Search PubMed⌕ Search

Biomedical subjects

L J Ling

Publications and source records attributed to L J Ling.

At least 37 records · Page 2Linked to original sources
PubMed1994

Guided tissue regeneration in surgically created 3-walled and 2-walled periodontal osseous defects in monkeys.

BACKGROUND: In the previous clinical studies, guided tissue regeneration resulted in periodontal regeneration after treatment of 3-walled intrabony defects. The purpose of the present study was to compare the regenerative potential of 3-walled and 2-walled surgically created periodontal osseous defects in monkeys following placement of a biocompatible, porous polytetrafluorethylene membrane. METHODS: In each of 8 Taiwan monkeys, 2 maxillary and 2 mandibular teeth were selected for experimentation. Using a diamond bur, 3-walled osseous defects were created on the distal of the maxillary cuspid and the mesial of the mandibular second bicuspid of one side. Two-walled (lingual wall and proximal wall) osseous defects were created on the contralateral side. After root planing, teflon membranes were applied to the mandibular test teeth. In the maxilla, all procedures were the same except for the placement of teflon membranes. Two monkeys were sacrificed 3, 6 and 9 months after operation and prepared for histologic and histometric evaluation. Reentries were performed while the other 2 monkeys were terminated 11 months after operation. RESULTS: Histologic evaluation revealed that new connective tissue attachments were found to a greater extent in the 3-walled periodontal osseous defects treated with teflon membranes compared with the non-membrane sites (p = 0.05). More periodontal regeneration was not predictably obtained in the surgically created 2-walled osseous defects when the teflon membranes were used. CONCLUSIONS: For 3-walled periodontal osseous defects, guided tissue regeneration was superior to conventional periodontal flap surgery. For 2-walled defects, new connective tissue attachment could not be predictably achieved.

Alveolar Bone Loss↗
PubMed1993

Safety assessment of high-dose narcotic analgesia for emergency department procedures.

STUDY OBJECTIVE: To evaluate the safety of high-dose IV narcotics in patients requiring analgesia for painful emergency department procedures. DESIGN: Prospective multicenter clinical trial. SETTING: Five adult urban EDs. METHODS AND MEASUREMENTS: All patients received IV meperidine (1.5 to 3.0 mg/kg) titrated to analgesia followed by a painful procedure. Vital signs and alertness scale were recorded at regular intervals, and patients were observed for four hours. Adverse events were monitored and documented. Comparisons between baseline and postanalgesia intervals were made with a repeated measures ANOVA (Dunnett's test). RESULTS: Although statistically significant changes in vital signs and alertness scale occurred, they were not clinically significant. Opiate reversal with naloxone was not needed in any patient, and no significant respiratory or circulatory compromise occurred. CONCLUSION: This study of 72 patients demonstrates that high-dose narcotic analgesia is appropriate, well tolerated, and safe when used in selected patients before painful procedures in the ED. Narcotic antagonists and resuscitation equipment nonetheless should be available to maximize safety.

Adolescent↗
PubMed1992

Acute fluoxetine overdose: a report of 234 cases.

Limited toxicity information is available in the medical literature on the antidepressant fluoxetine (Prozac, Dista Products Co, Indianapolis, IN). The goal of this prospective multicenter study was to develop a toxicity profile of initial signs and symptoms observed in an acute fluoxetine overdose. A prospective study was made of patients reported to one of four American Association of Poison Control Centers' regional poison control centers after ingesting an acute overdose of fluoxetine. A standard data collection form was used on all patients ingesting fluoxetine. Information obtained included age, current medications, dose, coingested drugs, presenting symptoms, vital signs, electrocardiogram abnormalities, outcome, and fluoxetine levels. The authors collected 272 cases; 234 cases met the criteria of the study. Fluoxetine was ingested alone in 87 cases and with ethanol or other drugs in the remaining 147 cases. Of the 87 cases where fluoxetine was ingested alone, 67 patients were adults and 20 were children. Symptoms that were seen in the adult group included: tachycardia (15/67), drowsiness (14/67), tremor (five/67), vomiting (four/67), or nausea (four/67). Thirty patients did not develop symptoms. Twelve of the adult overdose patients had total fluoxetine levels ranging from 232 to 1390 ng/mL. The authors conclude that symptoms that develop after an acute overdose of fluoxetine appear minor and of short duration. Aggressive supportive care is the only intervention necessary.

