Biomedical subjects
Publications and source records attributed to G A Wood.
A patient hit by a plastic bullet sustained severe facial contusion and a comminuted fracture of the mandible with bone loss. There was a non-union of the fracture. The injury and the restoration of the defect are described and the use of plastic bullets is discussed.
Dermatofibrosarcoma protuberans is an uncommon tumour of the dermis and rarely occurs on the scalp; there are few known predisposing factors. A case is described of such a tumour that occurred at the site of radiotherapy for a basal cell carcinoma. Histological characteristics, behaviour and management of dermatofibrosarcoma protuberans are discussed.
Sixteen experienced male powerlifters served as subjects in a training study designed to examine the effect of flexibility training on: (i) the stiffness of the series elastic components (SEC) of the upper body musculature and (ii) rebound and purely concentric bench press performance. Nine of the subjects participated in two sessions of flexibility training twice per week for 8 wk. Prior to and after the training period the subjects' static flexibility, SEC stiffness, rebound bench press (RBP), and purely concentric bench press (PCBP) performance were recorded. The flexibility training induced a significant reduction in the maximal stiffness of the SEC. Furthermore, the experimental subjects produced significantly more work during the initial concentric portion of the RBP lift, enabling a significantly greater load to be lifted in the post-training testing occasion. The benefits to performance achieved by the experimental group consequent to flexibility training were greater during the RBP lift as compared with the PCBP lift. The control subjects exhibited no change in any variable over the training period. These results implied that the RBP performance enhancement observed consequent to flexibility training was directly caused by a reduction in SEC stiffness, increasing the utilization of elastic strain energy during the RBP lift.
A method for draping in TMJ surgery including arthroscopy is presented using a urological drape. The advantage is that it allows movement of the mandible by the surgeon or assistant without their contamination by saliva.
The static flexibility of the gleno-humeral joint of fourteen experienced male weight lifters was determined. Further the subjects performed a series of quasistatic muscular actions of the deltoid/pectoralis musculature during which a brief perturbation was applied. The damped oscillations resulting from such a procedure provided data pertaining to the stiffness of each subject's musculature. A significant correlation (r = -0.544, p less than 0.05) between maximal stiffness and static flexibility was observed. This relationship is discussed with reference to the popular belief that flexibility is related to the incidence of muscular injury. It is proposed that the injury-reducing benefits associated with a high degree of flexibility can be effectively explained through the relationship between flexibility and stiffness.
Twelve experienced male weight lifters performed a rebound bench press and a purely concentric bench press lift. Data were obtained pertaining to 1) the benefits to concentric motion derived from a prior stretch and 2) the movement frequency adopted during performance of the stretch-shorten cycle (SSC) portion of the rebound bench press lift. The subjects also performed a series of quasi-static muscular actions in a position specific to the bench press movement. A brief perturbation was applied to the bar while these isometric efforts were maintained, and the resulting damped oscillations provided data pertaining to each subject's series elastic component (SEC) stiffness and natural frequency of oscillation. A significant correlation (r = -0.718, P less than 0.01) between maximal SEC stiffness and augmentation to concentric motion derived from prior stretch was observed. Subjects were also observed to perform the SSC portion of the rebound bench press movement to coincide with the natural frequency of oscillation of their SEC. These results are interpreted as demonstrating that the optimal stiffness in a rebound bench press lift was a resonant-compliant SEC.
Our aim was to assess the mechanisms determining the reflex formation of an oral airway in response to nasal obstruction (NO) and tracheal obstruction (TO). In nine conscious lambs (14-37 days old) NO was effected by blockade of nasal tubes; TO was later effected by blockade of an endotracheal tube. We measured arterial O2 saturation, PO2, PCO2, and pH and the depth and duration of inspiratory efforts when mouth opening (MO) occurred. Responses were compared when NO and TO followed breathing of room air, rebreathed air, and 100% O2. After both NO and TO, MO was initiated most rapidly after lambs rebreathed air and least rapidly after they breathed 100% O2. Similar changes in blood gases and pH were measured when MO occurred after air breathing and rebreathing; however, the extent of these changes was greater during TO than during NO. After 100% O2 was breathed, MO occurred when lambs were still hyperoxic, but they were more hypercapnic and acidemic than after breathing air or rebreathed air. There were no differences, related to prebreathed gases or site of airway occlusion, in the depth of inspiratory efforts at the time of MO. We conclude that the formation of an oral airway requires a critical level of inspiratory drive in the presence of airway obstruction. After the prebreathing of different gases, differences in response latency and blood gases at the time of MO can be attributed to the attainment of this threshold level of inspiratory drive. The formation of an oral airway is facilitated by, but not dependent on, receptors in the upper airway.
