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Biomedical subjects

C Phillips

Publications and source records attributed to C Phillips.

At least 235 records · Page 13Linked to original sources

Leukemia of non-T lineage natural killer cells.

An unusual case of an aggressive leukemia of natural killer (NK) cells occurred in a 65-year-old male. Clinical characteristics of this case included hepatosplenomegaly, ascites, marrow infiltrate with leukemic cells, and a WBC up to 82.8 X 10(9) before therapy. One year before his presentation he had been noted to have a WBC of 12.1 X 10(9) with 78% lymphocytes, and 6 months before had noted intermittent fever and weight loss. He and his brother had well documented hereditary cold urticaria. The patient was treated with a modification of ProMACE CYTABOM regimen and had prompt regression of the leukemia with associated acute tumor lysis. Renal, hepatic, and marrow failure predominated during a terminal course that ended 22 days after therapy was commenced, and at autopsy there was no evidence for leukemic cell infiltrate in the liver, spleen or marrow. The leukemic cells were large granular lymphocytes by light and electron microscopic criteria, and had the following immunophenotype: CD2+, DR+, Leu7+, NKH1+, CD11+, CD3-, CD5-, CD4-, CD8-, CD16-. The cells displayed high antibody-dependent cell-mediated cytotoxicity (ADCC) and NK activity, and had a high rate of spontaneous proliferation in vitro that was not augmented by phytohemagglutinin (PHA), concanavalin A (Con A), or pokeweed mitogen (PWM). Southern analysis of DNA from leukemic cells revealed normal germline arrangements for the beta and gamma chains of the T cell antigen receptor and immunoglobulin heavy chain genes. The majority of metaphases were clonally abnormal revealing consistent rearrangements involving extra material attached to the long arms of chromosomes 5 and 11.

Aged↗

Stability following superior repositioning of the maxilla by LeFort I osteotomy.

Cephalometric data from 61 patients who had undergone superior repositioning of the maxilla via LeFort I osteotomy by means of the downfracture technique were analyzed to evaluate stability of skeletal and dental landmarks at various time intervals up to 1 year. None of these patients had concurrent mandibular ramus or body osteotomy except genioplasty and all had at least 2 mm intrusion at the maxillary incisor or molar. In approximately 20% of the patients, there was 2 mm (critical value) or more postsurgical movement of skeletal or dental landmarks. During the first 6 weeks postoperatively, the maxilla showed a strong tendency to move farther upward in the patients in whom it was not stable. The posterior maxilla was vertically stable in 90% of the patients, the anterior maxilla in 80%. Horizontally, skeletal landmarks were stable in 80%, but when changes occurred, there was a tendency for the anterior maxilla to move back when it had been advanced. After the first 6 weeks, the posterior maxilla was stable vertically in all patients, but in 20% anterior maxillary landmarks moved downward, opposite to the direction of movement during fixation. In 11 of the 15 patients who demonstrated vertical changes postsurgery, the movement from fixation release to 1 year follow-up was opposite and approximately equal to the initial change, so that the net movement after 1 year was less than 2 mm. Only 6.5% (four patients) demonstrated 2 mm or greater net vertical movement for any of the variables studied 1 year after surgical treatment. There was no indication that the amount of presurgical orthodontic movement of incisors, the presence of multiple segments at surgery, the age of the patient, the presence or absence of genioplasty, or the presence or absence of suspension wires was a risk factor for instability.

Adolescent↗

Functional morphology of insect neuronal cell-surface/glial contacts: the trophospongium.

Ultrastructural studies were carried out on the surfaces of insect nerve cell bodies. Some of the neurons were identified, by using physiological criteria, before filling with dye. Their surface patterns were compared, to provide data needed for understanding dynamic relationships with glial cells, in the trophospongium. The data are also needed in connection with interpretation of electrical signals recorded from the somata and of their roles in integration and in learning and memory. The surfaces were found to be extremely complex and also varied, even for neurons of comparable size and function, as well as for different regions of the same neuron, suggesting that the surface is constantly changing as the neuron receives food and loses waste. There is a variety of cytoplasmic types of invagination of neuron somata by glial processes. The invaginations were classified into four easily recognized types: regular, chunky, filigree, and ridge (present only in axon hillock regions). Motor neurons also make reciprocal invaginations into the glial cells that surround them. Some of these extend for distances up to 40 microns from the surface. The effective surface area is increased, compared with that calculated for a smooth surface, as a result of the invaginations, by from as little as 5% for a small interneuron to as much as 12-fold for a large motor neuron. The axon hillock region of all types of neurons is heavily invaginated.

Animals↗

Analysing access to nursing home care.

The aim of this study is to investigate access to nursing home care in selected regions of Australia, Canada and the United States, and to examine the common ways in which nursing homes are used. Firstly, a review of methodological considerations in measuring access to nursing home care is made. Secondly, patient turnover patterns are interpreted with a view to showing differences in nursing home use among the countries studied; aggregate turnover rates, length of stay and outcomes are compared. Thirdly, groups of patients who differ in demographic and morbidity characteristics and in their use of nursing homes are discussed. Finally a number of distributive implications of these results are raised and a framework is outlined for considering redistributive consequences of changes in the use of nursing homes. It is concluded that the rate of flow of patients through nursing homes is as important a determinant of access to nursing home care as the level of bed provision and that adoption of this dynamic view of access indicates considerable scope for redistributing use of resources within the nursing home systems of all three countries.

Aged↗

Long-term neurosensory deficits following transoral vertical ramus and sagittal split osteotomies for mandibular prognathism.

