Biomedical subjects
Publications and source records attributed to E Ellis.
The use of Orthognathic Surgery Simulating Instrument (OSSI) is described. Two cases of facial asymmetry, one with hemifacial microsomia and one with unilateral condylar hyperplasia, are presented to demonstrate the diagnostic capabilities of the articulator. The OSSI has greatly improved our ability to plan the treatment of cases of gross facial asymmetry.
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A case report of a recurrent mucous extravasation phenomenon in the anterior lingual gland is presented. Multiple surgical procedures were necessary to eradicate the lesion. Alginate impression material was used during one of the surgical procedures to aid in defining the margins of the lesion. A foreign-body reaction arose in the tongue as a result of residual alginate within the tissues, necessitating further surgery. The use of this technique cannot be recommended in areas where extension into surrounding tissue planes is possible.
Ten adult rhesus monkeys underwent mandibular advancement surgery of 4-6 mm with and without suprahyoid myotomy. Serial lateral cephalograms using radiopaque bone markers were obtained during maxillomandibular fixation and for 96 weeks after release of fixation to determine the effects of suprahyoid myotomy on short-term and long-term adaptations in the advanced mandible. The non-myotomy group exhibited a significant reduction in the length of the advanced mandible (relapse) during the fixation period but showed no significant change in mandibular length after release of fixation. The myotomy group exhibited no relapse during the fixation period and after release of fixation displayed a slight but statistically significant increase in mandibular length. This supports the hypothesis that stretching of the suprahyoid musculature as a result of mandibular advancement surgery is a major factor leading to skeletal relapse.
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We evaluated an incentive spirometer (IS) for monitoring changes in lung function in hospitalized patients. Accuracy and reproducibility of IS measurements of known volumes were adequate (r = 0.87). Flow dependency was demonstrated but was not significant in the clinically useful range. Reproducibility of IS measurements in five normal subjects was good, with a small training effect uncovered. In 15 patients with asthma and chronic obstructive lung disease, change in IS values closely correlated with spirometrically measured changes in volume and flows (best correlation: IS versus FEV1/FVC%, r = 0.98) and in peak flow. The performance of the IS as tested and its availability in most hospitals outweigh its limitations. We advocate its use as an adjunct in monitoring progress of hospitalized patients with obstructive lung disease.
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We report a fatal case of Legionnaires' disease associated with myopathy, myoglobinuria, elevated creatine phosphokinase (CPK) level, and pneumonitis. The precise cause of skeletal muscle damage in this patient remains obscure. The association with Legionnaires' disease in this case supports the observation that the Legionnaires' organism has the potential for affecting multiple organ systems, including skeletal muscle. Elevated CPK levels and myoglobinuria in a patient with pneumonitis should suggest the diagnosis of Legionnaires' disease.
We studied the effect of a stable, cyclic ether analogue of prostaglandin endoperoxide (EPA) on canine renal function, hemodynamics, and renin release. Infusion of EPA into one renal artery decreased renal blood flow in a dose dependent manner. At a dose of 10(-7) g/kg/min the renal blood flow decreased from a baseline of 384 to 267 ml/min/100 g. This flow decrease was unaltered by phentolamine and saralasin, but was potentiated by prior treatment with indomethacin. Urine flow, glomerular filtration rate, sodium, and potassium excretion all decreased in a dose dependent manner; however, neigher fractional excretion of sodium nor free water clearance showed any significant change, making direct tubular effects of EPA unlikely. EPA caused a significant increase in renin release that was completely blocked by prior treatment with indomethacin. We conclude that EPA is a potent renal vasoconstrictor and that this vasoconstriction is responsible for the renal functional changes observed. Renin release is not a direct effect of EPA but probably is secondary to an endogenously generated prostaglandin. Since EPA mimics the effects of natural prostaglandin endoperoxides on smooth muscle in vitro, it is possible that prostaglandin endoperoxide-induced vasoconstriction in vivo modulates the effects of their vasodilatory products, prostaglandin E2 and I2.
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