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Biomedical subjects

D R Marshall

Publications and source records attributed to D R Marshall.

At least 37 records · Page 2Linked to original sources
PubMed1990

Regional macrodontia and regional bony enlargement associated with congenital infiltrating lipomatosis of the face presenting as unilateral facial hyperplasia. Brief review and case report.

Congenital infiltrating lipomatosis of the face (CIL-F) is a rare lesion. Presented here is a review of the literature concerning this condition, with the report of a case with clinical signs indistinguishable from those of unilateral facial hyperplasia. Previously unreported clinical and radiographic features of regional bony hypertrophy and macrodontia associated with this case of CIL-F are described and the proposition raised that previously reported cases of unilateral facial hyperplasia may have been due to CIL-F. It is suggested that the clinical findings in this case of facial asymmetry associated with CIL-F, regional macrodontia and regional bony enlargement may constitute a previously undescribed syndrome.

Adult↗
PubMed1990

Serum antibodies to periodontal bacteria.

The purpose of this study was to determine how serum antibodies reactive with periodontitis-associated bacteria with relates to the diagnosis of periodontitis subjects. Study groups included localized juvenile periodontitis (LJP) subjects, severe periodontitis (SP) subjects, chronic adult periodontitis (AP) subjects, and age matched controls. Twenty-two bacterial strains, representing 18 different species most commonly found in early onset periodontitis were evaluated using serum from LJP, SP, and age matched controls. Serum IgG reactive with these organisms was determined using a radioimmunoassay (RIA). Serum antibody reactive with 13 bacterial strains differed significantly (P less than 0.01) between the three clinical groups. Discriminate analysis revealed that antibodies reactive with 5 bacterial strains of the 13 were able to identify the clinical group to which subjects belonged 79% of the time with control subjects being correctly identified 100% of the time, LJP subjects 78% of the time, and SP subjects 60% of the time. These strains included two strains of Actinobacillus actinomycetemcomitans (Y4 and N27), Fusobacterium nucleatum (E1D1), Eubacterium brachy, and Bacteroides gingivalis. The low classification rate of SP subjects suggested heterogeneity. The SP group could be divided into three subgroups using the serological data. One subgroup, with "super" severe attachment loss, generally lacked antibody reactive with these five organisms, another subgroup was serologically similar to LJP subjects, while the third subgroup had antibodies to additional organisms. This suggests that some SP subjects may represent a more advanced form of LJP. Comparison of antibody reactivity of AP subjects with age matched controls to 23 bacterial types revealed that mean serum antibody reactivity to only Bacteroides gingivalis was higher in AP subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

Actinobacillus↗
PubMed1987

Osteoid osteoma of the distal phalanx: a case report.

A sixteen-year-old male presented with pain and swelling of the distal phalanx of his right middle finger. X-ray examination demonstrated an osteolytic lesion which at operation was found to be an osteoid osteoma.

Adolescent↗
PubMed1987

Delineation of myocardial oxygen utilization with carbon-11-labeled acetate.

Although positron-emission tomography (PET) with labeled fatty acid delineates infarct size and permits qualitative assessment of fatty acid utilization, quantification of oxidative metabolism is limited by complex alterations in the pattern of utilization of fatty acid during ischemia and reperfusion. Because metabolism of acetate by myocardium is less complex than that of glucose or palmitate, we characterized kinetics of utilization of radiolabeled acetate in 37 isolated rabbit hearts perfused with modified Krebs-Henseleit buffer and performed a pilot tomographic study in man. Results of initial experiments with carbon-14-labeled acetate (14C-acetate) indicated that the steady-state extraction fraction of acetate averaged 61.5 +/- 4.0% in control hearts (n = 4), 93.6 +/- 0.9% in hearts rendered ischemic (n = 4), and 54.8 +/- 4.0% in hearts reperfused after 60 min of ischemia (n = 3). Oxidation of 14C-acetate, assessed from the rate of efflux of 14CO2 in the venous effluent, correlated closely with the rate of oxygen consumption under diverse metabolic conditions (r = .97, p less than .001). In addition, no significant differences were observed between rates of efflux of total 14C in all chemical species (reflecting total clearance of tracer from myocardium) and efflux of 14CO2. Clearance of 11C-acetate, measured externally with gamma probes in normal and ischemic myocardium, correlated closely with clearance of 14C-acetate measured directly in the effluent (r = .99, p less than .001) and with overall myocardial oxygen consumption (r = .95, p less than .001). Accumulation and clearance of 11C-acetate from human myocardium with PET demonstrated kinetics comparable to those seen with radiolabeled acetate in vitro. Thus externally detectable clearance of 11C-acetate provides a quantitative index of myocardial oxidative metabolism despite variation in the patterns of intermediary metabolism that confounds interpretation of results with conventionally used tracers such as glucose and fatty acid.

