Biomedical subjects
Publications and source records attributed to B Alpert.
Complications related to teeth in the lines of mandibular fractures were studied in a retrospective review of 207 fractures; 32.3% resulted in some form of morbidity. Statiistical comparison of fractures in which teeth were removed and fractures in which teeth retained suggests that removal of teeth in fracture lines does not minimize morbidity.
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In microvascular replantation and transplantation surgery, vascular repairs must be performed on undamaged vessels without tension. Meticulous inspection under the microscope will enable the microsurgeon to delineate th proper level of vascular débridement. The resultant defect, be it 2 or 20cm in length, can then be bridged with autogenous microvascular grafts. Forty-one microvascular grafts have been used on 17 patients, with survival of all but one transplant and replant.
We describe a case in which maxillary alveolar hyperplasia (the long face syndrome) was corrected by excising a 12 mm band of bone through the maxilla, "down-fracturing" it, and telescoping it up into a new position.
A delayed formation of a pseudoaneurysm of the internal carotid artery occurred secondary to a gunshot wound of the maxillofacial region. Its treatment concurrent with the treatment of a severely comminuted fracture of the mandible has been reported.
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Two cases of severe and extensive electrical burns of the scalp and skull are presented. Large segments of composite groin tissue were successfully transplanted to cover the scalp defects. Microvascular surgical techniques were employed. Both patients had short postoperative hospitalizations. It is possible that a cranioplasty may now be performed as a second stage under the healed full-thickness skin. The advantages of providing a thick protective skin cover in a single operation are outlined.
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A method is described for the preparation of phosphate-free globin-porphyrin. In this work, only the tetrameric molecule, probably in the deoxy conformation was isolated and studied. The preparation procedure is likely to be of use in other cases for studying the effect of phosphates on the structure of various artificial hemoglobin derivatives.
Laser photolysis study of porphyrin-globin shows that the triplet state of the porphyrin is detectable by its light absorption and that it can be used to determine the rate of penetration of oxygen into the hemoglobin pocket in which the porphyrin is embedded. The oxygen penetration rate does not determine the binding rate of oxygen to iron in hemoglobin.
Photolysis of carbon monoxide and oxygen derivatives of hemoglobin by a short laser pulse produces a transient species that rapidly decays to normal deoxyhemoglobin. The effect, which is also observed on single chain proteins and on noncooperative aggregated forms, has been interpreted as corresponding to structural changes in the heme pocket on ligand dissociation. The decay of the transient species follows first-order kinetics with constants ranging from 0.8 to 1.8 x 10(7) sec(-1). In cooperative hemoglobins, the kinetic constants are pH-dependent, though remaining first- or pseudo first-order at all wavelengths. This shows the close linkage of tertiary and quaternary structure changes in normal hemoglobin.
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