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Biomedical subjects

S Silverman

Publications and source records attributed to S Silverman.

At least 127 records · Page 7Linked to original sources
PubMed1989

Oral erythema multiforme: clinical observations and treatment of 95 patients.

Erythema multiforme is a chronic, inflammatory mucocutaneous disease that can occur in both genders at any age. Although the cause remains obscure, a wide range of antigens and factors, including herpesvirus and other infections, has been suggested as triggering the disease. In the present study of 95 patients, we found that patients with oral involvement alone tend to predominate over those who have oral and lip, or oral, lip, and skin disease. There were also more women than men. Our study further confirmed that erythema multiforme cannot be characterized solely as a disease that is cyclical and self-limiting. The dramatic response to corticosteroids and to the immunoregulating agent levamisole, as well as the fact that patients with erythema multiforme are otherwise essentially healthy, suggests that erythema multiforme may be caused by a transient autoimmune defect, possibly triggered by multiple factors. Because 19 patients with oral candidiasis responded to antifungal therapy, a possible antigenic role for these organisms is suggested.

Adolescent↗
PubMed1989

Sorbinil prevents glomerular hyperperfusion in diabetic rats.

The role of polyol pathway metabolism in glomerular hyperperfusion of insulin-dependent diabetes mellitus (IDDM) was studied in rats. Streptozotocin-induced diabetic rats were fed the aldose reductase inhibitor, sorbinil (8 mg/day). Untreated diabetic rats and normal rats served as controls. All groups were fed the same diet, rationed to 20 g/day. Micropuncture, plasma renin activity (PRA), and glomerular angiotensin II (ANG II)-receptor measurements were made 7-15 days after streptozotocin injection. Untreated diabetic rats had higher than normal single-nephron filtration rate (SNGFR), plasma flow (QA), and blood flow (SNBF), and reduced afferent resistance. Glomerular ANG II-receptor sites were markedly decreased. In diabetic rats fed sorbinil SNGFR, QA, and SNBF were all lower than in untreated diabetic rats, and indistinguishable from values in normal rats. However, single-nephron filtration fraction (SNFF) rose above normal. PRA, glomerular ANG II receptors, and blood glucose were not affected by sorbinil. In normal rats fed sorbinil, SNGFR, QA, and SNBF were not significantly different than in normal rats. Our observations are consistent with the view that polyol pathway metabolism plays a role in glomerular hyperperfusion in IDDM. Inhibition of aldose reductase increased vascular smooth muscle tone at pre- and probably postglomerular sites.

Aldehyde Reductase↗
PubMed1989

The dentist and infectious diseases: a national survey of attitudes and behavior.

Two national surveys of infection control practices in 1986 and 1988 suggest several trends. A massive educational effort has brought about impressive acceptance and use of the hepatitis vaccine. Dramatic changes have occurred in respect to use of gloves and other barrier techniques. However, increased understanding of HIV infection has not, in the years surveyed, totally eradicated irrational fears about this disease.

Adult↗
PubMed1989

Recognition of malignancy and dysplasia in the dental implant patient.

The purpose of this paper is to report what appears to be an unusually high number of head and neck malignancies in a limited group of patients where primary referral was to undergo implant procedures. While the tumors were probably coincidental, the occurrences point out the importance of careful oral examinations, particularly in this age group.

Adult↗
PubMed1989

Oral manifestations of pediatric AIDS.

Pediatric victims of AIDS virus infection continue to increase. The major source of transmission is by birth from an HIV-positive mother. Recognition is often difficult because of the varied and misleading signs and symptoms. Only a few studies describe oral manifestations in children and adolescents. The most common oral findings include candidiasis, parotid salivary gland enlargement and herpetic infections. Oral involvement may reflect early signs and symptoms of HIV-related immunosuppression.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Prediction of malignant transformation in oral epithelial lesions by image cytometry.

