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Biomedical subjects

E Ellis

Publications and source records attributed to E Ellis.

At least 109 records · Page 6Linked to original sources
PubMed1993

Treatment of mandibular angle fractures using two 2.4-mm dynamic compression plates.

Sixty-five consecutive patients with fractures of the mandibular angle were treated by open reduction and internal fixation using two dynamic compression plates placed through a transoral incision using transbuccal trochar instrumentation and 2.4-mm screws. In the first 20 cases, the screws were inserted without tapping the drill holes. In the remaining 45 cases, the drill holes were tapped. No patient was placed into postsurgical maxillomandibular fixation or training elastics. Overall, 21 fractures (32%) developed infections requiring secondary surgical intervention. The infection rate was higher in those fractures where the holes were not tapped (40%) than those cases when the holes were tapped (29%). Of the 21 fractures that required hardware removal, 9 fractures were healed and required no further treatment; 12 had no firm bony union and required postsurgical maxillomandibular fixation. Only one case resulted in a malunion with resulting malocclusion. The use of two dynamic compression plates was found to be relatively easy, but resulted in an unacceptable rate of infection.

Adolescent↗
PubMed1993

The second Chalmers J. Lyons Academy study of fractures of the edentulous mandible.

A review of 167 fractures in 104 edentulous mandibles treated by several surgeons using a variety of methods was undertaken. Most patients (81.5%) had open reduction and internal fixation using bone plates. Problems in healing, either delayed or fibrous union, occurred in 21 of 167 fractures (12.6%) in 16 of 104 patients (15%). One fourth of patients treated by closed reduction techniques had problems with union, whereas extraoral open reduction with bone plate fixation produced very good results. The factors involved in treating these challenging fractures is discussed and comparisons are made with the previous Chalmers J. Lyons Academy study.

Adult↗
PubMed1993

Treatment of mandibular angle fractures using the AO reconstruction plate.

Fifty-two patients with fracture of the mandibular angle were treated by extraoral open reduction and internal fixation using the AO reconstruction bone plate (Synthes, Paoli, PA). None were placed into postsurgical maxillomandibular fixation. Four patients developed early infections requiring incision and drainage (7.5%). One patient required removal of the hardware after the fracture had healed. The use of the AO reconstruction bone plate for fractures of the mandibular angle was found to be very predictable and was associated with a low rate of complications.

Adolescent↗
PubMed1993

Use of homologous bone in maxillofacial surgery.

Homologous bone grafts were used in 135 maxillofacial surgical procedures, including acute midfacial fracture repair (n = 77), elective osteotomies of the facial bones (n = 35), secondary correction of traumatic deformities (n = 6), mandibular reconstruction (n = 10), facial bone augmentation (n = 5), and reconstruction of maxillary tumor defects (n = 2). Postsurgical complications occurred in five of the patients. This article reviews the rationale for using homologous bone grafts, their immune response, how they heal, and the risk of transmission of disease.

Adolescent↗
PubMed1993

Complications of nonrigid fixation of mandibular angle fractures.

This retrospective study analyzed complications in 96 patients with 99 mandibular angle fractures treated during a 3-year period with either closed reduction or nonrigid means of fixation combined with maxillomandibular fixation. An overall complication rate of 17% occurred. Infection was the most common complication, occurring in 17 fractures. Thirteen fractures had infection as the only complication; in the remaining four patients, infection was combined with malunion/malocclusion. The results of this study show that mandibular angle fractures in an inner-city population are associated with a high incidence of postsurgical complications.

Adolescent↗
PubMed1993

Relationship of substance abuse to complications with mandibular fractures.

This retrospective study analyzed the relationship between complications and substance abuse following mandibular fracture. Over a 2-year period, the records of 352 patients with 589 mandibular fractures were reviewed for methods of treatment and other variables, including chronic abuse of drugs. An overall complication rate of 18.5% was found. Positive associations between complications and chronic abuse of alcohol and nonintravenous and intravenous drugs were found. Intravenous drug abusers had a 30%, nonintravenous drug abusers had a 19%, and chronic alcohol abusers had a 15.5% incidence of complications. Those individuals who did not use any drug chronically had a 6.2% complication rate. The results of this study show that chronic substance abuse can significantly affect treatment outcomes for management of mandibular fractures.

Adolescent↗
PubMed1993

Sequencing treatment for naso-orbito-ethmoid fractures.

