Biomedical subjects
Publications and source records attributed to M R Wright.
The many-faceted reasons for patient dissatisfaction with the results of cosmetic procedures are discussed within a broad context, encompassing causative, preventive, and management factors. Psychological manifestations as they relate to patient expectations and disappointments are exposed. The author recommends that the surgeon adopt an affirmative, rather than a defensive, approach to the problem.
This is an investigative study of the personality of patients requesting cosmetic rhinoplasty. Analysis of data obtained from objective projective tests and psychological interviews indicated that patients seeking cosmetic surgery are not as psychologically disturbed as often as described. Comparative studies showed certain personality characteristics to be associated with patients who seek cosmetic surgery. While evaluations 18 months after surgery showed no major personality change, self-concept was improved. Certain disturbing personality patterns indicative of psychological risk were identified. These fell more in the range personality disorders, exemplified by the infantile-narcissistic and the manipulative controlling personalities rather than in somatic ranges. We recommend a simple interview question method of counseling designed to identify underlying psychological manifestations and to control the potential problem patient.
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1. The effect of a number of aromatic polysulphonic acids on the kinetics of haemolysis of rabbit erythrocyte suspensions by crude staphylococcal alpha-toxin was studied at pH8.6 and 6.8. 2. All of the inhibitory compounds caused an increase in the prelytic lag time (tau) of the sigmoid haemolysis curves, an increase in the time to reach 50% haemolysis (t((1/2))) and a decrease in the maximum rate of haemolysis (R(max.)). The most inhibitory compounds caused a 50% decrease in R(max.) at concentrations between 0.1 and 0.2mm. 3. The effect of pH varied considerably: compounds (I) and (II) were almost equally inhibitory at both pH values, compounds (IV) and (IX) were more inhibitory at pH6.8 than at pH8.6, and compounds (VII), (VIII), (X), (XI) and (XII) were more inhibitory at pH8.6. 4. Increased time of premixing alpha-toxin with compound (I) caused increased inhibition. 5. An attempt was made, where possible, to relate the inhibitory activity to the structure of the test compound.
1. Certain aromatic polysulphonic acids, previously tested for inhibition of the haemolytic activity of staphylococcal alpha-toxin, together with some additional related compounds, were tested as possible inhibitors of alpha-toxin in mice. 2. Compounds that inhibited the haemolytic activity of alpha-toxin at concentrations of 0.16mm or less [compounds (I), (II), (IV), (V), (VII) and (VIII)] were found to inhibit the lethal effect of alpha-toxin. 3. With the exception of compound (VIII), amounts of 1mg. were required to inhibit 4 LD(50) of toxin when the test compounds were premixed with alpha-toxin before injection; comparable inhibition with 0.3mg. of compound (VIII) was achieved without prolonged premixing. 4. Mixtures of alpha-toxin and compounds (I) and (II) containing an excess of test compound showed markedly diminished inhibitory activities. 5. The ;half-molecule' analogues of group 1 [compounds (III) and (XVIII)] were non-inhibitory. 6. Compounds (I)-(V), when administered separately from alpha-toxin by the same route (intraperitoneal), were active only when injected almost simultaneously with toxin, whereas compounds (VII) and (VIII) were strikingly inhibitory when injected 15min. before or after the toxin. 7. Compound (VIII) failed to inhibit the lethal effect of alpha-toxin when injected by a different route (intravenous).
This study explores the interrelationships of certain characteristics associated with the elective surgeon's personality. Findings indicate that the very characteristics that distinguish the surgeon's expertise also make it difficult for him to accept the changes that have occurred in the spectrum of modern medicine and the resulting role confusion. Rather than reacting defensively or negatively, this work recommends that the surgeon take an affirmative, assertive approach to the problem.
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Clarithromycin is a macrolide antibiotic similar in structure to erythromycin, but suggested to have fewer drug interactions. Although a pharmacokinetic interaction between clarithromycin and cyclosporine was recently reported, its magnitude and mechanism have not been explored. A 43-year-old renal transplant recipient receiving cyclosporine was treated with clarithromycin because of pneumonia. A cyclosporine pharmacokinetic study was performed 8 days after the initiation of the clarithromycin and 14 days after stopping the drug. Clarithromycin coadministration caused an approximately 2-fold increase in the area under the whole blood concentration versus time curve of cyclosporine. The oral clearance of cyclosporine was halved by clarithromycin, but the terminal elimination rate constant decreased only 15% and mean residence time 20%. These observations suggest that clarithromycin inhibits not only the hepatic metabolism but also the intestinal metabolism of cyclosporine. Caution is advised when administering the two drugs concurrently, and additional studies are necessary to elucidate the mechanism of this interaction.