The value of image analysis in predicting the malignant potential of oral epithelial lesions showing either hyperplasia or dysplasia was investigated; 5-micron formalin-fixed sections of 16 oral epithelial lesions, of which eight had later transformed to carcinoma and eight had not transformed during a follow-up of 10-15 years were studied. The sections were stained with the azure A-Feulgen reaction for nuclear DNA. In each section 200 nuclei of epithelial cells and 20 nuclei of lymphocytes were assessed; all measurements were made blindly. For each nucleus six features related to shape and amount of stain and six features related to chromatin pattern were assessed. For each feature the mean, SD, and interquartile range were determined and used for linear stepwise discriminant analysis. A model of three variables with the most discriminating power was developed. When the jackknifed classification test was applied using this model, the malignant potential of the lesions that later transformed could be predicted with 87.5% accuracy.

Aged↗
PubMed1988

Early diagnosis of oral cancer.

Oral cancer currently strikes about 30,000 Americans each year. Survival rates are approximately 50%. However, early detection followed by appropriate treatment can increase cure rates to about 80%, and greatly improves the quality of life by minimizing extensive, debilitating treatments. An early oral cancer can appear as an innocuous red or white change, an ulcer, or a lump, mimicking many benign lesions. Additionally, when the discomfort is minimal, professional consultation often is delayed, increasing the chance for local spread and regional metastases. Vital staining with toluidine blue and exfoliative cytologic examination can aid early detection by accelerating the biopsy of lesions that cannot be classified adequately or made to disappear.

Adolescent↗
PubMed1988

Kaposi's sarcoma of the oral cavity: a study of 134 patients with a review of the pathogenesis, epidemiology, clinical aspects, and treatment.

Since our first description and profile of patients with Kaposi's sarcoma (KS) in 1984, the relative rate of KS in patients with the acquired immunodeficiency syndrome has dropped from 34% to 20%. However, the absolute number is increasing. The pathogenesis of KS is still obscure, and its interaction with the human immunodeficiency virus infection remains unclear. Cause of death is usually opportunistic infections in both endemic and epidemic KS. The most common intraoral site is the palate, which is involved in 95% of our cases. The oral cavity may be the only or first site of KS, and therefore, becomes important in the diagnosis. More than 20% of our current patient population had the oral cavity as the initial site of manifestation. Because of functional impairment, bleeding, pain, or cosmetic reasons, treatment is frequently required. There are many modalities used, including chemotherapy, radiation, and laser resection. Radiation appears to be a most effective and practical control measure for oral KS.

Acquired Immunodeficiency Syndrome↗
PubMed1988

CO2 laser treatment of oral leukoplakia.

Treatment of oral leukoplakia has been disappointing with the available treatment modalities, because of inaccurate removal and an approximate 30% to 35% rate of recurrence. The CO2 laser has provided a promising new approach in the management of these lesions with very low morbidity and improved control. Twenty-nine patients were treated with the CO2 laser for 38 extensive (from 1 x 1 cm to 6 x 8 cm) intraoral leukoplakic lesions, 28 for cure and one for palliation. Microscopically the lesions varied from hyperkeratosis to carcinoma in situ. Follow-up of these patients ranges from 3 to 10 years, with an average of 5 years. An initial recurrence rate of 10.8% (4/37) was observed, and a 3-year local control rate of 97% after one to two procedures. A malignant transformation rate of 2.6% was encountered. Excellent wound healing and few complications were observed with this treatment approach. Surgical technique and results are reported supporting the advantages of the CO2 laser over conventional modes of treatment in the management of oral leukoplakia.

Adult↗
PubMed1988

Correspondences and thought-transference during psychoanalysis.

Correspondences, when the analyst has not verbalized his disturbed thoughts and they appear in the patient's spoken associations during analytic treatment, are not due to a single cause. Rather, they occur under a variety of circumstances: chance, coincidence, communication through sensory stimuli and perceptions, sometimes of extraordinary subtlety; or possibly thought-transference. Even if the latter possibility were doubted, the correspondence still may have usefulness as a finding of significance for the treatment process itself. It may alert the analyst to repressive forces directed toward the mix of his disturbing thoughts (reality derived), residues of old conflict areas that these have activated, even if transiently, and also to the current state of his countertransference. Utilizing the patient's associations will increase the analyst's awareness and facilitate the latter's quickly working through of these elements. This will favor progress of treatment. As for the question of thought-transference, preliminary findings suggest that the conditions under which it seems to occur involve the simultaneity of (1) the analyst's tendency to repress disturbing thoughts (including activated infantile residuals) because of guilt at being distracted and (2) qualitatively similar conflictual themes emerging from repression in the patient's unconscious. It raises the question as to whether extrasensory communication is between the unconscious of the two persons involved, occurring at a time when two opposite forces--repression in the analyst and modification of repression of qualitatively similar idea-complexes in the patient--are operative. The subject of correspondences and thought-transference in psychoanalytic treatment requires further study.

