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Biomedical subjects

E Ellis

Publications and source records attributed to E Ellis.

At least 73 records · Page 4Linked to original sources
PubMed1997

Educators' responses to changes in the health care system.

A survey was conducted to identity programmatic/curricular changes made by New York state nursing schools in response to the changing health care environment and to identity the success of job placement for new graduates. Data were reported for 84 programs. Respondents indicated that innovative curriculum initiatives were employed, such as increasing community experiences and primary health care content. Opportunities for job placement were enhanced by a number of strategies, including resume writing and job interviewing workshops.

Curriculum↗
PubMed1996

Characterization of inositolpolyphosphate binding to myocardial membranes.

Although it is well-accepted that the phosphatidylinositol signalling transduction pathway, producing inositol-1,4,5-P3 (InsP3) and inositol-1,3,4,5-P4 (InsP4) as second messengers, functions in heart muscle, virtually nothing is known about the roles of the higher inositol polyphosphates such as inositolhexakisphosphate (InsP6). This study demonstrates that InsP6 has the ability to bind intracellularly, with different binding characteristics, to different myocardial membranes. Binding to purified sarcoplasmic reticulum (SR) membranes, purified sarcolemmal (SL) membranes as well as to viable mitochondria were characterized. Binding to all these membranes display high as well as low affinity binding sites, with differing affinities. Kd values of binding to SR were 32 and 383 nM, to SL 61 and 1312 nM, while those of mitochondrial binding were 230 and 2200 nM respectively. InsP4 binding was also investigated and displayed the following characteristics: to SR, one low affinity binding site (Kd = 203 nM) and to SL, a high as well as a low affinity binding site with Kd values of 41 and 2075 nM respectively. Presence of InsP3, the second messenger for SR calcium release, at concentrations of 1 nM, elevated the binding of InsP4 to SR and SL by a mean of 30% and 20% respectively. Fractionation of SR and SL membranes on sucrose density gradients, after solubilization with CHAPS, indicated that InsP6 bound to two separate protein peaks in both these membranes, while InsP4 bound to only one. In SR membranes, InsP4 bound preferentially to a protein separating at high sucrose density while it bound to a protein separating at low sucrose density in SL membranes.

Animals↗
PubMed1996

Circulating factor associated with increased glomerular permeability to albumin in recurrent focal segmental glomerulosclerosis.

BACKGROUND: Heavy proteinuria and progressive renal injury recur after transplantation in up to 40 percent of patients with renal failure caused by idiopathic focal segmental glomerulosclerosis. A circulating factor may be responsible for this recurrence. METHODS: To determine whether patients with focal segmental glomerulosclerosis have a circulating factor capable of causing glomerular injury, we tested serum samples from 100 patients with the disorder in an in vitro assay of glomerular permeability to albumin. Of the 56 patients who had undergone renal transplantation, 33 had recurrences. Sixty-four patients, many of whom had undergone transplantation, were being treated with dialysis. Thirty-one patients with other renal diseases and nine normal subjects were also studied. RESULTS: The 33 patients with recurrent focal segmental glomerulosclerosis after transplantation had a higher mean (+/-SE) value for permeability to albumin (0.47+/-0.06) than the normal subjects (0.06+/-0.07) or the patients who did not have recurrences (0.14+/-0.06). After plasmapheresis in six patients with recurrences, the permeability was reduced (from 0.79+/-0.06 to 0.10+/-0.05, P = 0.008), and proteinuria was significantly decreased. Patients with corticosteroid-sensitive nephrotic syndrome or with membranous nephropathy after transplantation had low levels of serum activity. The circulating factor bound to protein A and hydrophobic-interaction columns and had an apparent molecular mass of about 50 kd. CONCLUSIONS: A circulating factor found in some patients with focal segmental glomerulosclerosis is associated with recurrent disease after renal transplantation and may be responsible for initiating the renal injury.

Adult↗
PubMed1996

Analysis of treatment for isolated zygomaticomaxillary complex fractures.

