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Biomedical subjects

J A Persing

Publications and source records attributed to J A Persing.

At least 19 recordsLinked to original sources
PubMed2001

A preliminary report of the virtual craniofacial center: development of Internet-/Intranet-based care coordination of pediatric craniofacial patients.

The authors present preliminary information regarding the development of an Internet-based Virtual Craniofacial Center that provides access to a patient database with visual and textual data. Patients are photographed by digital camera with standardized images. Through a Web site linked to a remote database, patient demographics, management data, reports, and acquired digital photographic images are stored and retrieved. The database can be used to sort and to present data as desired by multiple specialists. Confidentiality is maintained by unique identification numbers and password access to the server for craniofacial team members. The current system uses economical equipment (i.e., digital camera, personal computer with modem, and access to a remote Windows NT-based server), using data that can be entered in a variety of cross-platform personal computer systems and transmitted on a wide range of bandwidths-from a relatively low-bandwidth (28.8 KB per second) modem to a high-speed T-3 line connection. Long-term goals include archival data storage and analysis, as well as the development of multicenter telemedicine links for active craniofacial centers.

Child↗
PubMed2001

Web-based medicine as a means to establish centers of surgical excellence in the developing world.

The growth of the Internet has provided a unique opportunity for rapid, global communication. Web-based medicine uses this technology to help surgeons in developing regions of the world gain direct access to recognized experts. This serves to empower local surgeons in the developing world through direct skill-transfer and encouraging academic pursuit. Web-based medicine follows the paradigm of a university without borders, therefore requiring exacting patient record keeping, monthly peer review, and continuing medical education of all its participants. All those who participate in Web-based medicine have undergone a credentialing process to guarantee that they possess adequate credentials. Patient confidentiality is strictly maintained. Web-based medicine also provides a follow-up strategy for medical volunteer groups who provide overseas services. Interplast, Inc., has administered a Web-based medicine site at http://www.wiredmd.com since July of 1999. A total of 767 cleft malformation cases performed locally by participating host surgeons in the developing world have been reviewed through the site. Additionally, 16 consultations have been posted and discussed by participating surgeons worldwide. Financing remains the major impediment to the globalization of this technology.

Cleft Lip↗
PubMed2000

Spontaneously infected cephalohematoma: case report and review of the literature.

Spontaneously infected cephalohematomas are rare occurrences; only five cases have been reported previously. Uninfected cephalohematomas are common and usually resolve without treatment. However, physicians should be aware that cephalohematomas are potential sites for infection and may require aspiration for diagnosis and treatment. Untreated infected cephalohematomas may lead to osteomyelitis, epidural abscess, or subdural empyema. We present a case of a spontaneously infected cephalohematoma with an associated osteomyelitis which was successfully managed with drainage and long-term antibiotics. A review of the literature is also presented.

Anti-Bacterial Agents↗
PubMed2000

Complete congenital bony syngnathia in a case of oromandibular limb hypogenesis syndrome.

Congenital fusion of the maxilla and mandible (syngnathia) is rare and can present in a wide range of severity from single mucosal bands (synechiae) to complete bony fusion (synostosis). Congenital synostosis of the mandible and maxilla is even less common than synechiae, with only 19 cases reported in the literature. Most of them have presented as an incomplete, unilateral fusion. Only three of the reported cases showed more extensive but still incomplete, intermaxillary bony fusion. We present a case of complete bony fusion of the maxilla and mandible associated with a cleft palate, hypoglossia, micrognathia, unilateral choanal atresia, and limb abnormalities as a feature of oromandibular limb hypogenesis syndrome. Details of operative management are presented.

Choanal Atresia↗
PubMed1999

Biomaterials in the face: benefits and risks.

An extensive review of biomaterials in the face was conducted in an American Society of Maxillo-facial Surgeons-sponsored biomaterials symposium. The symposium was held in Boston, MA, immediately preceding the 1998 annual meeting of the ASPRS/PSEF. The scope of the symposium extended from current reconstructive techniques for the facial skeleton, including autogenous bone and biomaterials, to potential application of new techniques in molecular biology that may enable the body's own tissues to be engineered to provide bone and cartilage to reconstruct the facial skeleton. The authors review the presentations and relevant literature on biomaterials in the face. The following topics are reviewed: current reconstructive techniques using autogenous bone grafts, methyl methacrylate cranioplasty, demineralized bone, and hydroxyapatite; biomaterials used for rigid fixation, including metallic and bioabsorbable implants; biomaterials used for facial augmentation, including porous polyethylene, hard-tissue replacement, and ceramic biomaterials; biofilm, or a layered polysaccharide matrix secreted by bacteria on the surface of implants; and potential means of inducing bone formation by directing the body's own tissues through cytokine interaction, gene transfer, and tissue engineering.

