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Biomedical subjects

S Proper

Publications and source records attributed to S Proper.

8 recordsLinked to original sources
PubMed1999

Solitary fibrous tumor of the skin.

Solitary fibrous tumor (SFT) is an uncommon mesenchymal tumor that typically arises in the pleural cavity. Comprised of spindled cells characteristically arranged in diverse architectural patterns, SFT histologically simulates a variety of benign and malignant mesenchymal tumors. The diagnosis of SFT has been refined by the availability of newer immunohistochemical markers such as CD-34 and factor XIIIa, facilitating the identification of SFTs arising in multiple extrapleural sites, including the skin. We describe three cases of primary cutaneous SFT, review the literature, and discuss the histologic and immunohistochemical differential of other cutaneous tumors that SFT can mimic.

Adult↗
PubMed1995

Informed consent and informed refusal.

BACKGROUND: This article continues our medicolegal series that addresses issues affecting current dermatology practice. Informed consent and informed refusal have become cornerstones of modern American healthcare, and can serve to facilitate communication and trust between physician and patient. METHODS: A format with an initial discussion of legal concepts is followed by hypothetical problems and a review of actual cases to illustrate the principles of informed consent and informed refusal. RESULTS: A valid informed consent from a competent patient should be obtained before initiating most dermatologic treatment. When a competent patient refuses a recommended medical test or procedure, the physician should make sure the patient understands the potential negative consequences of refusal. Some form of written documentation in the medical record is advised in either situation. CONCLUSION: Failure to obtain a patient's informed consent prior to beginning treatment or failing to obtain an informed refusal before accepting a patient's decision to forego a test or procedure may subject the dermatologist to multiple later allegations, most commonly negligence.

Adult↗
PubMed1994

Terminating the physician-patient relationship.

BACKGROUND: This continues our series of articles addressing the many medicolegal aspects that impact the practice of dermatology. Because the physician-patient relationship is the cornerstone of every medical malpractice action, the proper termination of that relationship is very important. METHODS: A format of an initial discussion of legal concepts followed by hypotheticals and a review of actual cases was chosen to enhance interactive learning. The subject matter is based on a review of medico-legal literature and actual recorded case law. RESULTS: Once a physician-patient relationship has been established, improper termination of that relationship may constitute abandonment. CONCLUSION: Any termination of the physician-patient relationship must be reasonable in view of the patients' access to alternate medical care and medical problems and should be properly communicated to the patient.

Dermatology↗
PubMed1982

Mohs' surgery, fresh-tissue technique. Our technique with a review.

A modified method of the fresh-tissue technique of Mohs' surgery is presented with a discussion of its developmental background and advantages. The refinements obviate the need for the chemical fixative. We therefore advocate acceptance of this technique in all cases of cutaneous carcinomas requiring Mohs' surgery.

Basal Cell Carcinoma↗
PubMed1982

Metastatic basal-cell carcinoma.

Three cases of metastatic basal-cell carcinoma are reported. All of the cases were relatively small when compared with other lesions reported in the literature. With early chemosurgical treatment of small recurrent carcinomas, metastasizing basal-cell carcinoma will be a condition of the past.

Aged↗
PubMed1980

Blunted prolactin response to hypoglycemia in patients with hypothalamic-pituitary disease and in subjects receiving estrogen.

The prolactin response to hypoglycemia was evaluated in 22 control subjects and 8 patients with hypothalamic-pituitary disease but normal basal serum prolactin levels. Eighteen of the 22 control subjects demonstrated at least a twofold prolactin rise in response to hypoglycemia. In contrast to the control subjects, none of the 8 patients demonstrated a prolactin response to hypoglycemia. This blunted prolactin response to hypoglycemia was the only endocrine abnormality in 3 of these 8 patients. In an attempt to better determine the sensitivity of the prolactin response to hypoglycemia as an index of early pituitary disease, the effect of a short course of estrogen on the prolactin response to hypoglycemia was examined. Estrogen was selected because of its known acute stimulatory effect on pituitary mitosis and chronic effects that lead to pituitary tumor formation in rodents. Accordingly, diethylstilbestrol (DES) 5 mg t.i.d. was administered orally to 6 normal men for 3 days, a period known to stimulate pituitary mitotic activity in rodents. Diethylstilbestrol treatment caused significant elevation of the baseline prolactin (8 +/- 2 versus 18 +/- 3 ng/ml, p less than 0.05); however, the prolactin response to hypoglycemia was blunted (8 +/- 2--30 +/- 10 ng/ml, p less than 0.05, before DES; 18 +/- 3--20 +/- 5 ng/ml after DES, p greater than 0.05). This estrogen-induced blunted prolactin response to hypoglycemia resembled the blunted prolactin response to hypoglycemia found in patients with hypothalamic-pituitary disease.

Acromegaly↗
PubMed1979

Elevated prolactin levels in bronchogenic carcinoma.

The frequency and significance of hyperprolactinemia was studied in 21 consecutive, untreated male patients with bronchogenic carcinoma. Seven patients (33%) were found to have elevated serum prolactin (hPRL) levels. No correlation was demonstrated between increased hPRL levels, tissue histology, or tumor burden. L-dopa suppression and/or TRH stimulation tests were obtained in three untreated patients with hyperprolactinemia. The results of these tests were considered normal suggesting hypothalamic control.

Adenocarcinoma↗