PURPOSE: The purpose of this study was to evaluate the adequacy of reduction and stability of fixation of isolated zygomaticomaxillary complex (ZMC) fractures treated by various methods over a 5-year period. PATIENTS AND METHODS: Forty-eight patients with isolated, unilateral ZMC fractures that had at least 6 weeks' clinical follow-up were studied. Demographic information and methods of treatment were obtained from the medical records. Quality of reduction was assessed by examination of postoperative images. Stability of the repositioned ZMC was assessed by comparing immediate postoperative images with those obtained at least 5 weeks later. Cosmetic outcomes were assessed by clinical assessment and examination of photographs. RESULTS: A variety of surgical approaches and fixation sites were used in the sample. All patients but five had satisfactory reductions performed during surgery. In two of the latter, no noticeable facial deformity was apparent. No patient showed postsurgical change in position of the reduced ZMC. Three patients showed postsurgical enophthalmos at longest follow-up. Approximately 20% of those having lower eyelid incisions had some amount of scleral show at longest follow-up. CONCLUSIONS: A variety of techniques can be used to produce a satisfactory outcome. Based on the results and a review of the literature, recommendations for treatment are proposed.

Adolescent↗
PubMed1996

Improvement of maximum occlusal forces after orthognathic surgery.

PURPOSE: A number of studies have reported that maximum voluntary bite forces increase after orthognathic surgery. This study determined rates of long-term improvement in bite forces and looked for both sex-related differences in improvement and for any differences among surgical procedures. PATIENTS AND METHODS: The study tested 117 patients before surgery and between 6 months and 3 years after surgery. At each trial, unilateral maximum voluntary bite force was measured at four different tooth positions using a standard transducer. Forty-three control subjects were similarly tested. The rate of increase in maximum bite force was calculated separately for male and female patients in various groups of patients and the controls. RESULTS: The patients had significantly lower maximum bite forces than the controls before surgery and for as long as 2 years after surgery. Within 6 months after surgery, patients' bite forces were already greater than their pre-surgical forces. Patients generally showed steady improvement in bite force thereafter, with male patients improving more quickly than female patients. There were no clear differences among surgical procedures. CONCLUSIONS: Any temporary reduction in maximum voluntary bite force disappears less than 6 months after orthognathic surgery. Orthognathic surgery improves patients' bite forces, but this improvement may be gradual, requiring many months.

Analysis of Variance↗
PubMed1996

Bite forces before and after surgical correction of mandibular prognathism.

PURPOSE: The purpose of this investigation was 1) to compare morphologic parameters and voluntary bite forces between controls and a sample of patients with mandibular prognathism before surgical correction, and 2) to examine how these patients' bite forces adapt after treatment. PATIENTS AND METHODS: Twenty-four prognathic patients were compared with 24 controls before and up to 3 years after mandibular setback surgery. Measures of skeletal morphology and maximum isometric bite force were made on all subjects over time. Statistical analysis compared the controls, the patients before surgery, and the patients after surgery. RESULTS: Surgical shortening of the mandible averaged 4.1 mm, bringing most skeletal measures into the normal range. Before surgery, the jaw muscle mechanical advantages for patients were significantly smaller than for controls; surgery did not significantly change this relationship. Before surgery the patients had maximum isometric bite forces that were significantly less than those of controls. Bite forces steadily increased after surgery, approaching normal values within 2 to 3 years. CONCLUSIONS: The results of this study suggest that correction of mandibular prognathism by mandibular setback surgery produces some significant functional benefits.

Adolescent↗
PubMed1996

Use of lag screws for fractures of the mandibular body.

PURPOSE: This article presents the results of treating fractures of the mandibular body using lag screws alone or lag screws inserted through bone plates. PATIENTS AND METHODS: Thirty-one patients treated for fractures of the mandibular body using lag screws within a 5.5-year period were retrospectively studied for complications. Nine patients were treated with lag screws only and 22 with a lag screw inserted through a bone plate. No patient was placed into postsurgical maxillomandibular fixation. RESULTS: There were no intraoperative or postoperative complications, except for one dental abscess. CONCLUSIONS: Lag screw fixation of mandibular body fractures is a reliable technique when these is sufficient obliquity of the fracture.

Bone Plates↗
PubMed1996

Functional and morphologic changes after combined maxillary intrusion and mandibular advancement surgery.

