Search PubMed⌕ Search

Biomedical subjects

J C Fisher

Publications and source records attributed to J C Fisher.

At least 37 records · Page 2Linked to original sources
PubMed1991

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↗
PubMed1991

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↗
PubMed1990

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↗
PubMed1989

What's new in plastic surgery?

Plastic and reconstructive surgery is benefiting from the ideas and achievements of its innovators, while at the same time exploiting collaborative efforts with private industry and with other surgical specialties. The result is better and faster problem-solving for patients with physical impairments.

Humans↗
PubMed1988

Slowed growth of cultured fibroblasts from human radiation wounds.

To study radiation effect separate from the microcirculation, fibroblasts were cultured from four patients with radiation wounds. Cells could be grown from irradiated tissue near the ulcer and from control normal tissue, but no cells could be cultured from the ulcers. The ability of radiation-treated fibroblasts to attach to the substrate and form colonies was less than that of unirradiated cells. Irradiated skin fibroblasts from the four patients had significantly longer mean generation times than did control cells. During log-phase growth (1 to 9 days), the population doublings of damaged cells were significantly reduced compared to colonies from normal cells. These data suggest a permanent intrinsic radiation effect on fibroblasts or a selective ablation of faster-growing fibroblast subpopulations that is not dependent on decreased blood supply.

Aged↗
PubMed1988

A comparison of the resource intensity of inpatients in urban and rural nonteaching hospitals.

PL 98-21 mandated a prospective payment system based on diagnosis related groups (DRGs) for all Medicare inpatients. The predetermined payment for each DRG is intended to reflect the resources used to treat patients within the DRG. Eventually, the system will allow for one payment level for each DRG in rural hospitals and a higher payment level for the same DRG in urban hospitals. This represents an equitable approach, provided there is not a predominance of high severity cases in rural hospitals and that higher costs in urban hospitals are reflective of higher priced exogenous factors beyond the control of the hospital. Equitability also requires that DRGs capture the resource intensity of treatment for a given classification of patients, equally for urban and rural patients. This work compares the pediatric population of urban hospitals without a pediatric residency program with that of rural hospitals in terms of major diagnostic category, DRG, disease severity, length of stay, and charges. It also compares the capacity of DRGs to explain the variation in resource consumption in urban and rural hospitals. A sample of 116,721 discharges from 130 urban hospitals and a sample of 54,073 discharges from 97 rural hospitals are used in this work. The results indicate that there is no difference in the patient populations of these two hospital groups. The results also indicate that DRGs explain only 50 percent of the variance in the resource variables, but this obtains equally for both populations.

Child↗
PubMed1986

Laser myocardial revascularization.

A significant number of patients with ischemic heart disease are not candidates for coronary artery bypass or percutaneous transluminal angioplasty and do not respond to medical management. This group includes those who have diffuse coronary artery disease, those with poor ventricular function, and those who have had poor results from previous surgery. Developing a method to directly revascularize the myocardium by creating channels through the ventricular wall has challenged many investigators. Early methods, including needle acupuncture, were successful in the acute phase, but long-term patency could not be achieved. Closure of the channels was due to fibrosis and scarring. Experiments in our laboratory demonstrated that myocardial channels, made with the CO2 laser, remained patent up to five years. Histopathologic examination of the channels showed minimal damage to the surrounding cells in the acute phase. Studies at intervals of two months to two years showed patent endothelialized channels, with no evidence of fibrosis. Channels created in the myocardium protected the ventricle against an ischemic event when the left anterior descending branch of the coronary artery was ligated. Clinical experience with direct myocardial revascularization by CO2 laser indicates it may be a viable method of treating those patients with ischemic heart disease who are not candidates for other forms of management. The treatment and early postoperative follow-up in one patient are described.

Aged↗
PubMed1986

The scrotal myocutaneous flap.

The scrotum is a thermoregulatory, well-vascularized structure formed by skin and nonstriated muscle with unique elastic properties. This makes it an ideal source of tissue coverage for problem wounds in its vicinity. Two patients in which scrotal musculocutaneous flaps were used are reported: one, a paraplegic, with a recurrent ischioperineal decubitus ulcer, and another with an ulcer of the penis with exposed Dacron graft previously placed to treat Peyronie's disease. After reviewing the anatomy of the scrotum and the existent literature, we studied scrotal vascularity in a fresh specimen by transillumination. Based on our experience, we conclude that this flap is easy to perform, reliable, and very useful for wounds around the perineal region.

Adult↗
PubMed1985

A developmental approach to the classification of birth defects.

Surgeons are accustomed to categorizing the birth defects they treat surgically according to morphology rather than pathogenesis. Commonly used classification systems fail to take into account the cause or developmental pathology of a given structural defect. Furthermore, surgeons often select operative procedures without considering the evolution of specific defects. Dysmorphology is a fairly new discipline that seeks a better understanding of the cause and pathogenesis of birth defects, not only to ensure optimum treatment but also to encourage prevention of birth defects.

Abnormalities, Multiple↗
PubMed1985

Early tongue resection for Beckwith-Wiedemann macroglossia.

Dentists are aware of the extraordinary influence an active thrusting tongue can have on dental development. In the presence of the profound muscle hypertrophy characteristic of macroglossia in the Beckwith-Wiedemann syndrome, a compelling need exists for surgical reduction of the tongue as early in life as possible. This report describes our clinical experience with 3 children, 1 referred late and the other 2 treated within the first year of life.

Beckwith-Wiedemann Syndrome↗
PubMed1985

Safe margins for melanoma excision.

The oft-quoted 5-cm rule for melanoma excision is not valid. Substitute guidelines are offered and their scientific basis is discussed. A 1-2-3-cm rule is carefully outlined in terms of maximum rather than minimum margins, because little evidence exists to support the importance of wide excision limits in the treatment of melanoma.

Dermatologic Surgical Procedures↗