Samuel Packer

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Samuel LÉZÉ

École Normale Supérieure de Lyon

Sergio Rego

Fundação Oswaldo Cruz

Prof. Dr. İLHAN İLKILIÇ (MD PhD)

Istanbul University

Olivia Ivanova

Bogomolets National Medical University

Antonio Bonacaro

University of Parma

Eva Duarte

Mariano Gálvez University

abraham verghese

Stanford University

George J . Agich

Bowling Green State University

Patrick Coyne

Medical University of South Carolina

Sheryl Heron

Emory University

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Papers by Samuel Packer

I-125 plaque therapy for choroidal melanoma

Ophthalmic Plaque Irradiation of Choroidal Melanoma

Intraocular Tumors, 1983

Embryonic Stem Cells, Intellectual Property, and Patents: Ethical Concerns

Hofstra L. Rev., 2008

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Professionalism: questions, old and new

American Journal of Ophthalmology, 2004

NOTED MEDICAL ETHICIST HAS STATED THAT "TOday, we face another, but far more complicated, moral c... more NOTED MEDICAL ETHICIST HAS STATED THAT "TOday, we face another, but far more complicated, moral crisis. The enormous power of medical technology, coupled with the legitimization of market ethos in health care, threatens to overshadow both physician and patient." 1 As you read, you will find that this editorial is built on the premise of the above quotation and the foundation of previous works by others in the field who recognize the precipice on which the profession of medicine teeters. 2-6 What most physicians understand, to one degree or another, is that the foundation of the profession of medicine is changing and that the fundamental covenants between society, patients, and physicians are being replaced by a new contract. To reinforce medicine's foundation for our own betterment and for the betterment of future generations of medical professionals and of society, we must rebuild and reinforce the trust of patients and more intimately understand our covenants with patients and society. In this editorial, we do not intend to touch on some of the more basic philosophical issues, such as the practical application of philosophical knowledge (phronesis) or the basic components of a social contract, nor do we address issues related to the other learned professions. We instead address several old ethical issues that are worth restating and also discuss several new ethical concerns.

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The ethical education of ophthalmology residents: an experiment

American Journal of Ophthalmology, 2006

To demonstrate the effect of ethics education on a resident's ability to answer questions that re... more To demonstrate the effect of ethics education on a resident's ability to answer questions that relate to moral dilemmas and on the clinical evaluations of residents by faculty. Methods: The curriculum for the ethics education that was used for this study was designed by the author and consisted of 10 lectures of 1.5 hours each. Five residencies were included in the project. One residency received one lecture, two residencies received three lectures, and two residencies received 10 lectures. To evaluate the moral skills of the residents at the beginning of the course and at the end, the residents were given the Defining Issues Test (DIT-2) developed by James Rest, which involves answering standardized questions about four moral dilemmas. Faculty evaluations were completed before and after the ethics lectures were given. At the beginning of the ethics course, each resident was given a social survey that was designed to assess participation in community, religious, political, and societal activities as well as attitudes about these activities. All residents were also asked demographic information, including their age, gender, and year of residency. Results: The results of the DIT-2 taken before and after the ethics lectures were compared. No correlations were found in faculty evaluations of clinical performance of the residents before and after the course (P = .052). Associations between DIT-2 scores and questions on community and religion in the social survey were noted. Conclusion: The finding that the effect of an ethics course on residents' ability to answer moral dilemmas did not achieve statistical significance should be accepted with the understanding that this was a first attempt at standardization of many variables, especially the format of the curriculum and materials used. The use of faculty evaluations to assess clinical performance needs to be standardized, and the faculty members need additional training to ensure validity of the results. The social survey was also the first attempt to assess an association between a resident's response to moral dilemmas, attending evaluations, and residents' opinions that relate to community, society, politics, and religion.

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Cobalt plaque versus enucleation for uveal melanoma: comparison of survival rates

British Journal of Ophthalmology, 1988

Two hundred and twenty-three patients treated by cobalt plaque for uveal melanoma were compared w... more Two hundred and twenty-three patients treated by cobalt plaque for uveal melanoma were compared with 416 patients treated by enucleation for uveal melanoma in terms of patient survival. The median follow-up time for the patients treated by cobalt plaque was 4-3 years. Kaplan-Meier survival curves were calculated up to five years following treatment based on time to tumour-related deaths. Cox's proportional hazards multivariate analysis was performed to determine which variables were related to melanoma-related deaths while controlling for age, size, and location of the tumours. Statistically significant predictive factors were location of tumour and largest tumour dimension. There was not a statistically significant difference in survival between patients treated by cobalt plaque and those treated by enucleation.

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Boron Neutron Capture Therapy of Ocular Melanoma and Intracranial Glioma Using p-Boronophenylalanine

Progress in Neutron Capture Therapy for Cancer, 1992

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Non-invasive nuclear detection of choroidal melanoma

Of THIS BOCUHST tS DIUMtT^O From this work we concluded that there are several radiopharmaceutica... more Of THIS BOCUHST tS DIUMtT^O From this work we concluded that there are several radiopharmaceuticals that are appropriate for use as melanoma localizing agents (Table 1). The next problem is nuclear instrumentation. Blanquet (2) led the way with a dual pinhole collimator that we have further modified, by Bockslaff (3) and by Packer (10). In addition, we have had limited experience with two other detection systems. The ultrasound guided gamma probe, Wainstock (12) and a dual eye probe counting system designed by Packer and Lambrecht. We will report in this paper our results with our modified dual pinhole collimator and a pigment affinic agent (iodine-123 labeled quinoline) and a non-specific tumor seeking agent (gailium-67 citrate). Methods

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Ethical Concerns in Industry Support of Continuing Medical Education

