Ulnar train-of-four stimulation in predicting face movement during intracranial facial nerve stimulation.
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Biomedical subjects
Publications and source records attributed to L C Ho.
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A small series of patients with obstructive or secondary lymphoedema treated by microlymphatic bypass is presented. The procedures in the lower and upper limbs are described. Preoperative assessment by lymphangiography and lymphoscintigraphy are required to assess suitability for the procedure. Postoperatively, patent lymph collectors can be demonstrated by lymphoscintigraphy. Microlymphatic bypass must be carried out before the peripheral lymph collectors have been destroyed or permanently damaged by increasing back pressure and recurrent infection. Factors influencing a successful result are enumerated. Other microsurgical techniques and treatment are reviewed.
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Autoaugmentation mammaplasty of the small ptotic breast with adjacent pedicled fat and simultaneous correction of ptosis is presented. The operative procedure is described and some representative results are shown.
Of 77 eosinophilic male adolescents studied, 12% were found to have helminthiasis and high circulating serum levels of IgE to Dermatophagoides pteronyssinus. This shows that worm-infested individuals can still mount high IgE responses to atopic non-helminthic allergens. The total serum IgE levels of these individuals were not significantly different from those with helminthiasis only, suggesting that there may be some form of repression of helminth-induced non-specific IgE in the presence of atopy; alternatively, allergen-related IgE may be repressed when an individual is worm-infested.
In an eosinophilic population of 47 boys of the same age, a large proportion (92%) were helminth infested or atopic, or both, compared with 36% of 36 controls. The methods used to detect these conditions were not costly or elaborate, except for the radioallergosorbent test, which was used to measure concentrations of circulating IgE antibodies to atopic allergens. It is suggested that an economical approach to detect helminthiasis and atopy in cases of eosinophilia is adopted using the methods employed here, with skin prick tests replacing the radioallergosorbent test.
Filarial antibodies were detected by the indirect fluorescent antibody (IFA) technique using sonicated microfilariae of Brugia malayi as antigen. Of the 324 sera of patients with clinical symptoms suggestive of filarial infection, 90 (28%) had detectable antibodies with titres ranging from 1 : 4 to 1 : 4096. Forty-six percent of patients with eosinophilic lung were positive with titres ranging from 1 : 4 to 1 : 1024. Highest rates of positives were seen in Indians (48%) with lower rates in Malays (36%) and Chinese (15%).
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Ptosis of the breast and the optimum position of the nipple in the non-ptotic breast have been defined. A descent of the infra-mammary fold in ptosis is demonstrated: the concept of the nipple infra-mammary distance is introduced and the optimum values are defined. The principle of relocating the infra-mammary fold in any form of mammaplasty where the nipple is elevated is introduced together with a precise method for defining the new level of the infra-mammary fold in relation to the proposed size of the reconstructed breast. Emphasis is placed on the aesthetic significance of avoiding inter- and extra-mammary scarring.
A report is presented of a case of secondary lymphoedema of the upper limb successfully treated by microlymphatic bypass with a composite graft containing three lymphocollectors from the lower limb to bypass the ablated portion of the pathway. To ensure success the surgery must be carried out before the peripheral lymphatics have been damaged or destroyed by increasing pressure and recurrent infection. Pre-operative lymphangiography is mandatory to assess suitability for the bypass procedure. Other methods of treatment are reviewed.
Operational cellulose acetate reverse-osmosis membranes were examined for evidence of biological degradation. Numerous fungi and bacteria were isolated by direct and enrichment techniques. When tested, most of the fungi were active cellulose degraders, but none of the bacteria were. Neither fungi nor bacteria were able to degrade cellulose acetate membrane in vitro, although many fungi were able to degrade cellulose acetate membrane after it had been deacetylated. Organisms did not significantly degrade powdered cellulose acetate in pure or mixed cultures as measured by reduction in acetyl content or intrinsic viscosity or production of reducing sugars. Organisms did not affect the performance of cellulose triacetate fibers when incubated with them. The inability of the organisms to degrade cellulose acetate was attributed to the high degree of acetate substitution of the cellulose polymer. The rate of salt rejection decline was strongly correlated with chlorination of feed water and inversely with densities of microorganisms. These data suggest that microbial degradation of operational cellulose acetate reverse-osmosis membranes is unlikely.
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Bile acid pool size was measured in 10 Chinese without gallstones, 14 with pigment stones, and 10 with mixed stones by an isotope dilutin technique. Functional status of gallbladder was evaluated by intravenous cholecystogram and its gross appearance at surgery. Biliary lipid composition was also determined. The control subjects had a bile acid pool size comparable to that of Caucasians. Regardless of the nature of gallstones, bile acid pools of stone patients with functioning gallbladder were within normal range, whereas the pools of those with non- or poorly-functioning gallbladder diminished to about two-thirds of the control. Thus, the diminution of bile acid pool size was apparently the consquence of loss of storage function of gallbladder rather than the cause of production of lithogenic bile. The common bile duct bile obtained from stone patients with nonfunctioning gallbladder had a relatively high lithogenic index, at least partly related to its low total lipid concentration.
In the search for abnormalities in hypertensive vessels Ca kinetics was studied in the aorta of spontaneously hypertensive rats (SHR). The uptake of 45Ca was significantly less in hypertensive animals but the uptake of 'Lanthanum resistant' 45Ca was not. The efflux of 45Ca from aorta of SHR was different (P less than 0.01) from that of control rats because of faster initial efflux. The half-life of the first 2 components of efflux curves was significantly shorter in SHR. Results are interpreted as consequences of decreased Ca binding by smooth muscle membrane in hypertensive vessels.
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Aging of the face is staged. Rejuvenation by restoration of structural volume deficit with sedimented autogenous fat micrografts harvested by gentle syringe lipoaspiration is described. Atraumatic technique, avoidance of desiccation, and gentleness in handling the fat micrografts are required for successful vascularization and take of the grafts.