摘要:

Increasing familiarity with elective reconstructive approaches to craniofacial deformity has led to the application of a similar multispecialty approach to repair of selected cases of massive frontal and upper facial trauma. The fundamental steps in craniofacial reconstruction are outlined. The process of patient selection is emphasized. Illustrative case histories review the management of this type of injury. Contributions from anesthesiology, neurosurgery, ophthalmology, and plastic surgery are required. Specialized facilities for postoperative care are mandatory.

ISSN:0022-5282    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

Alteration in the insulin regulation of carbohydrate metabolism following 20% surface burn injury in the rat was biphasic. At 4 hr after burn there was fasting hyperglycemia (92 ± 6 (SE) mg/100 ml above controls) and a pronounced intolerance to 1 gm glucose/kg IV. Fasting serum insulin did not differ from controls and failed to rise appreciably following glucose administration. Two to four days after burn, the ability to cope with exogenous glucose was near normal or normal and the insulin response to standard glucose load was 41–69% higher than in the controls, indicating the presence of insulin resistance. This pattern was not altered by feeding the burned and control rats with glucose intragastrically, thus eliminating lower postburn food intake as the causal factor of exaggerated insulin response to IV glucose. Diaphragms from burned rats showed the same increase in glucose uptake in response to 0.1 U insulin/ml in vitro as those of controls, suggesting that the insulin resistance in vivo is not due to a decrease in the capacity of muscle to bind and respond to insulin.

ISSN:0022-5282    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

A prospective study of 410 fractures seen in 398 children during 1 year was carried out. Fractures were more common on the left, and the upper extremities were more frequently injured than the lower extremities. The two commonest sites were the hand and the distal forearm. The radius was the bone most commonly fractured. Fifty-seven (13.9%) of the fractures involved epiphyses and 67 (16.3%) were torus fractures. Of the 398 patients 236 were males. There was a slightly increased incidence of fractures in the summer months and in older patients.

ISSN:0022-5282    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

Fractures of the fibula were produced in rats with sciatic denervation. The denervated rats exhibited more rapid fracture healing than controls. Fifteen days following injury, enhanced union was measured by histologic assessment (p< 0.001), and biomechanical testing including fracture stress (p< 0.005), elastic modulus (p< 0.005), strain at failure (p= 0.01) and energy to failure (p= 0.05).

ISSN:0022-5282    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

Eyebrow reconstruction in burn patients has been effectively performed in nine eyebrows in six burn patients. The results were excellent in seven of the eyebrows and satisfactory in the remaining two. In the authors' experience, the free hair transplants have had marginal results because of the scarred recipient site, and we recommend the island pedicle graft as an alternative, in selected cases, for facial burn reconstruction. Case summaries, details of the operative procedure, and illustrations are presented.

ISSN:0022-5282    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

A 6-month study using the Therapeutic Intervention Scoring System (TISS) to evaluate trauma patients admitted to a surgical intensive care unit showed a correlation between severity of illness and TISS score at the same time. The TISS is useful in the ICU, where numerous complex interventions are made in caring for acutely ill and injured patients.

ISSN:0022-5282    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

When mice are given a 30% scald burn, the growth of subsequently inoculated Ehrlich ascites tumor is markedly accelerated. This effect, which parallels the well documented suppression of cell-mediated immunity occurring postburn, disappears 10 days postinjury. Possible clinical implications are discussed and an illustrative case report is presented.

ISSN:0022-5282    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

In a study of diabetic patients with hand infections reviewed at Jackson Memorial Hospital, University of Miami School of Medicine, 20 such diabetic patients with hand infections were found. The most outstanding result was that seven of the 20 had amputation either to control infection or because the function of the extremity was impaired by the remaining ravaged part. Pathologic examination of tissue removed showed the same changes commonly seen in diabetic gangrene of the lower extremity. Electromyographic studies, when done, have been confirmatory of a peripheral neuropathy with delayed nerve conduction studies. The bacterial organisms of the infections were variable, but a predominance of Gram-negative organisms were cultured in twelve of the 20 patients. Early aggressive management, including surgical debridement and intravenous antibiotics, is recommended to prevent unnecessary amputations and improve residual function.

ISSN:0022-5282    

出版商:OVID    

年代:1977

数据来源: OVID

ISSN:0022-5282    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

In a group of seven patients with percutaneous subclavian catheters in the pleural space, three were found to have continued blood loss from the catheter tip, and in four patients thoracotomy was prevented by discontinuing blood administration through the subclavian catheter during a re-evaluation phase.

ISSN:0022-5282    

出版商:OVID    

年代:1977

数据来源: OVID