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Biomedical subjects

R Hierons

Publications and source records attributed to R Hierons.

14 recordsLinked to original sources

Postoperative radiographs after open reduction and internal fixation of the mandible: are they useful?

Mandibular fractures are common in oral and maxillofacial departments in the UK. The aim of this study was to find out the national practice in preoperative and postoperative radiographic investigations for fractured mandibles and to audit their diagnostic capacity, including specificity and sensitivity to short-term complications. The audit took place over a 4-month period and involved 100 patients across the Northern region. Ninety percent of patients were reviewed up to discharge and five of these patients developed a short-term postoperative complication. The postoperative radiograph was diagnostic in only one of the five cases. Overall, postoperative radiographs had a sensitivity of 20% and a specificity of 5% in their ability to predict short-term postoperative complications.

Adolescent↗

Lessons from a remarkable family with dopa-responsive dystonia.

A family is described in which dopa-responsive dystonia affected six members and segregated in an autosomal dominant fashion. Patients either presented in childhood with dystonia of the legs, going to develop parkinsonism and pseudo-pyramidal deficits, or in adult life with parkinsonian tremor and rigidity, with pseudo-pyramidal signs. Remarkably, in the three cases with childhood onset the symptoms and signs of the condition were abolished 36 to 52 years later by small doses of levodopa. No long term side effects of levodopa have appeared after 15 years of treatment.

Adult↗

Bilateral optic neuritis. A long-term follow-up.

We have endeavoured to determine the fate of the adults and children presenting with bilateral optic neuritis who were reported by Hierons and Lyle (1959) and Meadows (1969). We have follow-up information from a variety of sources on 31 of the 34 adults for up to thirty-seven years, and on 17 of 19 children after up to thirty-two years. Three adult cases were excluded after review. The visual prognosis was variable in the adults but excellent in the children. None of the children has developed clinically definite multiple sclerosis. Two of the 11 adults with simultaneous bilateral optic neuritis developed multiple sclerosis, compared with 8 of 20 with sequential optic neuritis. We conclude that the risk of developing multiple sclerosis after simultaneous bilateral optic neurities in childhood is low; in adult life it is probably higher, but some patients even after more than two decades have no clinical evidence of the disseminated disease. Bilateral optic neuritis is aetiologically and prognostically diverse.

Adolescent↗

Clinical and toxicological investigations of a case of delayed neuropathy in man after acute poisoning by an organophosphorus pesticide.

Progressive neuropathy developed in a man during 2--8 weeks after acute poisoning by a pesticide said to contain trichlorphon. The neuropathy was typical of that caused by organophosphorus esters in the delay and in the maintenance of normal conduction velocity in surviving nerve fibres. A sample alleged to be typical of the ingested material was not more active against hen brain neurotoxic esterase (NTE) than was pure trichlorphon. Delayed neuropathy has never been produced in hens by a single dose of trichlorphon. This incident and studies of human brain in vitro suggest that the ratio neurotoxicity/lethality for trichlorphon is higher in man than in the hen. Suggestion is made of laboratory tests to improve neurotoxicity screening.

Adult↗

The late effects of necrotizing encephalitis of the temporal lobes and limbic areas: a clinico-pathological study of 10 cases.

The clinical and neuropathological features are reported of 10 patients who had suffered, usually for several years, from the after effects of an acute or sub-acute necrotizing encephalitis of the limbic grey matter and of the adjacent temporal lobes. Emphasis is laid on the memory disturbance and on the behavioural and emotional aberrations that tended to occur and that are in some ways reminiscent of the Klüver-Bucy syndrome.

Adult↗