- Email: [email protected]
Textbook and color atlas of traumatic injuries to the teeth
975
CURRENT LITERATURE Although most tear loss is through drainage through the nasolacrimal duct, increased tear evaporation can be a primary mechanism for the development of dry eye. In an earlier study, the authors found that tear evaporation from patients with dry eye is less than normal, but that such evaporation as a percentage of tear volume is greater than normal. This report measures tear evaporation under a range of conditions to study the effects of exposed ocular surface area and blink rate on tear dynamics. To study the effect of ocular surface area on tear evaporation, measurements of tear evaporation were taken with 15 subjects looking up, down, and straight. Ocular surface area was calculated as a function of palpebral fissure width. Measurement of evaporation were taken with 17 volunteers, looking straight ahead and blinking at rates of 10, 20, 30, and 60 times per minute, to study the effect of blink rate on tear evaporation. The evaporation was 3.4 and 2.5 times higher with subjects looking up and straight, respectively, than down. The blink rate volunteers were divided into two categories of having fully wet ocular surfaces at a blink rate of 20 or having a relatively dry ocular surface at a blink rate of 20. The tear evaporation was stable in the former group and was not affected by the blink rate. In contrast, tear evaporation decreased with decreased blink rate and increased with increased blink rate in the latter group. These findings support the authors' hypothesis that exposed ocular surface area and blink rate help determine tear dynamics on the ocular surface. The authors believe the results of this study provide understanding of the mechanism of tear evaporation and may contribute to the prevention of dry eye, and hence complaints of ocular fatigue, during video display terminals use and other work. They recommend that video display terminals be set at a lower height, where users can keep their eyes partially closed and blink more often.--P.S. LAM Reprint requests to Dr Tsubota: Department of Ophthalmology, Tokyo Dental College, 11-13 Sugano 5 Chome, Ichikawashi,Chiba, Japan 272.
Long-term Follow-up and Infectivity in Blood Donors With Hepatitis C Antibodies and Persistently Normal Alanine Aminotransferase Levels. Rossini A, Gazzola GB, Ravaggi A, et al. Transfusion 35:108, 1995 Little is known about the prevalence of serum hepatitis C virus (HCV) in blood donors with HCV antibodies and persistently normal alanine aminotransferase (ALT) levels. Thirty-nine patients with normal ALT levels but with positive anti-HCV levels were tested monthly for 6 months. Forty-one percent of the anti-HCV-positive donors with persistently normal ALT levels had active HCV infection by RNA studies. Long-term ALT monitoring allowed the detection of significantly increased enzyme values in only 2 of the 16 viremic donors. These observations suggest that in this group of HCV carriers, long-term follow-up and evaluation of liver histology may be necessary for a better understanding of the natural evolution of infection.--J.M. McCoY
mous cell carcinoma by using monoclonal antibody techniques. In normal oral tissues, Tn activity was seen to be most intense in a thin line in the basement membrane region. Hyperkeratosis without dysplasia showed an enhanced bandlike Tn reaction in the basement membrane region. In dysplasias of various degree, Tn activity increased as dysplasia became more severe. In most invasive carcinomas studied, Tn activity was intense, often covering the entire stroma. The advancing edges of the tumor displayed the greatest Tn immunoreactivity. The authors conclude that Tn must play a role in organizing and remodeling the stroma to support epithelial migration and proliferation. Inflammation was also seen to be associated with enhanced Tn expression.--C.E. PEOPLES Reprint requests to Dr Luomanen: Department of Anatomy, University of Helsinki, PO Box 9 SF-00014, University of Helsinki, Finland.
Experience With Percutaneous Tracheostomy in Intensive Care: The Technique of Choice? Manara AR. Br J Oral Maxillofac Surg 32:155, 1994 A report of percutaneous technique of tracheostomy, using a commercially available kit, is described by Ciaglia et al. Patients receiving intensive care who required tracheostomy were considered for the percutaneous technique. All procedures were accomplished with a combination of local and general anesthesia. Artificial ventilation was provided manually. After proper positioning of the patient, the endotracheal tube was partially withdrawn under direct vision, until the cuff lay in the larynx. The anatomic landmarks were identified and the area cleaned and infiltrated with local anesthesia. A 1.5- to 2-cm vertical midline skin incision was made from the lower border of the cricoid cartilage inferiorly. A saline-filled syringe was attached to a 16-gauge needle and cannula, which were then advanced into the trachea in a posterior and caudal direction between the cricoid cartilage and the first tracheal ring. Tracheal entry was confirmed by airflow into the saline on aspiration. The needle was withdrawn while the cannula was advanced further into the trachea. The guidewire was passed through the cannula into the trachea; the cannula was withdrawn and a short 11-FG dilator inserted over the guidewire. The Teflon guiding catheter was advanced over the guidewire until the two positioning marks were at the skin level. Dilation of the trachea with sequential passage of seven dilators (12 to 36 FG) was undertaken. Finally, the tracheostomy tube is loaded on the appropriate well-lubricated dilator (28 FG for a 9.0-ram tube, 24 FG for a 8.0-ram tube) and advanced until the cuff entered the trachea. The dilator, guidewire, and guiding catheter were removed, advancing the tracheostomy tube to its flange; the cuff was inflated and the stoma site dressed. The tracheostomy tube was secured in the usual fashion and a chest radiograph was obtained.-G. PENA-VELASCO
Reprint requests to Dr Rossini: Department of Internal Medicine, Universita di Brescia, Spedali Civili, Ple Spedali Civili 1, 25123 Brescia, Italy.
