Biomedical subjects
J Spiro
Publications and source records attributed to J Spiro.
Endoscopic management of an inverted nasal papilloma in a child.
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Expression of basic fibroblast growth factor and its receptors by head and neck squamous carcinoma tumor and vascular endothelial cells.
BACKGROUND: Basic fibroblast growth factor (bFGF) is a potent angiogenic factor implicated in tumor growth and metastasis. To determine if bFGF and basic fibroblast growth factor receptor 1 (bFGFR1) and 2 (bFGFR2) are upregulated in head and neck squamous cell carcinoma (HNSCC), we measured the distribution and levels of each in HNSCC specimens and control specimens. METHODS: Head and neck squamous cell carcinoma and control tissue specimens were analyzed qualitatively (40 patients, 10 controls) using immunohistochemistry, and quantitatively (26 patients, 8 controls) using immunoassays and graded immunohistochemistry. Control tissue consisted of palatal tissue obtained during uvulopalatopharyngoplasty (UPPP). RESULTS: Immunohistochemical analysis revealed that bFGF, bFGFR1, and bFGFR2 antigens were strongly associated with cancer and vascular endothelial cells in HNSCC. Control tissue had moderate staining of vascular endothelium and no stromal staining. Quantitative analysis of bFGF in tissue homogenates indicated that bFGF levels in cancer specimens were significantly elevated compared with control tissues (420.3 +/- 360.9 ng/mg total protein versus 49.2 +/- 48.7, respectively, P < or =0.05). When analyzed by clinical stage, bFGF levels were significantly higher in stage III patients as compared with stage IV patients (P < or =0.01). When immunohistochemistry results were correlated with clinical stage, bFGF (P < or =0.01), bFGFR1 (P < or =0.001), and bFGFR2 (P < or =0.0001) staining was significantly more intense in the cancer cells of stage III versus stage IV patients. CONCLUSION: Enhanced expression of bFGF and bFGF receptors by cancer and vascular endothelial cells is present in HNSCC, and may contribute to tumor growth and metastasis in HNSCC by mediating angiogenesis. Strategies aimed at decreasing the expression of bFGF and its receptors may be of therapeutic benefit in HNSCC, particularly at an early stage of disease.
The effects of topical indomethacin and clobetasol propionate on post-cryotherapy inflammation.
The effects of topical indomethacin and clobetasol propionate on erythema and oedema following low-dose cryotherapy to normal skin were examined using a single-blind technique. Both agents significantly reduced erythema, but neither had a significant effect on oedema. A further, controlled, double-blind study comparing topical indomethacin and inert gel base was performed after cryotherapy to hand warts. In this study, topical indomethacin had no significant effect on post-cryotherapy oedema, erythema, pain or blister formation 48 and 96 h after treatment. Both potent topical steroids and cyclo-oxygenase inhibitors reduce erythema after low-dose cryotherapy. In clinical practice, there is no evidence that topical indomethacin significantly inhibits the inflammatory response to cryotherapy.
Coordination of oral cavity and laryngeal movements during swallowing.
In this study, dynamic imaging was used to track the movements of oral cavity and laryngeal structures during swallowing in 10 normal adults subjects. The movements of tiny lead pellet markers attached to the lips, tongue, mandible, and soft palate, as well as anatomic landmarks on the hyoid bone, were measured in relation to a reference pellet affixed to the upper central incisors. Sagittal views of the oral cavity were obtained using standard videofluorography. Each subject produced 10 swallows of 12 ml of tap water followed by 5 swallows with a bite block placed between the molars. The recorded video images were input to a microcomputer where the x- and y-coordinates of the pellets were measured. Results of the analyses revealed considerable temporal overlap in the timing of oral cavity and laryngeal movements, widespread individual variability in coordination patterns and movement trajectories, and selective effects of the bite block. These data suggest the existence of individual adaptive strategies in the programming and control of swallowing movements.
Oral and laryngeal muscle coordination during swallowing.
The objective of this experiment was to determine the relative contributions and patterns of activity of different muscles involved during the oral phase of swallowing. Electromyographic (EMG) signals were recorded from the orbicularis oris inferior, masseter, palatal elevator, anterior and posterior genioglossus, mylohyoid, anterior belly of the digastric, and vocalis muscles of 12 normal adult subjects. Each subject swallowed 15 mL of water, under normal and bite block conditions, 15 to 20 times. The integrated EMG signals for each subject's swallows were ensemble averaged. The results of the analyses showed that swallowing function varies from individual to individual in terms of the specific muscles used and how the various muscle activity patterns are coordinated. These results suggest that swallowing is a highly complex adaptive motor activity which probably relies more on higher-level control mechanisms than previously believed.
Activation and coordination patterns of the suprahyoid muscles during swallowing.
This study was undertaken to determine the activation and coordination patterns of the three suprahyoid muscles--geniohyoid, mylohyoid, and anterior belly of the digastric muscle--in elevating the larynx during swallowing. Electromyographic activity was also recorded from two intrinsic laryngeal muscles (vocalis and lateral cricoarytenoid) and the anterior genioglossus. Ten adults served as participants. Each participant produced 15 swallows of 15 mL of tap water both normally and with a 12-mm bite block placed between the molars. The electromyographic data were ensemble-averaged with a laboratory computer. Analyses showed that the three suprahyoid muscles were used selectively by different participants. Some participants used all three muscles for hyoid elevation, while others used different pairs of two of the muscles. The activation patterns of the suprahyoid muscles during swallowing also varied with respect to each other and the onset of the laryngeal constrictor muscles; however, use of at least one suprahyoid muscle always preceded the onset of the laryngeal adductors, indicating that larynx elevation consistently preceded glottal adduction. The way in which the muscles responded to the bite block varied considerably both within and among participants. Some maintained temporal stability but increased overall muscle activity; others reorganized temporal relations either with or without corresponding muscle activity adjustments. These findings suggest that the laryngeal elevation system is an adaptive function rather than an immutable action.