Acetates↗
PubMed1986

Post-mastectomy breast reconstruction: the soft tissue alternative.

The available methods of soft tissue reconstruction of the breast are described. They are usually preferable to the use of a prosthesis. For unilateral reconstruction the appropriate method depends on the age of the patient and the size of the breast. In an elderly patient with large breast, a two-stage breast-sharing procedure is advocated. In a young patient with a small breast, an extended latissimus dorsi myocutaneous flap provides a suitable reconstruction. In a middle-aged woman with a breast of moderate size and an adequate amount of abdominal subcutaneous tissue, the most appropriate method of reconstruction is a rectus abdominis myocutaneous flap. For bilateral reconstruction where the consistency is less important, a prosthesis, with or without a latissimus dorsi flap for cover, is the method of first choice.

Abdomen↗
PubMed1986

Characterization of beta-adrenoreceptors in vivo with iodine-131 pindolol and gamma scintigraphy.

The aim of this study to was to assess the feasibility of using iodopindolol to delineate myocardial beta-adrenoreceptors in vivo. Preliminary biodistribution studies indicated that binding of 131I-d,I-pindolol in the heart was stereospecific, saturable, and displaceable by I-propranolol but not by phenoxybenzamine. However, considerable nonspecific binding was encountered. Subsequently, the stereoisomer, 131I-I-pindolol, was shown to be a high affinity beta-adrenoreceptor antagonist (Kd approximately 0.37 nM) as assessed by Scatchard analysis, and one exhibiting marked specific uptake in lung and heart in rabbits. In contrast, 131I-d-pindolol exhibited no specific binding in rabbit left ventricular membrane preparations nor specific organ uptake. Gamma camera scintigraphy with both isomers demonstrated that the I-isomer accumulated in lung and heart, and that its accumulation was blocked by I-propranolol. In contrast, d-isomer uptake was nonspecific and diffuse. The results indicate that it should be possible to externally visualize receptors by differentiating specific and nonspecific binding components of a ligand in vivo with the use of radiolabeled stereoisomers.

Animals↗
PubMed1986

Treatment of mallet thumb.

Two case reports of mallet thumb from closed injuries are presented. One patient was managed operatively and the other by conservative treatment. Both have regained excellent function.

Accidents, Occupational↗
PubMed1985

Serum antibody reactive with predominant organisms in the subgingival flora of young adults with generalized severe periodontitis.

In the present study we sought to determine whether serum antibody was present against microorganisms which predominate in the subgingival flora of young adults with generalized severe periodontitis (SP). Subjects with SP were often seropositive for Eubacterium brachy, Fusobacterium nucleatum E3C22, and Peptostreptococcus micros, whereas subjects with juvenile periodontitis (JP) and subjects with healthy periodontium (HP) were not. Both SP and JP subjects were more frequently seropositive for Bacteroides gingivalis, F. nucleatum D52B16, and F. nucleatum E1D1 than were HP subjects. The data were most striking for B. gingivalis, for which both the incidence and the magnitude of specific antibody was clearly elevated for SP and JP subject groups. However, SP subjects generally had either a high antibody titer or no detectable titer. In contrast, JP and HP subjects generally had at least very small amounts of antibody. Except at very low levels of antibody, neither SP nor JP groups differed significantly from the HP group for antibody to Eubacterium nodatum, Bacteroides intermedius (homology group 4197 or 8944), or Lactobacillus minutus antibody. There was a high frequency of antibody to E. nodatum, with very high titers in all groups despite the fact that this organism is rarely found in HP subjects. For Eubacterium timidum, the JP group was clearly more frequently seropositive than the HP group. Despite high levels of L. minutus in subgingival flora, none of the 50 SP subjects had a detectable antibody titer, and only four of the HP and JP subjects had detectable antibody. These results indicate that many organisms in the subgingival flora elicit antibody responses. B. gingivalis is probably the best example among the species tested. However, some organisms that are present in high concentration, e.g., L. minutus, apparently fail to induce significant antibody responses.

Adolescent↗
PubMed1985

Relationship between gingival crevicular fluid and serum antibody titers in young adults with generalized and localized periodontitis.

