Biomedical subjects
Publications and source records attributed to K J Tomecki.
A hypersensitivity reaction to low-dose (50-mg), short-term dapsone administration developed in a 16-year-old girl. The reaction included fever, malaise, dermatitis, jaundice with hepatic dysfunction, lymphadenopathy, and hemolytic anemia. Physicians should be familiar with this "sulfone syndrome," an uncommon, potentially serious, side effect of dapsone therapy.
We used gel electrophoresis to fractionate serum and urine samples of patients with malignant melanoma and of healthy volunteers (controls) and observed that a) all proteins found in the sera of melanoma patients also occurred in the sera of 2 or more healthy volunteers, b) two minor protein bands were present in the sera of 73% of the melanoma patients but in the sera of only 38% of the controls, and c) one major band was present in the sera of 73% of the melanoma patients but in the sera of only 12% of the controls. We characterized these proteins by molecular size and charge. Two proteins, analogous in electrophoretic behavior to those found more frequently in melanoma patients' sera, were observed exclusively in the urine from melanoma patients. The demonstration of such differences in serum and urine proteins warrants the further study of this system as a serologic and/or immunologic test for diagnosis of malignant melanoma.
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The isozymes of tyrosinase from normal and malignant melanocytes were studied; the data indicates that each consists of a basic tyrosinase polypeptide, and differs by post-translational modifications. T3 represents the de novo form of the enzyme; it is converted to T1 in vivo by the addition of sialic acids and neutral sugars, and in turn, to T4 by complexing with mealanosomal membrane constituents. The T2 isomer is suggested to be an artefact of the electrophoretic procedure, and due to deamidation of T3. It is shown that the apparent kinetics of enzyme activity are unafffected by any of these modifications.
Disseminated cryptococcosis with palpable purpura as the initial clinical manifestation developed in a patient with diffuse histiocytic lymphoma. Cryptococcal vascular injury in a thrombocytopenic cancer patient best explains this previously unreported presentation of cryptococcosis. Purpuric presentations of disseminated fungal infection are likely to increase in frequency as cancer therapy becomes more aggressive.
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Of 5,954 adult inpatients consecutively discharged from a university hospital during a three-month period, only 8.4% had serologic tests for syphilis performed during hospitalization. The testing rate was 20.1% on patients admitted to a medical teaching service and 1.4% on a surgical teaching service. In patients tested, a positive rapid plasma reagin test result was obtained in 6.2% and the diagnosis was confirmed by further testing, but effective therapy was not always given. On 9 of 30 patient records listed syphilis as a diagnosis on discharge. We conclude that serologic testing for syphilis is routinely omitted in the evaluation of hospitalized patients; even when tests are positive, the results are often ignored.
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A young woman presented with recurrent skin lesions that were predominantly perioral. Fixed drug reaction was diagnosed based on her history of intermittent ingestion of Pamprin, a common menstrual symptom reliever, and characteristic erythematous, pigmented, edematous patches. After oral challenge with two of the three ingredients in Pamprin, a diagnosis of fixed drug reaction to pamabrom was made. Pamabrom is a mild diuretic present in several over-the-counter and prescription menstrual symptom relievers. This is the first reported case of fixed drug reaction to pamabrom.
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