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Biomedical subjects

M D Paul

Publications and source records attributed to M D Paul.

15 recordsLinked to original sources
PubMed2001

The evolution of the brow lift in aesthetic plastic surgery.

For nearly 100 years, aesthetic improvement of the aging face has included surgical elevation of the brow. Early attempts to correct brow ptosis were largely unsuccessful. Recognizing the need to modify the frown muscles heralded the achievement of results previously unobtainable. Within the past decade, the minimal incision approach to brow lifting afforded with the endoscope radically changed surgical options in forehead rejuvenation. Further advances have added to these options and have provided a palette of alternatives in aesthetic correction of the upper one-third of the aging face.

Eyebrows↗
PubMed1990

Charcot-Marie-Tooth disease and nephropathy in a mother and daughter with a review of the literature.

We report a mother-and-child combination of Charcot-Marie-Tooth disease and nephropathy. The mother received a cadaveric renal transplant, and the daughter has heavy proteinuria with normal glomerular filtration rate. There have been 7 single case reports of both disease entities and 1 report of 3 patients which includes the only sib pair. The related literature is reviewed.

Adolescent↗
PubMed1990

Comparison of urinary tract infection in calcium oxalate and calcium phosphate stone formers.

To compare the frequency of urine infection in calcium oxalate and calcium phosphate stone formers, we reviewed charts from patients whose last renal stone submitted for analysis was predominantly composed of calcium phosphate in 118 and of calcium oxalate in 223. Positive cultures were commoner, but not significantly, in the phosphate than the oxalate stone formers, both in men (17 vs. 7.6%) and women (22 vs. 15%). Bacteria frequently producing urease were found in only 4% of the phosphate group. Urine leucocytes were slightly more frequent in the oxalate group for men and significantly so for women. The results do not support the concept that calcium phosphate stones are mainly due to infection with urease-producing or other bacteria.

Calcium Oxalate↗
PubMed1989

Contrast material-induced renal failure in patients with diabetes mellitus, renal insufficiency, or both. A prospective controlled study.

To determine the risk of nephrotoxicity induced by the infusion of radiographic contrast material, we undertook a prospective study of consecutive patients undergoing radiographic procedures with intravascular contrast material. There were three study groups: patients with diabetes mellitus and normal renal function (n = 85), patients with preexisting renal insufficiency (serum creatinine level, greater than or equal to 150 mumol per liter) without diabetes (n = 101), and patients with both diabetes and renal insufficiency (n = 34). The control group consisted of patients undergoing CT scanning or abdominal imaging procedures without the infusion of contrast material who had diabetes mellitus (n = 59), preexisting renal insufficiency (n = 145), or both (n = 64). Clinically important acute renal failure (defined as an increase of greater than 50 percent in the serum creatinine level) attributable to the contrast material did not occur in nondiabetic patients with preexisting renal insufficiency or in diabetics with normal renal function. The incidence of clinically important contrast-induced renal failure among the diabetic patients with preexisting renal insufficiency was 8.8 percent (95 percent confidence interval, 1.9 to 23.7 percent), as compared with 1.6 percent for the controls. The incidence of acute renal insufficiency, more broadly defined as an increase of greater than 25 percent in the serum creatinine level after the infusion of contrast material, was 11.8 percent among all patients with preexisting renal insufficiency. After the exclusion of patients whose acute renal insufficiency could be attributed to other causes, the incidence was 7.0 percent (95 percent confidence interval, 3.2 to 12.8 percent), as compared with 1.5 percent in the control group. The risk of acute renal insufficiency attributable to the contrast material was therefore 5.5 percent, and the relative risk associated with the infusion of contrast material was 4.7. These rates were similar whether the osmolarity of the contrast material was high or low. We conclude that there is little risk of clinically important nephrotoxicity attributable to contrast material for patients with diabetes and normal renal function or for nondiabetic patients with preexisting renal insufficiency. The risk for those with both diabetes and preexisting renal insufficiency is about 9 percent, which is lower than previously reported.

Clinical Trials as Topic↗
PubMed1989

The surgical management of upper eyelid hooding.

A technique is described that aesthetically corrects brow ptosis and upper eyelid hooding in selected patients. This procedure is performed through a standard upper eyelid blepharoplasty incision and addresses the common findings of soft tissue fullness below the brow due to excessive suborbicularis fat and hypertrophied orbicularis oculi muscle.

Blepharoptosis↗
PubMed1987

The effect of ethanol on serum cyclosporine A levels in renal transplant recipients.

Following an alcohol binge, cyclosporine A (CyA) levels rose by 100% in a 51-year-old transplant recipient treated with CyA. As CyA and ethanol are both metabolized by the cytochrome P-450 enzyme system, ethanol could theoretically interfere with CyA metabolism. Therefore, eight male renal transplant recipients were assessed in a crossover study to determine the effects of acute ethanol ingestion on CyA serum concentrations. CyA serum concentrations did not rise following 50 mL of 100% alcohol. We conclude that heavy alcohol intake may increase CyA levels but that acute moderate intake does not.