PURPOSE: The purposes of this investigation were 1) to compare the morphology and function of patients with combined vertical maxillary excess (VME) and mandibular retrognathia with that of controls, and 2) to examine how these parameters change after combined maxillary intrusion and mandibular advancement surgery. PATIENTS AND METHODS: Fifteen female VME/retrognathic patients were compared with 26 female controls before and for up to 3 years after orthognathic surgery. Facial skeletal morphology, mandibular range of motion, maximum isometric bite force, and levels of electromyographic activity (EMG) in selected muscles of mastication were measured on all subjects. Where appropriate, one-way analysis of variance (ANOVA) or t-tests were used to compare the patients with controls. Univariate repeated-measures ANOVA was used to study longitudinal changes. RESULTS: Preoperatively, patients' morphologic measurements were characteristic of VME compounded by mandibular retrognathia. At surgery, the maxilla was elevated an average of 2.8 mm, and the mandible was lengthened by an average of 7.1 mm. All of the postoperative morphologic measurements were closer to normal values. The patients' masseter mechanical advantage was significantly lower than that of controls both before and after surgery. Surgically induced changes in mechanical advantage were very small. The patients' maximum range of motion and excursion during mastication were all lower than those of controls before surgery. All measurements of mobility decreased immediately after surgery, with a gradual return to preoperative values. However, even 3 years after surgery, all of the motion measurements remained smaller than those of the controls. Before surgery, the patients had maximum isometric bite forces significantly lower than those of controls. Bite forces increased significantly after surgery, approaching normal values within 2 years. The activity levels in the muscles of mastication during isometric bites were not significantly altered by surgery. CONCLUSIONS: This study confirms that VME/retrognathia patients suffer from substantial deficiencies in their oromotor function. Surgical correction of this particular type of dentofacial deformity improves both the morphologic and functional deficits. Although some changes were not statistically significant, all were toward normalization of the presurgical values.

Adolescent↗
PubMed1996

Treatment of mandibular angle fractures using one noncompression miniplate.

PURPOSE: This study evaluated the results in patients treated for fractures of the mandibular angle with a single miniplate. PATIENTS AND METHODS: Eighty-one patients with fractures of the mandibular angle were treated by open reduction and internal fixation using one noncompression miniplate with 2.0-mm self-threading screws placed through a transoral incision. No patient was placed into postsurgical maxillomandibular fixation. They were prospectively studied for complications. RESULTS: Thirteen patients with angle fractures (16%) experienced complications requiring secondary surgical intervention. Most of the complications (n = 11), however, were minor and could be treated in the office. Most commonly, intraoral incision and drainage and later removal of the bone plate were required. All patients with minor complications had clinical union. Only two complications required hospitalization for intravenous antibiotics and further surgery. One of these patients had a fibrous union requiring a bone graft. CONCLUSIONS: The use of a single miniplate for fractures of the angle of the mandible is a simple, reliable technique with a relatively small number of major complications.

Adolescent↗
PubMed1996

The reliability and characteristics of the brief syntactic analysis.

BACKGROUND: Linguistic analysis is of great potential benefit to psychiatry as a research and assessment tool, but the skill and time it demands means that it has not been widely used. This paper describes a much simplified form of syntactic analysis. METHOD: A detailed protocol for the Brief Syntactic Analysis (BSA) was written, based on earlier work by Morice and Ingram. Three psychiatrists were trained in its use, and inter-rater reliability established through independent ratings of 12 transcripts taken from a mixed group of psychiatric patients and a group of non-psychiatric controls. Concurrent reliability of the BSA against the Morice and Ingram analysis was established by comparing measures from the two methods on 16 transcripts of mixed patients. RESULTS: There were high levels of agreement between the three psychiatrists and between the BSA and the Morice and Ingram analysis, although one-way ANOVA indicated that for some variables there were small but statistically significant absolute differences between the two. The reasons for this were discussed. A principal components analysis confirmed the presence of three factors corresponding closely to the three families of linguistic variables. CONCLUSIONS: The results indicate that psychiatrists can be trained to use a syntactic analysis with high levels of agreement. The BSA, which takes much less time to complete, produces measures that are comparable with the original analysis from which it was derived.

Cognition Disorders↗
PubMed1996

Speech and language in first onset psychosis differences between people with schizophrenia, mania, and controls.

