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Biomedical subjects

R S Tomsick

Publications and source records attributed to R S Tomsick.

11 recordsLinked to original sources
PubMed1996

Local anesthetics.

BACKGROUND: Dermatology is dependent upon the effects of local anesthetics for diagnostic and therapeutic interventions. A working knowledge of the drugs' actions and interactions is necessary for anyone aspiring to optimize the benefits derived from the use of local anesthetic agents. OBJECTIVE: This article reviews nerve physiology, pharmacology, classification of local anesthetics, adverse reactions (toxic, drug, allergic), local anesthetic use in pregnancy, alternatives to the "-caine" anesthetics, methods for reducing the pain of infiltration, and new agents under development. CONCLUSION: Local anesthetics are safe and effective. With the understanding of the actions and interactions of this class of drugs, maximum patient safety and satisfaction can be achieved.

Anesthesia, Local↗
PubMed1996

Renaut bodies. Benign disease process mimicking neurotropic tumor infiltration.

BACKGROUND: Mohs micrographic surgery maximizes the potential for complete tumor removal with normal tissue preservation through the histologic examination of all tissue margins. One component of the histologic examination is the evaluation of excised nerves for the presence of tumor infiltration. During such an evaluation, a subperineurial structure was noted. OBSERVATION: Further investigation displayed a discrete, loosely textured, cell-sparse, whorled, subperineurial structure that invaginated into the peripheral nerve. Inflammation was absent and the nuclei were monomorphous. These findings are those seen with Renaut bodies. CONCLUSIONS: Renaut bodies are found at sites of nerve compression. Mechanical factors are thought to play a major role in pathogenesis. Cells comprising the Renaut body are fibroblasts of perineurial origin with the extracellular matrix comprised of collagen fibrils, basal lamina material, and oxytalan filaments. Renaut bodies are important insofar as the surgeon must recognize that they are benign. Histologic characteristics that differentiate Renaut bodies from malignant neurotropic infiltration are: (a) a cell-sparse mass, (b) absence of nuclear atypia, (c) less than expected inflammatory infiltrate, and (d) well-defined borders.

Actin Cytoskeleton↗
PubMed1986

Epidermolysis bullosa acquisita antigen, a major cutaneous basement membrane component, is synthesized by human dermal fibroblasts and other cutaneous tissues.

The epidermolysis bullosa acquisita (EBA) antigen is identified as 2 chains: a 290,000-dalton protein and a less prominent 145,000-dalton protein. The 290,000-dalton chain is synthesized by human keratinocytes in culture. In this study, we show that the 290,000-dalton chain is synthesized by human skin fibroblasts and cutaneous human tumors. In contrast, HT1080 cells, a human sarcoma cell line known to produce matrix molecules (such as laminin and type IV collagen), does not synthesize the EBA antigen. Further, the EBA antigen is absent from serum and blood components, placenta, amnion, lung, and the EHS tumor, a murine sarcoma that produces large amounts of laminin, type IV collagen, nidogen, entactin, and basement membrane proteoglycan but is present in cutaneous tumors of adnexal and epithelial origin. These data suggest that while the EBA antigen is synthesized by both human skin keratinocytes and fibroblasts and is therefore not specific for a primordial germ layer, it does appear to be specific for tissue containing a stratified squamous epithelium.

Antigens↗
PubMed1984

Squamous cell carcinoma of the fingers treated with chemosurgery.

Squamous cell carcinomas of the fingers are uncommon tumors. While most of them pose little threat of metastasis, the clinician should know which tumors are likely to metastasize. Conservative surgical excision is the treatment of choice for squamous cell carcinoma of the finger. We present 19 cases treated conservatively with chemosurgery.

Adult↗
PubMed1983

Basal cell epithelioma. Types, treatment methods, and prognosis.

Basal cell epithelioma (BCE) is the most common cutaneous malignancy. Primary BCE (ie, previously untreated) can be satisfactorily treated by a variety of methods, including curettage with electrodesiccation, scalpel excision, cryosurgery, and radiotherapy. Cure rates approach 98%. Recurrent BCE is much more difficult to treat and deserves particularly aggressive therapy, such as chemosurgery.

Basal Cell Carcinoma↗
PubMed1983

The phenytoin syndrome.

Five cases of the phenytoin syndrome are reviewed here. This hypersensitivity reaction is characterized by fever, eruption, lymphadenopathy, and hepatitis. Anemia, pharyngitis, diarrhea, and nephritis may also be associated. The skin eruption is pleomorphic, presenting as morbilliform eruptions, follicular papules and pustules, erythroderma, or toxic epidermal necrolysis. The management of these patients is made more difficult by the tendency for multiple relapses even after the use of phenytoin has been discontinued.

Adolescent↗
PubMed1982

Hyperkeratosis in mycosis fungoides.

A case of mycosis fungoides with hyperkeratotic changes of the nails, palms, and soles is presented. Although these features have been reported in the older literature, most contemporary authors neglect to mention this interesting cutaneous change in mycosis fungoides.

Antineoplastic Agents↗