Adult↗
PubMed1987

Staphylococcal epidermidis infection of a hemodialysis button-graft complex controlled by vancomycin for 11 months.

A 54 year old woman had a Bentley DiaTAP button implanted in her thigh for hemodialysis access. She had been started on continuous ambulatory peritoneal dialysis (CAPD) because of intractable vascular access problems. Unfortunately, CAPD had to be discontinued because of fungal peritonitis. Transplantation had not been possible because of circulating cytotoxic antibodies. The prosthetic complex soon became infected with Staphylococcus epidermidis and blood cultures were intermittently positive for 11 months. However, with continuing vancomycin therapy she remained in her usual state of health, without side effects from vancomycin, until venous thrombosis resolved and it became possible to remove the infected prosthetic complex and implant a button in an arm. As a last resort, it may be possible to maintain a patient on dialysis in reasonable health with a DiaTAP button graft complex infected with Staphylococcus epidermidis and intermittent positive blood cultures using long term vancomycin therapy. Such management probably would not be appropriate for any other organism.

Arteriovenous Shunt, Surgical↗
PubMed1986

Influence of mannitol and dopamine on renal function during elective infrarenal aortic clamping in man.

The impact of elective infrarenal aortic clamping on parameters of renal function was evaluated in 27 extracellular fluid volume expanded patients. Significant transient decreases (p less than 0.05) in glomerular filtration rate were observed in all three groups either in the early or late post-clamp release period, despite maintenance of hemodynamic stability. This study documents transient decreases in glomerular filtration rate which occurred following release of the infrarenal aortic cross-clamp. No clinically important benefit from the use of mannitol and dopamine over extracellular fluid volume expansion with saline alone was demonstrated in the prevention of the changes in renal function associated with aortic cross-clamping.

Adult↗
PubMed1986

The outcome and complications of the DiaTAP bioCarbon button-graft vascular access device in haemodialysis patients: a two-year experience.

The outcome and complications which developed in 8 hemodialysis patients who received 12 DiaTAP bioCarbon button vascular-access devices were reviewed. All patients had a poor vascular access history. Three of twelve devices have been replaced because of thrombosis and two because of infection. Four patients have had 10 episodes of reduced blood flow. Streptokinase infusion into the DiaTAP button led to improved blood flow in 8 of 10 episodes. The 6-month survival rate of the DiaTAP access device was 67% and the average functioning life was 9.4 months. It was a valuable form of access when others had failed.

Adolescent↗
PubMed1985

Primary breast reconstruction with a subpectoral silicone tissue expander.

A Silastic tissue expander inserted subpectorally at the time of modified radical mastectomy has provided early development of the reconstructive envelope, thereby simplifying matching of the contralateral breast. Significant emotional support for the woman faced with imminent loss of her breast has been repeatedly observed. The early interaction of general and plastic surgeons in the management of breast cancer has been found to be beneficial to both patients and physicians.

Adult↗
PubMed1977

Subcellular effect of cytochalasin B and dimethylsulfoxide on Paramecium aurelia.

Paramecium aurelia syngen 4, stock 57 (sensitve) cultivated in Cerophyl infusion were exposed to cytochalasin B (CB) and dimethylsulfoxide (DMSO), the solvent for CB, to distinquish between the effects of these agents on a cellular system. DMSO significantly inhibited survival, fission rate,, [3H]leucine incorporation, and cell size. CB-treated cells generally and slower division and poorer survival rates than cells exposed to the equivalent DMSO concentration, although the [3H]leucine incorporation was generally greater at the lower CB concentrations than for DMSO alone. As seen by electron microscopy and a new glycerination technic for observing polysomes, DMSO caused nuclear (nucleolar, chromatin) abnormalities as well as membrane degradation and polysomal breakdown: CB caused the formation of aberrant membrane structures and ribosomal tetramers, crystals, and tubes.

Animals↗
PubMedDate not supplied

Subperiosteal transblepharoplasty forehead lift.

Contemporary options for correction of the aging upper one-third of the face include open techniques with a coronal or anterior hairline incision, endoscopic access to the forehead including muscle transection, brow lift through direct forehead skin excision and various forms of brow-pexies. Realizing the common need for aesthetic improvement in the upper eyelids and desiring minimal incisions for forehead rejuvenation, an approach through the blepharoplasty incision has been developed which addresses all of the components of the aging upper third of the face: A combined subperiosteal approach for forehead elevation and transection of corrugator and procerus muscles through the blepharoplasty incision is presented. The postoperative improvements in the position of the brow as well as improvement in the glabellar area rivals other approaches and allows simultaneous improvement in upper eyelid aesthetics.

Dermatologic Surgical Procedures↗