Women physicians in dual-physician relationships compared with those in other dual-career relationships.
This study compared the career and domestic responsibilities of women physicians whose domestic partners were physicians (WP-Ps) with those of women physicians whose domestic partners were not physicians (WP-NPs). In 1988 the authors surveyed 602 women physicians in a large midwestern city regarding their career and domestic roles; 390 were physicians in training (students and residents), and 212 were physicians in practice (academic medicine and private practice). Overall, 382 (63%) responded; of the 382, 247 (65%) had domestic partners; of these 247, 91 (37%) were WP-Ps and 156 (63%) were WP-NPs. The WP-Ps were found to be twice as likely as the WP-NPs to interrupt their careers to accommodate their partners' careers. The WP-Ps also assumed significantly more domestic responsibilities and worked fewer hours practicing medicine than did the WP-NPs. The 163 women physicians in training (44-48%-of the WP-Ps and 119-76%-of the WP-NPs) demonstrated a more egalitarian division of labor overall, with no significant differences between the WP-Ps and the WP-NPs. The authors recommend that longitudinal studies be undertaken to determine whether women physicians in training continue this trend as they enter the practice of medicine.
Steroid therapy of postcryotherapy inflammation.
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Effect of PUVA on plasma and skin immunoreactive alpha-melanocyte stimulating hormone concentrations.
Plasma alpha-melanocyte stimulating hormone (alpha-MSH) concentrations were measured in patients receiving PUVA therapy as treatment for mycosis fungoides, and PUVA or UVB as treatment for psoriasis. Skin immunoreactive alpha-MSH was also measured in those patients who received PUVA. The mean plasma and skin alpha-MSH concentrations after 2-3 weeks of PUVA were not significantly different from pre-treatment values and showed no relationship either to skin type or to the degree of tanning that occurred in response to PUVA. Plasma alpha-MSH concentrations were also unchanged after UVB. There was also no short term change in plasma alpha-MSH concentrations in patients after receiving their first treatment with PUVA. It would appear that circulating and skin alpha-MSH levels are unaffected by UV and show no causal relationship to PUVA induced pigmentation.
Measurement of risk of sensitisation and its application to Kathon.
The prevalences of patch test reactions to 27 common allergens including Kathon 100 ppm, were calculated in a standard test battery applied to 2 consecutive cohorts of 656 and 653 patients seen in 1985/6 and 1986/7. The overall prevalence of Kathon sensitivity was 0.9% for 1985-87. The prevalence for 1985/6 and 1986/7 was 0.8% and 1.1% (difference not significant). The rate of sensitisation to Kathon was measured in 212 patients with negative patch tests by retesting after 6-15 months (mean 10.8 months +/- 0.2 SE), and gave a mean rate of sensitisation of 1/2280 patient months or 0.5%/patient population. Retesting 45 negative reactors after 4 weeks gave no new reactors, showing that the rate of sensitisation by patch testing with 100 ppm Kathon is low. It is concluded that the low and stable prevalence of Kathon sensitivity and the low rate of new sensitisation is in keeping with a low potential for sensitisation. Used on a larger scale, the present method would rapidly define risk from potential new allergens.
PUVA therapy of chronic actinic dermatitis.
Four men with long-standing chronic actinic dermatitis were treated with a modified PUVA regime which initially included generalized applications of topical steroids given immediately after PUVA exposure. All patients are now free of rash, no longer need protection from UV radiation, and are being maintained on twice monthly PUVA therapy (IO J/cm2).
Clobetasol propionate ointment reduces inflammation after cryotherapy.
A double-blind, randomized, placebo-controlled trial was carried out comparing the effects of clobetasol propionate ointment and the ointment base on the inflammation induced by cryotherapy of basal cell carcinomata and warts. A single application of the steroid was shown to be significantly better at reducing erythema, pain and swelling than the ointment base.
Calcinosis universalis treated with disodium etidronate.
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Physician morbidity: a limited study.
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Clobetasol propionate for PUVA overdosage.
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Medical vs. graduate students: socialization and stress.
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Deficient mitogen-induced virus plaque-forming cells in patients with localized cancer.
The virus plaque assay (VPA), an assay capable of enumerating mitogen- or antigen-sensitive T-lymphocytes in a given cell population, was applied to the study of mitogen responses of peripheral blood leukocytes (PBL) in 50 patients with localized, solid cancers and in 29 normal controls. Concanavalin A (Con A)-responsive virus plaque-forming cells (V-PFC) were significantly reduced in the patients as compared with those of the controls. PBL from 20 of the patients but only 2 of the controls failed to show significant increments in V-PFC over background when cultured in the presence of Con A. This deficient response was also present in the patients when phytohemagglutinin was used as the mitogenic agent. Mitogen-stimulated uptake of [3H]thymidine (TdR) in parallel cultures failed to show a statistically significant difference between the patients and the controls, though some patients showed diminished stimulation in this assay. The VPA thus appeared to detect a defect of T-lymphocyte function not found in the [3H]TdR incorporation assay.