully introduced in 60 of these patients. The majority had the procedure performed as a day case, under a general anaesthetic. RESULTS: Seventy-two per cent of patients were symptomatically better when assessed at 6 weeks and their mean peak urinary flow rates had doubled. Early problems included haematuria, urge incontinence and dysuria. Stent displacement necessitating removal occurred in 10 patients. CONCLUSION: This technique offers the surgeon a quick and atraumatic method of relieving urinary outflow obstruction. There are, however, a number of problems associated with this technique which will probably be overcome by modification to the Urolume. As a result of our project, the waiting time for prostatic surgery was reduced from 3 years to under 2 years.

Aged↗
PubMed1993

Evolution of complex chromosomal rearrangements in a case of biphenotypic pre-B/myeloid acute leukemia.

A case of acute biphenotypic leukemia, in which blast cells coexpress antigens of both lymphoid and myeloid lineages, was seen in a 24-year-old female. The clonal karyotype was complex but did not include any of the abnormalities previously found in biphenotypic leukemia. Chromosome abnormalities included breakpoints seen in both acute lymphoblastic and acute myeloid leukemias as well as a number of known fragile sites, namely the rare heritable fragile site at 10q24, and the common, aphidicolin-induced sites on chromosome 7.

Adult↗