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Biomedical subjects

E B Smith

Publications and source records attributed to E B Smith.

At least 109 records · Page 6Linked to original sources
PubMed1987

Direct selection of a specifically blocked mutant of Actinomadura brunnea. Isolation of a third 8-methoxy substituted chlortetracycline.

Actinomadura brunnea produces 2'-N-methyl-8-methoxychlortetracycline. A derivative of this strain has been isolated that is specifically blocked in methylation of the 2'-amino position. This isolate was detected by screening approximately 30,000 colonies of a mutagenized population of Actinomadura brunnea using a direct soft agar overlay with an Escherichia coli indicator. The antibiotic produced by the blocked mutant has been identified as 8-methoxychlortetracycline (Sch 36969) based upon its biological activity, relative mobility on TLC and HPLC, and spectroscopic data.

Chemical Phenomena↗
PubMed1987

The screening Papanicolaou smear: contribution of the endocervical brush.

Between September 1984 and February 1985, cervical cytologic smears were collected from 510 patients using a spatula and an endocervical swab. These smears were compared with those collected from 510 patients between September 1985 and February 1986 using a spatula and an endocervical brush. The use of the endocervical brush increased the number of smears that contained endocervical cells, for both reproductive-age and postmenopausal women. In women without previous radiation therapy, the rate of suboptimal smears (those without endocervical cells) fell from 12.0 to 1.7% when the endocervical brush was used. This modified smear collection technique improved the quality of the cytologic material.

Adolescent↗
PubMed1987

Psychiatric disorder in medical in-patients.

Four hundred and fifty-three general medical in-patients were screened for mood disorder (anxiety and depression), organic mental states and alcohol problems. Using the Present State Examination, affective disorder was identified in 14.6 per cent, being especially common in younger women. Organic psychiatric disorder was very common in the elderly, occurring in 31 per cent of those over 70 years, and 18 per cent of men and 4 per cent of women admitted to a drink problem. Mood disorder was not related to the type or severity of physical illness, but was significantly associated with previous psychiatric history and social problems. Two-thirds of those with mood disorder on admission who were still alive four months after discharge were improved. House officers and family doctors identified approximately half the cases of depression and anxiety, but house officers were no more likely to recognise the more severe cases than the milder ones. Organic psychiatric disorder was often missed, alcohol problems less so.

Adolescent↗
PubMed1986

Fibronectin distribution in human aortic intima and atherosclerotic lesions: concentration of soluble and collagenase-releasable fractions.

Fibronectin is associated with cell attachment and migration and interacts with fibrin, collagen and glycosaminoglycans; thus, it may be a factor in the focal proliferation of smooth muscle cells and collagen in atherosclerosis. We have measured, by rocket immunoelectrophoresis, the concentrations of soluble and collagenase-releasable fibronectin in normal human aortic intima and different types of atherosclerotic lesions. Soluble fibronectin concentration showed no significant difference between normal intima and lesions, but was 6-8-times higher than expected on the basis of plasma concentration and molecular mass. The concentration free in the interstitial fluid was about 3-times the expected level, suggesting that it originates from local synthesis as well as plasma insudation. In tissue, about half the fibronectin appeared to be reversibly associated with tissue components. Incubation with collagenase released fibronectin equal to twice the soluble fraction from normal intima and early proliferative lesions. In more advanced plaques that were accumulating lipid, the amount released was significantly higher (P less than 0.05) and more than 3-times the soluble fraction, suggesting that it might be involved in lipid accumulation. However, there was no correlation between release of fibronectin and bound low-density lipoprotein.

Aorta↗
PubMed1986

Superior vena cava syndrome associated with gynecologic malignancy.

Superior vena cava syndrome is an infrequently noted complication associated with gynecologic malignancy. Three cases illustrate modern diagnostic and management methods. Patients developed superior vena cava syndrome secondary to mediastinal metastatic endometrial carcinoma, uterine leiomyosarcoma, and secondary to thrombosis induced by a subclavian hyperalimentation catheter. Awareness of this condition on oncology units and by physicians using central venous catheters is important to afford the prompt diagnosis and appropriate management of this life-threatening condition.