Acute Disease↗
PubMed1992

Survival following hydrofluoric acid ingestion.

Systemic toxicity after significant dermal exposure to hydrofluoric acid includes rapid development of hypocalcemia and hyperkalemia, leading to ventricular fibrillation. Similar dysrhythmias have occurred in patients after ingestion of sodium fluoride-containing compounds. Ingestion of hydrofluoric acid could induce similar cardiac toxicity; however, reported cases of hydrofluoric acid ingestion rarely have been described, and the rapid death of these patients has not allowed verification of this hypothesis. On two separate occasions, a 70-year-old woman ingested up to 2 oz of a 8% hydrofluoric acid-containing solution. Recurrent ventricular fibrillation with concurrent hypocalcemia and hypomagnesemia complicated her first episode, whereas a more aggressive administration of calcium and magnesium may have prevented dysrhythmias in the second episode. Survival from ventricular fibrillation after hydrofluoric acid ingestion has not been reported previously and suggests a role for aggressive empiric calcium and magnesium replacement.

Aged↗
PubMed1991

Absorption of iron after experimental overdose of chewable vitamins.

Even though ingestion of chewable iron preparations is much more common, treatment recommendations for iron overdose are usually based on experience with nonchewable preparations. To determine the optimal time to measure serum iron concentrations, five volunteers were given chewable iron in 5 mg/kg and 10 mg/kg doses and their serum iron concentrations monitored. Peak levels occurred at 4.2 and 4.5 hours, respectively, after ingestion, and levels drawn at 3 hours were within 90% of the peak. Nausea and headache were experienced by all volunteers, and serum iron exceeded baseline total iron binding capacity in two subjects at the 10 mg/kg dose. In minor iron overdose resulting from the ingestion of chewable vitamins, serum iron concentrations measured between 3 and 7 hours (95% confidence level of peak concentrations) may be adequate in assessing the peak serum iron concentration.

Administration, Oral↗
PubMed1991

Whole-bowel irrigation as a treatment for acute lithium overdose.

STUDY OBJECTIVE: To determine if gastrointestinal decontamination using whole-bowel irrigation (WBI) was an effective treatment for acute ingestion of sustained-release lithium. METHODS: In a two-phase, crossover protocol, ten normal volunteers ingested in each phase 0.80 mEq/kg sustained-release lithium carbonate. In the second phase, WBI was begun one hour after lithium ingestion, and 10 L of polyethylene glycol solution were administered over five hours. Serum samples were collected every half hour for six hours, every hour for an additional six hours, and then every 24 hours for as long as 72 hours after ingestion. These samples were analyzed for lithium concentration. The area under the lithium serum concentration-versus-time curve was calculated for each phase. RESULTS: The average area under the lithium serum concentration-versus-time curve in the WBI phase was 67% +/- 11% less than that in the control phase (P less than .0005 using a two-tailed Student's t test). The mean serum lithium concentration was significantly decreased (P = .03) within one hour of beginning WBI. CONCLUSION: WBI is an effective treatment for acute ingestion of sustained-release lithium. We recommend it as the decontaminant procedure of choice in this situation.

Adolescent↗
PubMed1991

The effect of a teflon membrane to augment the healing of extraction sockets in monkeys.

The present study was undertaken in 9 monkeys to test the effect of a teflon membrane to augment the healing of extraction sockets. The 4 lateral incisors of each animal were extracted using a surgical flap approach. Two of the sockets on one side were covered with teflon membrane (experimental sites), while the same procedure was repeated with the exception of the applications of the teflon membrane on the remaining two sockets of the contralateral side (controls). The distal surfaces of the central incisors were notched at the level of the crest of the alveolar bone as the reference points for measurements of alveolar bone response. Re-entries were performed on three monkeys at 50, 90 and 150 days after tooth extraction and the bone fill of the sockets was evaluated. It was concluded from the results that there was a tendency for the teflon membrane placement to result in a greater amount of clinical alveolar bone fill and lesser extent of bone resorption after tooth extraction.

