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J H Prystowsky

Publications and source records attributed to J H Prystowsky.

30 records · Page 2Linked to original sources
PubMed1992

MD-PhDs in dermatology.

A national survey was conducted to explore ways in which MD-PhDs in dermatology balance their research and clinical interests and the factors that influenced their career decisions. A questionnaire was mailed to all MD-PhDs who were affiliated with dermatology training programs as determined by a preliminary study. The survey consisted of a questionnaire about research background, career pathway, attitudes about personal and professional issues, and influence of residency training program on career decision making. From 60 MD-PhD dermatologists surveyed, 43 (72%) completed questionnaires. Eighty percent of the respondents (34 of 43) held positions in academic medicine; 76% entered dermatology with the intent to pursue academic medicine. Almost all (93%) held academic positions immediately after residency; 50% held positions with the title of assistant professor or higher as their first postresidency employment. Only 26% of the respondents received funding for their MD-PhD through the federally funded Medical Scientist Training Program. Fifty percent of the respondents completed their training with loans. Despite the long period of training and expense required for the dual career, a high percentage (80%) stayed in academic dermatology suggesting that they are an important source for supplying physician-scientists to the field of dermatology. The ability to limit patient care responsibilities and maintain protected time for research may be a factor responsible for the high percentage of MD-PhDs that stay in academic dermatology.

Age Factors↗
PubMed1992

Factors influencing the pursuit of careers in academic medicine: a survey of MD-PhD residents in dermatology programs in the United States.

A survey of all MD-PhD residents in dermatology in the United States was conducted to evaluate the factors important to them in making career pathway decisions. Twenty-six MD-PhDs responded to the survey representing a 90% response rate. Although essentially all entered dermatology with the intention of pursuing a career in academic medicine, 77% percent thought they would be in academic medicine 5 years post-residency. Factors explored for a negative influence on entrance into academic medicine post-residency were 1) financial concerns, 2) length of training, 3) research hiatus due to clinical training, and 4) eligibility for existing funding mechanisms.

Academic Medical Centers↗
PubMed1991

Acitretin plus UVB therapy for psoriasis. Comparisons with placebo plus UVB and acitretin alone.

UVB radiation is beneficial for the treatment of psoriasis vulgaris. Patients with recalcitrant disease, however, are slow to respond to UVB phototherapy with and without the use of coal tars or emollients. Etretinate and, more recently, acitretin have proved useful, but clinical improvement is slow when they are used as monotherapy in plaque psoriasis. Each drug also produces side effects, some of which are dose related. This study was designed to compare results of treatment with UVB combined with either acitretin (50 mg/day) or placebo to determine if psoriasis would respond faster and to less cumulative exposure to UVB and acitretin. The psoriatic disease cleared to a greater degree in patients treated with acitretin-UVB with fewer treatments and smaller amounts of UVB radiation than in patients treated with either placebo-UVB or acitretin alone.

Acitretin↗
PubMed1989

Treatment of cutaneous granulocytic sarcoma in a patient with myelodysplasia.

In this report, we have presented our experience with a patient with a rare cutaneous granulocytic sarcoma. In addition to hematoxylin and eosin, myeloperoxidase stain and specific stains for lysozyme and esterase were helpful in confirming the histologic diagnosis of granulocytic sarcoma. Despite multiple attempts to control this patient's tumor by conservative surgery, radiation therapy, and chemotherapy, we eventually had to resort to limb amputation. This procedure restored a meaningful quality of life to this patient for one and a half years prior to the development of acute leukemia. Treatment with corticosteroids at the time of surgery may have prevented a local recurrence of granulocytic sarcoma despite positive tissue margins. Our experience underscores the importance of directing treatment toward the granulocytic sarcoma whereas the myelodysplasia concurrently present may not require therapy for several years.

Amputation, Surgical↗
PubMed1989

Pityriasis rubra pilaris: a review of diagnosis and treatment.

