Biomedical subjects
Publications and source records attributed to M Brix.
The different extra-oral implant systems (screw and plate fixation) are not compatible. Rigorous surgical procedure (detailed and illustrated here) is mandatory to obtain the best implant osseointegration and epithesis loading 3 months later. Besides surgical procedure, careful bone and peri-abutment suture are required for success.
Maxillofacial surgeons are more and more confronted with wide defects of the face, particularly after resection of facial cancer. Complex wounds of the face, whatever the etiology may be, poses the difficult problem of their rehabilitation. The surgical reconstruction offers usually the most interesting solutions on the conceptual and morphological stages. There remain some particular cases where the therapeutic choice tends towards the rehabilitation by epitheses. The improvement of texture and color of epitheses and the improvement of the possibilities of their osseous anchorage by implants (endo-osseous or juxta-osseous) permit to reconstruct that kind of complex facial wounds with restoration of oral function and with a good morphologic result.
PURPOSE: To check post penetrating keratoplasty (PK) corneal wound healing characteristics after epidermal growth factor (EGF) application and to compare it with controls. MATERIAL AND METHODS: The PK was performed in the group of 72 young, healthy New Zealand rabbits (36 females and 36 males). Slit-lamp examination, tonometry and corneal topography by Tomey's corneal modeling system (TMS-1) were carried out before and after surgery. The PK was performed in both eyes. Half of animals were used as a bilateral donor for the other half, with a rule: right eye cornea to the right eye and left eye cornea to the left eye. As a result, after completed surgery 36 rabbits had bilateral grafts. The animals were divided into 3 equal groups (12 in each). Two drops of the human recombined EGF dissolved in the saline solution with concentration varied from 500 to 1500 ng in each drop were applied to the right eye according to schedule. The left eye was used as a control and did not receive EGF. Time of observation varied from 24 hours to 6 months. The tensinometry and the histopathologic study--light and electron microscopy were performed to determine corneal scarring. RESULTS: The wound healing pattern after PK was characteristic and constant in each group. The corneal wound healing significantly accelerated in the EGF treated group of rabbits compared with the controls (p < 0.05). In the group of rabbits receiving 1000 ng of hrEGF 3 times/day, after two weeks of application we noted increase of the wound strength up to 600 folds, comparing with controls. Well-organized scar was histologically seen on the 21st post-surgery day. The post-operative corneal astigmatism was less expressed in the eyes treated with EGF comparing to controls. CONCLUSIONS: These preliminary results of our experimental study indicated accelerated effect on the corneal wound healing after PK with topical, low dose hrEGF application. Clinical observation of utilization of similar low doses of the hrEGF after PK--is in progress.
Indications of appropriate treatment of tibial shaft fractures are one of the priority problems present-day traumatology has to address. In choosing the optimal mode of treatment of tibial shaft fractures not only the configuration of the fracture but also injury of soft tissues has been assigned increasing importance. At the Department of Traumatology of the Postgraduate Institute of Medicine in Bratislava, 962 tibial shaft fractures were treated over the period of 12 years from 1977-1988. Conservative treatment was applied in 600 fractures and 362 fractures were treated surgically. The therapeutic results obtained by using the newly introduced methods of treating tibial shaft fractures, i.e. functional plating and osteosynthesis by flexible Ender nailing, were analyzed in a retrospective and prospective study. The results of these approaches were compared with those achieved by classical methods of the AO school, rigid intramedullary nailing and external fixation. The favorable outcome of union and the good functional effect obtained in the studied and compared series of patients indicate that conservative functional treatment is the method of choice in tibial shaft fractures. Of the surgical therapeutic methods, flexible as well as stable intramedullary osteosynthesis by Ender nailing proved to be both the most sparing and the most physiological approach. The paper proposes an indication scheme of tibial shaft fracture treatment designed for clinical use considering the categorization of fractures according to up-to-date classification. For each type of tibial shaft fracture and soft tissue injury the optimal mode of treatment is suggested. Besides the main indication, possibilities of alternative treatment are also being pointed out.
The presented review analyzes the problem of the effect of electric current and electromagnetic fields on bone healing. The findings of the cited papers indicate that electronegativity, osteoblastic activity and bone formation fall within one group, while electropositivity, osteoclasia and resorption constitute another group. Stimulation is performed surgically by implanted electrodes or by current induction in the bone. Evidence on the effect of direct electric stimulation and pulsed magnetic filds in speeding up the process of bone healing fails to be convincing. However, the beneficial influence of electromagnetotherapy on the healing of soft tissues has been confirmed and is to be ascribed t its antiedematous, analgesic and antiinflammatory effect.
The importance of the forearm calls for attempts to preserve it and to restore its function even in severe injuries with extensive tissue loss. At early and comprehensive first surgical treatment providing sufficient perfusion good results can be achieved also in cases that do not appear promising at first sight. After treating the soft tissues fixation of the fracture is to be ensured externally and reconstitution surgery is to proceed according to the management plan. Of the reported series of 11 severe compound fractures the functional result of management was not favorable only in a single case.
The authors present an account on 60 patients where, based on the clinical picture, parasitological examination and laboratory parameters, the diagnosis of giardiasis was established. Among these patients a rise of one or several indicators of liver metabolism was found in 31%. The authors discuss whether the above conditions can be considered hepatitis within the framework of the basic parasitic disease. They eliminated non-parasitic causes (obstruction, HBsAg positive hepatitis, drug hepatitis, toxic hepatopathies) of elevated transaminase and bilirubin levels. For collection of duodenal juice or faeces for parasitological examination they used a gastrofibroscope or rectoscope. After treatment normalization of transaminase and bilirubin serum levels was recorded as well as regression of clinical symptoms and of eosinophilia.
Possibilities and up-to-date approaches to establishing prognosis and the degree of severity of injuries are presented. The authors have been concerned with the problem since 1986 and report on their own experiences and observations on using the system Abbreviated Injury Scale/Injury Severity Score. They suggest certain changes which may yield an increased validity of the system.
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