Adenocarcinoma↗
PubMed1986

Eosinophilic pustular folliculitis.

Sterile, pruritic papules and papulopustules that formed annular rings developed on the back of a 58-year-old woman. The individual lesions evidenced peripheral extension with central clearing and were characterized by exacerbations and partial remissions. The general health of the patient was good. Laboratory determinations showed moderate peripheral blood eosinophilia. Spongiosis with eosinophilic exocytosis, often localized to the hair follicles, was found on examination of histologic specimens. These findings led to a diagnosis of eosinophilic pustular folliculitis, a disease of unknown cause that has rarely been reported in the North American literature.

Eosinophilia↗
PubMed1986

Cutaneous secondary syphilis: preliminary immunohistopathologic support for a role for immune complexes in lesion pathogenesis.

A circulating immune complex-mediated pathogenesis for lesions of secondary syphilis has been postulated. Textbook descriptions of a lymphoplasmacytic histopathologic picture have contradicted a role for circulating immune complexes in lesion pathogenesis. Four patients with early cutaneous lesions of secondary syphilis were studied. All four patients had serum Raji cell and/or Clq binding assay evidence for circulating immune complexes. Three patients showed a neutrophilic vascular reaction on histologic study of early lesions. The patients studied had immunofluorescence microscopic evidence of immunoreactant deposition in dermal blood vessels (4 hours) and/or a neutrophilic vascular reaction (24 hours) after intradermal histamine injection. Dieterle staining of lesional tissue from all patients showed the presence of treponemal organisms in dermal blood vessels. This new preliminary evidence adds some support to a circulating immune complex-mediated pathogenesis of cutaneous lesions in human secondary syphilis.

Adult↗
PubMed1986

Acquired perforating disease in oil field workers.

Eight cases of an acquired perforating disease are reported in oil field workers who were exposed to drilling fluid. Analysis of the drilling fluid showed it to contain many components, including calcium chloride. Histopathologic study of patient lesions demonstrated transepidermal elimination of calcium. An in vivo mouse model was developed to study this phenomenon, which may represent a calcium-mediated perforating disorder.

Adult↗
PubMed1986

Role of circulating immune complexes in human secondary syphilis.

Studies in animal models and in the glomerulonephritis of human secondary syphilis and results from in vitro assays have suggested a role for circulating immune complexes (CICs) in human secondary syphilis. Nine adult subjects with early secondary syphilis were studied. All patients tested had CICs on C1q-binding or Raji cell assays. Proteins previously described as Treponema pallidum-specific antigens were detected by radioimmunoblot techniques in CICs from all five subjects tested. Biopsy of early cutaneous lesions revealed immunoreactants (IgG, C3, and/or C1q) in three of nine subjects and treponemal antigen in six of eight subjects tested. Histamine was injected intradermally as a trap for CICs, and biopsy of these injection sites revealed immunoreactants in four of nine subjects and treponemal antigen in five of eight subjects tested. A neutrophilic vascular reaction consistent with CIC-mediated vessel damage was seen in three of nine lesions and six of nine histamine injection sites. Normal controls did not show these changes.

Antigen-Antibody Complex↗
PubMed1986

Tinea faciei in infants caused by Trichophyton tonsurans.

Tinea faciei has been observed periodically in children, however, it is a relatively rare occurrence in infancy. We examined three infants with tinea faciei caused by Trichophyton tonsurans. Two of the patients were potassium hydroxide (KOH) negative for fungal hyphae but culture positive, while the third was both KOH and culture positive. Trichophyton tonsurans was isolated from the scalp of family members in two of the three infants.

Facial Dermatoses↗
PubMed1986

Hospital doctors' management of psychological problems.

Psychological and social difficulties are common amongst both medical and surgical patients, but psychiatrists are able to see only a very small proportion, and though hospital doctors have the main responsibility for psychological treatment, very little is known of what they actually do. Physicians and surgeons in Oxford answered a questionnaire on their attitudes and clinical practice: virtually all believed that emotional care is important, but what they do and what they would like to do in the assessment, treatment, and referral of their patients varied widely. There were associations with the extent of responsibility for chronic care, speciality, and seniority.

