We have analyzed predictors of mortality following closed head injury in a series of 1,031 consecutive patients with closed head injury admitted to hospital from January 1986 through December 1990. All patients were treated in a uniform manner and surgical intervention was performed as soon as possible in patients with intracranial mass lesions. Logistic analysis was used to identify patient and injury characteristics that were independent predictors of mortality within this patient group. Significant predictors were Glasgow Coma Score at admission (p = 0.0000), age (p = 0.0000), bilaterally unreactive pupils (p = 0.0000), presence of multiple systemic injuries (p = 0.0004), presence of an intracranial mass lesion (p = 0.0006), and presence of unilateral pupillary abnormalities (p = 0.0279). In an attempt to clarify the relationship between the incidence of these characteristics in series of severely head-injured patients reported during the last 2 decades and the mortality reported in those series, regression analysis was carried out comparing the mean age reported in the series, incidence of mass lesions, and reported mortality. Sixty-four percent of the variability in reported mortality rates could be accounted for by differences in mean age of the patients and mass lesion incidence (p = 0.0035). We conclude that apparent improvements in head injury mortality in the last 2 decades may be partly or wholly due to different population characteristics in the reported series. Multiple injuries appear to be important contributors to patient mortality, and in the interest of improved description of head injury populations, the Injury Severity Score should be reported with age, mass lesion incidence, and Glasgow Coma Score.

Adolescent↗

PubMedDate not supplied

Single-dose antibiotic prophylaxis in maxillofacial surgery.

The clinical efficacy of short-term antimicrobial prophylaxis with either one shot of ceftriaxone (1 g) or a course of 3 injections of a fixed combination of mezlocillin (2 g) and oxacillin (1 g) administered over 24 h was studied in a prospective randomized clinical study of 100 patients undergoing elective maxillofacial surgery. Tissue and plasma concentrations of the antibiotics were determined by high-pressure liquid chromatography in 6 tumor surgery patients from each treatment group. Statistical analysis showed the treatment group to be comparable both demographically and with respect to the types of surgery performed and the durations of the procedures. Only 1 patient in each group developed a postoperative wound infection. It is concluded that 1 g ceftriaxone given 30 min preoperatively meets the pharmacokinetic requirements for perioperative antimicrobial prophylaxis in maxillofacial surgery.

Adult↗

PubMedDate not supplied

Immunological reaction of UV-induced radiation damage in coliphage DNA.

Denatured DNA of coliphage T1, poly-dT and dTpT were UV-irradiated (2537 A) and conjugated to methylated bovine serum albumin. These molecules act as haptens after injection into rabbits. Antibodies are predominantly formed against UV-induced cyclobutane-type of cis-synthymine dimers. They belong to the IgG-type of antibody molecules. Antigen-antibody complexes were detected by means of the CsCl-density gradient method. Denaturation of the DNA strongly influences the amount of specific antibodies bound to the antigen. In native DNA thymine dimers are masked concerning their reaction with antibodies. Photoproducts of UV-irradiated dTpT induce a specific production of antibody. Our results indicate that the cyclobutane type of thymine dimers is the relevant antigenic determinant group in UV-irradiated DNA.

Animals↗

PubMedDate not supplied

Perseveration. Part I: a review.

Perseveration refers to the inappropriate continuation or repetition of a response or activity. It is associated with a variety of neurological disorders and, when pronounced, is thought to be pathognomonic of brain damage. Perseveration manifests itself in several different forms which have had various labels applied, and many hypotheses have been proposed to explain the mechanisms underlying these perseverative behaviours. In this article we review descriptions and classifications of perseveration as it occurs in various neurological disorders, and then discuss some of the neurobehavioural and neuropathological mechanisms thought to account for it.

Attention↗

PubMedDate not supplied

Perseveration. Part II: A study of perseveration in closed-head injury.

This study examines the nature and extent of perseveration in 15 individuals with closed-head injury (CHI) by (a) identifying and describing the types of perseveration that occurred on verbal and non-verbal tasks, (b) examining the possible underlying neuropsychological mechanisms of perseverative behaviour and (c) exploring neuroanatomical correlates of perseveration. Performance of the 15 CHI patients was compared with 15 neurologically normal subjects matched for sex, age, handedness and educational level. The CHI subjects produced significantly more perseverations than did normals, and 'recurrent' perseveration was the most frequently occurring type. A test of verbal learning elicited the greatest number of recurrent perseverations. Overall test performance of the CHI group suggested that memory dysfunction and impaired attention were most likely responsible for perseverative errors. CT scan analyses showed that the three most perseverative CHI subjects evidenced left temporal lobe damage.

Adolescent↗

PubMedDate not supplied

[The diagnostic value of the tumor markers CEA, "Ca 19-9", "Ca 125", "Ca15-3" and "SCC" for the detection of recurrent tumors in patients with tumors of the head and neck].

An increased squamous cell carcinoma antigen (SCC) value was found in 33.3% of the patients with carcinomas of the oral cavity. In those patients in whom the tumor recurred, this percentage increased to 75%. Although elevated in 43.4% of the tumor patients, CEA values failed to drop after treatment like the SCC antigens did. Nor was there, in contrast to the SCC antigens, any evident correlation with tumor volume. Thus, pathologic CEA values must be attributed to non-tumor specific concomitant diseases. Ca 19-9, Ca 125 and Ca 15-3 exhibited poor sensitivity. According to the results of our studies the only valid tumor markers are SCC antigens, particularly for monitoring treatment.

Antigens, Neoplasm↗

PubMedDate not supplied

[Collagen and fibrin as biologic binders for granular hydroxylapatite].

In an animal experiment the use of the biologic binders collagen and fibrin for the temporary stabilization of the shape of granular hydroxyl apatite grafts has been tested. A simple way of producing a hydroxyl apatite fibrin paste involves the use of a thrombin solution diluted to 1 i.u./ml. The fibrin-bound polygonal granules (Interpore 200) studied did not grow denser during the interposition of fibrous tissue, while the molded specimens of collagen-bound granules (Alveoform) underwent condensation involving a 30% decrease in intergranular distance.

Adhesives↗

PubMedDate not supplied

[Alveolar ridge augmentation using moldable implants of granular hydroxylapatite and fibrin adhesive].

First results in the use of a hydroxyl apatite fibrin paste for alveolar ridge augmentation are reported. In the production of the moldable implants a fibrin mixture containing 1 i.u. Thrombin/ml is used as an absorbable biologic binder for the granules. The individual shape and situation of the graft is maintained throughout the resorption of the fibrin adhesive and the spread of connective tissue into the intergranular spaces, without any additional means of fixation required. Even under functional load, which starts after 6 weeks, the intergranular distance and the shape of the implants remains unchanged.

Alveolar Ridge Augmentation↗

PubMedDate not supplied

[Clinical use of non-specific antibiotic treatment for infections of the maxillofacial area].

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Adult↗