Twelve experienced male weight lifters of varying ability completed a series of bench press lifts at 95% of maximum. These lifts included a rebound bench press, which was performed without a delay between the downward and upward components of the lift, a bench press performed without a downward phase, and two bench press movements performed with various pause periods imposed between the downward and upward phases of the lift. Force and cinematographic data were collected during each lift. The augmentation to performance derived from prior stretch was observed to decay as a function of the pause duration. This relationship was accurately described (P less than 0.01) by a negative exponential equation with a half-life of 0.85 s. The nature of this decay is discussed with reference to the implications for stretch-shorten cycle movements that are performed with a period of pause between the eccentric and concentric phases and for stretch-shorten cycle research paradigms.
The oral cavity is a rare location for the development of primary malignant melanoma. Less than 2% of all malignant melanomas develop in the region. A case report is presented, illustrating the management in the site of the palate, together with a review of the relevant literature.
This study was aimed at determining the role of carotid bodies in the initiation and maintenance of oral breathing during nasal obstruction. We have previously shown in sheep that oral breathing during nasal obstruction was less effective in the neonate than in older lambs or adults. We considered it possible that the reduced response of the neonate was due to immaturity of carotid body chemoreceptors. Respiratory and blood gas responses to nasal obstruction were determined in 5 neonatal lambs, 6 older lambs and 6 adult ewes before and after surgically denervating the carotid bodies. Denervations were performed at 4.2 +/- 0.9 days after birth in the neonatal lambs and at 41.5 +/- 2.5 days in the older lambs. Carotid body denervation led to hypoxia, hypercapnia and acidaemia in lambs and ewes during unobstructed nasal breathing, and, in response to nasal obstruction, delayed the onset of oral breathing so that it occurred at a greater degree of hypoxia. Following carotid body denervation the degree of hypercapnia and acidaemia during nasal obstruction was greater in lambs than in ewes. We conclude that the carotid bodies in lambs and ewes play an important role in the regulation of normal blood gases and pH, and in the establishment and effectiveness of oral breathing during nasal obstruction.
Our aim was to determine the effects of pharmacological sedation on oral breathing induced by nasal obstruction in chronically prepared newborn and mature sheep. Nasal obstruction (5 min) was achieved by blocking tubes temporarily fixed into the nostrils. We continuously recorded EMG activity of the diaphragm, genioglossus and digastric muscles, intrapleural pressure and percent O2 saturation in arterial blood (SaO2). Blood samples were taken intermittently and analysed for SaO2, P02, PCO2 and pH. As previously reported, nasal obstruction in lambs and ewes led to asphyxial changes in blood gases and pH; lambs were affected more than ewes. Respiratory responses to nasal obstruction were retested after administration of pentobarbitone Na (5 and 10 mg/kg), diazepam (0.2 and 0.4 mg/kg) and alcohol (nominally 0.075 and 0.11% of blood w/v). Pentobarbitone and diazepam, both of which produced sedation, delayed the onset of oral breathing and led to a greater degree of asphyxia during nasal obstruction. EMG activities in the genioglossus and digastric muscles were inhibited by the drugs, whereas the depth of inspiratory efforts was not. Alcohol had no apparent sedative effect, nor did it significantly affect responses to nasal occlusion. We conclude that sedating doses of pentobarbitone and diazepam depress the effectiveness of oral breathing when the nose is blocked, probably owing to their inhibitory effects on activation of muscles maintaining patency of an oral airway.
Cases have been presented that demonstrate the advantages of small plate ostesynthesis in the reconstruction of the mandible following resection of neoplastic disease. Mandibulotomies provide improved access to tumors and thus allow the tumor to be better excised. Prelocalization of the plates allows the precise reconstruction of the mandible following mandibulotomy with minimal morbidity and disturbance of function.
An extremely rare location for eosinophilic granuloma of bone in the mandibular condyle has been described, illustrating the difficulties of diagnosis. Excision and reconstruction with a costochondral graft was successfully undertaken and remodelling of the graft occurred with the formation of a new condylar head. The patient is disease-free 17 months after surgery. The relevant literature is reviewed and suggestions made for management protocol.
