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Biomedical subjects

R L Moy

Publications and source records attributed to R L Moy.

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

Local expression of antiinflammatory cytokines in cancer.

To characterize the nature of the local cytokine response to cancer, we chose to investigate cytokine patterns in biopsy specimens of basal cell carcinoma (BCC). We hypothesized that a distinct pattern of local cytokine production may be characteristic of BCC, a neoplasia of epidermis, in comparison to the pattern of seborrheic keratosis (SK), a benign growth of epidermis. We analyzed cytokine mRNAs in BCC versus SK by performing polymerase chain reaction on mRNA derived from biopsy specimens. The mRNAs encoding cytokines for IL-4, IL-5, IL-10, and granulocyte macrophage colony-stimulating factor were strongly expressed in BCC lesions and weakly expressed in SK lesions. Conversely, IL-2, IFN-gamma, and lymphotoxin mRNAs were strongly expressed in SK lesions and weakly expressed in BCC lesions. The response to malignancy, BCC, was typified by cytokines characteristic of murine TH2 cells. This cytokine pattern favors humoral immunity with concomitant immunosuppression of cell-mediated immune responses. In comparison, the response to the benign growth, SK, was typified by cytokines characteristic of murine TH1 cells that favor cell-mediated immune reactions. The findings of a distinct cytokine pattern in skin cancer provide a framework to develop strategies for immunologic intervention.

Anti-Inflammatory Agents↗
PubMed1993

Drug and nutrient aspects of wound healing.

An understanding of the major factors that influence wound healing enables the clinician to better prepare patients for surgery and to identify and correct the effects of either drugs or nutritional imbalances in patients whose wounds fail to heal. Ideally, factors that enhance wound healing should be optimized, and detrimental influences minimized whenever possible. Among the major factors influencing wound healing are the state of general health, drugs, and nutritional status. Nutritional assessment prior to surgery, following injury, and during recovery is an important part of management of patients with extensive wounds. In dermatologic surgical practice, nutritional support is not indicated; however, subclinical nutritional deficiencies may not be uncommon and may become relevant if wound healing is significantly impaired. Dermatologic surgeons must be aware of the potential for many drugs to interfere with wound healing and interrupt therapy prior to surgery whenever possible. Some drugs cannot be stopped and surgery should be performed only when absolutely necessary when patients are receiving antineoplastic, anticoagulant, and high-dose steroid therapy.

Animals↗
PubMed1992

Biology of cutaneous squamous cell carcinoma.

Nonmelanoma skin cancer is the leading cause of cancer in the United States. Cutaneous squamous cell carcinoma is second only to basal cell carcinoma in prevalence and its incidence is increasing. The biology of squamous cell carcinoma is reviewed under the broad areas of etiology, immunobiology, biochemistry, metastatic potential, and therapy, with emphasis on prevention, diagnosis, and management.

Animals↗
PubMed1992

Malignant melanoma of the eyelid. A report of eight cases and a review of the literature.

BACKGROUND: Because of the relatively rare occurrence of malignant melanoma (MM) of the eyelid, prognostic factors in relation to survival in these patients have not been established. OBJECTIVE: Our purpose was to examine prognostic indicators in relation to survival in patients with MM of the eyelid. METHODS: All patients seen at UCLA Medical Center with MM of the eyelid as well as all cases reported in the literature were reviewed retrospectively. RESULTS: The data obtained from 47 total cases seen at UCLA Medical Center revealed a significant disadvantage in 5-year survival for those patients with MM involving the lid margins in comparison to those without lid margin involvement. CONCLUSION: Our review suggests that melanoma involving the eyelid margin and conjunctiva has a worse prognosis than melanomas of the eyelid that do not involve the conjunctiva. We can make no predictions in regard to the benefits of narrow versus wide surgical margins in the treatment of these patients.

Adult↗
PubMed1992

Elective lymph node dissection in stage I malignant melanoma: a meta-analysis.

