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Biomedical subjects

R E Holmes

Publications and source records attributed to R E Holmes.

50 records · Page 3Linked to original sources

Orally absorbable cephalosporin antibiotics. 1. Structure-activity relationships of benzothienyl- and naphthylglycine derivatives of 7-aminodeacetoxycephalosporanic acid.

A structure-activity relationship study of a number of orally absorbed cephalosporins together with their syntheses is described. These new cephalosporins are benzothienyl- and naphthylglycine derivatives of 7-aminodeacetoxycephalosporanic acid. Several different synthetic methods for the glycine side chains, their protection, and the final acylations are reported. Several of these analogues were more active than cephalexin both in vitro and in vivo against commonly encountered Gram-positive bacteria. (R)-7-(3-Benzothienylglycylamido)-3-methyl-3-cephem-4-carboxylic acid (1R) has emerged as a potent antibacterial agent and is currently undergoing preclinical evaluation.

Administration, Oral↗

Forehead and scalp reconstruction after wide-field resection of skin carcinoma.

Full-thickness defects of the forehead and scalp after excision of extensive skin carcinomas are a reconstructive challenge. With loss of periosteum, bone can be covered by skin grafts after altering the outer table of the skull or by flaps. Axial subcutaneous fascial flaps and crane tissue methods are alternative techniques; clinical experience has elucidated their indications, benefits, and limitations.

Basal Cell Carcinoma↗

Bone regeneration within a coralline hydroxyapatite implant.

The hypothesis that incomplete resorption of osteons in an autogenous cortical bone graft may limit its replacement by new bone regeneration was explored by implanting a hydroxyapatite replica of a coral skeletal structure into bone gaps. This implant contained channels and interconnections similar to those in osteon-evacuated bone grafts. In 6 implanted mandibular defects in dogs, two of which were examined at two, 4, and 6 months, 11 percent, 46 percent, and 88 percent of the implant areas were filled with regenerated bone. The regenerated bone was a woven type at two months, but changed to a lamellar type by 6 months. In two implanted defects examined at 12 months, biodegradation of 29 percent of the implant had occurred. The bone regeneration was physiological, the implant was biocompatible, and the biodegradation began after the bone had regenerated.

Animals↗

Evolution of the mandibular mesh implant.

Between 1960 and 1972, the Dallas Veterans Administration Hospital Maxillofacial Research Laboratory developed and made over 150 cast-mesh implants. Successive designs were ovoid, circular, and double-lumened in cross section to improve implant strength, surface area for bioattachment, and adjustability. Sleeves, collars, and bows were employed in the assembly of these implants, with an acrylic condylar head attached when indicated. In 1972, our laboratory developed a mandibular mesh tray, cast in one piece on a single sprue, with preservation of the vertically adjustable ramus. Stainless steel replaced Vitallium because of its greater malleability. Essentially, a lost-wax technique is used to cast the mesh tray. The model of a mandibular segment is duplicated as a refractory model. Mesh wax, made in our own custom-made die, is adapted to the refractory model. The unit is then sprued and invested. The wax is fired our of the mold in a gas furnace. Casting is done by the transferral of molten stainless steel from the crucible to the mold by centrifugal force in an electro-induction casting machine. Other mesh implants that have been developed are made from wire mesh, Dacron mesh, cast Ticonium, and hydroformed titanium.

Dental Implantation, Endosseous↗

Maxillary sinus augmentation prior to placement of endosseous implants: A histomorphometric analysis.

The aim of this prospective study was to histomorphometrically evaluate at various time intervals the mineralization stage and process of an allogeneic-xenogeneic bone graft used in sinus augmentation procedures. One biopsy was taken from 20 patients at either 6, 8, 10, or 12 months after sinus augmentation. Immediately following the biopsy, an endosseous implant was placed into the biopsy site. This protocol provided 4 groups of 5 patients each, based on healing time following sinus augmentation. Using backscattered electron image analysis, the specimens were histomorphometrically analyzed to determine the volume fractions of residual cancellous bone, newly formed bone, soft tissue, bovine hydroxyapatite, and "remineralized" freeze-dried demineralized bone allograft (rDFDBA). "Remineralization" of DFDBA particles was observed in a few areas in all specimens. Polarized light microscopy showed that only the 12-month biopsies had a predominance of lamellar bone formation. The area within the biopsies that represented the residual alveolar ridge consisted of 32.6% +/- 8.6% (mean +/- SD) of bone. In the grafted area of the biopsies the volume fraction of newly formed bone at 12 months (20.7% +/- 8.3%) was significantly higher (P < .05, analysis of variance) than at 6 months (8.1% +/- 3.0%). There was no statistically significant difference between newly formed bone in the inferior, central, and superior grafted areas in all 4 time intervals. This prospective study indicates that the mineralization process of an allogeneic-xenogeneic sinus graft is incomplete 6 months after the sinus augmentation procedure. New bone formation increased up to 12 months postaugmentation; however, it remained lower than the volume of residual bone.

Analysis of Variance↗

Coralline hydroxyapatite bone graft substitutes: radiographic evaluation.

The authors discuss a recently described bone graft material substitute derived from sea corals. They briefly review its background leading to the potential for clinical use. Radiologic evaluation is provided, with attention directed to its characteristics, compared with other bone grafts.

Biocompatible Materials↗

Six-year clinical and histologic study of sinus-lift grafts.

This study retrospectively evaluated the results of 36 sinus-lift graft augmentations performed to place 66 implant cylinders in the posterior maxilla where vertical bone height was less than ideal. Grafts were accomplished with porous hydroxyapatite (HA) alone, porous HA mixed with autogenous bone removed from the iliac crest, and HA combined with autogenous bone removed from within the mouth. Nineteen core biopsy specimens were taken from different grafts at time intervals ranging from 4 to 36 months from the time of grafting. These cores were evaluated using histomorphometric analysis to yield data comparing volume fractions of bone formation, allowing comparison of different graft materials and healing times. Grafts using porous HA alone on mean produced 16.38% bone by volume after 6 months. After the same healing time, grafts using HA and hip bone on mean produced 19.30% bone by volume compared with an 11.30% bone volume when using HA and bone harvested intraorally. Evaluation of cores taken at 19 and 36 months revealed greater volumes of bone formation. Recommendations based on clinical and histologic results are discussed in detail.

Adolescent↗