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Biomedical subjects

W H Clark

Publications and source records attributed to W H Clark.

176 records · Page 10Linked to original sources
PubMed1966

Infectious hepatitis in California; a community-wide epidemic.

In an epidemic of infectious hepatitis in a rural California community during 1961, 514 cases were reported among 8,166 residents. A sample of the 396 cases reported up to 1 September was studied, and only about a third of these cases could be confirmed in retrospect. A community survey indicated that the attack rate for the first eight and a half months of 1961 was slightly over 3 per cent. Unusual epidemiologic features of what was thought to be a contact epidemic included a summer peak, a preponderance of young and middle-aged adults, a relative sparing of lower socioeconomic groups and mildness of the illness with jaundice appearing in a minority of cases. Secondary cases were rarely observed within the expected 10- to 50-day incubation period.

Adolescent↗
PubMedDate not supplied

Malignant melanoma of the head and neck.

Sixty-nine patients with head and neck melanoma were prospectively evaluated from 1971 to 1977. Patients presenting for initial therapy underwent wide excision of their primary tumor, and those with deeply invasive melanoma also underwent regional lymphadenectomy, whether their nodes were clinically positive or negative. The results suggest that the prognosis of this tumor is similar to that of melanoma arising at other sites. Clinical stage and primary-tumor histopathologic microstage both correlated with disease recurrence. At 1 to 75 months, patients with clinical Stage I disease had a 13% recurrence rate, while 58% of those with Stage II disease developed recurrence. Patients with superficially invasive melanoma had a 10% recurrence rate, while 17%-33% of those with deeply invasive disease developed recurrence. However, the presence of node metastases, rather than the microstage of the primary tumor, appeared to be the dominant indicator of outcome. Radical excision of the primary tumor may reduce the incidence of local disease recurrence. We believe that regional lymphadenectomy is indicated for deeply invasive melanoma.

Head and Neck Neoplasms↗
PubMedDate not supplied

"Catalyst" symptoms in malignant melanoma.

Despite efforts to identify and cure early melanoma, mortality from this potentially curable disease continues to increase. In a retrospective analysis of the charts of 568 patients treated for superficial spreading melanomas during a ten-year period, the authors studied the relations between type of symptom, symptom duration, and thickness of the lesion. "Catalyst" symptoms, the particular events that preceded diagnosis, were identified. Patients described 75 different catalyst symptoms or symptom combinations. Bleeding precipitated prompt medical attention but was associated with the deepest lesions (mean thickness 1.77 mm); ulceration, itching and tenderness were associated with delays of several months and lesions of intermediate thickness (1.13 to 1.28 mm); and changes in size, color, or elevation eventuated in diagnosis an average of a year after patients' observations of these changes, with mean lesion thickness of .80 mm to 1.33 mm. Patients react slowly to signs and symptoms of early melanoma.

Female↗
PubMedDate not supplied

Ethics and LSD.

Explore the source record for details and available documents.

Attitude of Health Personnel↗
PubMedDate not supplied

Skin markings in malignant melanoma.

Photographic analysis of the skin markings in 92 malignant melanomas (66 superficial spreading, seven nodular, 12 acral lentiginous, and seven lentigo maligna melanomas) was undertaken. Skin markings are uniformly eradicated in areas of vertical growth phase disease and sometimes in areas of regression. Not only were skin markings always preserved in areas of radical growth phase disease, but they were sometimes accentuated. For all types of melanoma, loss of skin markings is a poor diagnostic criterion because it is a late sign associated with invasion of the dermis and thus a deteriorating prognosis.

Humans↗