Biomedical subjects
Publications and source records attributed to D Laufer.
A case of acute sinusitis caused by a gutta-percha point is presented. The foreign body was introduced into the sinus during root therapy. Antibiotic therapy was ineffective. Surgical treatment consisted of radical antrostomy and removal of the foreign body.
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Twenty-five patients operated upon between 1969 and 1973 for correction of mandibular prognathism were recalled in 1975 and asked to evaluate their attitudes toward the procedure and the postoperative results. All but one were satisfied with the results. Postoperative numbness of the lip and chin lasting more than 6 months was commonly noted following the intraoral sagittal split method. This did not influence the patient's satisfaction with the operation. The minimal postoperative scar following the extraoral oblique osteotomy was not a negative factor. Most patients underwent the surgical procedure for esthetic reasons. A large number (68 per cent) noted a change in personality postoperatively. A rationale for selective preoperative psychologic counseling is suggested.
A project by Rhode Island Health Services Research (SEARCH) to develop, adapt, and improve data systems in several Rhode Island long-term care settings includes skilled nursing and intermediate care facilities, two chronic care hospitals, mental health institutions, and home health agencies. A successful medical review system was developed for Medicaid nursing home patients which is now a program funded by the state, as well as a good abstracting system for the two chronic hospitals. Also, steps were taken to correct omissions and inaccuracies found in mental health data used in the Multi-State Information System (MSIS), and to modify a limited management information system used by home health agencies. In retrospect, the project would have been better served had it attempted to be less comprehensive and instead focused its resources in areas of high visibility and unequivocal public concern. The approach would have given the state population-based information of much greater power than is currently available, despite the recognized successes of the project in the nursing home and chronic hospital areas.
Various methods of treatment used for 70 patients with complex fractures of the zygomatic bone are reviewed. It was established that adequate fixation of most instances of rotated tripodal fractures can be accomplished with use of a zygomaticofrontal wire supplemented by an intrasinus Foley catheter.
A case of an injured, necrotic tongue in a child of 12 months was investigated. It was found that the patient was suffering from congenital analgesia. The injury was due to errupted lower incisor teeth, and the injury healed following their extraction. We believe that in cases of repeated self-injury of the tongue some form of sensory disturbance should be considered.
Whole unstimulated saliva was analyzed in 15 healthy individuals and 15 patients with malignant tumors in the head and neck region before and during irradiation therapy. Flow rate, pH, electrolytes (Na, K, Ca, Mg), protein and phosphate were measured. There was a decrease in rate of flow, and pH changed towards acidity. The most significant finding was the increased sodium content. We believe that irradiation reduces the reabsorption ability of the tubuli, causing the sodium content of the saliva to increase.
A case of osteosarcoma of the right mandible is described. The patient had a long-standing fibrous dysplasia (Jaffe & Lichtenstein disease) in that area. The osteosarcoma did not respond to surgical treatment or radiation and continued to grow, causing the death of the patient. This case is of interest because of the correlation between the radiographic image and the 85Sr-uptake on a scintiscan which corresponded exactly to the tumor mass.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Salivary composition and flow rate were examined in 35 patients with insulin-dependent diabetes mellitus (IDDM) and compared to 31 healthy controls. Significantly lower whole-saliva flow rate was observed in the IDDM patients, but was not correlated with the subjective complaint of xerostomy. Glucose concentration was significantly higher in the parotid saliva of the IDDM patients. Potassium concentration was significantly higher in whole and parotid, resting and stimulated saliva, as was total protein concentration in resting whole and in stimulated parotid saliva of the diabetics. No significant difference between diabetics and healthy controls was found in sodium and IgA concentration or in amylase activity. The significantly higher glucose, lower flow rate, and higher potassium and protein concentrations indicate that salivary glands are affected in IDDM. The subjective complaint of dry mouth, often present in diabetics, while not correlated with salivary flow rate, might reflect qualitative changes in salivary composition and/or altered mucosal perception. Salivary glucose concentration, although significantly higher in the diabetics, was not significantly correlated with serum glucose, preventing the use of saliva for monitoring blood sugar.