Twenty-six patients who had been treated for mandibular prognathism by either bilateral sagittal split osteotomy or transoral vertical ramus osteotomy were evaluated by neurosensory examination. Neuropathy was demonstrable in 28.8% of the 52 mental nerves examined. The incidence of neuropathy was significantly higher in the bilateral sagittal split osteotomy group than in the transoral vertical osteotomy group.

Adolescent↗

The relationship between the dentist's year of graduation and ordering of bitewing radiographs.

This article reports the results of a survey of general practice dentists on the relationship of the dentist's year of graduation to the ordering of bitewing radiographs for patients. More recent graduates were more likely to indicate ordering the radiographs at 6-month intervals. There were no differences in ordering associated with the dentist's experience. Shorter intervals between ordering were indicated by all dentists for patient groups at high risk of caries.

Adolescent↗

Age-specific differences in duration of clinical protection after vaccination with meningococcal polysaccharide A vaccine.

Sequential case-control studies were used to monitor changes in the clinical protection induced by group A meningococcal polysaccharide vaccine over a 3-year period. Overall, vaccine efficacy declined from 87% 1 year after vaccination to 70% and 54% at 2 and 3 years, respectively. When stratified by age at time of vaccination the data showed that, although vaccine efficacy remained high in children greater than or equal to 4 years of age (vaccine efficacy 85%, 74%, and 67% at 1, 2, and 3 years after vaccination, respectively), it declined dramatically in those less than 4 years of age at time of vaccination (vaccine efficacy 100%, 52%, and 8%, respectively, at 1, 2, and 3 years after vaccination). Thus, a single dose of group A meningococcal vaccine does not yield lasting clinical protection in children less than 4 years of age.

Adolescent↗

Evaluation of condylar position from temporomandibular joint radiographs.

This investigation evaluated the accuracy of three different transcranial TMJ radiographic records of condylar position and joint space dimension. In addition, the study evaluated how reliably observers determined condylar position and joint space dimensions from the radiographs. The results of this investigation support the following conclusions. The classification of condylar position is not the same at different sagittal locations within a TMJ. Skull position and radiographic projection must be identical if joint space measurements from serial radiographs are to be compared. The actual joint space dimensions and the anatomic anterior/posterior position of the condyles in the glenoid fossae cannot be accurately recorded by the radiographic techniques used in this investigation. Condyle/fossa relationships cannot be classified reliably by subjective evaluation of TMJ radiographs.

Cephalometry↗

A morphometric analysis of the craniofacial configuration in achondroplasia.

Human achondroplasia can be viewed as an experimental model for studying the effects of abnormal endochondral bone formation on the development of the skull as a whole. In this study, lateral cephalograms of 25 adult males and 26 adult females with achondroplasia were converted to a two-dimensional coordinate model of craniofacial morphology and analyzed using 66 linear, angular, and area variables. Lateral cephalograms of 951 normal adults were used for comparison. Two sample t-tests were used to compare achondroplastic cephalograms with normal cephalograms. Multivariate statistical analysis included Hotelling's T2 and discriminant function analysis. Selected variables were graphed as profile patterns in which mean values were expressed as standard deviation units (Z scores) relative to the norm. Finally, Calcomp plots were used for visual inspection and for comparison of the average cephalometric tracings of male and female achondroplastic subjects with normal male and female subjects, respectively. Significant findings in achondroplasia included enlarged calvaria, frontal bossing, large frontal sinuses, occipital prominence, normal anterior cranial base length, strikingly shortened posterior cranial base length, an acute cranial base angle, a short nasal bone that was deformed and depressed, short upper facial height, recessed maxilla, posterior tilt of the nasal floor, and a prognathic mandible that was anteriorly displaced but of normal size with a normal gonial angle and a high coronoid process. The finding of normal anterior cranial base length in achondroplastic subjects was surprising since the cranial base is preformed in cartilage and hypoplasia and shortening would be expected. Since the brain is enlarged in achondroplasia, the expanding frontal lobes may possibly influence the growth of the anterior cranial base, since it is known to follow a neural pattern of growth. Cribriform plate length was strikingly reduced, but anterior sphenoidal length was strikingly increased, compensating for the shortened cribriform plate length and suggesting that growth in the length of the anterior cranial base takes place primarily by adaptation at one site--namely, the sphenoethmoidal synchondrosis. Strikingly short posterior cranial base length was interpreted as resulting from hypoplasia of bone that is preformed in cartilage with possible early closure of the spheno-occipital synchondrosis. The exaggerated closure of the cranial base angle in achondroplasia may be related to an increased brain size and possibly earlier than normal closure of the intersphenoidal synchondrosis.(ABSTRACT TRUNCATED AT 400 WORDS)

Achondroplasia↗

Immunological similarity of milk sulfhydryl oxidase and kidney glutathione oxidase.

A radioimmunoassay for sulfhydryl oxidase, a membrane enzyme, was developed using antibodies raised to the bovine milk enzyme which had been purified by transient covalent affinity chromatography on a cysteinylsuccinamidopropyl-glass matrix. Bovine milk sulfhydryl oxidase and bovine kidney sulfhydryl oxidase ("glutathione oxidase") appear to be immunologically identical as evidenced by parallel responses in radioimmunoassays. Antibodies raised to the purified milk sulfhydryl oxidase can immunoprecipitate glutathione oxidase activity, but not gamma-glutamyltransferase ("transpeptidase") activity, from bovine kidney preparations.

Animals↗