The role of elective lymph node dissection (ELND) in stage I melanoma has been a controversial issue for decades. Numerous studies have been conducted to try to establish the benefit of ELND versus wide local excision (WLE). The majority of these studies suggest no significant difference in survival, although some investigations have shown ELND to be of benefit in intermediate thickness (0.76-3.99 mm) melanomas. In order to resolve this ongoing controversy, a meta-analysis was undertaken to review and analyse the results of previous reports. There was a total of 10,132 patients of whom 3,409 in 15 studies underwent ELND for all melanoma patients and 3,618 patients of whom 1,336 in eight studies had ELND for intermediate thickness (0.76-3.99) melanomas. No significant 5-year survival was present in all patients treated with ELND (p > 0.05, confidence intervals -0.0780, 0.0788), however, a significant 5-year survival was found in the intermediate thickness subgroup (p < 0.0001, confidence intervals -0.02, 0.22). Therefore, ELND may be valuable for improving the prognosis of patients with intermediate thickness melanomas.

Humans↗
PubMed1992

Lack of predictive factors in late recurrence of stage I melanoma.

Through the UCLA tumor registry, patients treated for late-relapse malignant melanoma (after a 10-year disease-free interval) were identified and studied retrospectively. The patients were studied in regards to age, sex, primary site of the lesion, the disease-free interval, elective lymph node dissection, mode of recurrence and survival time following relapse. The histologic characteristics studied included the maximal tumor thickness, Clark's levels, rate of mitoses, and presence of ulceration. Based on the 0.84% incidence of late-relapse, the recommendation for annual life-time follow-up examinations for all patients with malignant melanoma is supported.

Adult↗
PubMed1992

Scar wars strategies. Target collagen.

Hypertrophic scarring and keloid formation are clinical problems with effectively limited solutions. Although numerous methods have been devised to combat them, this article focuses on promising pharmacologic strategies that target collagen metabolism. Laboratory investigations of amino-acid analogs, procollagen peptides, D-penicillamine, and pentoxifylline have demonstrated them to be effective inhibitors of collagen synthesis in cultured cells and/or in animal models. Clinical trials of intralesional administration of interferons have shown impressive reductions in the size and collagen production of keloids. Furthermore, interference of extracellular matrix-enhancing cytokines, such as TGF-beta, may be an effective solution to keloids and hypertrophic scars. Additional research of soluble cytokine receptors, autoantibodies to cytokines, cytokine receptor antagonists, and cytokine-binding molecules may lead to the development of better therapeutic agents.

Cicatrix, Hypertrophic↗
PubMed1992

Efficacy of double gloving as a protection against blood exposure in dermatologic surgery.

Double gloving has been widely suggested as a means of decreasing exposure to blood and other body fluids. However, most dermatologists do not routinely follow this practice when performing surgical procedures because it reduces manual dexterity and increases costs. To determine whether double gloving should be routinely practiced in dermatologic surgery, pairs of sterile surgical gloves worn during weekly UCLA dermatologic surgery clinics were collected over a period of 3 months and examined for perforations. The procedures gloves were used for ranged from excision of benign lesions, lasting 15 minutes, to hair transplants, lasting 3 hours. Upon completion of the procedures, 8 (5.5%) of 144 pairs of single gloves, 2 (3.7%) of 54 pairs of double inner gloves, and 3 (5.5%) of 54 pairs of double outer gloves were found to have perforations. There were no instances of both the double outer and the double inner gloves having perforations when worn on the same hand. This suggests that double gloving offers a protective advantage by providing extra protection for both the surgeon and the patient during dermatologic surgery.

Blood↗
PubMed1992

A review of sutures and suturing techniques.

The ideal suture is strong, handles easily, and forms secure knots. It causes minimal tissue inflammation and does not promote infection. It stretches and accommodates wound edema. Although no single suture possesses all of these features, proper selection of sutures helps achieve better results in skin surgery. Proper suturing technique is essential for obtaining good cosmetic results and avoiding scarring and poor wound healing. Techniques that must be mastered include good eversion of skin edges, avoiding suture marks, maintaining uniform tensile strength along the skin edges, and precise approximation along skin edges.

Humans↗
PubMed1992

Properties of topical sunscreen formulations. A review.