The diagnosis of pityriasis rubra pilaris is based essentially on characteristic clinical features. Although the histologic features are not pathognomonic, a lesional skin biopsy for evaluation is important to rule out other papulosquamous and erythematous disorders. The presence of prominent seborrheic keratoses occurring in two cases of pityriasis rubra pilaris is presented. Our understanding of the relationship between vitamin A metabolism and pityriasis rubra pilaris is discussed. Currently available systemic therapeutic modalities for pityriasis rubra pilaris are reviewed. Although pityriasis rubra pilaris does not represent a vitamin A deficiency state, it is responsive to isotretinoin, etretinate, and vitamin A. Antimetabolites remain an alternative therapy.

Aged↗
PubMed1989

Present status of pyoderma gangrenosum. Review of 21 cases.

This article summarizes the management of 22 cases of pyoderma gangrenosum over the past four years at the hospital of the University of Pennsylvania, Philadelphia. Eighteen patients with pyoderma gangrenosum were studied using the most sensitive routine laboratory method for detection of monoclonal immunoglobulins, immunofixation electrophoresis. Four cases of IgA gammopathy were detected, confirming previous reports of the incidence of monoclonal gammopathy in pyoderma gangrenosum. High-dose glucocorticoid therapy (pulse therapy) is an effective treatment for some severe, refractory cases of pyoderma gangrenosum. Eight patients were treated with pulse therapy. Six responded favorably, and none had serious complications.

Adrenal Cortex Hormones↗
PubMed1988

Keratinocyte urokinase-type plasminogen activator is secreted as a single chain precursor.

Urokinase-type plasminogen activator (uPA) is produced and secreted by cultured human keratinocytes as a single chain precursor. UPA in keratinocyte conditioned medium is not susceptible to inhibition with diisopropylfluorophosphate (DFP), and it has an apparent molecular weight of 55 kD under both reducing and nonreducing conditions. Cleavage of keratinocyte uPA by plasmin results in the formation of a 96 kD complex comprised of activated uPA and PA inhibitor 2. PA extracted from normal human epidermis is only partially inhibited by DFP, suggesting that precursor uPA is also present in vivo. The synthesis of uPA as a precursor with reduced enzymatic activity as well as decreased affinity for inhibitors is likely to be a mechanism by which normal epidermis regulates plasminogen activation in vivo.

Cells, Cultured↗
PubMed1984

Rat liver retinyl palmitate hydrolase activity. Relationship to cholesteryl oleate and triolein hydrolase activities.

Studies were conducted to explore relationships in rat liver between retinyl palmitate hydrolase activity and the hydrolytic activities against cholesteryl oleate and triolein. Previous studies have shown positive correlations between these three lipid ester hydrolase activities. In order to extend this work, the hydrolase activities were further purified and characterized. The activities against cholesteryl oleate and triolein resembled retinyl palmitate hydrolase activity in showing great variability from rat to rat as assayed in vitro. The relative levels of the three activities were highly correlated with each other over a 50-fold range of activity in a series of 66 liver homogenates. Partial purification (approx. 200-fold) in the absence of detergents was achieved by sequential chromatography of an acetone powder extract of liver on columns of phenyl-Sepharose, DEAE-Sepharose and heparin-Sepharose. The three hydrolase activities copurified during each of these chromatographic steps. The properties of the three copurifying activities were similar with regard to stimulation of activity by trihydroxy bile salts, pH optimum (near 8.0), and observance of Michaelis-Menten-type saturation kinetics. The three activities were different in their sensitivity towards the serine esterase inhibitors diisopropylfluorophosphate and phenylmethanesulfonyl fluoride, and in their solubility properties in 10 mM sodium acetate, pH 5.0. Thus, triolein hydrolase activity was much less sensitive than the other two activities to the two inhibitors. In addition, the activity against cholesteryl oleate could be separated from the other two activities by extraction of an acetone powder with acetate buffer, pH 5.0. These results indicate that the three lipid hydrolase activities are due to at least three different catalytically active centers, and at least two distinct and separable enzymes. It is likely that three separate but similar enzymes, that appear to be coordinately regulated, are involved.

Animals↗