Faculty Bibliography

The purpose of this article is to report how a group of 391 well-educated, White, midwestern American married fathers of young adolescents (11 to 14 years) described their perceptions of how they were raised. The question 'Describe how your parents parented you' was asked as part of a larger quasi-experimental study to test the outcomes of communication skills training among a sample of families in a community. The fathers' short-answer descriptions were succinct yet substantive. Using content analysis procedures, 6 themes were identified. Four reflected the men's perceptions of specific strategies used by their parents. The themes were labeled establishing boundaries, parental presence, adhering to guidelines, and communication techniques. A 5th theme, labeled family size, indicated that some men perceived that the structure influenced how they were parented. The 6th theme, evaluation of their parents' parenting, encompassed the men's opinions of how successful they perceived their parents were at raising them. The men's perceptions are discussed within the context of fathering roles. The themes are offered as a framework to define parenting, and implications for nursing practice and research are proposed

One of the most unsettling sequela of facial paralysis (FP) is the loss of the blink reflex, leading to both a functional and aesthetic deformity. A successful method of treating FP and, in particular, loss of eye-sphincter function, is the use of the cross-facial nerve graft (CFNG) to reinnervate the previously denervated orbicularis oculi muscle. The present study examined the histomorphometric aspects of the entire CFNG, with respect to axon diameter and myelin area. The axon profile of the CFNG had a positive correlation with motor end-plate counts and electrophysiologic recordings. These results should help in further understanding the number of motor axons needed to restore adequate function to the paralyzed eye sphincter, and establish more rational reconstructive procedures

The salvage rate of degloved amputation of the fingers is as low as 50%. This case report consists of a multiple-finger degloving amputation characterized by intact tendons, pulleys, and bone, but avulsed neurovascular bundles. After replantation, the range of motion of the fingers was nearly full. Protective-to-light touch sensation was obtained with transpositional digital nerve transfers. Grasp strength was 80% that of the uninjured side. In addition to good functional recovery, the aesthetic appearance obtained by replantation of the degloved skin was far better than that obtained by other reconstruction methods. A first web space flap was used to release a flexion contracture of the proximal interphalangeal joint of the middle finger

Although root fractures are among the less common oral injuries (6 percent), a careful diagnostic evaluation of such injuries is required to arrive at an appropriate treatment plan. The position of the fracture in the root will determine the proper management. The problem of luxation due to trauma often involves the use of dental splints, which, if not properly designed, may cause root resorption, loss of alveolar bone, pulpal necrosis and pulp canal obliteration. The guidelines for the type of splint to use and conditions under which it should be placed are presented

PURPOSE/OBJECTIVE:There are little data available on the prevalence of human immunodeficiency virus (HIV) disease and its relationship to postoperative infection in patients presenting with mandibular fractures. This retrospective study assesses these parameters. PATIENTS/METHODS:The study population consisted of 251 patients treated for mandibular fractures at San Francisco General Hospital (SFGH) between January 1990 and December 1993. Group 1 (n = 20) was composed of patients with documented HIV infection and group 2 (n = 231) served as controls. The groups were comparable with regard to age, sex, etiology, and number and types of fractures. RESULTS:HIV prevalence for this population was 7.9%, and was consistent with previously documented prevalence studies in SFGH surgical patients. In the HIV-positive group, 6 of 20 patients (30%) developed postoperative infection: 2 soft tissue (10%) and 4 bone-related (20%). In the control group, 22 of 231 patients (9.5%) developed postoperative infections: 16 soft tissue (6.9%) and 6 bone-related (2.6%). Statistical analysis showed a significant difference between the two groups with regard to overall (P = .016) and to bone-related (P = .001) infection rates. There was no statistically significant difference in soft tissue infections between the two groups (P = .953). The rate of postoperative infection was significantly higher in those patients (both HIV-positive and controls) who had open reduction and internal fixation (ORIF; 25/155; 16%) versus those who had closed reduction and maxillomandibular fixation (3/96; 3.1%; P = .003). The postoperative infection rate after ORIF was significantly higher in the HIV-positive (5/11; 45%) compared with the control group (20/144; 13.9%; P = .02). CONCLUSIONS:The results of this study indicate that the overall rate of postoperative infection after treatment of mandibular fractures is significantly higher in HIV-positive than in HIV-negative patients. Specifically, the use of ORIF in HIV-positive patients represents a significant risk.