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Biomedical subjects

J S Weiss

Publications and source records attributed to J S Weiss.

At least 37 records · Page 2Linked to original sources
PubMed1994

Dapsone-induced neutropenia in patients treated for ocular cicatricial pemphigoid.

BACKGROUND: Dapsone is used widely in treating ocular cicatricial pemphigoid, leprosy, and dermatologic disorders. Hemolysis is a well-known complication of dapsone therapy. Rarely, neutropenia or agranulocytosis may occur, resulting in up to a 50% mortality rate. To the authors' knowledge, agranulocytosis has not been reported in patients treated with dapsone for ocular cicatricial pemphigoid. METHODS: The authors report two cases of dapsone-induced neutropenia with bone marrow suppression in patients with ocular cicatricial pemphigoid. RESULTS: Neutropenia was detected on routine laboratory examination 8 and 10 weeks after initiating dapsone therapy. Bone marrow biopsy showed acellular or hypocellular marrow. Leukocyte count returned to baseline value after cessation of dapsone. CONCLUSION: Patients with ocular cicatricial pemphigoid who were treated with dapsone are at increased risk for agranulocytosis. Dapsone-induced neutropenia may not be a dose-dependent phenomenon. The authors indicate that there is a need for routine monitoring of leukocyte counts, especially 8 to 10 weeks after initiating therapy. Signs or symptoms of infection require immediate investigation.

Aged↗
PubMed1992

Panstromal Schnyder's corneal dystrophy. Ultrastructural and histochemical studies.

BACKGROUND: A large cohort comprising four kindreds of patients with Schnyder's dystrophy has been identified in central Massachusetts. All patients were Swede-Finn with ancestry from the southwest Finnish coast on the Bay of Bothnia. METHODS: Of 60 members of this cohort examined by one of the authors (JSW), 18 had evidence of Schnyder's dystrophy. One female with Schnyder's dystrophy from each of three kindreds underwent penetrating keratoplasty for decreased visual acuity. We examined 4 corneal buttons from these unrelated women, aged 47, 63, and 72 years. RESULTS: The fluorescent probe filipin revealed that the majority of the lipid deposits were rich in unesterified cholesterol. Electron microscopy demonstrated abnormal accumulation of lipid and dissolved cholesterol in the epithelium, Bowman's layer, and throughout the stroma. Examination of the kindreds reflected the variable expression of crystals, which were present only in two patients, the 47-year-old and 63-year-old women. CONCLUSION: Ultrastructural and histochemical studies showed the panstromal localization of lipid in Schnyder's corneal dystrophy in three patients with Schnyder's dystrophy who underwent penetrating keratoplasty.

Aged↗
PubMed1992

Schnyder's dystrophy of the cornea. A Swede-Finn connection.

Schnyder's crystalline dystrophy is an uncommon hereditary disease in which there is abnormal deposition of cholesterol and/or lipid usually in the anterior stroma of the central and peripheral cornea. Four families with Schnyder's dystrophy have been identified in central Massachusetts. Of the 173 living members of these pedigrees, 60 patients were examined by the author. Eighteen patients had Schnyder's dystrophy. Affected individuals less than 23 years of age had bilateral, central disc-like corneal opacification. Those greater than 23 years of age also demonstrated prominent arcus lipoides. By age 40, all affected individuals developed a diffuse stromal haze. Only 50% of affected individuals had corneal crystalline deposits. Abnormal cholesterol deposition affected the entire stromal thickness in the majority of patients. Although the four families said that they were not related to each other, all had ancestry from towns within a 100-k area on the southwest coast of Finland. Patients in this area of Finland were examined by the author and demonstrated signs of Schnyder's dystrophy. This may represent the largest cohort of Schynder's dystrophy described to date.

Adult↗
PubMed1992

Effect of the somatostatin analogue octreotide on gastric fluid pH in ponies.

The effect of the somatostatin analogue, octreotide, on gastric fluid pH was investigated in 4 ponies. Gastric fluid pH was determined after SC administration of octreotide or physiologic saline solution (control). A baseline sample of fluid was obtained, the agent was given, and 8 additional samples were collected hourly. Administration of octreotide at all dosages tested (0.1, 0.5, 1.0, and 5.0 micrograms/kg of body weight) increased gastric pH to > 5.0. Baseline values were consistently < 2.7. Administration of octreotide at these same dosages induced gastric pH values > 4.0 for 2.4 +/- 1.2, 4.8 +/- 0.8, 5.7 +/- 1.3, and 5.4 +/- 2.6 (mean +/- SD) continuous hours, respectively. Treatment at all dosages increased the pH of gastric fluid, compared with control values. The duration of the increase in pH was significantly (P < 0.05) different than that of the control treatment, even for the lowest dosage, 0.1 microgram/kg.

Animals↗
PubMed1991

Reproducibility and relation to mean heart rate of heart rate variability in normal subjects and in patients with congestive heart failure secondary to coronary artery disease.

Before heart rate (HR) variability can be used for predictive purposes in the clinical setting, day-to-day variation and reproducibility need to be defined as do relations to mean HR. HR variability and mean HR were therefore determined in 2 successive 24-hour ambulatory electrocardiograms obtained from 33 normal subjects (age 34 +/- 7 years, group I), and 22 patients with coronary disease and stable congestive heart failure (CHF) (age 59 +/- 7 years, group II). Three measures were used: (1) SDANN (standard deviation of all mean 5-minute normal sinus RR intervals in successive 5-minute recording periods over 24 hours); (2) SD (the mean of the standard deviation of all normal sinus RR intervals in successive 5-minute recording periods over 24 hours); and (3) CV (coefficient of variation of the SD measure), a new measure that compensates for HR effects. Group mean HR was higher and HR variability lower in group II than in group I (80 +/- 10 vs 74 +/- 9 beats/min, p less than 0.04). Mean group values for HR and HR variability showed good correlations between days 1 and 2 (mean RR, r = 0.89, 0.97; SDANN, r = 0.87, 0.87; SD, r = 0.93, 0.97; CV, r = 0.95, 0.97 in groups I and II, respectively). In contrast, considerable individual day-to-day variation occurred (group I, 0 to 46%; group II, 0 to 51%). Low HR variability values were more consistent than high values. SDANN and SD correlated moderately with HR in both groups (r = 0.50 to 0.64). The CV measure minimizes HR effects on HR variability.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

The effect of corneal hypesthesia on the duration of proparacaine anesthetic eyedrops.

The duration of action of proparacaine is known in the normal cornea but not in the hypesthetic cornea. To determine this, we examined both eyes in seven patients with documented unilateral corneal hypesthesia associated with inactive herpetic disease. Cochet-Bonnet measurements were made in both eyes before and at two- to five-minute intervals after the instillation of one drop of 0.5% proparacaine until baseline corneal sensitivity levels were again achieved. Mean recovery time was 34.86 minutes in eyes with normal corneal sensitivity, compared to 45.43 minutes in hypesthetic corneas. In all patients, the recovery time was remarkably longer in the hypesthetic eye than it was in the normal fellow eye. These data demonstrate the need to wait up to one hour after the instillation of proparacaine in eyes suspected of having corneal hypesthesia if corneal sensitivity is to be determined accurately. Additionally, the duration of action of topically instilled anesthetic may be a useful method of discovering subtle differences in corneal sensitivity.

Adult↗
PubMed1991

A review of two controlled multicenter trials comparing 0.05% halobetasol propionate ointment to its vehicle in the treatment of chronic eczematous dermatoses.

The efficacy and safety of 0.05% halobetasol propionate ointment were evaluated in patients with chronic atopic or other eczematous dermatoses in two vehicle-controlled, double-blind studies: a paired-comparison study in 124 patients (study A) and a parallel-group study in 100 patients (study B). In study A, patients applied both treatments twice daily for 2 weeks and were evaluated by investigators on days 0, 7, and 14 with 0 to 3 severity scales and by self-assessment with two 5-step end-of-treatment rating scales. In study B, patients applied treatments twice daily for 2 weeks, and investigators made evaluations on days 0, 3, 7, and 14 with 0 to 6 scales and also made a 5-step end-of-treatment physician's global assessment. In study A, both severity scores and patient ratings favored halobetasol propionate significantly on days 7 (p less than or equal to 0.0013) and 14 (p less than 0.0001); in study B, severity scores on days 3 (p less than or equal to 0.045, pruritus, erythema, and overall lesion severity), 7, and 14 (p less than 0.001, all comparisons) also favored halobetasol propionate significantly, and global assessments showed complete resolution or marked improvement for 83% of patients using halobetasol propionate versus 28% of those using vehicle (p less than 0.0001). No instances of systemic effects or skin atrophy were reported in either study. We conclude that 0.05% halobetasol propionate ointment is highly effective and well tolerated in the treatment of the conditions studied, with the rapid action and high degree of clearing associated with superpotent corticosteroid formulations.

