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Biomedical subjects

T Rosen

Publications and source records attributed to T Rosen.

At least 73 records · Page 4Linked to original sources
PubMed1994

Treatment of cutaneous leishmaniasis.

The World Health Organization estimates that approximately 400,000 new cases of leishmaniasis occur worldwide each year. Cutaneous leishmaniasis is being encountered more frequently in the United States because of increasing travel and immigration from endemic areas. The indications for treatment and recommended treatment regimens reported in the infectious disease and dermatology literature vary widely. We examine both classic and newly developed therapeutic agents and modalities for cutaneous leishmaniasis. Proper therapy depends on species identification. New World leishmaniasis, in general, requires more aggressive therapy; parenteral antimonials are the drugs of choice. Physical modalities may suffice in most cases of Old World leishmaniasis because of its strong tendency toward spontaneous resolution.

Americas↗
PubMed1994

Basal cell carcinoma of the scalp resulting in spine metastasis in a black patient.

Basal cell carcinoma (BCC), the most common skin cancer in the United States, is locally invasive but has a low risk of metastasis. BCC is rare in black patients but, regardless of racial origin, most BCC occurs on sun-exposed areas. We describe a 67-year-old black man with a large BCC on the hairy scalp, a relatively sun-protected area, that metastasized to the spine. To our knowledge, this is the first description of a black patient with development of metastatic BCC on an otherwise normal scalp.

Aged↗
PubMed1994

Cashew nut dermatitis.

The urushiol dermatitis caused by plants of the Anacardiaceae family is the most common cause of acute allergic contact dermatitis. We have reported a case of cashew nut urushiol dermatitis due to ingestion of homemade cashew nut butter contaminated by cashew nut shell oil. With the precautions taken today to avoid contamination of food products with cashew urushiols, it is rare to find a case of cashew nut dermatitis in the United States. We have found no other report of contact dermatitis due to cashew nut butter. Moreover, though hinted at in the literature, there has been no previous detailed report of perianal contact dermatitis due to cashew ingestion. The fact that our patient was ill enough to require treatment with 3 weeks of systemic steroid therapy highlights the potential public health hazard of consumption of improperly prepared cashew products. However, the risk of cashew nut dermatitis today remains small, and this should not discourage cashew lovers from enjoying their treats. A final lesson to be learned from this case is that perianal eruptions may be due to materials deliberately applied to the anogenital region or to ingested antigens that remain sufficiently intact within the feces to affect perianal skin.

Acute Disease↗
PubMed1994

Evaluation of acetowhitening in Bowen's disease.

BACKGROUND: From a clinical standpoint, the lesions of Bowen's disease (squamous cell carcinoma in situ) are generally sharply demarcated. Following excision, however, contiguous extension and/or small foci of Bowen's disease are occasionally found, located outside the clinically apparent margins. Acetowhitening has been suggested as a means of delineating the extent of involvement and identifying subclinical lesions of condyloma acuminata. More recently, acetowhitening has offn similarly reported to be of potential value in the presurgical evaluation of Bowen's disease. OBJECTIVE: The purpose of this investigation was to further evaluate the use and reliability of acetowhitening both to delineate margins of Bowen's disease and to identify subclinical foci of involvement. METHODS: Eight patients with histologically confirmed Bowen's disease were studied. Six percent acetic acid was applied to the lesions and the surrounding skin. Histologic examination of acetowhite lesions and adjacent acetowhite skin as well as adjacent, nonwhitened normal appearing skin was performed. RESULTS: Our results were inconsistent, and included both false positives and false negatives. CONCLUSIONS: Acetowhitening is unreliable in identification of Bowen's disease. Clinically normal, acetowhite-negative skin adjacent to a lesion of Bowen's disease may be involved.

Acetates↗
PubMed1994

Laboratory techniques used in the diagnosis of chancroid, granuloma inguinale, and lymphogranuloma venereum.

The preceding discussion summarized the historical, modern, and evolving laboratory techniques for the diagnosis of chancroid, GI, and LGV. The correct diagnosis of these sexually transmitted diseases, which are uncommon in the United States and Europe but often endemic in Africa, Asia, and South American, can usually be made if appropriately selected laboratory techniques are used to confirm the presumptive clinical impression.

Chancroid↗
PubMed1993

Synthesis, in vitro binding profile, and autoradiographic analysis of [3H]-cis-3-[(2-methoxybenzyl)amino]-2-phenylpiperidine, a highly potent and selective nonpeptide substance P receptor antagonist radioligand.

The synthesis of a highly potent and selective NK1 receptor antagonist radioligand, [3H]-cis-3-[(2-methoxybenzyl)amino]-2-phenylpiperidine (6a) is described. The in vitro binding pharmacology and autoradiographic distribution of 6a in guinea pig brain following peripheral administration are also reported.

Amino Acid Sequence↗
PubMed1993

Nonvenereal treponematoses: yaws, endemic syphilis, and pinta.

The nonvenereal treponematoses--yaws, endemic syphilis, and pinta--constitute a major health concern for many third world countries. These diseases are caused by an organism that is morphologically and antigenically identical to the causative agent of venereal syphilis, Treponema pallidum. Nonvenereal treponematoses differ significantly in their modes of transmission, epidemiology, and clinical presentation from venereal syphilis. Like venereal syphilis, they have a chronic relapsing course and have prominent cutaneous manifestations. Recently, several cases of imported yaws and endemic syphilis have been described in Europe. With the escalating U.S. military presence in many remote areas of the world and ever-increasing world-wide travel, the diagnosis of the nonvenereal treponematoses must be considered in appropriate clinical and historical situations.