Reprint requests to Dr Manara: The Intensive Care Unit, Franchu Hospital, Bristol BSI 61LE, United Kingdom.
Distribution of Tenascin in Oral Premalignant Lesions and Squamous Cell Carcinoma. Tiitta O, Happonen RP, Virtanen I, et al. J Oral Pathol Med 23:446, 1994
New Book Annotations
The distribution of the extracellular matrix protein tenascin (Tn) was studied in oral premalignant lesions and squa-
Textbook and Color Atlas of Traumatic Injuries to the Teeth (ed 3). Andreasen JO, Andrcasen FM (eds), with 22
976 contributors. St Louis, MO, Mosby, 1994, 771 pages, illustrated This classic text continues to provide the latest information on the diagnosis and treatment of traumatic injuries to the teeth. A significant addition is the section devoted to the principles of healing of acute dental trauma and the role that infection plays in the development of complications. There is also extensive material on tooth preservation, restoration, and replacement, including the topics of autotransplantation and implantology. Throughout the text, the results of longterm clinical investigations and experimental studies form the basis for a sound biologic approach to therapy. Oral and Maxiliofacial Surgery in Children and Adolescents. Kaban LB (ed), with 23 contributors. Oral Maxillofac Surgery Clinics of North American, Volume 6, No 1, 1994, Philadelphia, PA, Saunders, 215 pages, illustrated The editor of this volume has selected topics representing either complex problems or recent surgical advances that can be applied to the management of pediatric patients. These include such areas as facial fractures, craniomaxillofacial tumors, infections, AIDS, oral lesions, and temporomandibular joint ankylosis. Other topics include orthognathic surgery, rigid internal fixation, the use of endosseous implants, and sources of autogenous bone grafts. Throughout the book emphasis is placed on the uniqueness of the pediatric patient and the special considerations needed for their management. Atlas of Cosmetic and Reconstructive Periodontal Surgery (ed 2). Cohen ES. Philadelphia, PA, Lea & Febiger, 1994, 424 pages, 1,463 illustrations, $95.00 The emphasis in periodontics has shifted toward reconstructive procedures involving guided tissue regeneration,
CURRENT LITERATURE biomechanical root preparation, bone regeneration, cosmetic gingival reconstruction, and cosmetic treatment of maxillary anterior teeth. These changes are reflected by the addition of new chapters on many of these topics and by the revision of previous chapters. The various techniques are carefully explained and information on their indications and contraindications, advantages and disadvantages, and related treatment problems are provided. Atlas of Regional and Free Flaps for Head and Neck Reconstruction. Urken ML, Cheney ML, Sullivan M J, et al. New York, NY, Raven, 1995, 379 pages, illustrated, $210.00 Fresh cadaver dissections supplemented by numerous drawings are used to provide step-by-step details of the various regional and free flaps. In every section, the most important designs of each flap are presented, as are the major applications for the use of these flaps. In addition to flap design and application, anatomy and anatomic variations, preoperative and postoperative care, potential pitfalls, and harvesting techniques for each donor site are discussed. Ambulatory Anesthesiology: A Problem-Oriented Approach. McGoldrick KE (ed), with 58 contributors. Baltimore, MD, Williams & Wilkins, 1995, 808 pages, illustrated With the increasing emphasis on providing surgery on an outpatient basis, ambulatory anesthesiology is becoming an ever-increasing aspect of cost-effective care. In this book, the various contributors discuss preoperative evaluation, selection of anesthetics and anesthetic techniques, perioperative monitoring, germaine surgical considerations, postoperative complications, and pain control in the ambulatory patient. Special emphasis is given to the management of those patients with complicating medical problems and those undergoing procedures that present technical anesthetic challenges.