Adolescent↗
PubMed1991

Tretinoin treatment of photodamaged skin. Cosmesis through medical therapy.

Topical tretinoin is an effective therapy for the treatment of photodamaged skin. Clinically, patients experience decreased wrinkling, improved texture, and pinkening of sallow skin. However, the changes induced by topical tretinoin extend beyond simple cosmesis. Microscopic, ultrastructural, and biochemical alterations indicate that topical tretinoin is a significant medical therapy. Its successful use requires the guidance of an experienced physician.

Cosmetics↗
PubMed1991

Antimalarial medications in dermatology. A review.

Antimalarial medications are effective for the treatment of a variety of dermatologic conditions. Their use is often curtailed by concern for adverse reactions, including ophthalmologic side effects; however, recent evidence points to a greater margin of safety with these medications than was previously appreciated. This article reviews the pharmacology of antimalarial medications as well as indications and safe guidelines for their use in the treatment of dermatologic conditions.

Antimalarials↗
PubMed1990

Treatment of photoaged skin with topical tretinoin increases epidermal-dermal anchoring fibrils. A preliminary report.

Topical 0.1% tretinoin or vehicle control was applied daily to the forearm skin of six caucasian adults for 4 months. Two-millimeter punch biopsy specimens were obtained from treatment sites at the beginning and end of the study period for electron microscopy. Anchoring fibrils within the epidermal-dermal junction of skin treatment sites were quantitated by blinded, standardized, computer-assisted morphometry. After 4 months of continual daily treatment, skin sites that received topical tretinoin showed double the anchoring fibril density compared with vehicle control sites (1.34 anchoring fibrils per micron of lamina densa vs 0.65, respectively). The possible mechanisms by which topical tretinoin increases anchoring fibrils in skin include the drug's property of inhibiting collagenase, a dermal enzyme that degrades anchoring fibril collagen. We speculate that increased numbers of collagenous anchoring fibrils within the papillary dermis of human skin is one of the connective-tissue correlates of the clinical improvement observed in photoaged skin after treatment with topical tretinoin.

Administration, Cutaneous↗
PubMed1990

Sustained improvement with prolonged topical tretinoin (retinoic acid) for photoaged skin.

We performed a 22-month trial of topical tretinoin (retinoic acid) in the treatment of photoaging. Thirty patients participated in a 4-month, randomized, blinded, vehicle-controlled study that has been reported previously; 21 patients continued tretinoin therapy on an open-label basis, participating in the study for a total of 10 months, and 16 patients continued for 22 months. During the open-label study, the statistically significant improvement that had occurred in fine and coarse wrinkling and skin texture during our original study was sustained, despite reductions in dose or frequency of application of tretinoin. The number of discrete lentigines decreased by 71% compared with the number before therapy. Histologic findings included a statistically significant thickening of the epidermis. Side effects were limited to a cutaneous retinoid reaction that diminished as therapy proceeded.

Administration, Topical↗
PubMed1990

Ocular manifestations and impression cytology of anorexia nervosa.

A prospective age- and sex-controlled study of seven anorexia nervosa patients and seven normal control patients was conducted to determine the ocular manifestations of anorexia nervosa. Slit-lamp examination of the anorexic patients demonstrated a high incidence (4/7) of multiple episcleral capillary aneurysms and subconjunctival hemorrhages. Two of seven anorexia nervosa patients had bilateral superficial punctate keratopathy. Anesthetized Schirmer tear testing demonstrated a significantly (P less than 0.005) reduced mean tear production in the anorexia nervosa group (11.3 mm) compared with the control group (22.4 mm). Masked interpretation of conjunctival impression cytology demonstrated moderate to severe conjunctival squamous metaplasia in the majority of the anorexia nervosa group (5/7) compared to normal conjunctival epithelium in the majority of the control group (5/7). Absence of nyctalopia, Bitot's spots, and xerosis, and lack of conjunctival goblet cell loss indicate that the anorexia nervosa group did not have vitamin A deficiency.

Adult↗