Biomedical subjects
Publications and source records attributed to M S Leonard.
Modifications of the sagittal split osteotomy of the mandible have essentially reduced the major drawbacks of the procedure, such as condyle displacement, short-term skeletal relapse, and protracted maxillomandibular fixation and mental nerve dysesthesia. These techniques have proved effective over a period of 4 years in fifty-seven patients treated.
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Utilization of computer technology in health care is expanding, and managers need information regarding existing automated functions when making decisions relative to system design or acquisition. The Automated Hospital Information System (AHIS) Component Catalog, compiled by the Health Services Research Center/Health Care Technology Center (HSRC/HCTC) at the University of Missouri-Columbia, describes the features of software packages offered by vendors and utilized in hospitals. On the basis of an analysis of the contents of the Catalog relative to automated functions for dietetic departments, charge capturing and diet change notification were the functions used most frequently in hospitals. Although a stores inventory was not included as a component offered by any of the responding vendors, 23 of the hospital systems described in the catalog included a stores inventory component. Menu planning and meal scheduling were functions which were both available from vendors and utilized in hospitals. The nutrient analysis function was implemented in some of the larger hospitals. The information in the Catalog reflects the availability and adoption of automated hospital information system components for dietetic functions.
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Stereophotogrammetry is an attractive technique for mapping changes in facial form and contour following surgery. The need for trained personnel, however, has prevented the technique from gaining wide use. We report the development of a stereophotogrammetric system in combination with an inter-graphics computer system which overcomes this and other limitations. An interactive computer graphics system is used to record, present and manipulate the three-dimensional data obtained from a digitized stereophotogrammetric picture. The system also permits measurement of morphological changes following surgery as well as volume changes and has the potential for use in indicating the order in which multistage procedures should be undertaken and the time delay before such surgeries.
Goldenhar's syndrome is a variant of hemifacial microsomia - one of the more common congenital syndromes of the first and second arch. The Goldenhar's type is characterized by varying degrees of underdevelopment of craniofacial structures. The major deformities involve the mandible and the ear; but they also include the orbit and vertebral column, specific defects pathognomonic of this condition. Medical management requires reconstructive surgery of which treatment must take into consideration the timing of surgery and the effects of surgery upon the growth and development of the poorly formed structures. This paper presents a discussion of the pathogenesis and the favorable and unfavorable factors affecting the selection and timing of surgery. The literature is reviewed and two additional cases are added with an evaluation of the effects of early reconstruction. A single-stage procedure, utilizing rib autograft, is described for correction of the defective hemimandible, glenoid fossa, and zygoma. The results are evaluated by means of photographs and radiographs with a follow-up period of at least one and one-half years. The data suggest a remodeling of the grafts to resemble normal structures, and a downward growth of the maxilla to fill a space created by the reconstruction of the mandible and expansion of the lower portion of the face. Multiple stages of surgery as well as unnecessary delays in performing surgical procedures are challenged by the report.
Demographic data for the general population for the year 1978 and those predicted for 1998 have been collected and compared to the number of oral and maxillofacial surgeons practicing in 1979 and predicted to be practicing in the year 1998. The implications of these predictions are discussed, and some of the pros and cons concerning suggestions offered to meet the problems that may arise are presented.
Oral infections that result from trauma or dental manipulation are often thought to be of minor importance to the practicing clinician. The majority of oral infections respond well to treathis form of simple therapy is no longer as efficacious as it has been though to be. Soment with the common antibiotics without the need for laboratory culture and sensitivity. There are instances, becoming increasingly frequent, when this form of simple therapy is no longer as efficacious as it has been thought to be. Some exotic infections are frequently recalcitrant to treatment. These infections are usually caused by ubiquitious organisms, such as Eikenella corrodens. We are presenting several of our cases that were caused by this organism, as well as a review of some aspects of its microbiology, in order to attract the attention and interest of our colleagues in dental practice to this increasingly frequent problem.
This is a report of a little-known technique of closing an oral nasal fistula and an unusual case of anosmia which resolved after the palatal closure.
A method for evaluating drug information systems is described. The method measures both qualitative and quantitative performance. For the categories, "Basic Therapeutic Information", and "Commercial and Investigational Product Information," specific data that should be present are identified; evaluated systems are searched for these data related to a standard sample of 122 drugs. Systems are also searched for the presence of any information relating to these drugs in the categories, "Applied Clinical Research Information" and "Nonclinical Laboratory Research Information". In addition, systems are searched for the presence of 215 drug-drug interactions and 244 drug-laboratory test interferences. Using relative weights that have been assigned to the content statistics, an aggregate measure of system's content is determined. The method also measures annual cost of operating a system. The application of the method to two drug information systems is discussed briefly.
This paper presents the development and validation of an emergency medical service (EMS) systems quality of care evaluation measure. The System Input Severity Measure consists of a set of single and multiple injury survival rates that would be expected to occur in an EMS system classified as providing "baseline" advanced life support services. These expected survival rates were developed by a nationwide panel of emergency medicine experts through the use of the Delphi group opinion surveying technique. Validation of the System Input Severity Measure was a twofold process. First, reliability of the results of the Delphi surveying process was validated by comparing the resultant expected survival rates with Illinois Trauma Registry data. Second, the applicability of the measure was validated using data collected in EMS systems generally recognized to be providing exceptional (either superior or inferior) emergency patient care. It was recognized that the development of a comprehensive, large-scale System Input Severity Measure through the use of the Delphi technique alone is impractical. Consequently, a functional relationship between single and multiple injury survival rates was also developed. It appeared that when employed in conjunction with data developed from the Delphi technique, such an approach would make practicable the development of a comprehensive System Input Severity Measure.
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A computer-based analysis was undertaken on 227 white males and females to establish the relationship of the sella-nasion orbitale angle to that of the sella-nasion A point. The ratio of sella-orbitale to sella-nasion was also studied and it was discovered that these results were significantly related to the sella-nasion A-point angle. There was little sexual dimorphism. These results provide objective guidelines to the surgical treatment of people suffering from hypoplastic development of the middle part of the face.
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