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Biomedical subjects

J Fine

Publications and source records attributed to J Fine.

At least 19 recordsLinked to original sources

Histologic evaluation of pigmented lesions in Connecticut and its influence on the reporting of melanoma.

BACKGROUND: Underreporting of melanoma to state tumor registries has been identified as a problem in gathering accurate statistics on melanoma incidence. OBJECTIVE: Our purpose was to examine two factors that could influence the reporting of melanoma to the Connecticut Tumor Registry: histologic diagnosis of melanoma in the private offices of dermatologists and histologic diagnosis of melanoma in out-of-state laboratories. METHODS: From December 1990 to April 1991, questionnaires were sent to all known practicing dermatologists in the state of Connecticut (N = 149). Of the 127 dermatologists who were eligible, 124 (97.6%) completed the survey. RESULTS: The estimated number of melanomas diagnosed in private offices during 1990 was 9 to 18; this was based on the number of dermatologists who officially read their own slides (n = 19), the estimated number of melanomas diagnosed by these 19 dermatologists (n = 91), and the percentage of melanomas and uncertain pigmented lesion cases sent for consultation (80% to 90%). According to the estimates of Connecticut dermatologists, out-of-state laboratories diagnosed 84 of 523 melanomas (16%) in Connecticut residents. CONCLUSION: The diagnosis of melanoma in private offices did not appear to be a significant factor in underreporting whereas the diagnosis of melanoma in out-of-state laboratories did appear to be more significant. However, the possibility exists that some of these latter melanomas would eventually be reported at the time of reexcision.

Biopsy

An analysis of interobserver recognition of the histopathologic features of dysplastic nevi from a mixed group of nevomelanocytic lesions.

BACKGROUND: The diagnostic criteria for the histopathologic recognition of the dysplastic nevus are defined, but difficult to apply in practice. However, the use of skin biopsy is on the increase to search for this nevus because of a possible role in melanomagenesis. OBJECTIVE: The aim was to determine the degree of observer reproducibility in the detection of histologic nevomelanocytic dysplasia as measured across multiple observers and to test whether each observer was precise over a wide sample population. A second aim was to gain some measure of the threshold a person has for such lesions. METHODS: Histologic specimens from 50 coded nevomelanocytic tumors, which included a group of dysplastic nevi, were independently read by five observers in a blinded fashion. At study completion, the same 50 cases were read again by a melanoma reference pathologist and results analyzed by Cohen's kappa to assess agreement and interobserver variation. RESULTS: Corrected rates of agreement for dysplastic nevi ranged from 0.32 to 0.71. CONCLUSION: Continued study and experience are required for precision and reproducibility in the histologic recognition of dysplastic nevi.

Dysplastic Nevus Syndrome

Safe sex behavior in drug-addicted males as a function of object relations.

An inventory of sexual behavior was administered in a hospital detoxification program to 127 drug-addicted males, who also completed a modified form of the Defense Mechanisms Inventory (DMI) which yields a measure of object relations. Condom use was shown to be related to an object relations mode that typifies the individual who can structure reality and needs without requiring an integral aspect of "the other" in his approach. Standardization and factor analytic data are also presented for the DMI and the object relations measure for this population. The resulting pattern and the small effect size are discussed within the reality constraints of the addicted patient, as well as within the psychometric parameters inherent in psychoanalytic research.

Adult

The use of intonation to communicate in pervasive developmental disorders.

The objective of this paper was to employ a functional linguistic approach to explore pragmatic failure in the spontaneous speech of subjects with pervasive developmental disorders (PDD). Patterns of intonation use were compared among subjects with Asperger's syndrome (AS), high-functioning autism (HFA), and psychiatric out-patient controls (OPC) with a variety of non-specific social problems. Written transcripts and audio-recordings were used to measure rates of various intonation types relative to the amount of speech produced. The major finding of the study was that the HFA subjects less often tend to employ useful patterns of intonation for communication than the AS or OPC groups. This suggests that HFA either send random intonation signals to hearers or else demonstrate systematic misuse of the linguistic system. AS subjects differed little from the controls. The implications of these results for understanding the communicative failure of PDD subjects is discussed.

Adolescent

Airway oedema and obstruction in guinea pigs exposed to inhaled endotoxin.

Protein extravasation and airway conductance (SGaw) were examined in awake guinea pigs exposed to inhaled endotoxin or saline for three hours. A significant increase in protein extravasation (as estimated by the leakage of protein bound Evans blue dye) was seen in the conducting airways of endotoxin exposed animals compared with saline exposed animals. Mean dye extravasation was significantly increased by one to threefold in the mainstem and hilar bronchi of endotoxin exposed animals. These changes in extravasation were accompanied by decrements in pulmonary function and by an influx of polymorphonuclear leucocytes into the airway wall. The SGaw decreased significantly by 60-90 minutes into exposure to endotoxin and had decreased by 22% and 34% at the end of exposure in the low and high dose endotoxin groups, respectively. Similar findings were obtained in animals exposed to cotton dust. Contrary to studies suggesting that platelet activating factor (PAF) is involved in the systemic and peripheral lung effects of endotoxin, pretreatment with the PAF antagonist WEB2086 did not prevent the conducting airway injury produced by inhaled endotoxin.

