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Biomedical subjects

M J Coleman

Publications and source records attributed to M J Coleman.

At least 55 records · Page 3Linked to original sources
PubMed1986

Persistent postoperative enterocutaneous fistula: pathophysiology and treatment.

The cause of an enterocutaneous fistula following an abdominal operation, in the absence of inflammatory bowel disease or irradiation damage, is often obscure. In this study, it is postulated that distal obstruction, associated with peritoneal adhesions or abscess, is the critical determinant of fistula persistence. The 'venting' effect of the fistula, and the presence of obstruction which is frequently partial, makes recognition of the obstructive element difficult. It is suggested that operations to cure postoperative fistula should be based on the assumption that distal obstruction is always present, and should include a complete lysis of adhesions involving the small and large bowel. A postoperative fistula was cured in 21 out of 23 patients treated on this basis.

Abscess↗
PubMed1986

Splenic protection in left upper quadrant operations.

Splenectomy produces significant immediate and long-term risks for the patient, and there is general agreement that it should be reserved for clear-cut unavoidable indications. However, accidental injury to the spleen in the course of another operation (incidental splenectomy,) accounts for almost 40% of splenectomies in some series. Incidental splenectomy is most likely to occur in left upper quadrant operations such as proximal gastric vagotomy, or in colonic operations involving mobilization of the splenic flexure. Incidental splenectomy rates of between 2% and 9% have been reported in association with these procedures. The results of an operative strategy of specific protection of the spleen as the first step in a left upper quadrant operation ('defusing' the spleen) are reported. It was not necessary to remove the spleen because of accidental injury in 417 consecutive operations over a 5 year period after implementation of this policy. There were several minor splenic capsular tears which were controlled by intraoperative haemostatic measures. There were no cases of postoperative splenic bleeding. 'Defusing' the spleen is an effective step in preventing splenic injury in left upper quadrant operations.

Abdomen↗
PubMed1985

Hyperalimentation as cause of markedly worsened metabolic control in a patient with autoantibodies to the insulin receptor.

Patients with type B insulin resistance and acanthosis nigricans have autoantibodies to their insulin receptors and usually have signs and symptoms of other autoimmune diseases. The first case demonstrating that hyperalimentation markedly disturbs blood glucose control in type B insulin-resistant patients is described. Neither prednisone, insulin (up to 240 units per hour), nor tolbutamide appeared to help this patient's metabolic control. After the addition of cyclophosphamide for one week, the anti-insulin receptor autoantibody titer dropped from greater than 1:1,000 to 1:1. Six months later, the patient had a complete remission, which is rare, with only three other reported remissions in these patients with type B insulin resistance.

Acanthosis Nigricans↗
PubMed1984

Epidemiology of peptic ulcer in Australia. A study based on government statistics in four states.

A study of Pharmaceutical Benefits Scheme cimetidine prescriptions, hospital admissions, and deaths due to peptic ulcer in 13 million Australians in 1981 indicated that the annual ulcer incidence per 1000 population was 3.8 for duodenal ulcer and 0.7 for gastric ulcer. Approximately 70 000 Australians appear to receive initial treatment for a peptic ulcer each year. Two-thirds of patients were managed outside hospital. Patients with gastric ulcers were more likely to be admitted to hospital or to die from their ulcer than were patients with duodenal ulcers. Significant regional differences in ulcer frequency were found; in particular, the risk of gastric ulcer in NSW was four times that in Victoria. Gastric and duodenal ulcers were more common in New South Wales than in Victoria, Queensland or Western Australia. These differences, and other regional variations, indicate appropriate localities for further studies of the aetiology of peptic ulcer.

Adolescent↗
PubMed1981

The summating potential in ultrasonic labyrinthectomy for Menière's disorder.

This paper reports SP changes pre- and post-operatively in a series of 12 patients who have undergone ultrasonic labyrinthectomy for Menière's disorder. The unoperated ear in 7 of these patients also had pre- and post- operative ECochG. The SP in the operated ear was reduced in amplitude and duration in 50 per cent and 66 per cent of ears respectively. However, the SP was also reduced in the unoperated ears by similar proportions. Statistical analysis showed no significant difference in SP change between the two sets of ears. It is concluded that the value of the SP in prediction or assessment of results of treatment in Menière's disorder is not at present proven, and that future investigations require the use of controls.

Adult↗
PubMed1981

Intussusception in the adult.

Intussusception in the adult is an uncommon cause of intestinal obstruction. Seventeen cases were seen at two teaching hospitals over a twenty-year period. A local causative lesion was present in all cases; a malignant tumour was present in two out of seven intussusceptions arising in the small intestine and in seven out of ten arising in the large intestine. More than half the cases had a protracted clinical course prior to diagnosis.

Adolescent↗
PubMed1980

'Costen's syndrome'--correlation or coincidence: a review of 45 patients with temporomandibular joint dysfunction, otalgia and other aural symptoms.

Forty-five patients with temporomandibular joint dysfunction, and otalgia together with other aural symptoms (deafness, tinnitus, pressure/blockage and vertigo) were evaluated clinically and audiometrically. The theoretical mechanisms by which aural symptoms may be produced as a result of temporomandibular joint dysfunction are outlined and discussed in the light of the patients under review. The wide diversity in the incidence of additional aural symptoms apart from otalgia reported in the literature is noted, together with the general lack of full objective audiometric assessment. In 37 patients the aural symptoms were directly attributable to other coincidental otolaryngological pathology. Details of the remaining 8 cases are presented. The other aural symptoms of 4 of these patients were also probably accounted for by other coincidental otalaryngological pathology. It may be significant that 2 of the other patients were suffering from concurrent psychiatric disorders. Thus in this series at least 9% of the patients were considered to have other aural symptoms coincidental to temporomandibular joint dysfunction. This is compatible with the relatively common occurrence of both temporomandibular joint dysfunction and aural symptoms in the general population. This study leads us to believe that there is no direct aetiological basis to link temporomandibular joint dysfunction and other aural symptoms apart from otalgia.

Adolescent↗
PubMed1979

Antral patch esophagoplasty. A new procedure for acid-peptic esophageal stricture.

Antral patch esophagoplasty is a new procedure for intractable fibrous stricture of the esophagus secondary to acid-peptic reflux. A full-thickness patch of gastric antrum, supplied by a pedicle based on the left gastroepiploic vessels, is inserted, mucosal surface to lumen, into the opened stricture. A fundoplication is done below the esophagoplasty to prevent reflux. The functional results were excellent in five of six patients. The procedure may have application also in other types of benign esophageal stricture.

Aged↗