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Biomedical subjects

E Sommers

Publications and source records attributed to E Sommers.

11 recordsLinked to original sources
PubMed2001

Stenting unprotected left main coronary artery stenosis in heart transplant patients--the good, bad, and the ugly.

The major cause of late death following orthotopic heart transplantation is coronary artery vasculopathy. Approximately 50% of heart transplant patients have coronary artery vasculopathy 5 years post-transplantation. With advances in interventional cardiology technology, heart transplant patients with selected lesions are now undergoing intravascular stenting with acute-gain and late-loss rates similar to stenting in non-transplanted patients. We describe 3 consecutive cases of stenting unprotected left main coronary artery disease in orthotropic heart transplant patients. With follow-up to 3 years and no evidence of restenosis, these results suggest that stenting unprotected left main coronary artery lesions in heart transplant patients can be performed with excellent immediate and long-term results.

Adult↗
PubMed1991

Temporomandibular joint findings in pediatric populations and young adults: a critical review.

The etiology, diagnosis and treatment of temporomandibular joint (TMJ) pain and dysfunction is a controversial subject. There are varying opinions regarding the contribution of occlusion (malocclusion) to the development of mandibular dysfunction and further, the contribution of occlusal alterations (orthodontic and restorative) to the development of pain and dysfunction. Epidemiologic investigations suggest there is a high incidence of subjective and objective symptoms in the pediatric population. Observations on incisal relationships, condyle position and joint sounds, and comparisons to controls seem to suggest that these factors are not the cause of pain or dysfunction. The purpose of this review is: (1) to bring the clinician's attention existing published information reporting the presence of symptoms in children, (2) to evaluate selected information in young adults, (3) to question anecdotal information on the etiology of TMJ problems. It is not in the purview of this paper to determine the overall etiology of TMJ dysfunction.

Adolescent↗
PubMed1990

Epidemiology of signs and symptoms in temporomandibular disorders: clinical signs in cases and controls.

An epidemiologic study of clinical signs and symptoms of temporomandibular disorders (TMD) was conducted with a probability sample of adults enrolled in a major health maintenance organization (HMO). This report presents data from a first wave field examination and interview conducted by trained, calibrated dental hygienist field examiners. Significant gender differences for vertical jaw opening measures were observed but no significant age differences were found for the distribution of clinically relevant findings. Clinic cases showed smaller amounts of vertical range of jaw motion but did not differ from community cases or controls on extent of lateral, protrusive, or retrusive mandibular movements; on classification of occlusion; or on dentally related variables. Clinic cases had more pain during all jaw excursions as well as during muscle and joint palpation. Joint clicking sounds were also observed more frequently in clinic cases.

Adolescent↗
PubMed1990

Pharmacological management of recurrent oral mucosal ulceration.

A number of diseases can cause recurrent intraoral ulceration. This review focuses principally on drug management of intraoral ulceration associated with local and systemic conditions most likely to be observed on an outpatient basis by the general practitioner. These consist of recurrent aphthous stomatitis, erosive lichen planus, benign mucous membrane pemphigoid (BMMP), erythema multiforme. Behçet's disease, allergic stomatitis and infection. Information is provided on a spectrum of medication found useful in ulcer management, including topical antimicrobial and antifungal agents, topical and systemic corticosteroids, topical and systemic analgesics, and systemic immunosuppressive and anxiolytic drugs, plus details of dosage, important adverse reactions and interactions. A treatment guide for management of recurrent aphthae is presented. The reader is presumed to be familiar with differential diagnosis and the importance of establishing an accurate impression before starting drug therapy.

Humans↗
PubMed1988

Temporomandibular disorders. Variation in clinical practice.

This research describes the extent of variability in diagnosis and treatment of temporomandibular disorders (TMD) and relates this variability to treatment outcomes. A health maintenance organization sequentially referred 145 patients with orofacial pain and dysfunction to two TMD clinics. The two clinics differed substantially in their use of tomography (applied to 28% vs. 64% of all patients), and varied moderately in diagnoses assigned to the patient groups. There was large variation in selection of treatments including appliances for bruxism (64% vs. 5%), mandibular repositioning (10% vs. 25%), and joint stabilization (3% vs. 30%); anti-inflammatory medications (44% vs. 19%) and analgesics (16% vs. 2%); and subsequent referral for dental or orthodontic treatment (1% vs. 42%). The differences in diagnostic and therapeutic practice that were found were not associated with important differences in patient-reported pain and dysfunction at 1-year follow-up. These data indicate the need for systematic approaches to identifying, evaluating, and modifying variation in health care practices for common presenting problems lacking reliable methods of evaluation and generally accepted clinical standards for choice of treatments.