This article presents a strategy for treating naso-orbito-ethmoid fractures. Eight steps for the management of such injuries are presented: surgical exposure, identification of the medial canthal tendon/tendon-bearing bone fragment, reduction/reconstruction of medial orbital rim, reconstruction of the medial orbital wall, transnasal canthopexy, reduction of septal fractures, nasal dorsum reconstruction/augmentation, and soft tissue adaptation. Following these steps can make treatment outcomes more predictable.

Cerebrospinal Fluid Rhinorrhea↗
PubMed1993

Repeat administration of high dose melphalan in relapsed myeloma.

At a median time of 20 months following high dose melphalan for myeloma, 29 patients relapsed and were treated with induction chemotherapy to maximum response followed by a second course of high dose melphalan. The majority (90%) of patients received 200 mg m-2 with an autologous bone marrow transplant. Sixteen (55%) patients achieved complete remission and 11 (38%) a partial response. The median duration of remission was 17 (4-42) months. The median survival has not been reached, with 50% of patients alive at 58+ months after presentation. The period of neutropenia was similar during both first and second high dose procedures, but the duration of thrombocytopenia was longer in patients receiving melphalan for a second time (median 22 (16-56) days and 41 (18-69) days respectively). There was one treatment-related death due to thrombocytopenic haemorrhage. Repeated administration of high dose melphalan is a feasible approach for patients with relapsed myeloma.

Adult↗
PubMed1992

Validation of respiratory inductance plethysmography ("Respitrace") for the measurement of tidal breathing parameters in newborns.

INTRODUCTION: The ratio of the time to reach peak (maximum) tidal expiratory flow (Tme) to total expiratory time (Te) is smaller in infants who later develop lower respiratory tract disease. In previous studies infants have been sedated and flow measured using a pneumotachograph with face-mask. These methodological factors are known to affect tidal breathing, and the frequent need for sedation limits the use of the technique to relatively small studies. The aim of this study was to validate uncalibrated respiratory inductance plethysmography (Respitrace) to measure Tme/Te in unsedated newborns. METHODS: Nineteen normal term infants were studied during quiet sleep. Agreement between Tme/Te measured directly using a pneumotachograph and with Respitrace was assessed in 15 infants. Repeatability of the Respitrace technique was assessed in 10 infants. RESULTS: The mean Tme/Te for the 19 infants using Respitrace was 0.46 (S.D. 0.14). The mean difference between Tme/Te obtained using Respitrace and that measured with a pneumotachograph was 0.014; 95% of Respitrace readings were between -0.042 and 0.070 of the pneumotachograph values. The mean difference between repeat Respitrace values was 0.02 with 95% of the second measurements within 0.066 of the first. CONCLUSIONS: These results indicate that Respitrace can be used to determine Tme/Te accurately.

Evaluation Studies as Topic↗
PubMed1992

Gut protection by cyclophosphamide "priming" in patients receiving high-dose melphalan--effect of drug scheduling.

A "priming" injection of cyclophosphamide (400 mg/m2 given i.v. on day -7) has been shown to reduce intestinal permeability and thus gut toxicity in patients receiving high-dose melphalan. To determine the optimal timing for this injection, patients receiving 200 mg/m2 melphalan with an autologous bone marrow transplant were randomly assigned to receive cyclophosphamide at 5, 7 or 9 days before the melphalan. The median percentage of [51Cr]-ethylenediaminetetraacetic acid excretion was similar (9.1% vs 7.1% vs 7.7%, respectively), with equivalent duration of WHO grade 2-4 mucositis and diarrhoea being recorded for each group. Thus, the timing of the cyclophosphamide prime is not critical, and the priming injection may be given between 5 and 9 days prior to high-dose melphalan.

Bone Marrow Transplantation↗
PubMed1992

Reproducibility of mandibular motion and muscle activity levels using a commercial computer recording system.

A commercial computer recording system (BioPak) was tested for its accuracy and reproducibility in recording mandibular motion and muscle activity levels (EMG). Accuracy of measurements of mandibular motion was tested using sliding calipers. Accuracy of muscle activity levels was checked with a sine-wave calibration signal of known amplitude and frequency. Reproducibility of motion and of EMG was made using five control subjects each tested on 3 separate days. Computer measurements of motion were found to require correction for nonlinearity at openings beyond 45 mm. Most maximum voluntary excursions were found to be more reproducible than motions during mastication. However, lateral deviation during opening was strongly affected by magnet orientation and varied greatly between trials. Electromyographic recordings were distorted by improper treatment of high-frequency components of the signal and also varied greatly between trials. This study suggests that the BioPak system may indicate changes in some measures of mandibular motion and EMG levels in patients for whom no changes have occurred.