The objective of the present study was to determine the relationship between concentrations of antibodies in serum and those in gingival crevicular fluid (GCF) of patients with juvenile periodontitis and severe periodontitis. Most antigens used to quantitate antibodies were obtained from a panel of bacteria associated with juvenile periodontitis or severe periodontitis. We further investigated variation in antibody titer among different periodontal sites and the extent to which antibody in GCF is locally derived. Titers of antibody, total immunoglobulin G (IgG), and human serum albumin were determined with sensitive radioimmunoassays. The relationship between serum and GCF antibody was complex. Both person-to-person variability and marked variability within the same subject were found among different sites of similar clinical status. The site-to-site variability was found not only for antibody reactive with periodontal organisms, but also for antitetanus toxoid, total IgG, and even human serum albumin. Generally the variability was in the degree of depression of the level in GCF relative to that in serum. However, anti-Bacteroides gingivalis and anti-Actinobacillus actinomycetemcomitans in GCF often exceeded the level in serum. When antibody titers in serum and GCF were calculated per milligram of human serum albumin, most of the apparent depressions of antibody in GCF disappeared. The ratio of antibody in serum to that in GCF approached unity for all organisms except B. gingivalis and A. actinomycetemcomitans Y4, which were markedly elevated. Furthermore, the level of IgG per milligram of human serum albumin in GCF was about twice the level in serum. We believe that human serum albumin reflects serum contribution to the GCF, and we therefore attribute the increased level of IgG per milligram of albumin in GCF to local synthesis. It appears that anti-B. gingivalis and anti-A. actinomycetemcomitans represent an important portion of this local antibody synthesis, since most seropositive patients with severe or juvenile periodontitis had at least one site elevated, and the magnitudes of the elevations were large in many sites. Those sites yielding elevated antibody exhibited no obvious differences in clinical parameters of probeable depth or attachment level as compared with sites in which antibody levels in GCF were similar to serum levels. Elevated antibody in GCF may relate to changes in disease activity that are not detectable by usual clinical measures.

Actinobacillus↗
PubMed1985

An Alcaligenes faecalis isolate from turkeys: pathogenicity in selected avian and mammalian species.

An Alcaligenes faecalis isolate of known pathogenicity for turkeys was examined for adherence and cytotoxicity in tracheal organ cultures of turkeys, chickens, Japanese quail, guinea pigs, hamsters, and mice, and for colonization and pathogenicity in these 6 species. Adherence and colonization were detected by fluorescent antibody staining. Infected and noninfected tracheal rings were examined by phase-contrast microscopy for cytotoxicity (ciliostasis, blebing of the cell membrane, and sloughing of the ciliated epithelium). Alcaligenes faecalis adhered to the tracheal rings of all species examined. Cytotoxicity was apparent in the tracheal rings of turkeys, quail, and chickens. Cytotoxicity was not detected in tracheal rings from the mammalian species. Alcaligenes faecalis colonization of turbinates and tracheas of intact turkeys and quail was detected. Clinical signs of alcaligenes rhinotracheitis were observed and histopathologic characteristics of the disease were detected. Chickens, guinea pigs, hamsters, and mice were refractory to infection with this isolate of A faecalis.

Adhesiveness↗
PubMed1984

Soft tissue reconstruction of the breast using an extended composite latissimus dorsi myocutaneous flap.

A method of breast reconstruction using the whole of the latissimus dorsi muscle is described in which the usual skin flap is extended to include a large de-epithelialised flap of dermis and subcutaneous tissue from the loin to provide the necessary augmentation with living tissue rather than with a prosthesis. The method can be used as a reliable one-stage reconstruction, without a prosthesis, either secondarily or as a synchronous combined procedure at the time of the mastectomy.

Adult↗
PubMed1983

Intracranial complications of rhinoplasty.

The practicing plastic surgeon acquires a wide experience of the complications of rhinoplasty. These range in severity from minor imperfections of contour to the more dramatic but re complications of haemorrhage and infection. While causing alarm to patient and surgeon alike, they rarely pose a threat to life. We wish to bring to the attention to our colleagues three potentially lethal intracranial complications of rhinoplasty which they may not have previously experienced: cerebrospinal fluid rhinorrhea, meningitis and cavernous sinus thrombosis. These three unusual cases have occurred in the author's practice over a period of 20 years.

Adult↗
PubMed1982

Surgical treatment of lip cancer: the long term prognosis and functional results.

This paper presents a long term review of the prognosis and surgical results in carcinoma of the lip. The results are based on the examinations of 75 patients treated at the Peter MacCallum Clinic in Melbourne followed up for a minimum of 11 years. Surgical excision is considered to be the treatment of choice for carcinoma of the lip. Radical local excision, combined with neck dissection for involved nodes, is shown to result in a good, long term prognosis. Functional and cosmetic results have been examined closely. The simple procedures of wedge excision and vermilionectomy produce a virtually normal lip. Cross lip Abbé flaps, used to reconstruct larger lip defects, are shown to provide a durable, functional lip.

Adult↗
PubMed1981

Post-mastectomy breast reconstruction using a direct flap from an abdominal lipectomy.

If a patient requires a breast reconstruction and at the same time is a candidate for an abdominal lipectomy, it is possible to combine the operation and carry out a breast reconstruction using a direct flap from the abdominal wall. The technique of this two-stage operation is described. In suitable cases one can produce a breast resembling the normal without any obvious scarring to detract from the result and without the complication of a silastic prosthesis.

Abdominal Muscles↗