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Biomedical subjects

R E Marx

Publications and source records attributed to R E Marx.

49 records · Page 3Linked to original sources
PubMed1983

Osteoradionecrosis: a new concept of its pathophysiology.

The classic sequence in the pathogenesis of osteoradionecrosis of the jaws has been accepted as radiation, trauma, and infection. This paper challenges this sequence and offers a new one more accurately describing the biochemical and cellular pathology. The clinical data are based on 26 consecutive cases of osteoradionecrosis from which 12 en bloc resection specimens were cultured and stained for microorganisms. Review of the histories and treatments, as well as the microbial assays, indicates that microorganisms play only a contaminant role in osteoradionecrosis and that trauma is only one mechanism of tissue breakdown leading to the condition. The sequence suggested by this study is as follows: (1) radiation, (2) hypoxic-hypocellular-hypovascular tissue, (3) tissue breakdown, and (4) chronic non-healing wound.

Humans↗
PubMed1983

Principles and methods of osseous reconstruction.

Osseous reconstruction must be predicated on the cellular mechanisms related to bone regeneration. The use of particulate bone and cancellous marrow in allogeneic cribs was developed with cellular physiology as its basis. Consequently, this form of graft system has repeatedly met the requirements for osseous reconstruction. Hyperbaric oxygen therapy, when utilized to improve local tissue physiology, offers the surgeon another modality to overcome some of the unique problems of the oncologic patient.

Bone Marrow Transplantation↗
PubMed1982

The use of hyperbaric oxygen therapy in bony reconstruction of the irradiated and tissue-deficient patient.

Eighteen bony reconstructions of the mandible or maxilla using a newly defined and specific hyperbaric oxygen protocol are reported. Eleven of 12 grafts in irradiated tissue met six rigid criteria for a 91.6% rate of success. All six grafts into scarred and deficient tissue beds also met the same criteria, for an overall success rate of 94%. The rationale for emphasizing preoperative tissue preparation using hyperbaric oxygen is discussed, as are the mechanisms of action of hyperbaric oxygen on a biochemical, cellular, and tissue level. Neovascularity and neocellularity are demonstrated histologically by human biopsy specimens, and this is suggested as being the reason for the excellent results of reconstruction in irradiated and/or deficient tissue beds.

Adult↗
PubMed1981

The use of freeze-dried allogeneic bone in oral and maxillofacial surgery.

Clinical experience with 36 cases using freeze-dried allogeneic bone is reported. Its use in a variety of surgeries, including ridge augmentation, mandibular and maxillary osteotomies, mandibular reconstruction, midfacial advancement and obliteration of cystic cavities was associated with a minimal incidence of complications and excellent host acceptance. The collection of bone under sterile conditions and the rigid criteria for the tissue banking process are shown to account for this host compatibility and low complication rate. The physiochemical and biologic properties of freeze-dried allogeneic bone are discussed. This material provides unique practical advantages leading to long-term stability.

Adolescent↗
PubMed1980

Case 32, part 1.

Explore the source record for details and available documents.

Aged↗
PubMed1979

Cellular survival of human marrow during placement of marrow-cancellous bone grafts.

The survival of human marrow cells during the placement of marrow-cancellous bone grafts was studied by three independent viability assays. Marrow cells are resistant cells able to survive the surgical harvest from the ilium. Salt solutions such as normal saline solution and 5% dextrose in water (D5W) were superior to tissue culture medium, the serum of the patients, and several other solutions in supporting the survival of the graft cells. High survival rates of marrow cells stored in normal saline solution and D5W for four hours or less established that 95% to 100% live cells can be transplanted even with long delays between harvest and placement of the graft.

Bone Marrow↗
PubMedDate not supplied

Current advances in reconstruction of the mandible in head and neck cancer surgery.

Today's reconstruction of head and neck cancer related deformities is based on an in-depth knowledge of soft and hard tissue repair coupled with the technical ability to transplant and reorient soft and hard tissues into a functional and cosmetic improvement for each patient. The recent advances of (1) the science of bone regeneration, (2) myocutaneous flaps, (3) hyperbaric oxygen, and (4) allogeneic bone cribs have resulted in reconstructions which are now predictable outcomes with few complications and minimal morbidity. This writing will discuss the contribution and mechanism of each of these four advances and how their application can be used to consistently reconstruct even large deformities with both hard and soft tissue loss, as well as in tissues which have been severely radiated.

Bone Transplantation↗