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Biomedical subjects

R F Wagner

Publications and source records attributed to R F Wagner.

At least 73 records · Page 4Linked to original sources
PubMed1993

Malpractice litigation against child and adolescent psychiatry residency programs, 1981-1991.

A national survey was conducted to investigate malpractice litigation at United States child and adolescent psychiatry residency programs between 1981 and 1991. Fourteen percent of the directors of child and adolescent psychiatry reported at least one malpractice claim during this period. The highest percentage of lawsuits reported was in the northeast. Suicide and sexual abuse of latency age patients by other patients accounted for the most litigation. The mean monetary award was $167,000, and the largest award was $500,000 for discharge of a patient who killed his mother. There has been an increase in malpractice litigation during the past 10 years. Risk management strategies should be implemented to address areas of liability in child and adolescent psychiatry training programs.

Adolescent↗
PubMed1993

Medical and technical issues in office electrolysis and thermolysis.

BACKGROUND: Most university medical centers do not directly offer electrolysis or thermolysis services to hirsute patients. Little research activity has been focused on these procedures. The successful introduction of a clinical and research electrolysis service into the University of Texas Medical Branch (UTMB) dermatology clinic is described. OBJECTIVE: The purpose of this communication is to familiarize clinicians with an electrolysis service in a university clinic setting. New advances in permanent hair removal equipment and methods are reviewed. METHODS: A description of the UTMB electrolysis clinic is given. RESULTS: Electrolysis services offered by the UTMB dermatology department have been well received by patients, clinical staff, UTMB faculty, UTMB resident physicians, and private physicians. CONCLUSION: This successful medical model for electrolysis services may provide other university dermatology clinics with background information for the development of their own programs. Future research advances in electrolysis and the management of hirsutism may result from this activity.

Academic Medical Centers↗
PubMed1993

Localized multiple neurilemmomas of the lower extremity.

A neurilemmoma usually presents as a solitary subcutaneous tumor adherent to a peripheral nerve. Multiple localized neurilemmomas may occur as an isolated cutaneous finding or as part of the syndrome of neurilemmomatosis. We report a case of multiple neurilemmomas appearing on an extremity after trauma. The multiplicity and localization of the tumors are rare and illustrate that neurilemmomas are not invariably solitary tumors and that their distribution can be regional. We review the previously reported cases of multiple neurilemmomas and review the characteristics that help the clinician to differentiate between multiple localized neurilemmomas and neurilemmomatosis.

Ankle↗
PubMed1993

Fluoxetine treatment of trichotillomania and depression in a prepubertal child.

The case of a ten-year-old boy with a two-year history of trichotillomania and depression is presented. Imipramine was unsuccessful in treating trichotillomania and showed limited success in alleviating depression. Treatment with low-dosage fluoxetine (10 mg daily) led to marked improvement of both trichotillomania and depression.

Behavior Therapy↗
PubMed1992

p53 mutations in basal cell carcinomas.

Genomic DNA from 14 basal cell carcinoma biopsies was screened for the presence of mutations in the p53 gene, using the polymerase chain reaction followed by direct DNA sequencing. Heterozygous mutations were detected in 7 of 14 (50%) samples investigated. All mutations were G:C-A:T transitions, and five (71%) of these mutations were transitions at hot spots with CpG sites, three at codon 248 and two at codon 273. The striking similarity of the type of mutations detected in this study and with the UV mutagenesis studies reported in literature suggest the hypothesis that UV may act on the p53 gene in a carcinogenic-specific fashion.

Base Sequence↗
PubMed1992

Photographic utilization in dermatology clinics in the United States: a survey of university-based dermatology residency programs.