Archives of Ophthalmology, 2004

LASIK reporting

Journal of Cataract and Refractive Surgery, 2004

for further action. 4-6 If this direct approach fails to elicit LASIK reporting: Preserving an ap... more for further action. 4-6 If this direct approach fails to elicit LASIK reporting: Preserving an appropriate response, the Code of Ethics offers a our responsibility to our patients reasonable alternative by fairly determining, through due process, whether there has been a violation of 1 of K och 1 asked for suggestions on how ophthalmolothe rule(s) of the Code. gists can work together to uphold the ethical prin-The key to success is the willingness to stand behind ciples of the profession of medicine. In his editorial, the AAO's Code of Ethics and other appropriate guide-Koch mentions that the American Society of Cataract lines that defend our profession. The privileges associand Refractive Surgery (ASCRS) and the American ated with being a professional will only continue if Academy of Ophthalmology (AAO) have developed our covenant with society is preserved. Our covenant guidelines relating to appropriate advertising and noted mandates self-regulation and adherence to a professional the web site for the ASCRS/AAO guidelines. The code of ethics. 7,8 AAO's Code of Ethics, 2 another valuable resource for I have not discussed the responsibilities of our proophthalmologists, may be accessed through the AAO's fessional societies as others have thoroughly and eloweb site as well (http://www.aao.org/aao/member/ethics). quently addressed these concerns. 9 The Code of Ethics addresses concerns about appropriate advertising by setting forth the requirements for

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Nuclear Ophthalmology: Dynamic Function Studies in Intraocular Disease

Archives of Ophthalmology, 1977

Bioelectronic Medicine—Ethical Concerns

Cold Spring Harbor Perspectives in Medicine

Bioelectronic medicine (BEM) offers exciting opportunities to treat diseases such as movement dis... more Bioelectronic medicine (BEM) offers exciting opportunities to treat diseases such as movement disorders and refractory inflammatory disease. The many variations of BEM allow for noninvasive aspects of treatment that might eliminate or reduce the need for pharmaceuticals; therefore, the term "electroceuticals" may be suitable. BEM has been effective for movement disorders and improvement of prosthetic devices. Based on this implication, there is an allowance to impact many focus areas that include but are not limited to autoimmune disease, sensory motor conditions, and neurological conditions. There are a wide array of ethical issues that relate to BEM, which include informed consent, research ethics, innovation, academic-industry relationships, intellectual property, and the conundrum that needs to be addressed when altering the brain such as the issues of autonomy and free beneficence and social justice. The major goal is to heighten awareness of ethical issues and facilitate a proactive ethical approach regarding BEM research.

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Metal isotopes used as radioactive indicators of ocular melanoma

We studied radioactive metal compounds to determine their localization in malignant Greene melano... more We studied radioactive metal compounds to determine their localization in malignant Greene melanoma in the eye of the Syrian golden hamsters. Scintigraphy of an ocular melanoma was achieved with several radioactive metals: radioactive (Â¹Â¹Â¹In)-bleomycin, radioactive gallium (â¶â·Ga)-citrate, and radioactive lead (Â²Â°Â³Pb)-tris. The Â¹Â¹Â¹In-bleomycin had the highest tumor uptake (5.45% dose/g), but not the highest tumor-to-background ratios. The â¶â·Ga-citrate had a

Method for non-invasive detection of ocular melanoma

Quinoline analog labeled with Â¹Â²Â³I in melanoma detection

Using the Greene melanoma in the hamster (Syrian Golden), the ; radiopharmaceutical, Â¹Â²Â³I-4(3-... more Using the Greene melanoma in the hamster (Syrian Golden), the ; radiopharmaceutical, Â¹Â²Â³I-4(3-dimethylaminopropylamino)- 7-Iodoquinoline, ; was tested for its ability to localize melanoma. This quinoline analog has been ; described for use in the detection of melanoma, but this is the first report, to ; our knowledge, of its being used with an Â¹Â²Â³I label. Hamsters with either ; skin

Short-lived radiopharmaceuticals for the diagnosis of ocular melanoma

... The Medical Research Center (Dr. Packer, Dr. Atkins) and the Chemistry Department (Dr. Lanbre... more

Radiotherapy of choroidal melanoma with Iodine 125. [⁶°Co]

Radiotherapy of Choroidal Melanoma with Iodine 125* SAMUEL PACKER MARVIN ROTM AN Radiotherapy of ... more

Differential radioactivity monitor for non-invasive detection of ocular melanoma

A novel instrument for the noninvasive diagnosis of ocular melanoma was evaluated with 67Ga in pa... more A novel instrument for the noninvasive diagnosis of ocular melanoma was evaluated with 67Ga in patients with pathologically confirmed tumours. The decision to enucleate was based on the results of standard ophthalmic diagnostic modalities including the 32P uptake test. The differences in the ocular radioactivity at 48-72 h predicted the presence of ocular abnormality. A positive differential result was found for tumours having a volume of greater than 600 mm3. Smaller tumours indicated lower retention of 67Ga in the eye with the tumour, whereas control subjects showed less than 2% differences in the radioactivity present in either eye.

Production of 203 Pb-tris-hydroxymethyl amino methane

Direct-to-Consumer Advertising: Education or Anathema?—Reply

Jama the Journal of the American Medical Association, Oct 6, 1999

Holmer plays down the inflationary effect of DTC advertising, with which the costliest drugs are ... more

I-125 plaque therapy for choroidal melanoma

Ophthalmic Plaque Irradiation of Choroidal Melanoma

Intraocular Tumors, 1983

Embryonic Stem Cells, Intellectual Property, and Patents: Ethical Concerns

Hofstra L. Rev., 2008

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Professionalism: questions, old and new

American Journal of Ophthalmology, 2004