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Biomedical subjects

R N Meddings

Publications and source records attributed to R N Meddings.

8 recordsLinked to original sources
PubMed1995

Bladder transection revisited.

OBJECTIVE: To ascertain the safety and effectiveness of bladder transection for the treatment of enuresis and urinary frequency. PATIENTS AND METHODS: Twelve patients who had an open bladder transection performed at the Victoria Infirmary, Glasgow, were followed up for a mean of 37 months. RESULTS: Of the 12 patients, three were 'cured', seven were better, two were no better and none were worse than before the operation. All six patients with preoperative enuresis were cured of this by the procedure. CONCLUSIONS: Bladder transection remains a useful procedure in selected patients and avoids the problems associated with enterocystoplasty.

Adult↗
PubMed1993

A new bioprosthesis in large abdominal wall defects.

A collagen-coated Vicryl mesh bioprosthesis was used to repair a 4 x 4 cm full-thickness abdominal wall defect, created in experimental rats. The tensile strength of the repair at 6 months reached 70% of the original abdominal wall. Implant collagen could not be differentiated from host collagen after 2 weeks. The increase in collagen content of the repair was responsible for the increasing tensile strength of the wound with time. All histological sections showed good tolerance of the implant. These results support the use of collagen Vicryl membrane to repair large abdominal wall defects. Clinical trials are indicated.

Abdominal Muscles↗
PubMed1991

First clinical report of a new biodegradable membrane for use in urological surgery.

Following preliminary in vitro and in vivo experiments a new collagen Vicryl mesh has been devised. The membrane has been extensively tested in the laboratory and has been found to resist the passage of urine. It holds sutures well and has been shown on an experimental animal to be biodegradable. The membrane has now been applied in human subjects. It has been particularly efficacious in renal surgery and as a means of sealing a bladder after it has been opened. With respect to the ureter the sealing effect is excellent, to the extent of having produced a urinoma. The membrane has been found to be easily applied in vesicovaginal fistulae but difficulties have been experienced in the presence of infection. It is also an ideal membrane for repair of a urethrovaginal fistula--an area where natural tissues are less easily available. This is the first recorded use of this new biodegradable membrane in the human subject.

Biodegradation, Environmental↗
PubMed1991

Abdominal aortic aneurysm in south-west Scotland.

Between 1977 and 1988, 155 patients with abdominal aortic aneurysm in the Dumfries and Galloway health region were traced. One hundred and six patients underwent surgery; 57 elective operations for non-leaking aneurysms were performed locally without mortality, and of the 49 patients operated on with ruptured aneurysm, 11 were transferred to a major vascular centre with four deaths (36% mortality rate). The remaining 38 patients were treated locally. Twenty-three of these were operated on by a surgeon with vascular interest with nine deaths (39% mortality rate) and of the remaining 15 patients operated on by a surgeon without a vascular interest, ten died (66% mortality rate). These findings emphasize that patients presenting at a district hospital with leaking abdominal aortic aneurysm should be transferred to a major vascular unit if there is no local vascular expertise available, and our figures suggest that transfer of such patients does not prejudice survival. Further, of those patients who died of leaking aneurysm in hospital without undergoing surgery (25 patients), 15 were in hospital for longer than 3 h without the correct diagnosis. A significant improvement in mortality could follow prompt and accurate diagnosis at hospital level, with the most common error in diagnosis being renal colic.

Aged↗
PubMed1989

Maintenance cimetidine instead of surgery for duodenal ulcer: the first decade.

Fifty five patients with severe longstanding dyspepsia originally selected as candidates for elective duodenal ulcer surgery were instead entered into a maintenance cimetidine study. Forty six have been reviewed after 10 years. Twenty patients had required surgery, all in the first three years, but six of them had proven or suspected recurrent ulceration during follow up. Twenty six patients avoided surgery, either with continuous cimetidine 400 mg nocte or intermittent full dose cimetidine. Of the 17 on continuous maintenance cimetidine, six had proven or suspected recurrent ulceration responding to full dose cimetidine. All nine patients on intermittent cimetidine experienced symptomatic relapse within eight to 12 weeks of drug withdrawal. By using cimetidine, 64% of patients selected for surgery have avoided operation over this 10 year period, although none has had drug free remission.

Adult↗