Biomedical subjects
Publications and source records attributed to W A Burke.
Pruritus can be due to a variety of factors and can often be difficult for a physician to manage. Often the etiology is psychosomatic, wherein a careful history is the key to proper diagnosis. Such a case is presented.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Epidermolysis bullosa acquisita (EBA) is a chronic blistering disease characterized by circulating and tissue bound IgG auto-antibodies to the basement membrane zone (BMZ) of stratified squamous epithelium. Recent studies have shown that antibodies recognize epitopes present in the noncollagenous carboxyl-terminal domain of type VII collagen, a BMZ matrix protein. Antibodies with identical specificity also have been detected in patients with the rare blistering disease, bullous systemic lupus erythematosus (bullous SLE), suggesting EBA and bullous SLE are immunologically related diseases. In this study we determined the major histo-compatibility antigen types of 29 EBA patients and 6 patients with bullous SLE. Analysis of the results showed HLA-DR2 was significantly increased in both black EBA patients, P = 0.013 (corrected, RR = 4.8) and white EBA patients, P = 0.0008 (corrected, RR = 13.1). Five of the six bullous SLE patients also were positive for the DR2 antigen, P = 0.009. These results show the expression of autoimmunity to type VII collagen is HLA class II allele associated and that EBA and bullous SLE are immunogenetically related diseases.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
A 53-year-old man developed multiple, widespread infiltrative tumors of his lips, eyelids, ears, distal fingers and toes, tongue, buccal mucosa, scrotum, and larynx. Biopsy results of three involved sites were similar, with dermal infiltration by well-differentiated plasma cells. Bone marrow aspirate and biopsy were essentially normal. The patient responded well to therapy with cyclophosphamide, doxorubicin, vincristine, and prednisone. Extramedullary plasmacytoma is a rare disease that most often arises in the upper respiratory tract. The relationship of this entity to other forms of myelomatosis is discussed.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Because many viruses can survive extremely cold temperatures for extended periods of time, transmission of viral diseases from person to person using improper cryosurgical techniques might conceivably occur. To investigate the survivability of herpes simplex virus during cryotherapy, virus was first inoculated onto cotton-tipped applicators from either tissue cultures or from active lesions on patients, and then frozen for variable times in liquid nitrogen (-196 degrees C). After thawing, the applicators were cultured for the virus. The virus survived 12 hours of freezing (the maximum time of freezing in the study), which suggests that herpes simplex could be transmitted between cryosurgical patients if care is not taken to use separate cotton-tipped applicators and liquid nitrogen containers for each case.
Epidermolysis bullosa acquisita is an acquired blistering disorder, with a probable autoimmune basis, which has been associated with a number of other autoimmune disorders. We encountered a case of epidermolysis bullosa acquisita associated with multiple endocrinopathies syndrome.
Explore the source record for details and available documents.
Surgical resection has failed notably as definitive treatment for small cell carcinoma of the lung. Newer treatment programs combining intensive chemotherapy with radiation therapy achieve a significant response in about 85 percent of cases, with about 50 percent of patients showing clinically complete remission. Long-term survival without recurrence has been the outcome in a small minority of cases. A frequent mode of failure after treatment of limited disease is recurrence within the chest. The course of one patient treated early in this series suggests that exclusion of initial surgical resection from programs of combined treatment may be a serious omission. Since that time, four patients have undergone initial resection, apparently with uniformly favorable courses to date. Selection criteria based on staging factors are proposed. Admittedly, only a minority of patients will be suitable for this treatment at the time of first diagnosis. Much opportunity exists for improvement in survival rates of patients, even those with limited disease.