Adolescent↗
PubMed1993

Pharmacology of CP-99,994; a nonpeptide antagonist of the tachykinin neurokinin-1 receptor.

(+)-(2S,3S)-3-(2-methoxybenzylamino)-2-phenylpiperidine (CP-99,994) binds selectively and with high affinity (Ki = 0.25 nM) to neurokinin (NK)-1 tachykinin receptors in a human cell line and in guinea pigs where it acts as an antagonist as evidenced by its blockade of substance P-induced excitation of locus coeruleus neurons in vitro. Subcutaneously administered CP-99,994 antagonized locomotor activity in guinea pigs induced by intraventricular infusion of [Sar9,Met(O2)11]-substance P (50 micrograms) with an ID50 = 0.59 mg/kg, indicating that CP-99,994 penetrates into the central nervous system. Orally administered CP-99,994 potently blocked (ID50 = 4 mg/kg) the leakage of Evans blue dye into trachea and bronchi elicited by exposure of guinea pigs to aerosol capsaicin (1 mM). CP-99,994 has reduced affinity (IC50 = 3 microM) for the L-type calcium channel in contrast to CP-96,345 (IC50 = 27 nM) an earlier nonpeptide antagonist. Thus, CP-99,994 represents an important pharmacological tool for investigating the physiological role of substance P and a potentially novel therapeutic agent for treating a variety of diseases.

Animals↗
PubMed1993

Injectable soft tissue substitutes.

Historical and modern advances in the development of an injectable soft tissue substitute are reviewed. Nonbiologic alloplastic and biologic injectables are described. The authors' experiences, as well as those of others, employing presently available materials in terms of specific indications and special techniques are delineated. The search for a safe, effective, easy-to-use, and long-lasting soft tissue substitute continues.

Adipose Tissue↗
PubMed1993

Sweet's syndrome with an exogenous cause.

A sixty-six-year-old white man presented with a five-day history of painful erythematous papules, plaques, pustules, and hemorrhagic bullae on both hands. His history was remarkable for having prepared and pickled fifteen quarts of home-grown jalapeño peppers several days before the eruption occurred. The light microscopic examination of sections of lesional skin stained with hematoxylin and eosin revealed pathologic findings characteristic of Sweet's syndrome. We report this case because of its unusual presentation and apparent exogenous cause.

Aged↗
PubMed1992

The effect of intralesional 5-fluorouracil therapeutic implant (MPI 5003) for treatment of basal cell carcinoma.

BACKGROUND: Basal cell carcinomas (BCCs) are usually treated with ablative procedures. A nonsurgical treatment alternative would be of value in selected patients. OBJECTIVE: We evaluated the safety and efficacy of a new preparation for intralesional sustained-release chemotherapy with MPI 5003, 5-Fluorouracil Therapeutic Implant, for treatment of BCCs. METHODS: Two doses of intralesional MPI 5003 (0.25 and 0.5 ml) were compared in a double-blind study of 20 patients with biopsy-proven BCC. One BCC per patient was treated weekly for up to 6 weeks and followed up monthly for 3 months until excisional biopsy for histologic examination. Before excision the cosmetic appearance of the test site was graded. RESULTS: Eighty percent of 10 BCCs treated with 0.5 ml of MPI 5003 had histologically confirmed cures as compared with 60% of 10 tumors treated with the lower dose (0.25 ml). Cosmetic assessments before excision were typically good to excellent. No systemic side effects occurred. CONCLUSION: Results indicate the potential of MPI 5003 for targeted local chemotherapy for BCC.

Adult↗
PubMed1992

Shipboard medicine: a new niche for emergency medicine.

STUDY OBJECTIVES: To describe the spectrum of illness that presents to shipboard hospitals and thereby recommend optimal qualifications for the ship's medical personnel. DESIGN: Retrospective review of medical logs from two cruise ships' hospitals. SETTINGS: Two passenger cruise ships, with seven-to-ten day cruises in the Caribbean. PARTICIPANTS: All patients presenting to the ships' hospitals from January 4, 1989, to June 10, 1989, on one ship and from October 13, 1990, to November 10, 1990, on another ship. METHODS: Analysis of ship medical logs with regard to patient complaint, diagnosis, and treatment. RESULTS: Of 1,547 new patient visits, 12% were related to injuries and 88% to medical problems; 97% of visits were noncritical, and 3% required immediate emergency intervention. Among these were four cardiac arrests, two stab wounds, two serious ocular injuries, one closed-head injury, and one near-drowning. Five patients required endotracheal intubation. CONCLUSION: There is a sizeable number of visits to ships' hospitals by patients with acute and serious problems of a wide variety. Physicians and nurses with significant emergency training or experience are best qualified to deal with this broad spectrum of patient problems in this isolated environment.

Adolescent↗
PubMed1991

Evidence for percutaneous inoculation as the mode of transmission for chromoblastomycosis.

The exact pathogenesis of chromoblastomycosis is unknown. Direct percutaneous inoculation, inhalation, and hematogenous dissemination have been implicated. We report a case of chromoblastomycosis that followed a well-defined episode of penetrating trauma. The causative organism, Fonsecaea pedrosi, was cultured from the patient's lesion and from the tree branch responsible for the trauma. This "natural" experiment supports the contention that one cause of chromoblastomycosis is traumatic cutaneous implantation of the fungus.

Chromoblastomycosis↗