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Biomedical subjects

J C Fisher

Publications and source records attributed to J C Fisher.

At least 19 recordsLinked to original sources

Town and gown.

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California

Endoscopic laser-assisted lacrimal surgery.

Since Sept. 1, 1989, we have successfully performed 20 video-endoscopic, transnasal, laser-assisted lacrimal procedures on 18 patients ranging in age from 3 to 88 years. This technique avoided a cutaneous scar and caused less surgical trauma and bleeding than that seen in conventional lacrimal surgery, which shortened postoperative recovery time and lessened postoperative pain. With minor modifications in surgical technique, both dacryocystorhinostomy and conjunctivodacryocystorhinostomy were performed with either the potassium titanyl phosphate or carbon dioxide lasers. The use of the video endoscope allowed laser surgery to be performed across a broad range of intranasal structural variations and provided an excellent medium for teaching this new technique.

Adolescent

Human antibody response following multiple injections of bovine collagen.

The enzyme-linked immunosorbent assay (ELISA) was selected to further characterize the human antibody response to Zyderm (ZCI). Our studies have involved both patients and volunteers. Five patients with delayed cutaneous hypersensitivity reactions to Zyderm were positive for anti-Zyderm antibody. Six of nine patients treated with Zyderm who never displayed cutaneous reactions did develop significant levels of anti-Zyderm serum antibody. Some of these patients progressively increased their antibody levels. None of the volunteers who received multiple skin-test doses (0.1 cc) of Zyderm developed significant levels of anti-Zyderm antibody. Polyvalent anti-Zyderm antibody titers among patients with positive ELISA absorbance ranged from 1:16 to greater than 1:128. All were positive for antibodies of the IgG subtype; half were positive for the IgA subtype. None was positive for IgM or IgE subtype. We did not observe cross-reactivity between patient anti-bovine collagen sera and commercially prepared antibodies to human anti-collagen types I, II, and III. Given the frequency of current Zyderm use, it seems evident that for most patients, biologic exposure to collagen does not pose a health hazard. Nevertheless, because of the scarcity of data pertaining to the long-term significance of humoral anti-Zyderm antibodies, physicians and patients should be aware that unanswered questions remain whenever clinical use of injectable collagen is recommended.

Animals

Designing an internal organizational merger.

Healthcare managers face problems resulting from restructuring and downsizing activities meant to increase operational efficiency and reduce costs. Although keys to the success of multiorganizational mergers are well documented, directives for managing internal mergers are less clearly stated. The authors discuss a five-step plan designed to facilitate an internal merger through the strategic coordination of stakeholders.

Attitude of Health Personnel

Studies on the transmission of viral disease via the CO2 laser plume and ejecta.

While recent reports have noted the presence of viral DNA sequences in the laser plume, no significant effort has been made to study transmission of the virus in vivo via airborne laser debris. Studies were undertaken to identify potential hazards to operating room occupants in gynecologic laser surgery. ACO2 laser in the continuous wave mode using a power density of 666 W/cm2 was fired through a 5-cm metal cylinder at virus-infected tissues. Airborne particulate debris, 100-200 microns, was removed from the cylinder's inner surfaces. In one instance, deposition of the debris was found on the surgeon's eyeglasses 1 m from the site of impact despite the use of a smoke evacuator. The first set of studies involved confirmed human papillomavirus (HPV) lesions of the human female lower genital tract. Specimens were collected for electron microscopy and Southern Blot viral hybridization. Additional cervical electron microscopy specimens were recovered from the speculum during pulsed CO2 laser treatment at 13 W average power during conization. Electron microscopy of the vulvar debris revealed only anucleate keratinized squamous epithelial cells. Cervical specimens demonstrated similar cells with nearly instantaneous vaporization of intracellular water and apparent condensation of cellular carbon. HPV Southern Blot testing revealed insufficient quantities of DNA for that technique. The second set of studies involved bovine papillomavirus lesions from dairy cattle. The debris was transmitted to susceptible animals. The bovine studies failed to demonstrate the transmission of disease in vivo.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals