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Biomedical subjects

S J Herman

Publications and source records attributed to S J Herman.

48 records · Page 3Linked to original sources

Fleck (Mouchetée) dystrophy of the cornea.

Five families, four Caucasian and one Negro (14 patients) with fleck (speckled or Mouchetée) dystrophy of the cornea are presented. In each, the typical presentation of fine scattered fleck-like dystrophic lesions was found throughout all layers of the central and peripheral corneal stroma but not affecting the epithelium, Bowman's membrane, Descemet's membrane or the endothelium. Clear stroma was noted between each lesion. Visual acuity in all patients was normal or only slightly affected. Except for an occasional patient with minor photophobia, almost all patients found affected with this dystrophy were asymptomatic in regard to their corneal condition. There was no decrease in corneal sensitivity noted in any patient. All families displayed evidence of an autosomal dominant hereditary pattern and progression of the dystrophy is slow and benign in character. With the exception of one family with atopic disease, no systemic organic illness was noted by histroy in all of the families. Laboratory screening of 2 of the 5 families showed no abnormalities of any systemic metabolic disorders. The characteristic clinical picture and favorable prognosis of this condition enables one to easily differentiate this condition from other known parenchymatous corneal dystrophies. The incidence of this condition is probably much more common than the reported cases in the literature might indicate.

Adolescent↗

Staging of bronchogenic carcinoma.

Both computed tomography (CT) and magnetic resonance imaging (MRI) can provide important information not obtainable by chest radiography regarding staging of patients with bronchogenic carcinoma. However, while CT and MRI can both detect enlarged mediastinal nodes, this only approximately indicates tumor involvement. For example, enlarged nodes do not necessarily contain tumor, so biopsy is necessary before declaring the patient inoperable. As well, normal-sized nodes may contain tumor, and whether mediastinoscopy is required in such situations is controversial. Similarly, neither MRI nor CT is highly accurate in detecting mediastinal or chest-wall involvement, although certain specific features can occasionally be highly predictive of invasion.

Biopsy↗

The relationship of family dynamics/social support to patient functioning in IDDM patients on intensive insulin therapy.

A 6 month pilot study was conducted to examine the relationship between family dynamics/social support and patient functioning in diabetic patients on intensive insulin therapy. Intensified therapy was associated with improvements in the DUHP symptom score, MHI psychological well-being score, and in the DUHP social functioning score. In diabetic patients, regardless of therapy, extreme family dynamics were correlated with higher DUHP symptom scores and lower MHI psychological well-being scores at the initial measurement time. However, over the 6 month study period, extreme family dynamics were predictive of improvements in the DUHP symptoms score and in the quality of friendships in diabetic patients on intensive insuline therapy. In diabetic patients, regardless of therapy, higher levels of social support correlated with higher levels of psychological and social functioning at the initial measurement time, and with improvements in quality of family life over the 6 month measurement time. Higher social support was also associated with improvements in quantity of friends and the DUHP social functioning score in diabetic patients on intensive insulin therapy. The study also generated empiric support for co-evolutionary models of disease states/family dynamics/treatment systems by showing that 6 month changes in family dynamics were predicted by the initial FACES adaptability measure and the initial mean monthly glucose value. Intensified therapy predicted lower family cohesion and more family rigidity over the 6 month study period. These findings also suggest, when combined with the result that diabetic patients from more cohesive families experienced a rise in monthly mean glucose values, that some diabetic patients may become trapped in a vicious cycle which perpetuates poor glucose control and extreme family dynamics.

Adaptation, Psychological↗