Animals↗
PubMed1991

Histopathologic change of pulp tissue after surgical trauma in monkeys.

The present study was designed to investigate the effect of surgical trauma on pulp tissue. Two-walled osseous defects were surgically created at the mesial sides of the bilateral mandibular second bicuspids of four Taiwan monkeys. The cementum and partial thickness of dentin were removed with diamond bur. At one side of the mandible, the perforation was made at the midpoint of the root surface facing the created osseous defect to allow the pulp tissue to communicate the defects. The flaps were readapted. The monkeys were sacrificed 6 months postoperatively and prepared for the histologic evaluation. The results showed that in three of the four perforated sites, cementum-like structures were formed at the perforated areas. The pulp tissue kept vital. But replacement resorption was taking place in fourth studied site.

Animals↗
PubMed1990

Attaining academic department status for emergency medicine within medical schools.

The specialty of emergency medicine has emerged as a separate academic department within medical schools. These academic departments were contacted and asked to submit information on the process they undertook to attain department status. The path taken by each department was unique and dependent on many factors. Information about these departments is summarized, and ten broad recommendations for academic emergency physicians to consider when seeking department status are given.

Emergency Medicine↗
PubMed1990

How serious is the radon problem?

In the last year or two, a vast array of radon-detection kits has appeared in stores and catalogs. The authors explain what radon is and why it has captured the interest of the American public. They also examine the extent and significance of the radon problem and suggest solutions for homes that are found to have a high concentration.

Humans↗
PubMed1990

The effects of fluoxetine in the overdose patient.

Fluoxetine (Prozac) is a new antidepressant, first marketed in the United States in January 1988. Only limited toxicologic information during a fluoxetine overdose is available. The goal of this prospective multi-center study was to develop a toxicity profile of initial signs and symptoms observed in fluoxetine overdose. A standardized data collection form was used on all patients ingesting fluoxetine as reported to four poison centers. Information obtained included age, dose, co-ingested drugs, presenting symptoms, vital signs, EKG abnormalities and lab values. Of the 127 cases of acute fluoxetine overdose collected, 106 cases met the criteria of the study. Of these, 69/106 ingested other drugs, including ethanol and 37/106 ingested fluoxetine alone. Of the latter group, the amounts ingested ranged from 20 to 1500 mg. It was observed that 48.6% (18/37) remained asymptomatic, 16.2% (7/37) were sleepy, 24.3% (9/37) had a sinus tachycardia (of 100 beats per minute or greater), and 8.1% (3/37) had a diastolic pressure over 100 mm Hg. Data collection is ongoing. Based upon our initial experience, fluoxetine in overdose appears to be relatively benign.

Adolescent↗
PubMed1989

Duration of antagonistic effects of nalmefene and naloxone in opiate-induced sedation for emergency department procedures.

Naloxone is an effective opiate antagonist, but its short half-life limits its usefulness. For outpatient procedures, a longer acting opiate antagonist could eliminate two to four hours of nursing observation in patients postoperatively. A controlled, randomized, double-blind trial comparing the effects of nalmefene, naloxone, and placebo in reversing opiate-induced sedation was carried out to determine efficacy, duration of action, and adverse effects in patients undergoing outpatient procedures. Each patient received 1.5 to 3.0 mg/kg meperidine intravenously before the procedure. After the procedure, each patient received either nalmefene, 1.0 mg; naloxone, 1.0 mg; or saline, 1.0 mL intravenously. Vital signs and assessments for alertness were performed for four hours. Naloxone significantly reversed sedation for only 15 minutes, whereas nalmefene was significantly effective (P less than .05) for up to 210 minutes. Nalmefene was significantly more effective than naloxone in reversing sedation at 60, 90, and 120 minutes. Nalmefene is an effective agent for the reversal of opiate-induced sedation after outpatient procedures.