BACKGROUND: Several studies have revealed linguistic differences between diagnostic groups. This study investigates the extent to which these differences are accounted for by factors such as chronicity, or disturbances in cognition associated with acute psychosis. METHOD: Transcripts of interviews with patients suffering from RDC schizophrenia (n=38), mania (n=11) and controls (n=16) were examined using the Brief Syntactic Analysis (BSA). Patients were within two years of first onset of psychotic symptoms, and received tests of working memory and attention. RESULTS: The speech of patients with schizophrenia was syntactically less complex than that of controls. Patients with schizophrenia and mania made more errors than controls. These differences were, to some extent, related to group differences in social class, working memory and attention, although significant group differences in language persisted after the effects of covariates were removed. CONCLUSIONS: The study confirms the existence of differences in the speech of psychiatric patients. Low complexity appears to be a particular feature of speech in schizophrenia, even in the earliest stages of the condition. The importance of this finding is discussed in relation to two recent theories of schizophrenia: Crow's evolutionary model, and Frith's neuro-psychological model.

Bipolar Disorder↗
PubMed1996

Major psychological disorders in acute and chronic TMD: an initial examination.

This study assessed psychological disorders in 50 patients with chronic temporomandibular disorders and 51 patients with acute TMD. The results revealed a significant psychological comorbidity in both groups of patients. Both groups had high rates of psychopathology that exceeded the base rates of the general population. Such findings are in keeping with an integrated biopsychosocial model of TMD, and have significant implications for treatment of these patients.

Acute Disease↗
PubMed1996

Treatment methods for fractures of the mandibular angle.

Fractures of the mandibular angle are plagued with the highest rate of complication of all mandibular fractures. Over the past 8 years, the following six accepted forms of treatment for these fractures were performed on an indigent inner-city population: closed reduction or intra-oral open reduction and nonrigid fixation; extraoral open reduction and internal fixation with an AO/ASIF reconstruction bone plate; and intraoral open reduction and internal fixation using either two 2.0 mm minidynamic compression plates, two 2.4 mm mandibular dynamic compression plates, two noncompression miniplates, or a single noncompression miniplate. This article reviews the results of those treatment modalities when used for the same patient population at one hospital. Results show that the use of either an extraoral open reduction and internal fixation with the AO/ASIF reconstruction plate or intraoral open reduction and internal fixation using a single miniplate was associated with the fewest complications.

Bone Plates↗
PubMed1996

Complications of rigid internal fixation for mandibular fractures.

The application of rigid internal fixation to maxillofacial trauma is among the truly great advances that have been made in the field. The use of rigid internal fixation techniques has resulted in many advantages for the patient. Unfortunately, complications have occurred with this technology that are often devastating in their consequences for treatment outcomes. This article addresses some of the problems that stem from the use/misuse of rigid fixation devices in the treatment of mandibular fractures. It presents the most common complications and their management, including malunion, fibrous union, infection/osteitis, and impalement of the tooth roots and/or inferior alveolar canal.

Alveolar Process↗
PubMed1996

The future of oral and maxillofacial surgery in the United States.

This paper explores the past, present, and future of the specialty of oral and maxillofacial surgery in the United States as viewed through the eyes of the author. Many changes have occurred over the past ten years that have changed the complexion of the entire health care industry. The overall effect of these changes is to decrease the amount of funding that will be available for our services. These changes have caused challenges for the specialty. How will we cope? Will we survive? Are we relevant? The challenges facing the specialty of oral and maxillofacial surgery as practised in the United States are discussed, and recommendations for change are put forth.

Education, Dental↗
PubMed1996

Functional characteristics of patients with anterior open bite before and after surgical correction.

The purposes of this investigation were to compare functional performance between controls and a sample of patients with skeletal anterior open bite prior to surgical correction and to examine how the patients' oral motor function adapted after treatment. Five female patients with skeletal open bite malocclusion were treated with Le Fort I osteotomy and compared to sex-, size-, and age-matched controls. Measurements of skeletal morphology, mandibular range of motion, occlusal force, and muscle efficiency were taken on all subjects over time. Prior to surgery, all patients had lower occlusal forces than did controls at all bite positions. After surgery, occlusal forces at several occlusal positions increased significantly from the presurgical recordings but remained below the level of controls. The mechanical advantages of the muscles of mastication were not significantly different between controls and patients either before or after surgery. The results of this study suggest that correction of skeletal open bite malocclusion may improve occlusal force, but a larger sample is needed to confirm this finding.

Analysis of Variance↗