Adult↗
PubMed1987

Estrogen inhibition of a Mr 39,000 glycoprotein secreted by human breast cancer cells.

We have identified a secreted glycoprotein with an apparent molecular weight of 39,000 that is inhibited by estrogens and stimulated by antiestrogens in the MCF-7 human breast cancer cell line. The protein was detected within 24 h of hormone treatment with inhibition occurring at concentrations as low as 10(-11) M estradiol and stimulation occurring with antiestrogens. When phenol red, which has been found to have estrogenic activity, is removed from the tissue culture medium, no inhibition of cell growth or induction of the Mr 39,000 protein is seen with antiestrogens. A 6-fold decrease in the amount secreted in the presence of estrogens is seen under these conditions. The induction was specific in that growth inhibition by several other means did not induce expression of the Mr 39,000 protein. The Mr 39,000 protein has been identified as a glycoprotein complex that can be resolved into four polypeptides with two major components that migrate in the pH range of 5.5 to 6.3 by two-dimensional gel electrophoresis. This protein is the first evidence that estrogens inhibit a specific protein and it may prove useful as a marker of antiestrogen-induced growth arrest in breast cancer.

Breast Neoplasms↗
PubMed1987

Physiological study of pruritus ani.

Physiological abnormalities in the anorectum of 34 patients with pruritus ani, and 20 age and sex matched controls were assessed. A saline infusion (1500 ml) test showed that leakage started after infusion of 600 ml in patients with pruritus ani compared with 1300 ml in controls (median values: P less than 0.001). There was an inverse relationship between the severity of the symptoms of pruritus ani and the volume of first leakage on the saline infusion test P less than 0.02. Studies to assess anal sphincter function, rectal sensation to balloon distension, rectal compliance, and perineal descent did not show any significant differences between pruritic patients and controls. However, pruritic patients without co-existing anal pathology had a significantly greater fall of anal pressure when a rectal balloon was inflated (57 per cent) when compared with controls (40 per cent) P less than 0.05.

Adult↗
PubMed1987

Granulocytic sarcoma (chloroma) of the oral cavity: a case with aleukemic presentation.

A case of granulocytic sarcoma, or chloroma, of the palatal mucosa, which developed 15 months before the onset of acute myelogenous leukemia (AML), is reported. The diagnosis was suspected on the basis of the light microscopic findings and confirmed by histochemical studies. Granulocytic sarcomas are rare, may be observed in a variety of body locations, and are considered specific lesions of AML or of the onset of blast crisis in chronic myelogenous leukemia. Primary granulocytic sarcomas of the oral cavity without systemic manifestations of AML are extremely rare. Clinical diagnosis of these lesions in patients with normal peripheral blood and bone marrow may be very difficult.

Aged↗
PubMed1987

Silence as resistance to medical intervention.

A group of 47 individuals initially silent about their physical symptoms and/or dysfunction were studied after they finally had come to medical attention. They were then interviewed, using the associative anamnesis technique, to evaluate the psychologic aspects of their silence. It was found to be a key element in the defensive complex directed against intense neurotic feelings activated by the patient's current physical condition. The tendency toward silence appeared to have been reinforced by emotionally traumatic experiences involving physical illness or injuries in early life. Also found associated with silence were such different factors as a series of ostrich-like denying rationalizations, a fanatic commitment to cultist beliefs, a conviction that emotional conflict is the primary cause of organic illness, and motivations linked to retention of power in reality situations. Clinical examples drawn from these categories are given. Means of increasing the awareness that such silence exists and methods of dealing with it are discussed.

Adult↗