Biomedical subjects
Publications and source records attributed to J G Jackson.
A patient with typical classic migraine, including clear-cut visual auras, who had been followed up clinically for more than 15 years developed permanent right homonymous hemianopia. The underlying cause of this clinical syndrome was established by computerized axial tomography as vascular infarction or ischemia, involving the contralateral visual cortex.
The volar approach to open reduction of the complex dislocation of the index metacarpophalangeal joint as described by Kaplan proved to have certain disadvantages. Digital nerves are easily damaged during exposure and there is a limited view of the entrapped fibrocartilaginous volar plate dorsal to the metarcarpal head. A direct dorsal longitudinal incision through the skin and extensor tendon gives full exposure. The volar plate attached to the proximal phalanx and trapped over the dorsal aspect of the metacarpal head is in full view. The volar plate is split longitudinally and the dislocation reduces spontaneously as the flexor tendons and lumbrical muscle slip by the metacarpal head. The advantages of this approach as compared with the volar approach are: (1) there is full exposure of the fibrocartilaginous volar plate, the main structure blocking reduction; (2) digital nerves are not as apt to be damaged; and (3) accurate reduction and fixation of the osteochondral fracture of the metacarpal head, frequently seen with this dislocation, is possible.
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This study compares the efficacy of two drug regimens used for oral sedation in pediatric dental patients: chloral hydrate (50 mg/kg)/promethazine (1 mg/kg) and meperidine (1 mg/kg)/promethazine (1 mg/kg). Twenty-four pediatric dental patients, ASA Class I, were evaluated in this double-blind, randomized study. The patients ranged in age from 18 to 48 months. Each dental procedure under sedation was videotaped and rated independently by two raters. Intraoperative ratings of sleep, movement, crying, an overall behavior score for each treatment interval, and an overall behavior score for each sedation were also evaluated. No treatment was aborted for either regimen. In all cases, chloral hydrate/promethazine sedations had significantly better results for sleep (P = 0.0001), movement (P = 0.0168), crying (P = 0.0041), and overall behavior score (P = 0.0186) for the sedations compared to meperidine/promethazine sedations. Although chloral hydrate/promethazine sedations produced significantly better results, clinically, both drug regimens were equally effective.