Adolescent↗
PubMed1989

Substance abuse education in residency training programs in emergency medicine. NIAAA Task Force of the American College of Emergency Physicians.

The emergency department is the focal point for many social ills, not the least of which is substance abuse. We conducted a study to determine to what degree substance abuse education is taught in emergency medicine residency training programs. A set of educational objectives was developed by a task force composed of representatives of the American College of Emergency Physicians, the Society of Teachers of Emergency Medicine, and the University Association for Emergency Medicine. A questionnaire then was sent to the directors of all emergency medicine residency programs accredited by the Accreditation Council for Graduate Medical Education to determine the degree to which those objectives are covered in residency training. A 62% response rate was achieved. The data revealed that such topics as narcotic prescription law, patterns of risk, and issues pertaining to substance abuse by physicians were covered by fewer than half of the programs responding. Respondents were generally satisfied with the adequacy of training of residents and faculty in the area of substance abuse; however, they were dissatisfied with the adequacy of available training materials. Recommendations for changes in graduate curriculum as well as avenues for further research are provided.

Attitude of Health Personnel↗
PubMed1989

An assessment of emergency medicine residency graduates' perceptions of the adequacy of their residency training.

A study of emergency medicine residency training graduates was conducted to determine their perceptions of the quality of their graduate training. A sample of 300 individuals was randomly selected from a population of 1,000 persons graduating from 1982 through 1984. Respondents were asked to use a scale of 1 to 5 (with 1 being highest) to rate the adequacy of their residency training relative to 20 major core content areas. A 50% response rate (N = 151) was achieved. Mean ratings of residents' perceptions of the adequacy of their training relative to the core content ranged from 1.7 to 3.24. Training in resuscitation and stabilization, principles of emergency care, and general assessment were among the most highly rated, while training in physician interpersonal skills, disorders related to the immune system, and cutaneous disorders were rated the lowest. Overall, residents were quite positive in their perceptions regarding the quality of their training. They indicated plans to attend continuing medical education programs to reinforce some of their training and to address some of the deficiencies they perceived in residency training. Programs are encouraged to conduct similar surveys with their own graduates to assess particular strengths and weaknesses.

Adult↗
PubMed1989

Breast feeding of infants between 0-6 months old in 20 provinces, municipalities and autonomous regions in the People's Republic of China. National Coordinating Working Group for Breastfeeding Surveillance.

This investigation was designed as an overall study of breast feeding rates and corresponding influencing factors in urban and rural communities in the People's Republic of China. In all 95,578 infants between 0 and 6 months old who lived within 20 different provinces or autonomous regions were subjects for the study which was conducted from March 1983 to August 1985. The findings revealed that breast feeding rates for urban areas were significantly lower than the rates for the rural areas.

Bottle Feeding↗
PubMed1989

Comparison of single-dose meperidine, butorphanol, and dihydroergotamine in the treatment of vascular headache.

We treated 64 emergency room patients with a primary vascular headache with dihydroergotamine (DHE), meperidine, or butorphanol. Post-treatment pain scores were lowest in the DHE group (p less than 0.01). Eight of 21 patients receiving DHE had greater than 90% reduction in pain compared with three of 19 patients receiving butorphanol and none of 22 receiving meperidine.

Adult↗
PubMed1988

CNS depression in an infant after the ingestion of tobacco: a case report.

An 8-month-old female infant was brought in after ingesting cigarette butts. Upon presentation to the ED approximately 2.5 hr post-ingestion, the child was very lethargic and respirations were depressed. She was intubated and a NG tube was placed. Gastric lavage was performed, after which activated charcoal and sorbitol were given. Atropine was administered to treat excessive secretions. The patient became progressively more obtunded throughout the emergency department stay. Upon admission to the PICU she was minimally responsive. The urine tox screen was positive only for nicotine. The patient gradually improved with supportive care and was sent home on the third hospital day. Although the effects of Nicotine are well documented, few cases have been reported of severe toxicity in pediatric patients. We believe this to be the only reported case of severe CNS depression secondary to the ingestion of cigarette butts in a pediatric patient.

Blood Gas Analysis↗