CURRENT LITERATURE Although most tear loss is through drainage through the nasolacrimal duct, increased tear evaporation can be a primary mechanism for the development of dry eye. In an earlier study, the authors found that tear evaporation from patients with dry eye is less than normal, but that such evaporation as a percentage of tear volume is greater than normal. This report measures tear evaporation under a range of conditions to study the effects of exposed ocular surface area and blink rate on tear dynamics. To study the effect of ocular surface area on tear evaporation, measurements of tear evaporation were taken with 15 subjects looking up, down, and straight. Ocular surface area was calculated as a function of palpebral fissure width. Measurement of evaporation were taken with 17 volunteers, looking straight ahead and blinking at rates of 10, 20, 30, and 60 times per minute, to study the effect of blink rate on tear evaporation. The evaporation was 3.4 and 2.5 times higher with subjects looking up and straight, respectively, than down. The blink rate volunteers were divided into two categories of having fully wet ocular surfaces at a blink rate of 20 or having a relatively dry ocular surface at a blink rate of 20. The tear evaporation was stable in the former group and was not affected by the blink rate. In contrast, tear evaporation decreased with decreased blink rate and increased with increased blink rate in the latter group. These findings support the authors' hypothesis that exposed ocular surface area and blink rate help determine tear dynamics on the ocular surface. The authors believe the results of this study provide understanding of the mechanism of tear evaporation and may contribute to the prevention of dry eye, and hence complaints of ocular fatigue, during video display terminals use and other work. They recommend that video display terminals be set at a lower height, where users can keep their eyes partially closed and blink more often.--P.S. LAM Reprint requests to Dr Tsubota: Department of Ophthalmology, Tokyo Dental College, 11-13 Sugano 5 Chome, Ichikawashi,Chiba, Japan 272.
Long-term Follow-up and Infectivity in Blood Donors With Hepatitis C Antibodies and Persistently Normal Alanine Aminotransferase Levels. Rossini A, Gazzola GB, Ravaggi A, et al. Transfusion 35:108, 1995 Little is known about the prevalence of serum hepatitis C virus (HCV) in blood donors with HCV antibodies and persistently normal alanine aminotransferase (ALT) levels. Thirty-nine patients with normal ALT levels but with positive anti-HCV levels were tested monthly for 6 months. Forty-one percent of the anti-HCV-positive donors with persistently normal ALT levels had active HCV infection by RNA studies. Long-term ALT monitoring allowed the detection of significantly increased enzyme values in only 2 of the 16 viremic donors. These observations suggest that in this group of HCV carriers, long-term follow-up and evaluation of liver histology may be necessary for a better understanding of the natural evolution of infection.--J.M. McCoY
mous cell carcinoma by using monoclonal antibody techniques. In normal oral tissues, Tn activity was seen to be most intense in a thin line in the basement membrane region. Hyperkeratosis without dysplasia showed an enhanced bandlike Tn reaction in the basement membrane region. In dysplasias of various degree, Tn activity increased as dysplasia became more severe. In most invasive carcinomas studied, Tn activity was intense, often covering the entire stroma. The advancing edges of the tumor displayed the greatest Tn immunoreactivity. The authors conclude that Tn must play a role in organizing and remodeling the stroma to support epithelial migration and proliferation. Inflammation was also seen to be associated with enhanced Tn expression.--C.E. PEOPLES Reprint requests to Dr Luomanen: Department of Anatomy, University of Helsinki, PO Box 9 SF-00014, University of Helsinki, Finland.
Experience With Percutaneous Tracheostomy in Intensive Care: The Technique of Choice? Manara AR. Br J Oral Maxillofac Surg 32:155, 1994 A report of percutaneous technique of tracheostomy, using a commercially available kit, is described by Ciaglia et al. Patients receiving intensive care who required tracheostomy were considered for the percutaneous technique. All procedures were accomplished with a combination of local and general anesthesia. Artificial ventilation was provided manually. After proper positioning of the patient, the endotracheal tube was partially withdrawn under direct vision, until the cuff lay in the larynx. The anatomic landmarks were identified and the area cleaned and infiltrated with local anesthesia. A 1.5- to 2-cm vertical midline skin incision was made from the lower border of the cricoid cartilage inferiorly. A saline-filled syringe was attached to a 16-gauge needle and cannula, which were then advanced into the trachea in a posterior and caudal direction between the cricoid cartilage and the first tracheal ring. Tracheal entry was confirmed by airflow into the saline on aspiration. The needle was withdrawn while the cannula was advanced further into the trachea. The guidewire was passed through the cannula into the trachea; the cannula was withdrawn and a short 11-FG dilator inserted over the guidewire. The Teflon guiding catheter was advanced over the guidewire until the two positioning marks were at the skin level. Dilation of the trachea with sequential passage of seven dilators (12 to 36 FG) was undertaken. Finally, the tracheostomy tube is loaded on the appropriate well-lubricated dilator (28 FG for a 9.0-ram tube, 24 FG for a 8.0-ram tube) and advanced until the cuff entered the trachea. The dilator, guidewire, and guiding catheter were removed, advancing the tracheostomy tube to its flange; the cuff was inflated and the stoma site dressed. The tracheostomy tube was secured in the usual fashion and a chest radiograph was obtained.-G. PENA-VELASCO
Reprint requests to Dr Rossini: Department of Internal Medicine, Universita di Brescia, Spedali Civili, Ple Spedali Civili 1, 25123 Brescia, Italy.