Absorbable Implants↗
PubMed1998

Modified Le Fort III osteotomy in adult Crouzon disease.

The authors present a unique case of a woman with Crouzon disease who was treated for symptomatic exorbitism with a modified Le Fort III osteotomy. Midface advancement with reduction of exorbitism was accomplished without intermaxillary fixation. The technical details are described.

Adult↗
PubMed1998

Intracranial pressure in single-suture craniosynostosis.

In this paper, we review the incidence of increased intracranial pressure in children with single-suture craniosynostosis. The major studies in this area are presented, along with their limitations. A rational treatment plan including multidisciplinary team management is recommended. All patients with proven synostosis should be followed closely, whether or not surgery is chosen. Continued clinical and basic science research are necessary to further clarify the ramifications of asymptomatic elevations of intracranial pressure in these patients.

Child↗
PubMed1997

Secondary craniofacial management following initial correction of nonsyndromic craniosynostosis.

Marked technical improvements in the surgical management of craniosynostosis have come hand-in-hand with refinements in anesthesia, intensive care, and radiographic image analysis. At the beginning of the second century of the care of these patients, we now have a variety of sophisticated options that represent safer, more physiologically sound and aesthetically more pleasing options for the correction of secondary problems in craniosynostosis.

Cephalometry↗
PubMed1996

Frequent clones of p53-mutated keratinocytes in normal human skin.

The multiple genetic hit model of cancer predicts that normal individuals should have stable populations of cancer-prone, but noncancerous, mutant cells awaiting further genetic hits. We report that whole-mount preparations of human skin contain clonal patches of p53-mutated keratinocytes, arising from the dermal-epidermal junction and from hair follicles. These clones, 60-3000 cells in size, are present at frequencies exceeding 40 cells per cm2 and together involve as much as 4% of the epidermis. In sun-exposed skin, clones are both more frequent and larger than in sun-shielded skin. We conclude that, in addition to being a tumorigenic mutagen, sunlight acts as a tumor promoter by favoring the clonal expansion of p53-mutated cells. These combined actions of sunlight result in normal individuals carrying a substantial burden of keratinocytes predisposed to cancer.

Adult↗
PubMed1996

Squamous cell carcinoma of the lip in a 19-month-old child: a case report.

Squamous cell carcinoma of the lip is rarely seen in children. We present the case of a 19-month-old child, without known risk factors, who developed invasive squamous cell carcinoma involving the skin and underlying muscle of the lip. The histology of the tumor was invasive squamous cell carcinoma of the keratoacanthoma type. The distinction between this lesion and keratoacanthoma is often difficult and rests on the findings of invasion and significant atypia. Due to the extremely low incidence of squamous cell carcinoma in children, there are few therapeutic guidelines pertaining specifically to infants or children. This patient underwent wide local excision as definitive treatment. Currently, it is 24 months after excision of the tumor and he remains free of clinical recurrence.

Carcinoma, Squamous Cell↗
PubMed1996

Cranial plate and screw fixation in infancy: an assessment of risk.

Sixty-seven surgeons, members of the International Craniofacial Surgery Society, responded to a questionnaire focused on assessing the incidence and risk of cranial plate and screw translocation intracranially in infants undergoing cranial surgery. Despite screws, plates, and wires being evident intracranially in individual cases, no apparent increase in seizure frequency or susceptibility to head trauma was noted in this preliminary study.

Bone Plates↗
PubMed1995

Squamous cell carcinoma growth in irradiated tissue: a murine model for quantitative assessment of treatment.

Locoregional recurrent and distant metastases from squamous cell carcinomas, despite multimodality therapy, remain troublesome clinical realities. Discrepancies in success rates of various surgery and radiation treatment regimens dealing with these problems are confusing to the clinician attempting to recommend the most beneficial treatments. There is a need for an experimental model to assess therapeutic effectiveness quantitatively from which guidelines for developing clinical trials may be suggested. In this study, we provide such a model. We injected DBA-2 mice with defined numbers of KLN-205 squamous carcinoma cells to obtain baseline growth characteristics; 216 animals had no previous irradiation. The remaining 131 received 30 Gy irradiation to the right leg 50 days before injection of the tumor cells. Tumor incidence, growth and number, and location of tumor metastasis were determined in both previously irradiated and nonirradiated groups. The data demonstrate a growth-retardant effect on tumor groups by the previous irradiation (tumor bed effect). The data also show that the incidence of hematogenously spread metastases was more frequent in mice in which tumors developed in previously irradiated tissue than in mice with tumors in nonirradiated tissue.

Animals↗