Adult↗
PubMed1986

Arthrographically assisted splint therapy: a 6-month follow-up.

After repositioning splint therapy, 51 patients were evaluated for a minimum of 6 months. Forty-five (88%) of the patients were considered to have been treated successfully, whereas six (12%) patients required surgery to correct meniscal displacement. A detailed analysis of signs and symptoms before and after splint treatment is in progress.

Adolescent↗
PubMed1986

Hyperoxic lung injury in mice: a possible protective role for prostacyclin.

Arachidonic acid metabolites have biologic properties that can mimic the pulmonary changes produced by hyperoxic exposure, but little information is available regarding their importance in this setting. The role of prostacyclin (PGI2) and thromboxane (Tx) A2 in oxygen-induced lung injury was evaluated by exposing mice to 100% oxygen for up to 4 days and measuring plasma and bronchoalveolar lavage (BAL) fluid concentrations of 6-keto-prostaglandin F1 alpha (6-keto-PGF1 alpha), a metabolite of PGI2, and TxB2, a metabolite of TxA2. To determine whether a relationship exists between changes in these arachidonic acid metabolites and the severity of the lung injury, we also measured mortality, BAL protein concentration, BAL angiotensin-converting enzyme (ACE) activity, and plasma lactate dehydrogenase activity, and we examined lung sections by light and electron microscopy. After 3 days of exposure to 100% oxygen, microscopic and biochemical changes consistent with mild lung damage were found, but there was no increase in either plasma or BAL 6-keto-PGF1 alpha concentration. On day 4, severe lung damage was present. and BAL 6-keto-PGF 1 alpha level increased threefold (P less than 0.001). The level of TxB2 in BAL fluid did not change on any day. Twice-daily administration of either a high (5 mg/kg) or a low (1 mg/kg) dose of indomethacin reduced BAL concentrations of 6-keto-PGF1 alpha, and it resulted in increased mortality and higher BAL protein concentration and BAL ACE activity. These data suggest that TxA2 has little if any role in the pathogenesis of oxygen-induced lung injury, whereas prostacyclin may play a protective role.

6-Ketoprostaglandin F1 alpha↗
PubMed1984

Sigmoid colon perforation: result of accidental swallowing of a toothpick.

Acute surgical abdomen is a very serious situation that arises in various medical conditions. Common among them are appendicitis, foreign-body ingestion, and intestinal obstruction or perforation. These complications usually require emergency abdominal surgery. A case of rectal bleeding accompanied by acute surgical abdomen following the accidental ingestion of a toothpick is described in this report.

Abdomen, Acute↗
PubMed1984

Intraligamentary anesthesia: a double-blind comparative study.

Three local anesthetic agents (Xylocaine 2%, Xylocaine 2% with epinephrine 1:50,000, and Marcaine 0.5 with epinephrine 1:200,000) were injected intraorally using an intraligamentary injection technique. The study used a double-blind design and electrical tooth pulp stimulation to examine the duration of pulpal anesthesia. Patterns of recovery from each drug, subjective discomfort associated with each drug, pain of injection, and pain in comparison with local infiltration were also measured. The extent and duration of adjacent soft tissue anesthesia were recorded. Xylocaine 2% with epinephrine 1:50,000 produced the longest pulpal anesthesia. The decay pattern of this particular drug was less abrupt than that of the two others. No difference in discomfort or pain was found across the various drugs. There was no significant difference in pain at injection when intraligamentary anesthesia was compared with local infiltration. Post-injection pain was slightly lower with local infiltration. The extent of soft tissue anesthesia was significantly related to vasoconstrictor levels in the drugs. The study shows that duration of pulpal and soft tissue anesthesia can be tightly controlled by the operator and tailored specifically to planned dental procedures.

Adult↗