Sunscreens reduce the deleterious effects of ultraviolet radiation (UVR) by absorbing, reflecting, or scattering photons. Ultraviolet radiation includes UVB, which is primarily responsible for sunburn and skin cancers, as well as UVA, which has been implicated in photoaging. Topical photoprotective agents include physical and chemical sunscreens. Physical sunscreens are important in individuals who are unusually sensitive to UVA and visible light such as those with photosensitizing diseases. Chemical sunscreens are more cosmetically appealing and can selectively absorb UVB and/or UVA. The increased awareness of the importance of sun protection has encouraged the regular use of sunscreens. This article will review physical and chemical sunscreens. The properties and vehicle design of various sunscreen formulations are also discussed.

Administration, Topical↗
PubMed1992

Estrogen receptors and the response to sex hormones in angiolymphoid hyperplasia with eosinophilia.

BACKGROUND: Angiolymphoid hyperplasia (ALH) with eosinophilia is a benign rare tumor, characterized by marked proliferation of endothelial cells. The tumors are associated with extensive infiltrate of lymphocytes, histiocytes, and eosinophils, and occur on the head and neck of young adults. A variety of treatments have been attempted with frequent recurrences. We report two cases of ALH with eosinophilia that seemed to be dependent on sex hormones. OBSERVATION: The first case is a patient with ALH that resolved after stopping treatment with birth control pills. Biopsy specimens of the tumor demonstrated increased level of estrogen and progesterone receptors compared with her normal skin. The second case is a patient with a previous lesion of ALH with eosinophilia, who during pregnancy had new lesions develop and whose primary lesion increased in size. All lesions decreased to half their original sizes after pregnancy. CONCLUSION: Both of these cases suggest a role for hyperestrogen states with the presence of hormonal receptors. The response to sex hormones could contribute to the pathogenesis of the disease and may offer future alternative treatment modalities.

Adult↗
PubMed1991

The reliability of frozen sections in the evaluation of surgical margins for melanoma.

As the width of surgical margins declines, histologic evaluation of the margins is needed to assess the completeness of excision of a malignant melanoma. We studied 221 specimens in 59 patients and compared the interpretations of frozen and paraffin sections from the same block. Frozen sections had a sensitivity of 100% in detecting melanoma when present and a specificity of 90%.

False Positive Reactions↗
PubMed1991

Syringoid eccrine carcinoma.

Eccrine carcinomas are locally aggressive and have an infiltrative growth pattern. They have a variable clinical appearance and a diversity of histologic findings that often make the diagnosis difficult. The histologic findings, together with immunoperoxidase and enzyme histochemical studies, usually allow differentiation between eccrine carcinomas, other cutaneous neoplasms, and visceral adenocarcinomas with skin metastases. Provided there is no evidence of distant metastases, surgical excision is the treatment of choice. We report a case of syringoid eccrine carcinoma that was treated with Mohs micrographic surgery.

Adenocarcinoma↗
PubMed1991

The role of human papillomavirus in carcinoma.

Human papillomaviruses have long been identified as the cause of common warts and condylomata acuminata. Evidence is now accumulating that human papillomaviruses may be involved in not only benign, but also in malignant neoplasms. They might also be significant in the malignant transformation of cutaneous neoplasms. This review examines the oncogenic potential of human papillomaviruses when they are found in carcinomas in various anatomic areas, including the skin.

Carcinoma↗
PubMed1991

Clinical comparison of polyglactic acid (Vicryl) and polytrimethylene carbonate (Maxon) suture material.

Over a 1-year period, 584 repairs of surgical defects were completed using two different synthetic absorbable sutures, polyglactic acid (Vicryl) and polytrimethylene carbonate (Maxon). No difference in scar width or postoperative complications were found between the two sutures, but polytrimethylene carbonate (Maxon) demonstrated preferable handling and tying characteristics.

Cicatrix↗
PubMed1991

Periorbital reconstruction.

Reconstructions of the lower lid, the upper lid, the medial canthus, the infraorbital area, and the eyebrow area are reviewed. Various flap procedures are described.

Eyebrows↗