Antidepressive Agents↗
PubMed1986

Plasma macromolecules in interstitial fluid from normal and atherosclerotic human aorta.

The concentration of LDL free in the IF from normal intima is twice the concentration in the patients plasma. LDL is virtually excluded from media, thus it seems to be trapped between endothelium and the internal elastic lamina. Expressed as percent of plasma concentration, concentration of macromolecules in IF is directly related to molecular mass suggesting molecular sieving. There appears to be specific reversible association of fibronectin with tissue components, but not of LDL. In IF from early proliferative (gelatinous) lesions LDL concentration increased by an average of only 30%, and in some samples it was decreased, suggesting that it was not the stimulating factor. There was a slight decrease in its net negative charge. Numerous fat-filled cells totally depleted IF of LDL. The net negative charge of LDL from samples containing fat-filled cells was the same as adjacent normal intima.

Aorta↗
PubMed1986

Primary bilateral breast cancer.

At the St. Francis Medical Center during the 20-year period 1960-1980, there were 1,148 primary breast cancers with a 7.1 percent incidence of synchronous and metachronous invasive primary breast cancer. Twenty-one cases (1.8 percent of the total series) illustrate noninvasive cancer of the breast. The essential approaches toward the diagnosis of a contralateral cancer were breast self-examination, history and physical examination, and x-ray mammography. Biopsy of contralateral discrete breast masses was advocated. If biopsies were positive for malignancy, definitive surgical management with indicated supplemental oncological therapy were recommended. "Blind focal biopsy" of the contralateral breast was discouraged. The five- to 25-year disease-free survival rate for 82 invasive bilateral breast cancers was 51 percent with a follow-up percentage of 98 percent during an interval of five to ten years. The survival statistics in the primary bilateral breast cancers when compared to results in primary unilateral breast cancers were not as grave as anticipated.

Adult↗
PubMed1986

Fibrinogen, fibrin and fibrin degradation products in relation to atherosclerosis.

Many human atherosclerotic lesions, showing no evidence of fissure or ulceration, contain a large amount of fibrin which may be in the form of mural thrombus on the intact surface of the plaque, in layers within the fibrous cap, in the lipid-rich centre, or diffusely distributed throughout the plaque. Small mural thrombi are invaded by SMCs and collagen is deposited in patterns closely resembling the early proliferative gelatinous lesions. In experimental animals, thrombi are converted into lesions with all the characteristics of fibrous plaques, and in saphenous-vein bypass grafts, fibrin deposition is the main cause of wall thickening and occlusion. There seems little doubt that fibrin deposition can both initiate atherogenesis and contribute to the growth of plaques. Epidemiological studies indicate that increased levels of fibrinogen and clotting activity are associated with accelerated atherosclerosis, and although blood fibrinolytic activity has given inconsistent results, in arterial intima both fibrinolytic activity and plasminogen concentration are decreased in cardiovascular disease. Fibrin may stimulate cell proliferation by providing a scaffold along which cells migrate, and by binding fibronectin, which stimulates cell migration and adhesion. Fibrin degradation products, which are present in the intima, may stimulate mitogenesis and collagen synthesis, attract leukocytes, and alter endothelial permeability and vascular tone. In the advanced plaque fibrin may be involved in the tight binding of LDL and accumulation of lipid. Thus there is extensive evidence that enhanced blood coagulation is a risk factor not only for thrombotic occlusion, but also for atherogenesis. Enhanced blood coagulation frequently coexists with hyperlipidaemia and, together, these may have a synergistic effect on atherogenesis.

Animals↗
PubMed1986

Surgery in Jehovah's Witnesses.

Surgical experiences are described with 96 adult patients who professed and practiced the Jehovah's Witness faith and whose refusal of blood transfusions and blood-related products created problems in circulatory fluid volume, cardiorespiratory exchanges, cerebral, hepatic, and renal metabolic processes, and wound healing. The surgical mortality rate was representative and the surgical complication rate was excessive. The most frequent complications (93.5 percent) were wound-healing problems.

Adult↗