Search PubMed⌕ Search

Biomedical subjects

E B Smith

Publications and source records attributed to E B Smith.

At least 91 records · Page 5Linked to original sources
PubMed1990

Patient personal injury litigation against dermatology residency programs in the United States, 1964-1988. Implications for future risk-management programs in dermatology and dermatologic surgery.

A national survey reviewing patient injury litigation against US dermatology residency programs revealed that 50% of the respondents had experienced at least one lawsuit between 1964 and 1988. The northeast region reported the most legal activity. Fifty percent of the lawsuits related to therapeutic or surgical complications. Plaintiffs were successful in 37.9% of the lawsuits. The mean award was $26,505, and the largest reported award of $200,000 was for failing to diagnose herpes simplex in an immunocompromised patient. In view of several recent trends in dermatology, the amount of litigation against dermatologists may increase.

Dermatology↗
PubMed1989

Platinum-based combination chemotherapy for malignant mixed mesodermal tumors of the ovary.

Although considerable clinical data are available to guide treatment decisions for patients with ovarian epithelial malignancies, therapy for the rare malignant mixed mesodermal (mullerian) tumor (MMMT) of the ovary is poorly studied. Ten untreated patients diagnosed with primary ovarian MMMT were managed with cis-platinum-based combination chemotherapy from 1980 to 1985. Six of the 10 patients were stage III suboptimal with evaluable residual disease; 4 of these 6 had CRs with a median duration of response of 13 months. The remaining 2 patients had PRs, of 2 and 11 months duration. Four patients had stage III optimal disease; 1 progressed at 7 months, 1 progressed at 16 months and the other 2 patients have no clinical evidence of disease at 12+ and 22+ months. Despite impressive initial response rates, survival overall was poor, with a median survival for all 10 patients of 16+ months.

Adult↗
PubMed1989

An evaluation of the structure-activity relationships of a series of analogues of mephenesin and strychnine on the response to pressure in mice.

1. A range of compounds structurally related to the centrally acting muscle relaxant mephenesin and to the chemical convulsant strychnine were synthesized and tested for their ability to alter the threshold pressures for the onset of high pressure convulsions in mice. 2. The ability of both groups of compounds to alter the threshold pressure for convulsions was found to be dependent on the nature of a simple molecular skeleton. Thus, compounds that possessed a negatively polarized group located both in the same plane as and some 4.5 A from an aromatic nucleus increased the thresholds whereas compounds with a positively polarized group at the same location reduced the thresholds. 3. These findings support the suggestion that pressure elicits convulsions via a selection action on a receptor protein complex rather than via some general perturbation of the lipid regions of cellular membranes.

Animals↗
PubMed1989

Primary cancer of the lung in women.

Analyses of the St. Francis Medical Center Cancer Registry for a 30-year period corroborated the publicized information of a gradual increase in the incidence of lung cancer in women and a recent decrease in the incidence among men. Our objectives were to highlight the biological and clinical features of lung cancer in women with the adoption and utilization of primary and secondary preventive measures.

Adenocarcinoma↗
PubMed1989

Primary cancer of the pancreas: a surgical enigma.

Pancreatic cancer is a frequent gastrointestinal malignancy with demonstrable increases in blacks. Predisposing factors are nonspecific but statistically relevant. Early signs and symptoms are vague and the duration prior to medical or surgical evaluation is typically more than four months. The overt clinical picture represents advanced stages of pancreatic cancer that are nonresectable. Positive results or prolonged survivals in excess of five years for curative surgical procedures are meager. The best approaches toward cancer of the pancreas are improvements in education, prevention, early diagnosis, palliative surgical procedures with adjuvant medical measures, and radical surgery in selective cases and under specific circumstances.

Aged↗
PubMed1989

Gastric cancer: views and overviews.

During the periods 1960 to 1975 and 1976 to 1986, all primary cancers of the stomach at the St. Francis Medical Center were analyzed according to patient age, ethnic origin, sex, environmental and occupational hazards, diet, smoking and alcoholic intake habits, family history of cancer, signs and symptoms, diagnostic procedures, medicosurgical management, surgical cancer staging, surgical procedures, follow-up, and survival. These data are presented and reasons for the decline in the incidence of gastric malignancies in the US are discussed in relation to the increase reported here.

