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Biomedical subjects

K Altman

Publications and source records attributed to K Altman.

At least 19 recordsLinked to original sources

Reconstruction techniques in oral carcinoma.

Resection of oral carcinoma can cause serious problems with speech, mastication and swallowing. Several methods of reconstruction of the defects caused by tumour resection are available to the modern oral and maxillofacial/head and neck surgeon, some of which are more effective and aesthetically pleasing than others. This article discusses the methods available, their advantages and disadvantages, and gives guidelines on the circumstances in which each is ideally used.

Female

Non-union of mandibulotomy sites following irradiation for squamous cell carcinoma of the oral cavity.

Mandibulotomy improves surgical access to the oral cavity for the resection of tumours. Non-union of the mandibulotomy due to osteoradionecrosis has been observed in five patients with oral squamous cell carcinoma, all of whom had radiotherapy either as the primary modality of treatment or for tumour recurrence. This paper reports this series of patients, discusses their management and highlights the risk factors for the development of osteoradionecrosis.

Bone Plates

Merkel cell carcinoma.

A case of Merkel cell carcinoma of the cheek is described, highlighting the clinical behaviour, diagnosis and management of this uncommon tumour.

Aged

Bone scans and the timing of treatment for condylar hyperplasia.

Bone scintiscans comparing the uptake of technetium 99 in the normal and affected condyles of 10 patients with unilateral condylar hyperplasia were recorded at or after the time when overall growth had ceased. The scans of 6 patients demonstrated persisting increased growth activity at this time. In 2 of these cases where the abnormal condyles showed uptakes of 240% and 170% with respect to the normal side, the nature and timing of treatment were changed when the results of the scans were known.

Adolescent

A survey of surgical rotations for oral & maxillofacial surgery trainees.

Seventy oral and maxillofacial surgery departments were sent questionnaires to determine whether they made provision for their medically qualified registrars to undergo 1 year's surgical training in recognition for the Part II FRCS oral and maxillofacial surgery option of the Royal College of Surgeons of Edinburgh. Fifty-six (80%) replies were received revealing that 11 (19.6%) departments had existing arrangements for a surgical rotation while 14 (25%) had plans to implement one. These results are further reported.

Curriculum

Nuclear imaging and the assessment of human Fc receptor function: studies in systemic lupus erythematosus.

In vivo immune clearance of immunoglobulin G sensitized autologous erythrocytes (rbc) was studied in nine patients who fulfilled American Rheumatism Association (ARA) criteria for systemic lupus erythematosus (SLE). Opsonized rbc were radiolabelled with technetium 99. The rate of radioactive blood clearance was measured, as was organ-specific radioactive uptake utilizing area-of-interest (AOI) measurements in a computerized scintigraphic imaging system. It was shown that dynamic quantitation of an AOI corresponding to the heart generated time-activity curves which approximated blood-clearance curves. Calculation of first order clearance (min per 50% decrease in counts) showed a highly significant correlation between rates derived from heart AOI curves and those derived from blood-clearance curves (r = 0.9483, P = 0.0003). Clearance curves showed a monoexponential slope in most patients. Further exploration of organ-specific AOI curves showed that percent splenic uptake and the nature of the splenic uptake curves varied between patients. These studies point toward a variable splenic role in Fc receptor function for SLE patients and further demonstrate the utility of nuclear imaging in studying immune clearance.

Adult

Training graduate students in parent conference skills.

Twelve graduate students were trained in three categories of parent conference skills: communicating diagnostic information, communicating recommendations, and organizing the conference and interacting with parents. Training done individually with each student consisted of written programmed learning materials plus oral practice. Training effects were measured during role-play and actual parent conferences. Training effectiveness was assessed with a multiple baseline design across three skill categories. Eleven of 12 students exhibited significant skill acquisition and nine generalized skills to an actual parent conference. Professionals and parents of developmentally delayed children attested to the importance and effectiveness of the training program. Results demonstrated that parent conference skills can be operationalized, trained, and generalized to actual conferences.

Adult

Modifying the self-injurious behavior of an infant with spina bifida and diminished pain sensitivity.

This clinical case study extends the literature on behavioral treatment of self-injury to an intellectually normal infant with spina bifida and diminished sensitivity to pain. After treatment by attention-play periods plus an aversive tasting substance applied to the injured finger, severe biting of the index finger was eliminated and the finger healed. Follow-up inquiries 2 months, 2 and 3 yr later revealed no biting and no substantial tissue damage.

Behavior Therapy

Suppressing aggressive-destructive behavior by delayed overcorrection.

Delayed overcorrection reduced the aggressive-destructive behavior of a developmentally delayed adolescent when it was added to previously ineffective procedures of differential reinforcement (tokens and token-removal) of other behavior. The delayed contingency was necessary because target behaviors occurred exclusively in the absence of the only family member who could overpower the subject. A multiple baseline design across two levels of problem-behavior severity indicated that delayed overcorrection effectively suppressed the aggressive-destructive episodes. The results support the notion that delayed contingencies can effectively suppress target behaviors.

Adolescent