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Biomedical subjects

S Robbins

Publications and source records attributed to S Robbins.

At least 55 records · Page 3Linked to original sources
PubMed1986

Spindle cell carcinoma of the breast: case report and review.

Spindle cell carcinoma is a distinct, but unusual, variant of squamous cell carcinoma. It is seen most frequently in the upper aerodigestive tract and esophagus. The natural history seems to be similar to that of the more typical squamous cell carcinoma. A case of spindle cell carcinoma arising from the ductal epithelium of the breast is reported. The light and electron microscopic histology is described. A review of the literature suggests that this rare neoplasm should be managed in a fashion similar to that for more common types of epithelial breast duct malignancies.

Aged↗
PubMed1986

Long-term morbidity and mortality in morbidly obese adolescents after jejunoileal bypass.

To evaluate the long-term results of jejunoileal bypass in the treatment of morbidly obese adolescents, we studied 11 patients who underwent surgery between 1972 and 1974. More than 10 years after surgery, 45% of the patients had extremely satisfactory results (correction of morbid obesity). Three patients died within the year after surgery, two of them under extenuating clinical circumstances. There have been no subsequent deaths. All eight survivors were found to have metabolic abnormalities to various degrees. Two patients had a total of five pregnancies; each had one healthy infant, and three pregnancies ended in abortion (one spontaneous). Two patients had significant medical problems related to the procedure but basically remained in good health, whereas three patients had severe symptoms requiring reanastomosis. Of the five patients who continue with the bypass, none has become significantly obese. They have all maintained a weight loss of between 45 and 90 kg, and as adults express strong feelings in favor of the procedure. This series demonstrates that, although significant weight loss was maintained, and improvement in the quality of life for half of our patients was dramatic, side effects and complications continue to develop, mandating careful follow-up for an indefinite time.

Adaptation, Psychological↗
PubMed1983

The value of the autopsy in three medical eras.

To determine whether advances in diagnostic procedures have reduced the value of autopsies, we analyzed 100 randomly selected autopsies from each of the academic years 1960, 1970, and 1980 at one university teaching hospital. In all three eras about 10 per cent of the autopsies revealed a major diagnosis that, if known before death, might have led to a change in therapy and prolonged survival; another 12 per cent showed a clinically missed major diagnosis for which treatment would not have been changed. Among 1980 autopsies, renal disease and pulmonary embolus were less common causes of death than before, but systemic bacterial, viral, and fungal infections increased significantly and were missed clinically 24 per cent of the time. The introduction of radionuclide scans, ultrasound, and computerized tomography as diagnostic procedures did not reduce the use of conventional tests in patients who subsequently died and were studied by autopsy. Over-reliance on these new procedures occasionally contributed directly to missed major diagnoses. We conclude that advances in diagnostic technology have not reduced the value of the autopsy, and that a goal-directed autopsy remains a vital component in the assurance of good medical care.

Autopsy↗
PubMed1983

UCLA hospice evaluation study. Methodology and instrumentation.

An unbiased evaluation of hospice effectiveness requires a randomized controlled trial (RCT), but the implementation of such a design is difficult. This paper describes the methods of the only RCT to date and reports on the validity and reliability of scales selected or developed to assess attainment of hospice goals. The patients involved are those in a VA hospital in Los Angeles who have cancer and a prognosis of about 6 months and who consent. They and their significant others are interviewed periodically until the patient's death to measure such hospice variables as pain, depression, anxiety, satisfaction with care and the environment, activities of daily living, and bereavement effects. Many of the scales, including McGill Pain, CES-D Depression, and Satisfaction with Care scales, have been validated in other studies with similar samples. The authors' test-retest reliability analyses show that these scales are reliable with advanced cancer patients and their significant others with coefficients ranging from 0.77 to 0.97.

California↗
PubMed1981

A prospective study of infant zinc nutrition during intensive care.

Zinc nutritional status was evaluated during intensive care for 55 infants. Plasma zinc, serum albumin, alkaline phosphatase, growth, nutrient intake, and clinical data were examined. The more premature infants (less than 32 wk gestational age) had higher zinc levels on admission, but their levels declined more rapidly than in more mature infants. Zinc level did not correlate with albumin or alkaline phosphatase. Low zinc levels (45 microgram/dl or less) occurred at about 6 wk in 14 of 39 premature infants. True zinc deficiency occurred in two premature infants; it was manifest by increased gastric residuals, poor suck, and decreased growth, but neither infant had the skin or gastrointestinal signs generally expected with zinc deficiency. There was evidence that sick premature infants may need more zinc than is currently recommended to supplement parenteral nutrition and more than the amount supplied in premature infant formulas currently available.

Critical Care↗
PubMedDate not supplied

The effects of expression of an activated rasG mutation on the differentiation of Dictyostelium.

Dictyostelium discoideum contains two ras genes, rasG and rasD, that are expressed during growth and differentiation, respectively. It was shown previously that Dictyostelium transformants expressing an activated rasD gene (a mutation producing a change in amino acid 12 from glycine to threonine) developed abnormally. When developed on filters these transformants formed multitipped aggregates, which did not go on to produce final fruiting bodies, but in a submerged culture assay on a plastic surface they either formed small aggregates or did not aggregate. In this study we transformed cells with the rasG gene, mutated to change amino acid 12 from glycine to threonine. The resulting transformants developed normally on filters, but aggregation under other conditions was impaired. In particular, in submerged culture on a plastic surface they either produced very small aggregates or did not aggregate, one of the phenotypes exhibited by the activated rasD transformants. Molecular analysis of the transformants revealed the presence of high copy numbers of the mutated rasG gene, but the level of expression of the mutant gene never exceeded the level of expression of the endogenous gene. These results indicate a powerful dominant effect of a relatively small amount of the activated RasG protein in Dictyostelium.

Animals↗
PubMedDate not supplied

Protective sensation of the plantar aspect of the foot.

The scientific literature suggests that barefoot activity may be beneficial. There is a current trend in recreational barefoot activity in children and adults, and barefoot running among athletes. Although the type of skin over most of the body (hairy skin) seems to be easily injured by painful abrading loads, little is known about protection provided by plantar sensory feedback against damage from excessive wear during barefoot locomotion. To evaluate this, we administered a volley of 35 painful abrading loads to glabrous and hairy skin sites over a 5-min period, and examined its effects for signs of cutaneous injury in a sample of 12 normally shod healthy male subjects. Compared with hairy skin of the thigh, plantar skin required approximately 600% greater abrading loads to reach pain threshold. Furthermore, painful stimulation produced visible redness and hypersensitivity in all subjects at the hairy skin site 24 hr after stimulation, whereas only 8.3% reported hypersensitivity and none showed erythema at the plantar area 1 day later. We found that plantar skin possesses a higher pain threshold to abrading stimuli than hairy skin. In fact, loading of the plantar area was limited to innocuous levels due to intolerable pain. We conclude that plantar skin is well protected through sensory feedback from abrasive injuries when barefoot. This information combined with previous reports suggests that risk of injury when normally shod individuals perform barefoot locomotion should be low.

Adult↗