Adult↗
PubMed1989

Effect of investigator bias on clinical trials.

Two clinical trials were performed to determine the relative efficacy of tioconazole, a new antifungal agent for treating patients with tinea pedis. One study compared the new agent with a placebo cream and the other with miconazole nitrate, an established effective antifungal agent. The investigators found a much higher "cure" rate for tioconazole when both treatment groups were known to receive active agents than the cure rate for tioconazole found in the placebo-controlled study. These results showed that the expectations of investigators can influence their clinical evaluations. Such bias could also influence the results of clinical trials.

Antifungal Agents↗
PubMed1988

Investigations into the origin of the high pressure neurological syndrome: the interaction between pressure, strychnine and 1,2-propandiols in the mouse.

1. The effects of a variety of structural isomers of the centrally acting muscle relaxant mephenesin on the high pressure neurological syndrome have been investigated. Threshold pressures for the onset of the behavioural signs, tremors and convulsions, were established. The effects of these compounds on the response to pressure were also compared with their ability to antagonize the convulsive action of strychnine. 2. The dose-response relationships for strychnine and picrotoxin were investigated at fixed pressures. Additionally, the dose-response relationship of strychnine, in the presence of mephenesin, at pressure was investigated. 3. All the isomers of mephenesin protected against the effects of both pressure and strychnine. The relative potency was found to be identical with respect to both. Mephenesin was clearly the most effective; it raised the threshold pressure for tremors by 2.5 times, that for convulsions elicited by pressure by 1.5 and the ED50 for strychnine convulsions by 1.6 times. Strychnine was found to be strictly additive with pressure whereas picrotoxin exhibited gross deviations from additivity. Mephenesin ameliorated the combined effects of pressure and strychnine equally. 4. The marked dependence on structure of the anticonvulsant activity of the mephenesin isomers can be interpreted as evidence that pressure acts not by some general perturbation of the membranes of excitable cells but rather via some specific interaction. The finding that strychnine and pressure are strictly additive supports the idea of specificity and also indicates that they may share a common mechanism in the production of convulsions. By analogy with the established mechanism of action of strychnine, it is suggested that the hyperexcitability associated with pressure might arise from an action on glycine-mediated inhibitory processes.

Animals↗
PubMed1988

Rabbit model of disseminated syphilis: immunoblot and immunohistologic evidence for a role of specific immune complexes in lesion pathogenesis.

Circulating immune complexes (CIC) containing Treponema pallidum proteins have been preliminarily implicated as inducers of a neutrophilic vascular reaction in early human cutaneous lesions of secondary syphilis. To clarify the role of specific CIC in producing cutaneous and renal lesions, 12 rabbits were studied at the following intervals after induction of disseminated syphilis: 20 days (4 rabbits: biopsies of normal and lesional skin for direct immunofluorescence (IMF) for (IgG, IgM, IgA, Clq, C3, C4), fibrin, and T. pallidum proteins; routine histology; and immunoblots of serum for CIC containing T. pallidum proteins); 21 days (4 rabbits: as at 20 days without IMF for T. pallidum protein); 23 days (4 rabbits: as at 20 days without IMF); 30 days (same 12 rabbits restudied with routine histology of normal and lesional skin; kidneys from 4 rabbits removed for routine, IMF, and electron microscopy (EM). Treponemal polypeptide antigen (MW-87 kd) was demonstrated in CIC from rabbits. Routine cutaneous histology showed evolution of lesions from an early neutrophilic vascular reaction to the typical lymphoplasmacytic reaction. IMF showed vessel-based immunoreactants in 3 of the 4 rabbits tested at 20 days and 1 of 4 at 21 days, and T. pallidum proteins in 3 of 4 rabbits at 20 days. Routine histology, IMF, and EM studies of glomeruli showed glomerular abnormalities, but no evidence of immune deposits containing specific T. pallidum protein. Skin and kidney studies of 4 controls were all negative. These data indicate a role for specific immune complexes in the pathogenesis of cutaneous lesions in this rabbit model.

Animals↗
PubMed1988

Effect of benzazole-related centrally acting muscle relaxants on HPNS.