BACKGROUND: Photography has recently been introduced as an adjunct to the clinical management of patients with the dysplastic nevus syndrome (DNS). OBJECTIVE: Our purpose was to evaluate the methods used and the extent of clinical photography in dermatology residency programs in the United States. METHODS: Nonmilitary accredited dermatology residency programs in the United States were surveyed (73% response rate) regarding utilization and technical aspects of clinical photography. RESULTS: Forty-one percent of respondents used photography for the clinical management of 90% or more of patients with DNS. Twenty-four percent of respondents used photography for the clinical management of all patients with DNS. Eighty-one percent of respondents used slides, and 62% utilized total body photographs. The median number of photographs taken for a patient with DNS was 20. CONCLUSION: Dermatologic photography has been widely adopted for the clinical management of patients with DNS. Failure of the health insurance industry to recognize the value of this procedure may result in its underutilization.

Dermatology↗
PubMed1992

Culture of basal cell carcinoma.

Studies of basal cell carcinoma have been hindered by a lack of a suitable and reproducible tissue-culture model system. We have succeeded in growing this tumor in primary culture from eight different patients. We can separate and grow the tumor cells and the stromal cell component. We also culture normal keratinocytes and fibroblasts from the same patient for comparative studies. All the cell types have been subcultured four to five times and cryopreserved. The normal keratinocytes were indistinguishable from the tumor cells in ploidy, in rate of growth, and in the failure to express ICAM-1. Both cell types also fail to synthesize the matrix proteins: types I and IV collagens. Differences were noted in the expression of fibronectin and the bullous pemphigoid antigen, with the normal cells expressing the antigens although the tumor cells did not. Interferons exogenously added to the culture media preferentially killed the basal cell carcinoma cells, as compared to normal keratinocytes from the same patients. We believe that our culture system opens possibilities for biochemical and molecular studies of this disease, and for in vitro testing of antitumor agents for clinical therapy.

Basal Cell Carcinoma↗
PubMed1992

Senior medical student clinical and research electives in dermatologic surgery.

Five senior medical students enrolled in the 4 week clinical elective in dermatologic surgery and cutaneous oncology (DSCO); two of these students also enrolled in a 4 week research elective in DSCO. During the elective(s) the students made significant improvement in the six areas of clinical diagnosis, histopathologic diagnosis, clinical management, DSCO procedures, research skills, and general information about the subspecialty. Following their elective(s), these students submitted a total of six abstracts, one letter, and seven manuscripts for presentation or publication.

Curriculum↗
PubMed1992

Squamous cell carcinoma secondary to recessive dystrophic epidermolysis bullosa. A report of 4 patients with 17 primary cutaneous malignancies.

Four patients with recessive dystrophic epidermolysis bullosa and 17 invasive primary cutaneous squamous cell carcinomas (SCCs) are presented. All skin cancers arose at the site of scarring due to recessive dystrophic epidermolysis bullosa. Three of 17 (18%) primary cutaneous SCCs recurred locally following initial treatment with either surgical excision or wide surgical excision. Patients with recessive dystrophic epidermolysis bullosa are more likely to develop SCCs of the extremities than nonimmunocompromised patients or patients with epidermodysplasia verruciformis. Like patients with epidermodysplasia verruciformis, patients with recessive dystrophic epidermolysis bullosa are likely to suffer from invasive and metastatic SCCs at a much younger age than nonimmunocompromised patients.

Adult↗
PubMed1992

Optical illusions in clinical dermatology: the Mach band phenomenon and afterimages.

A survey of dermatologists was conducted to determine whether the perceptions of afterimages and Mach bands impacted on clinical dermatology practice. 26.5% (13/49) of respondents indicated that they perceived one or both of these optical illusions. No false-positive potassium hydroxide interpretations of skin scrapings for hyphae were reported due to perceived afterimages, and no skin biopsies were reportedly performed as a result of Mach bands.

Adult↗
PubMed1992

Eccrine acrospiroma of the external auditory canal.

Tumors of the external auditory canal include osteomas, ceruminomas, sebaceous cysts, keloids, basal cell carcinomas, squamous cell carcinomas, and, in rare cases, eccrine acrospiromas. We describe an eccrine acrospiroma arising from the distal external auditory canal, which was associated with decreased hearing on the affected side. Surgical resection of the tumor resulted in improved hearing.

Adenoma, Sweat Gland↗