Reprint requests to Dr Manara: The Intensive Care Unit, Franchu Hospital, Bristol BSI 61LE, United Kingdom.
Distribution of Tenascin in Oral Premalignant Lesions and Squamous Cell Carcinoma. Tiitta O, Happonen RP, Virtanen I, et al. J Oral Pathol Med 23:446, 1994
New Book Annotations
The distribution of the extracellular matrix protein tenascin (Tn) was studied in oral premalignant lesions and squa-
Textbook and Color Atlas of Traumatic Injuries to the Teeth (ed 3). Andreasen JO, Andrcasen FM (eds), with 22
976 contributors. St Louis, MO, Mosby, 1994, 771 pages, illustrated This classic text continues to provide the latest information on the diagnosis and treatment of traumatic injuries to the teeth. A significant addition is the section devoted to the principles of healing of acute dental trauma and the role that infection plays in the development of complications. There is also extensive material on tooth preservation, restoration, and replacement, including the topics of autotransplantation and implantology. Throughout the text, the results of longterm clinical investigations and experimental studies form the basis for a sound biologic approach to therapy. Oral and Maxiliofacial Surgery in Children and Adolescents. Kaban LB (ed), with 23 contributors. Oral Maxillofac Surgery Clinics of North American, Volume 6, No 1, 1994, Philadelphia, PA, Saunders, 215 pages, illustrated The editor of this volume has selected topics representing either complex problems or recent surgical advances that can be applied to the management of pediatric patients. These include such areas as facial fractures, craniomaxillofacial tumors, infections, AIDS, oral lesions, and temporomandibular joint ankylosis. Other topics include orthognathic surgery, rigid internal fixation, the use of endosseous implants, and sources of autogenous bone grafts. Throughout the book emphasis is placed on the uniqueness of the pediatric patient and the special considerations needed for their management. Atlas of Cosmetic and Reconstructive Periodontal Surgery (ed 2). Cohen ES. Philadelphia, PA, Lea & Febiger, 1994, 424 pages, 1,463 illustrations, $95.00 The emphasis in periodontics has shifted toward reconstructive procedures involving guided tissue regeneration,
CURRENT LITERATURE biomechanical root preparation, bone regeneration, cosmetic gingival reconstruction, and cosmetic treatment of maxillary anterior teeth. These changes are reflected by the addition of new chapters on many of these topics and by the revision of previous chapters. The various techniques are carefully explained and information on their indications and contraindications, advantages and disadvantages, and related treatment problems are provided. Atlas of Regional and Free Flaps for Head and Neck Reconstruction. Urken ML, Cheney ML, Sullivan M J, et al. New York, NY, Raven, 1995, 379 pages, illustrated, $210.00 Fresh cadaver dissections supplemented by numerous drawings are used to provide step-by-step details of the various regional and free flaps. In every section, the most important designs of each flap are presented, as are the major applications for the use of these flaps. In addition to flap design and application, anatomy and anatomic variations, preoperative and postoperative care, potential pitfalls, and harvesting techniques for each donor site are discussed. Ambulatory Anesthesiology: A Problem-Oriented Approach. McGoldrick KE (ed), with 58 contributors. Baltimore, MD, Williams & Wilkins, 1995, 808 pages, illustrated With the increasing emphasis on providing surgery on an outpatient basis, ambulatory anesthesiology is becoming an ever-increasing aspect of cost-effective care. In this book, the various contributors discuss preoperative evaluation, selection of anesthetics and anesthetic techniques, perioperative monitoring, germaine surgical considerations, postoperative complications, and pain control in the ambulatory patient. Special emphasis is given to the management of those patients with complicating medical problems and those undergoing procedures that present technical anesthetic challenges.