A series of benzazole-related, centrally acting muscle relaxants, comprising benzimidazole, chlorzoxazone, and zoxazolamine, were found to give substantial protection against the tremors and convulsions associated with the high pressure neurologic syndrome (HPNS) in the mouse. In this respect they represent a new class of nonanesthetic, anti-HPNS agents. Their anti-HPNS properties, like those previously established for the mephenesin group of centrally acting muscle relaxants, seem to be related to their ability to antagonize the convulsive action of strychnine. These findings are consistent with the suggestion that one of the principal effects of pressure, expressed as HPNS, arises from a perturbation of strychnine-sensitive mechanisms.

Animals↗
PubMed1987

Lafora's disease. The role of skin biopsy.

Lafora's disease is a neurometabolic disease characterized by progressive myoclonus epilepsy. It is thought to be transmitted by autosomal recessive inheritance. The diagnosis of Lafora's disease is based on both clinical symptomatology and histologic detection of intracytoplasmic periodic acid-Schiff-positive inclusions, termed Lafora bodies. Despite the absence of cutaneous clinical findings, typical inclusions are present in eccrine duct cells and peripheral nerve of skin biopsies. By electron microscopy, the inclusions are electron-lucent and contain glycogenlike granules and filamentous material. Skin biopsy is a convenient and the least invasive method of establishing the diagnosis of Lafora's disease.

Adolescent↗
PubMed1987

Mitogenic activity in human atherosclerotic lesions.

Focal smooth muscle cell proliferation is a key event in atherogenesis, but the stimulating factors are unknown, and there is little information on the occurrence of growth promoting factors in the arterial wall. We have tested extracts of human aortic intima for stimulation of DNA synthesis, using the chick chorioallantoic membrane (CAM) assay in an attempt to avoid artifacts arising with cultured cells. Consistently high levels of stimulation were obtained with early proliferative (gelatinous) lesions (mean DNA synthesis 188% of control, n = 6) and slightly more advanced transitional lesions (mean 160%, n = 4); results with mature fibrous plaques were variable (range 120-182%, n = 3). Significant stimulation was also given by four of eleven samples of apparently lesion-free intima. Intima contains fibrinogen and a range of fibrinogen and fibrin degradation products (FRA) and preliminary fractionation experiments suggest that activity may reside in the FRA fraction. Serum does not stimulate DNA synthesis in the CAM; extract activity was retained in FRA-containing fractions after removal of most serum proteins by affinity chromatography, but was mainly lost from serum protein-containing fractions after removal of FRA.

Adult↗
PubMed1987

Evidence for histamine in the urticating hairs of Hylesia moths.

An urticarial dermatosis after contact with the urticating hairs of the adult female Hylesia moth may occur by several mechanisms including the intradermal injection of inflammatory mediators through the urticating hairs. Extracts were prepared from whole moths, urticating hairs, and other moth parts. Each of these extracts was subjected to a radioenzyme assay for histamine. Histamine was present in extracts made from whole moths and from urticating hairs. Extracts made from other moth parts contained no histamine. Cutaneous wheals occurred after intradermal injections of histamine and various concentrations of Hylesia extract (HE) into the backs of cynomolgus monkeys. This whealing response was suppressed by pretreatment of the animals with diphenhydramine hydrochloride, but not by pretreatment with indomethacin. Histologic examinations showed a perivascular lymphocytic infiltrate around dilated capillaries without evidence of mast cell degranulation in HE-injected sites but not in controls. These findings provide evidence that histamine may be the mediator responsible for the urticarial lesions seen after contact with Hylesia moths.

Animals↗
PubMed1987

Differential virulence of herpes simplex virus intratypic strains.

Many events determine the severity, duration, and predisposition to recurrent herpes simplex virus (HSV) disease. In addition to the various host immune responses, such as local, humoral, and cellular immunity, which influence the outcome of infection and subsequent development of disease, evidence is also accumulating to suggest that intratypic strains of HSV may also play an important role in the outcome, depending on the degree of virulence each strain exhibits. Since it has been suggested that each individual is initially infected and colonized with a strain of virus whose characteristic virulence or avirulence will determine the type of HSV disease that individual will experience, it is suggested that intratypic strains should be considered an important variable in recurrent HSV disease.

Humans↗