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Biomedical subjects

C Paul

Publications and source records attributed to C Paul.

At least 181 records · Page 10Linked to original sources
PubMed1995

A rational approach to career change.

Recently, the number of physicians who have been interested in alternative careers has vastly increased. Many physicians express dissatisfaction with clinical practice, but they are uncertain about which nonclinical options are appropriate for them. Pursuing a different career after many years of studying and practicing medicine can seem like an overwhelming task. In this article, the author briefly outlines a decision-making process that can be used in analyzing career options and suggests some careers that have provided challenging opportunities for physicians.

Career Mobility↗
PubMed1995

[Cutaneous granulomatous lesions in congenital immune deficiencies. 5 cases].

INTRODUCTION: Cutaneous granulomatous lesions rarely occur in primary immunodeficiency syndromes. CASES REPORTS: We observed chronic granulomatous lesions on the skin of 5 children with inborn immunodeficiency syndromes. The deficiency was of the mixed type in all 5 cases and included major hypogammaglobulinaemia in 4. Erythemato-squamous infiltrated plaques were found in 4 children and erythematous nodules in the fifth. Extra-cutaneous lesions (cavum and rectocolon) occurred in 2 children. Search for an infectious cause was negative. Anti-tuberculosis drugs were tried in 3 children as a test regimen and were ineffective. Systemic corticosteroids gave major clinical improvement in 2 children. DISCUSSION: Several pathogenic processes have been hypothesized to explain the development of granulomatous lesions in immunodeficiency syndromes. The action of an unknown infectious agent has been suspected. An intrinsic anomaly in immune function regulation, particularly in a disequilibrium in the complex cytokine network controlling the formation of granulomas could also be involved. Systemic corticosteroid therapy appears to be effective but must be given with caution in these patients with immune deficiency.

Child↗
PubMed1995

[Cosmetic dermopigmentation. The pigment stays ... as do regrets].

INTRODUCTION: Cosmetic dermopigmentation designates tattooing of the superficial derma with pigments in order to obtain an aesthetic effect. We observed two cases illustrating the inconveniences of this technique. CASE REPORTS: Two women underwent dermopigmentation on the face in a beauty institution to create pseudo-freckles. Definite macular hyperpigmentation occurred with dyschromia in both subjects. COMMENTS: There is a major risk in subjects who undertake dermopigmentation of freckles and/or naevus, a practice which should be discouraged by dermatologists.

Adult↗
PubMed1994

Preparation and preliminary characterization of poly(ethylene glycol)-pepstatin conjugate.

The carboxyl function of pepstatin has been coupled, through an amide bond, to methoxypoly(ethylene glycol) (5 kDa), to which an amino function had been previously grafted. The mPEG-pepstatin conjugate inhibits hog pepsin (aspartic proteinase) in vitro as pepstatin itself, however, with a 400 times higher apparent Ki. The conjugate apparently does not inhibit proteinases belonging to other proteinase families such as serine (trypsin, carboxypeptidase Y), cysteine (Papaya proteinase III), or metallo (collagenase) proteinases.

Carboxypeptidases↗
PubMed1994

Comparison of the intracellular pharmacokinetics of daunorubicin and idarubicin in patients with acute leukemia.

Five patients with acute non-lymphoblastic leukemia were treated with a mixture of daunorubicin 50 mg/m2 and idarubicin 10 mg/m2 given as a short-time infusion. Daunorubicin, idarubicin and the main metabolites daunorubicinol and idarubicinol were separated and the concentrations in plasma and leukemic cells were determined by HPLC. Although idarubicin was given in one-fifth of the dose, the intracellular peak concentration was 70% of that of daunorubicin. The initial elimination of idarubicin from leukemic cells was somewhat faster but in the terminal phase the drug was retained longer than daunorubicin. Intracellular concentrations of both metabolites were low and probably of little importance for the activity of the drug. We conclude that the intracellular pharmacokinetics of idarubicin, with higher peak concentration and longer terminal retention, is a possible explanation for the higher toxicity and suggested better antileukemic effect of this drug.

Acute Disease↗
PubMed1994

Determinants of career choices among women and men medical students and interns.