The salivary composition and flow rate were examined in 20 patients with insulin-dependent diabetes mellitus (IDDM) and in 19 patients with non-insulin-dependent diabetes mellitus (NIDDM) and compared with 20 healthy controls. Resting and stimulated whole and submandibular saliva was analyzed. Significantly lower resting salivary flow rates were found in the IDDM patients as compared to the NIDDM group. In the IDDM patients potassium concentration in resting saliva was significantly higher compared with healthy controls and in stimulated whole saliva compared with NIDDM patients. No difference in salivary total protein, amylase, lactoferrin, or lysozyme was found among the three groups examined. The IgA concentration of the IDDM patients was significantly higher in whole resting saliva compared with controls and in the submandibular saliva compared with both NIDDM patients and controls. No difference was found between controls and the diabetic patients examined in prevalence of complaint of dry mouth. The salivary flow rates, however, were significantly lower in the three subgroups with dry mouth compared with the subgroups without this complaint. Caries were detected in 100% of the diabetic patients and controls. No correlation was observed between the incidence of caries and any of the salivary parameters examined. A higher prevalence and severity of periodontal disease was detected in the diabetic patients as compared to the controls. A significant positive correlation was found between the gingival index and the concentrations of total protein, albumin, lysozyme, and lactoferrin in whole resting saliva in the three groups examined.
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Osteoarthritic lesions are observed in temporomandibular joint cartilage of ICR mice aged 7 months and older, accompanied by reduced proliferation and matrix synthesis. Transforming growth factor-beta (TGF-beta), is a multifactorial growth factor affecting matrix synthesis and cell proliferation in bone and cartilage, whereas interleukin-1 (IL-1) is involved in cartilage degradation. In order to establish the repair capacity of cartilage in aging, the response of cartilage from young and old animals to TGF-beta and IL-1 was studied. Mandibular condyles from young (1-month-old) and old (18-month-old) mice were cultured for up to 72 h in medium supplemented with TGF-beta1 or IL-1alpha. TGF-beta increased protein (+9.26%) and DNA (+36.0%) contents in young animals and DNA content (+19.49%) in old animals. Incorporations of [(3)H]thymidine and [(35)S]sulfate were enhanced in young (+254% and +116%, respectively) and in old (+22.6% and +6.88%, respectively) and animals and activity of alkaline phosphatase was induced in old animals. Treatment with IL-1 resulted in reduced DNA content in young (-35.76%) and old (-33.33%) animals, but acid phosphatase activity was induced in old animals. It is concluded that TGF-beta can induce anabolic activity even in cartilage from old animals indicating repair response in articular cartilage in aging.
PURPOSE: To summarize the experience in our halitosis clinic, emphasizing an interdisciplinary approach. PATIENTS AND METHODS: Thirty-nine patients with a primary complaint of halitosis were evaluated. Their health was established by a questionnaire, by clinical examination, and by laboratory analysis. Halitosis was evaluated organoleptically by a dentist and an otolaryngologist (odds ratio [OR] = 5.7). The volatile sulfide levels were measured with a portable sulfide monitor (Halimeter; RH-17 series, Interscan, Chatsworth, CA). RESULTS: The patients were found to suffer from otolaryngological disorders (26%), dental problems (23%), oral discomfort (18%), and gastrointestinal pathology (10%), or several of the above. In 31% of the patients, however, no clinical involvement was detected. The salivary flow rates in the patients were similar to those in healthy controls, whereas their oral Candida carrier rate was low (28%). Fifty-seven percent of the patients had objective halitosis by organoleptic evaluation and 61% by Halimeter measurement. CONCLUSION: A high percentage of the patients who came to the clinic with a primary complaint of halitosis did not have a detectable problem.