Calcification of the cricoid cartilage mistaken for a foreign body: report of a case.
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Adult↗
Biomedical subjects
M A Pogrel
Publications and source records attributed to M A Pogrel.
Trigeminal somatosensory evoked potentials: a normal value study.
Normal somatosensory evoked potentials were obtained from the lower lip of 40 volunteers. Efforts were made to exclude artefact. A consistent triphasic wave form of three peaks and troughs was defined. There were greater variations in amplitude than latency between subjects. Statistically, one side of the lower lip can be used as a control for the contralateral side, but it may not be possible to have reliable normal values between subjects. Somatosensory evoked potentials may however represent an objective method of evaluating trigeminal sensory nerve function.
Adult↗
A substrate-gel assay for hyaluronidase activity.
Hyaluronic acid (HA) is a key structural element of the extracellular matrix. Turnover rates of HA are determined in part by hyaluronidases, that are themselves modulated by hyaluronidase inhibitors. A substrate polyacrylamide gel electrophoresis procedure is described here that separates enzyme from inhibitors. The HA is embedded in the gel, and following electrophoretic separation, enzymatic digestion of the HA is allowed to occur. The gel is stained with Alcian blue and can be secondarily stained with Coomassie blue. Enzymatic activities appear as cleared bands on a light blue background, while major proteins appear as dark blue bands. The procedure can be performed in the presence or absence of sodium dodecylsulfate, though levels of hyaluronidase activity decrease when the detergent is used. Hyaluronidases active in the neutral or acid pH range can be detected. This technique will facilitate characterization of hyaluronidases and inhibitors from a wide variety of sources.
Alcian Blue↗
Surgically assisted rapid maxillary expansion in adults.
Twelve adults with maxillary width discrepancy of greater than 5 mm were treated by surgically assisted rapid maxillary expansion. The procedure consisted of bilateral zygomatic buttress and midpalatal osteotomies combined with the use of a tooth-borne orthopedic device postoperatively. Mean palatal expansion of 7.5 mm (range of 6 to 13 mm), measured in the first molar region, was achieved within 3 weeks in all patients. Expansion remained stable during the 12-month study period, with a mean relapse for the entire group of 0.88 +/- 0.48 mm. Morbidity was limited to mild postoperative discomfort. The results of this preliminary study indicated that surgically assisted rapid maxillary expansion is a safe, simple, and reliable procedure for achieving a permanent increase in skeletal maxillary width in adults. Further study is necessary to document the three-dimensional movements of the maxillary segments and long-term stability of the skeletal and dental changes.
Adolescent↗
What are normal esthetic values?
The management of dentofacial deformities is at least partially assessed on the basis of standardized radiographs and photographs, which are analyzed according to accepted norms. Although one frequently hears the cry of "Treat the patient, not the cephalometric radiograph," with the development of sophisticated computer-assisted digitizing systems and cephalometric analysis programs, there may be a greater reliance on cephalometric and photometric norms than previously. If we are to become more dependent on these normal values, it is necessary to know their origin and significance.
Cephalometry↗
Bicoronal flap approach to the temporomandibular joints.
The bicoronal scalp flap provides an excellent approach to the temporomandibular joint, particularly in cases where bilateral operation is required. It is also indicated when wide exposure is required and when previous surgery may make more conventional techniques difficult. In this report, the anatomy and indications for this approach are reviewed, the operative technique is described and complications are discussed.
Ankylosis↗
Application of laser and cryosurgery in oral and maxillofacial surgery.
The laser, with its ability to use electromagnetic energy in its most efficient and concentrated form, has held out promise as a surgical tool for 20 years. However, its early promise has not been fulfilled, and with a few isolated exceptions, the laser has not gained widespread acceptance in surgical circles. Recent developments regarding delivery systems and different lasing media have, however, stimulated renewed interest. Similarly, cryosurgery, with its ability to devitalize tissues by the use of extreme cold, has been available in a controllable form in surgery for nearly 30 years. Lack of precision has prevented its widespread use, but it may still have an important role in a number of specialized areas, such as cryoneurectomy and the management of locally aggressive tumors of bone.
Animals↗
[DNA cytophotometric studies of central giant-cell lesions of the jaw region].
Giant cell nuclear DNA, in 30 giant cell lesions of the jaws, was quantitated by computer-assisted image analysis. DNA content was then used to predict clinical behavior and outcome. Four.nuclei in each of 25 giant cells (total = 100 nuclei) were randomly selected and DNA content was quantitated by the LEITZ Texture-Analysis-System-Plus. DNA in nuclei of normal appearing stromal fibroblasts (n = 20) was similarly measured. DNA index was calculated as the mean nuclear DNA content of giant cells divided by mean DNA content of control fibroblasts. The mean DNA index of aggressive lesions (1.09, S. D. = 0.12) was not significantly different from that of non-aggressive lesions (1.18, S. D. = 0.15) (p = 0.093). The results indicate that nuclear DNA content of giant cells is not useful as a predictor of clinical behavior of giant-cell lesions of the jaws.