Women continue to be poorly represented in medical specialties other than general practice. A cross-sectional design was used to explore the development of career plans as medical training progressed; men and women students were compared in their first (n = 316), final (n = 295) and intern (n = 292) years. Women at each stage of training were significantly more likely to choose general practice as the field in which they were most likely to practise. There was little evidence that these differences were influenced by experience during training: women were as likely to choose general practice in first year as in the intern year. The most important determinant of career choice appeared to be the flexibility of training and of practice of medicine: variables such as the opportunity for part-time training, flexible working hours and part-time practice were important determinants of career choice and were of more importance to women than to men. The study also found high rates of discrimination or harassment reported by women medical students and interns. The results indicate the need for continued debate about these issues within medicine and the development of more flexible styles of medical training and practice.

Career Choice↗
PubMed1994

Increased intracellular concentrations of doxorubicin in resistant lymphoma cells in vivo by concomitant therapy with verapamil and cyclosporin A.

The tumor cell uptake of doxorubicin was studied in vivo in cells from 2 patients with clinically resistant leukemic lymphomas treated with continuous infusions of doxorubicin 9 mg/m2 and vincristine with oral dexamethasone. After 24 hours, intravenous or oral verapamil was added and in one treatment course intravenous cyclosporin A was given. Plasma and intracellular doxorubicin concentrations and plasma concentrations of verapamil and norverapamil were determined with HPLC. In the 1st patient the intracellular uptake rate of doxorubicin was increased from 0.007 to 0.013 nmol/mg protein/h after the start of verapamil infusion. In the first treatment course of patient number 2, the intracellular concentration of doxorubicin was increased by 280% during a 6-h infusion of verapamil. When this patient in the next treatment course was given oral verapamil, no significant effect on doxorubicin uptake was seen. However, when 100 mg of cyclosporin A was added in three intravenous injections at 8-h intervals, the doxorubicin concentration in the tumor cells increased from 0.027 to 0.086 nmol/mg protein. In conclusion, this study shows that the intracellular concentrations of doxorubicin can be increased also in vivo during patient therapy by the addition of verapamil or cyclosporin A.

Adult↗
PubMed1994

HIV surveillance by testing saliva from injecting drug users: a national study in New Zealand.

OBJECTIVE: To determine whether the prevalence of HIV infection among injecting drug users in New Zealand has remained low since the introduction of a needle and syringe exchange scheme in May 1988. DESIGN: Anonymous survey of intravenous drug users attending outlets of the exchange scheme, based on questionnaires and saliva testing. SETTING: Twelve pharmacies and community outreach organisation in six cities. SUBJECTS: Altogether 620 people provided saliva specimens and completed questionnaires. These represented 73% of those who visited exchange scheme outlets during a three month period in 1992. MAIN OUTCOME MEASURE: Saliva was tested for antibodies to HIV-1 and HIV-2 using an IgG-capture enzyme linked immunosorbent assay (GACELISA). RESULTS: Of 591 specimens eligible for inclusion, only three (0.5%) were repeatedly reactive in the GACELISA test, while two of these were also positive in a Western blot test. CONCLUSIONS: Although surveys show that sharing of needles and syringes was common in New Zealand until recently, the prevalence of HIV infection in intravenous drug users has remained low. This can probably be attributed to the success of educational campaigns and legislative action to allow a needle and syringe exchange scheme to be set up.

Adolescent↗
PubMed1994

[Use of ultrasound in acute and follow-up diagnosis of septic accident surgery].

In 50 patients with infections of soft tissue, bone and joints, ultrasound examination was the first diagnostic procedure performed after clinical and X-ray examination. In 22 soft tissue infections the liquid portion of the infection area could be differentiated. Deep subfascial infections were detected in 7 cases before they were clinically apparent. The results of the ultrasound examination had an influence on the operation performed in 10 cases. In 18 patients with bone infections with abscesses the linkage of the fluid zone to the bone was demonstrable, and in 6 of these cases we saw extramedullary sequestrae as total reflecting parts. Empyema was diagnosed by ultrasound in association with clinical and laboratory parameters in 10 cases, including 3 in which clinical examination had not yet led to a firm suspicion. Real-time sonography influenced the operative treatment (time of intervention, approach) in 36% of all these cases was helpful in the diagnosis in all.

Abscess↗
PubMed1993

Cervical smear histories of Maori women developing invasive cervical cancer.