A cheek splitting incision giving good access to lesions of the posterior region of the mouth is described. The incision is particularly useful when the CO2 laser is being used for the resection of malignant neoplasms. For cosmetic reasons the incision is most suitable in elderly patients.
The aims of this study were to compare the ability of awake newborn lambs and adult sheep to breathe orally when the nasal route was blocked and to determine the means by which it was accomplished. Chronic EMG electrodes (diaphragm, genioglossus, geniohyoid, posterior crico-arytenoid, digastric, thyroarytenoid) and fibre-optic catheters were implanted in 10 lambs and 4 ewes. Before each study soft tubes were fixed into the nostrils allowing rapid blockade of the nasal ventilatory pathway. During nasal blockade inspiratory upper airway dilator EMG activity increased. SaO2 fell until mouth opening occurred, then returned to near control values; oral breathing then ceased leading to desaturation again. In lambs and ewes there was significant hypoxia, hypercapnia and acidaemia. In lambs 2-14 days old, PO2 and pH fell to lower levels than in older lambs (15-30 days) or ewes and PCO2 rose more. In lambs PCO2 gradually increased during the period of obstruction. We conclude that maintenance of blood gas homeostasis in newborn lambs is more severely impaired by nasal obstruction than in older lambs or ewes, possibly due to an immaturity of neural mechanisms controlling the creation of an oral airway.
Breathing frequency (f) is often reported as having an integer-multiple relationship to limb movement (entrainment) during rhythmic exercise. To investigate the strength of this coupling while running under hypoxic conditions, two male Caucasians and four male Nepalese porters were tested in the Annapurna region of the Himalayas at altitudes of 915, 2,135, 3,200, 4,420, and 5,030 m. In an additional study in a laboratory at sea level, three male and four female subjects inspired various O2-N2 mixtures [fraction of inspired O2 (FIO2) = 20.93, 17.39, 14.40, 11.81%] that were administered in a single-blind randomized fashion during a treadmill run (40% FIO2 maximum O2 consumption). Breathing and gait signals were stored on FM tape and later processed on a PDP 11/73 computer. The subharmonic relationships between these signals were determined from Fourier analysis (power spectrum), and the coincidence of coupling occurrence was statistically modeled. Entrainment decreased linearly during increasing hypoxia (P less than 0.01). Moreover, a significant linear increase in f occurred during hypoxia (P less than 0.05), whereas stride frequency and metabolic rate remained constant, suggesting that hypoxic-induced increases in f decreased the degree of entrainment.
To investigate whether ventilation frequency could be entrained to a sub-harmonic of the exercise rhythm, 19 experimentally naive male volunteers were tested during steady state bicycle ergometry and arm cranking under conditions of constant applied workload. Each exercise was performed at two separate ventilatory loads, one within the linear range and the other in the curvilinear range of ventilatory response to exercise. A preferred exercise rhythm was initially adopted (4 min.) followed by forced incremented and decremented rhythm changes each lasting 3 min during a 12 min exercise period. Ventilation, pedal pulse train and heart rate were sampled at 17 Hz on a PDP 11/23 computer. Ratios of limb frequency to dominant respiratory frequency were determined following Fourier analysis of these signals. Data that lay within +/- 0.05 of an integer and half-integer ratio were accepted as indices of entrainment, provided that the observed entrained scores were statistically significant. Ventilation frequency showed a clear, but intermittent tendency to entrain with limb frequency. This tendency was greater during bicycle ergometry, possibly as a consequence of task familiarisation, although both exercise entrainments were independent of workload. No difference between preferred versus varied exercise rhythm was evident, but more entrainment (p less than 0.01) was observed during a decremental change in exercise rhythm. These responses do not appear to support an appreciable role for limb-based afferents in the control of entrainment. The results of this study provide evidence that exercise rhythm has some regulatory role in the control of breathing during moderate rhythmical laboratory-based exercise ergometry.
An analysis of errors arising from the Direct Linear Transformation (DLT) approach to three-dimensional reconstructions from two-dimensional images has been undertaken, the principal factor studied being the number and distribution of control points used in the calibration procedure. Significantly increased error was found to be associated with extrapolation to unknown points outside the control point distribution space. Differences in accuracy between two camera position set-ups and 11 vs 12 DLT parameter solutions were also examined.