Adolescent↗
The problems of running a phantom department.
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Dental Service, Hospital↗
The increasing cost of health care--doctors suffer as well!
At long last there does appear to be general agreement that all is not well with the American health care system. Costs are out of control and the bureaucracy that has been spawned to control costs and administer the financial aspects of health care has developed a mind of its own. Two recent problems within our own department at the University of California, San Francisco, have shown that even doctors can be on the receiving end of these problems, with amusing but potentially serious consequences.
Emergency Medical Services↗
Prophylactic antibiotics.
The prescribing of antibiotics in the absence of infection has always been controversial and when the lawyers get involved as well, it becomes almost unmanageable. With this is mind, it might be useful to look at some of the problems we have with antibiotics in California.
Anti-Bacterial Agents↗
Letter from California: conscious sedation permit.
In Britain matters of clinical judgement and practice rarely become the subject of political action and are usually not covered by legislation, but rather by 'guidelines' and well-meaning persuasion. In California, however, where the medical and dental professions are not trusted to put their own house in order, everything is covered by legislation and becomes the subject of intense political lobbying. The giving of general anaesthesia by dentists has been tightly governed since 1980 but the legislature has only just come to grips with the question of conscious sedation.
Anesthesia, Dental↗
A comparison of carbon dioxide laser, liquid nitrogen cryosurgery, and scalpel wounds in healing.
With the carbon dioxide surgical laser, the liquid nitrogen cryoprobe, and the scalpel, wounds were created on the shaved abdomen of 24 rats, and the patterns of healing were studied. The laser wounds were the first to epithelialize, followed by the scalpel wounds, with the cryosurgery wounds the slowest to epithelialize. The results were confirmed histologically.
Animals↗
Histologic evaluation of the width of soft tissue necrosis adjacent to carbon dioxide laser incisions.
This study evaluated the width of tissue necrosis lateral to carbon dioxide laser incisions on human intraoral excisional biopsy specimens. Measurements were made on specimens including epithelium, muscle, dense and loose connective tissue, and salivary gland. Results showed a mean width of tissue necrosis of 86 microns in epithelium, 85 microns in muscle, 51 microns in loose connective tissue, 96 microns in dense connective tissue, and 41 microns in salivary gland. The range of thermal necrosis in different tissue types is probably based on the water content within each type. A cellular partially homogenized zone of reversible thermal damage up to 500 microns in width was visible adjacent to the zone of thermal necrosis. The relatively narrow width of tissue necrosis with this technique may account for the claimed superior properties of laser-induced wounds compared with those created by electrosurgery.
Connective Tissue↗
The role of a temporalis fascia and muscle flap in temporomandibular joint surgery.
Temporalis fascia, with a varying thickness of temporalis muscle, may be harvested as an axial flap based on the middle and deep temporal arteries and veins. The dependable blood supply, the proximity to the temporomandibular joint, and the ability to alter the arc of rotation by basing the flap inferiorly or posteriorly make this a versatile flap for lining the temporomandibular joint. In this report, the anatomy is reviewed, the harvesting technique is described, and multiple uses of the temporalis muscle-fascia flap in temporomandibular joint surgery are described.
Cartilage, Articular↗
Gorham's syndrome (massive osteolysis): a case report.
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Fractures, Spontaneous↗
Letter from California: what is informed consent?
It seems only reasonable that if a health care professional (doctor, dentist, etc) is going to carry out a procedure on a patient, then the patient should know what is being carried out and why and what the consequences may be. This is basically all informed consent is.
California↗
The carbon dioxide laser in soft tissue preprosthetic surgery.
The surgical carbon dioxide laser has the ability to vaporize soft tissues with little bleeding, pain, swelling, or wound contraction. The laser was evaluated on 27 patients requiring soft tissue preprosthetic surgery, including frenectomies, tuberosity reduction, hyperplasia removal, and sulcus deepening. Surgery was performed on an ambulatory basis with no bleeding or infection. Swelling was minimal and pain, as measured on a linear pain scale, was moderate. One third of the patients required no analgesics. Wound contraction did occur but was less than is historically quoted for scalpel wounds. The carbon dioxide laser would appear to have advantages for soft tissue preprosthetic surgery that warrant further evaluation.
Carbon Dioxide↗