AIMS: To locate problems with the implementation of cervical screening for Maori women by investigating the histories of women with invasive cervical cancer, and determining why their disease had not been detected by screening and treated at an intraepithelial stage. METHODS: In a national study, the screening histories of 46 Maori women with invasive cervical cancer were ascertained by interview and from hospital, general practitioner and cytology laboratory records. RESULTS: Possible reasons for failure of cervical screening were never having had a smear (54%), infrequent smear tests (22%) and previous abnormal smears without appropriate follow-up (4%). Only six women (13%) had one or more normal smears in the three years before diagnosis. CONCLUSIONS: The main factor underlying the onset of invasive cancer was an absence of cervical screening or infrequent smear tests. Although no slide review was done, false negative reporting could have been a factor in only a small number of cases. Ways need to be found to encourage Maori women to be screened and to recall women regularly.

Adult↗
PubMed1993

Comparative study of high-mannose-type oligosaccharides in membrane glycoproteins of rat hepatocytes and different rat hepatoma cell lines.

A comparative study was undertaken to characterize the oligosaccharides released by endo-beta-N-acetylglucosaminidase H (endo H) from the membrane glycoproteins of rat hepatocytes and three different Morris hepatoma cell lines (NA-MH 7777, HTC and MH1C1). It is shown that the membrane glycoproteins of hepatocytes and hepatoma cells contain markedly different quantities and forms of high-mannose-type carbohydrate chains. After radiolabelling of the cells with D-[2-3H]mannose, in the absence and presence of 1 mM 1,5-dideoxy-1,5-imino-D-mannitol (1-deoxymannojirimycin), high-mannose-type oligosaccharides were released from delipidated membrane glycoproteins by enzymic digestion with endo H. The carbohydrate chains were converted to their corresponding oligosaccharide alditols by reduction with sodium borohydride, then further analysed by HPLC using an APS-2 Hypersil column. In the absence of 1-deoxymannojirimycin, up to 10% of the radiolabelled oligosaccharides were released by endo H-treatment of the membrane glycoprotein fraction from rat hepatocytes. In contrast, the quantity of radiolabelled high-mannose-type carbohydrate chains released by endo H-treatment from tumour-cell membrane glycoproteins of hepatoma cell lines NA-MH 7777 (31.5%). MH1C1-MH 7795 (37.2%) and HTC-MH 7288c (48%) was increased up to fivefold. The formation of higher-mannosylated structures after oligosaccharide analysis was observed in all hepatoma cell lines, with Man8GlcNAcOH as the major component, whereas in hepatocytes Man5GlcNAcOH was the predominant high-mannose-type structure. In contrast, in the presence of the Golgi alpha-D-mannosidase I inhibitor, 1-deoxymannojirimycin, no significant differences were observed between the distribution of high-mannose-type oligosaccharides in the membrane glycoproteins of hepatocytes and hepatoma cells. However, in the presence of this inhibitor, the proportion of radiolabelled glycans sensitive to deglycosylation by endo H was greatly increased (> 85%) in all the cell lines investigated, the predominant structures being Man8-9-GlcNAcOH. This study shows that an increased content of high-mannose-type sugar chains is a general characteristic of membrane-bound glycoproteins for malignant transformed hepatocytes.

1-Deoxynojirimycin↗
PubMed1993

Unlinked anonymous monitoring of HIV prevalence at sexually transmitted disease clinics.

AIM: To determine the prevalence of HIV infection among patients attending the four sexually transmitted disease (STD) clinics in two metropolitan areas of New Zealand. METHODS: The population studied comprised everyone who attended between August 1991 and August 1992 because of concern about a possible new episode of an STD and who had a blood specimen taken for hepatitis B (or syphilis) serology. The study involved unlinked anonymous testing of left-over blood specimens, following ethical guidelines that have been proposed internationally. RESULTS: Among 8478 specimens tested, 23 (2.7 per 1000) were found to be HIV positive. The seroprevalence rates per 1000 among women, heterosexual men, and homosexual or bisexual men were 1.1, 1.3, and 44, respectively. All but five of the infected people were either known to be HIV positive or had an identifiable test during their clinic attendance. CONCLUSIONS: The seroprevalence rates are similar to those reported from STD clinics in England, and suggest that heterosexual transmission of HIV infection has not yet been extensive in New Zealand.

Adolescent↗