Adult↗
PubMed1992

Reproducibility of data from a hand-held digital pulp tester used on teeth and oral soft tissue.

Controlled studies of the reproducibility of data from electronic pulp testing instruments are limited and contain few statistical analyses. The reproducibility of these readings is important if the instrument is to be used for determining differences in sensitivity. Twenty human subjects (16 male) were used in this study. One incisor, one premolar, one molar tooth with small or no restorations, and two gingival soft tissue positions from each upper and lower arch of each subject were stimulated with the Analytic Technology vitality scanner. This procedure was repeated twice with a 5-minute rest between each trial, for a total of three trials. Each subject was then seen again after a period of at least 3 days, at which time the trials were repeated. The collected data were grouped by trial, tooth position, and day. Paired t test analysis of both the absolute difference between any two trials on the same day and the average of the absolute differences between corresponding trials on days 1 and 2 showed no statistically significant differences (p greater than 0.05). Accommodation to the stimulus was evaluated by examining differences in the mean values between the three same-day trials. The Analytic Technology vitality scanner was found to be reproducible both for consecutive same-day trials and for corresponding trials on different days. No same-day trends in meter readings were noted.

Adult↗
PubMed1992

A comparative study of the effects of intranasal triamcinolone acetonide aerosol (ITAA) and prednisone on adrenocortical function.

A comparison of adrenocortical function before and after treatment with either intranasal triamcinolone acetonide aerosol (ITAA), prednisone, or placebo was done. Sixty-two male subjects with allergic rhinitis were treated for 6 weeks with either ITAA (220 or 440 micrograms/day), oral prednisone (10 mg/day), or placebo in double-blind, parallel-group fashion. Adrenocortical function was assessed by 6-hour cosyntropin stimulation before and at the end of the treatment period. The placebo-treated and two ITAA-treated groups produced no changes in adrenocortical function with treatment, and the ITAA-treated groups were not different from the placebo-treated group with mean +/- SEM changes in stimulated plasma cortisol (micrograms per deciliter) as follows: placebo, -2.68 +/- 1.77; ITAA 220 micrograms, -2.69 +/- 1.18; ITAA 440 micrograms, -2.96 +/- 1.81. The prednisone-treated group had a mean reduction in adrenocortical function (mean +/- SEM change in stimulated plasma cortisol of -19.8 +/- 1.77 micrograms/dl) that was significant (p less than 0.0001) compared with that of the placebo-treated group. The results of this study indicate that 6 weeks of treatment with 220 micrograms/day or 440 micrograms/day of ITAA has no effect on adrenocortical function, but prednisone, at a dosage of 10 mg/day for 6 weeks, produces partial adrenocortical suppression.

Administration, Intranasal↗
PubMed1992

Treatment of mandibular angle fractures using two mini dynamic compression plates.

Thirty patients with 31 fractures of the mandibular angle were treated by open reduction and internal fixation using two mini dynamic compression plates with self-threading screws placed through a transoral incision with transbuccal trochar instrumentation. None of the patients were placed into postsurgical maxillomandibular fixation (MMF) or training elastics. Complications requiring secondary surgical intervention occurred in nine fractures (29%). Three were early infections requiring incision and drainage, removal of the hardware, and postoperative MMF. One was a nonunion with malocclusion requiring application of a more rigid bone plate. Five fractures developed late chronic swelling and low-grade infection requiring plate removal. Osseous union had occurred in these cases and no MMF was necessary. The use of two mini dynamic compression plates in the manner done in this study was found to be a relatively easy but unpredictable treatment for fractures of the mandibular angle.

Adolescent↗
PubMed1992

Osseous healing of the sagittal ramus osteotomy: a histologic comparison of rigid and nonrigid fixation in Macaca mulatta.

Twenty-three adult female rhesus monkeys underwent advancement of the mandible by the sagittal split ramus osteotomy. Twelve had the proximal and distal segments wired together and underwent 6 weeks of maxillomandibular fixation (MMF). Eleven animals had bicortical bone screws placed between the segments and no postsurgical MMF. The animals were killed at 6 and 12 weeks and the osteotomy sites were prepared for histologic examination. Overall, the results showed that the two groups of animals underwent markedly different patterns of osseous healing. The osteotomy sites in the MMF animals were filled with callus, which then formed bone. In contrast, no callus was found in the majority of the rigid fixation osteotomy sites; direct bony deposition was found instead. The results of this investigation show that, like long bones, the sagittal osteotomy can heal by direct or indirect means depending on the rigidity of the fixation.

Animals↗