Aerosols

The relationship of prostaglandins to cAMP, IgG, IgM and alpha-2-macroglobulin in gingival crevicular fluid in chronic adult periodontitis.

Gingival crevicular fluid, collected from 8 patients with chronic adult periodontitis before and 21 days after root planing and scaling, was analysed for prostaglandin E2, 6KPGF1 alpha, cAMP, IgG, IgM and alpha-2-macroglobulin, and their inter-relationship evaluated. There was a significant decrease in the levels of prostaglandin E2, IgG, IgM and alpha-2-macroglobulin after treatment, whereas the levels of 6KPGF1 alpha and cAMP remained essentially unchanged. The level of prostaglandin E2 decreased by 35%, IgG by 32%, IgM by 90%, and alpha-2-macroglobulin by 79%. There was a significant degree of correlation between prostaglandin E2 and 6KPGF1 alpha and cAMP before treatment but not after, but no correlation between prostaglandin E2 and IgG, IgM and alpha-2-macroglobulin either before or after. This correlation pattern indicates the involvement of E2, prostaglandin 6KPGF1 alpha and cAMP in inflammation in the periodontium. The changes in IgG, IgM and alpha-2-macroglobulin reflect yet another mechanism of host response which appears to be independent of prostaglandins.

6-Ketoprostaglandin F1 alpha

AIDS-related risk behaviors among substance abusers.

Ninety-two substance abusers were surveyed about AIDS-related risk behaviors. The questionnaire administered elicited information on demographics, sexual practices, substance abuse, and risk behaviors involving the use of needles. Results indicated an appropriate base of prevention knowledge and patients' efforts to modify vulnerability to HIV exposure. Nevertheless, patients continue to engage in behaviors resulting in HIV exposure and transmission.

Acquired Immunodeficiency Syndrome

Tear gas--harassing agent or toxic chemical weapon?

Tear gas has gained widespread acceptance as a means of controlling civilian crowds and subduing barricaded criminals. The most widely used forms of tear gas have been o-chlorobenzylidenemalononitrile and omega-chloroacetophenone. Proponents of their use claim that, if used correctly, the noxious effects of exposure are transient and of no long-term consequences. The use of tear gas in recent situations of civil unrest, however, demonstrates that exposure to the weapon is difficult to control and indiscriminate, and the weapon is often not used correctly. Severe traumatic injury from exploding tear gas bombs as well as lethal toxic injury have been documented. Moreover, available toxicological data are deficient as to the potential of tear gas agents to cause long-term pulmonary, carcinogenic, and reproductive effects. Published and recent unpublished in vitro tests have shown o-chlorobenzylidenemalononitrile to be both clastogenic and mutagenic. Sadly, the nature of its use renders analytic epidemiologic investigation of exposed persons difficult. In 1969, eighty countries voted to include tear gas agents among chemical weapons banned under the Geneva Protocol. There is an ongoing need for investigation into the full toxicological potential of tear gas chemicals and renewed debate on whether their use can be condoned under any circumstances.

Adult

Evaluation of nocturnal penile tumescence in the differential diagnosis of sexual impotence. A quantitative study.

Nocturnal penile tumescence (NPT) was assessed in 30 impotent patients for the purpose of differential diagnosis. In 11 psychogenic cases, with several exceptions, NPT was found to be normal, with a marked discrepancy between the NPT findings and the patients' estimates of their daytime erectile capacity. In 19 organic patients, maximal NPT corresponded closely to and mirrored the patient's subjective estimate of his impaired waking performance. Statistically, the figures for frequency, degree, duration, and amount of NPT were found to be significantly and markedly greater in the psychogenic group. Statistical significance was maintained when the 11 psychogenic patients were closely age-matched with 11 of the 19 organic cases. The method is not 100% accurate; some 15% of impotent patients without organic findings have reduced NPT, several of whom were shown to be psychogenic, but others in this group may have undetected organic pathology. The NPT method is very promising, but beset by a number of methodological problems.

Adult

Loeffler's syndrome?

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Diagnosis, Differential

Overnight admission for psychiatric emergencies.

Patients identified as psychiatric cases on the emergency ward of a 1036-bed teaching hospital are handled in one of three ways: released with outpatient referral, admitted to a psychiatric inpatient facility, or hospitalized in a general medical holding unit with a 24-hour stay. The authors obtained demographic and diagnostic data on 377 psychiatric patients seen consecutively on the ward and then compared those admitted to the holding unit (83) with those released (193) or hospitalized (101). The three groups were demographically similar but the patients in the holding group fell between the other two groups in severity of psychopathology. More than half the patients admitted to the holding unit were released the following day. The authors discuss the advantages of overnight admission as an alternative to hospitalization or release.

Adult