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Biomedical subjects

M J Timmons

Publications and source records attributed to M J Timmons.

At least 19 recordsLinked to original sources
PubMed2005

The bacteriology of children before primary cleft lip and palate surgery.

OBJECTIVE: Bacterial infections can complicate any surgery. Knowledge of potentially pathogenic bacterial flora in children with cleft lip and palate allows appropriate risk management, including the need for prophylactic antibiotics. This project reviewed the bacteriology of children before primary cleft lip and palate surgery. DESIGN: A retrospective study of the results of nose, throat, and ear microbiological swabs taken from children, aged 1 to 26 months, before repair of primary cleft lip, cleft palate, or both was carried out. Swabs with Staphylococcus aureus and beta-hemolytic streptococcus were considered positive. RESULTS: From October 1987 to May 2002, 321 primary cleft lip or palate operations were performed in 250 patients. Results from 326 sets of preoperative swabs were available, including five repeat sets from patients whose operations were postponed. There were 235 (72.1%) negative sets and 91 (27.9%) positive sets. Of the positive swabs, 86 sets grew S. aureus, and 10 sets grew beta-hemolytic streptococcus. CONCLUSIONS: Children with unrepaired cleft lip and palate have a significant risk of carrying S. aureus and a small risk of carrying beta-hemolytic streptococci. These risks need to be considered when deciding on protocols for preoperative bacteriology tests and prophylactic antibiotics.

Antibiotic Prophylaxis↗
PubMed2004

Cellular neurothekeoma in the arm of a child.

Soft tissue tumours of the limb in children are uncommon. We report a cellular neurothekeoma, which presented as a hard, irregular tumour in the upper arm of a 7-year-old child. The differential diagnosis of soft tissue tumours in the upper limbs of children is discussed.

Arm↗
PubMed2003

The impact of violent injuries on an NHS plastic surgery unit.

BACKGROUND: Violence and injuries caused by violence appear to be increasing. PATIENTS AND METHODS: A prospective study of violent injuries treated in our unit. RESULTS: Over a 5-month period, 148 (21%) of 704 acute admission patients aged 14 years or more and 11 children had injuries due to violence. The head, neck and hands were the commonest sites of injury. Of the 148 patients, 144 (91%) underwent surgery for their injuries. CONCLUSIONS: Injuries due to violence have a significant effect on the resources of our NHS hospital and probably of all NHS hospitals with acute surgical services.

Adolescent↗
PubMed2001

Speech after repair of isolated cleft palate and cleft lip and palate.

The speech of children with isolated cleft palate (CP) repaired by one surgeon has been compared with the speech of children with some form of unilateral cleft lip and palate (CLP) repaired by the same surgeon. All palate repairs included an intravelar veloplasty. We identified 57 children (5--12 years old) with cleft palates repaired in infancy, of which three patients with other medical problems were excluded. Of the 54 patients, 44 (81%) attended for review (27 CP, 17 CLP). Video recordings were analysed by two speech and language therapists, using the Cleft Audit Protocol for Speech. The CP patients had no evidence of permanent fistulas. Final speech outcomes were similar for CP and CLP patients. Intelligibility was normal in 10 (37%) CP and nine (53%) CLP patients. Mild consistent hypernasality was present in five (18.5%) CP and four (23.5%) CLP patients. No patients had moderate or severe hypernasality or nasal emission. Mild consistent hyponasality was present in five (18.5%) CP and five (29%) CLP patients. Moderate consistent hyponasality was present in one (4%) CP patient. Dysphonia was present in eight (30%) CP and seven (41%) CLP patients. Cleft-type characteristics were noted in 11 (41%) CP and nine (53%) CLP patients. No CLP patients but 10 (37%) CP patients had required a pharyngoplasty (P=0.004, Fisher's exact test). Possible reasons for this (age, cleft type, surgeon and surgery) are discussed.

Child↗
PubMed1994

The posteromedial arm flap for posterior elbow defects.

A sensate, fasciocutaneous flap for cover of posterior elbow defects is described. The flap is innervated by the lower lateral cutaneous nerve of the arm. The flap is simple to raise and can be rotated and advanced over the posterior elbow region with direct closure of the proximal donor site. A case is presented.

Elbow↗
PubMed1993

Malignant melanoma excision margins: plastic surgery audit in Britain and Ireland, 1991, and a review.

In 1991, 146 consultant plastic surgeons in Britain and Ireland were sent a short questionnaire about their policies for excision margins for primary cutaneous malignant melanoma. 106/146 (73%) replied. 39/106 (37%) considered narrow margin (2-3 mm) excision biopsies adequate in certain cases. The minimum tumour thickness for a margin of more than 1 cm was 1 mm or more for 67/106 (63%) on the leg and for 57/106 (54%) on the back. The maximum margin was specified as 4 cm or more on the leg by 37/106 (35%) and on the back by 42/106 (40%). Other sub-groups of results were analysed. A review of the literature is presented.

Attitude of Health Personnel↗
PubMed1992

Intracellular actin as a marker for myofibroblasts in vitro.

BACKGROUND: Myofibroblasts are found in a wide variety of normal tissues and pathological conditions. It is suggested that myofibroblasts are derived from normal fibroblasts and share with smooth muscle cells the expression of actin microfilament bundles. The aim of this study was to establish if the myofibroblast phenotype from tissue expander capsules and Dupuytren's nodules could be distinguished from normal dermal fibroblasts by quantitation of intracellular actin and the ratio of polymerized (filamentous) actin to nonpolymerized (globular) actin. EXPERIMENTAL DESIGN: Cell lines were established from six patients from each group. In addition to quantitation of intracellular actin, the cells were characterized by criteria of light microscopy, ultrastructure, actin immunofluorescence, and growth rates. RESULTS: Dermal fibroblasts were the smallest and the most spindle-shaped but grew rapidly and had few actin microfilament bundles. By contrast, myofibroblasts from expander capsules were larger and more stellate, proliferated slowly, and had the most prominent microfilament arrays. Cells from Dupuytren's nodules were intermediate in phenotype. Substantial and significant differences in intracellular actin contents were found, ranging from 0.69 +/- 0.05 micrograms/10(4) cells in fibroblasts and 0.77 +/- 0.15 micrograms/10(4) cells for Dupuytren's nodule cells to 1.46 +/- 0.44 micrograms/10(4) cells in expander capsule myofibroblasts (p < 0.05). Similar findings were found with respect to ratios of fibroblast to globular actins, being 0.22 for fibroblasts and 0.38 for Dupuytren's nodule cells compared with 0.70 for expander capsule myofibroblasts (p < 0.01). CONCLUSIONS: Measurement of intracellular actin contents and fibroblast:globular actin ratios offers a rapid, sensitive, and reliable technique for establishment of the myofibroblast phenotype and has considerable advantages over traditional ultrastructural approaches for the study of myofibroblast differentiation/regression and in vitro responses to experimental manipulation.

Actins↗