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Biomedical subjects

C Phillips

Publications and source records attributed to C Phillips.

At least 145 records · Page 8Linked to original sources
PubMed1995

Recounts of elderly deaths: endorsements for the Patient Self-Determination Act.

Circumstances in the last 3 days of life were examined for a sample of 1,227 elderly decedents in Fairfield County, Connecticut, in 1985. Interviews were with a surviving next-of-kin or a nonrelative about 3 months after the event of death. Most decedents were in a hospital or a nursing home the night before death (45% and 24%, respectively). In the days preceding death, about 34% of the decedents knew that death was impending and about 40% had difficulty recognizing family members. These and other findings support the need for elderly people to complete advance directives.

Advance Directives↗
PubMed1995

Evaluation of the use of orthodontic records to measure the width of keratinized tissue.

Understanding the gingival tissue response in patients undergoing orthodontic treatment requires accurate pretreatment measurements of the width of the attached and keratinized tissue. Even though these may not be routinely recorded, it has been suggested that the orthodontic records can provide an accurate method of assessing the pretreatment keratinized tissue width. This clinical study was conducted to compare measures of the width of the keratinized tissue calculated from intraoral photographs and study models with direct clinical measures. Maxillary and mandibular study models and intraoral photographs were obtained from 33 patients. The width of the keratinized gingiva facial to the mandibular incisors was measured on two occasions to the nearest 0.5 mm. The width of the gingiva was calculated for the same teeth from two measures taken from projected photographic slides and the study models using a modification of Coatoam's technique. The method error was determined to be 0.43 mm for clinical measures and 0.32 mm for the calculated gingival tissue width. The reliability of measurement from orthodontic records was slightly greater than direct clinical measurement, with intraclass correlations of 0.93 and 0.90, respectively. The differences between the averaged clinical measure and averaged calculated measure for each tooth were small and not statistically significant (paired t-test, P = 0.21, 0.66, 0.24, 0.24 for teeth 23 through 26 respectively). The results indicate that carefully taken photographic slides and study models can provide an accurate measure of keratinized tissue width.

Adolescent↗
PubMed1995

An unusual foreign body in the hand: delayed presentation of an intact human tooth. A case report.

A 44 year old man presented with a painful, swollen right hand 10 days after a brawl. A radiography showed an intact human tooth embedded in the soft tissue between the metacarpals of the middle and index fingers. The tooth was removed, and the wound debrided and left to heal by second intention. He made a complete recovery. This case emphasizes the importance of a plain radiography, particularly when skin has been breached, and of removal and adequate debridement. Our patient was lucky to have had a successful outcome after so long a delay in treatment.

Adult↗
PubMed1995

In vitro and in vivo validation of time domain velocity and flow measurement technique.

This study was undertaken to validate the time domain processing method for measuring (1) the peak velocity in comparison to pulsed-wave spectral Doppler findings in an in vitro system; (2) the volumetric flow in comparison to the actual flow measured by a graduated cylinder in an in vitro circulation; and (3) the volumetric flow in comparison to a transit time flowmeter in a permanently instrumented neonatal lamb model. A prototype implementation of time domain processing in a commercial ultrasound device was used. For velocimetry, both time domain processing and Doppler methods showed low variance, low intrarater variability (0.03 and 0.09%, respectively), high reliability coefficients (97% and 96%, respectively), and a significant correlation (r = 0.96; P < 0.001). For in vitro flow quantification, time domain processing and graduated cylinder methods showed low variance, low intrarater variability (0.09 and 0.01%, respectively), high reliability coefficients (99.60% and 99.96%, respectively), and a significant correlation (r = 0.98, P < 0.001). For in vivo flow quantification, time domain processing and transit time flowmeter showed a significant correlation (r = 0.96; P < 0.001). Within the limits of the in vitro and in vivo experimental conditions, this study proves the validity of the time domain processing sonographic technique for measuring peak flow velocity and volumetric flow.

Analysis of Variance↗
PubMed1995

The impact of transrectal ultrasound on stage migration in a predominantly African-American population.

An important question left unanswered is whether transrectal ultrasound will result in earlier diagnosis in African Americans. Tumor registry data for 1985 and 1990 for a predominantly African-American population were reviewed to determine whether transrectal ultrasound influenced the stage at diagnosis of prostate cancer. Diagnosis by ultrasound increased from 0% to 60% of cases in those 5 years. Curable diseases (stages A and B) increased from 38% to 57% of cases. It is concluded that transrectal ultrasound can increase the diagnostic yield of potentially curable disease in a predominantly African-American population.

Aged↗
PubMed1995

Non-invasive management of organic impotence.

OBJECTIVE: To establish the efficacy of a vacuum device (ErecAid) in the management of organic impotence. DESIGN: Cohort study; questionnaire before and after a 6-month study period. SETTING: Groote Schuur Hospital, Cape Town. PARTICIPANTS: A total of 19 men with organic impotence, 8 diabetic and 11 with previous pelvic surgery or radiotherapy. INTERVENTION: Vacuum device (ErecAid, Osbon Medical Systems). OUTCOME MEASURE: Efficacy of ErecAid. RESULTS: Six of 8 diabetics and 6 of 11 non-diabetics reported successful intercourse, while 16 of the participants would recommend the device to others. Some difficulty with the device was experienced by 11 and only 9 described an increase in self-esteem. CONCLUSION: Although some difficulties may be experienced in the use of the ErecAid, it clearly has a role to play in the management of patients with organic impotence, who ideally should be able to select their preferred form of therapy.

Adult↗
PubMed1995

Perception of facial attractiveness by patients, peers, and professionals.

Self-perception of facial attractiveness of 19 women (15 with Class II malocclusion and four with Class I malocculsion) was compared to the perceptions of the patient's peers, five orthodontists, and five oral surgeons. Each respondent ranked a set of four standardized facial photographs of each patient from most (1) to least (19) attractive. A surgical treatment plan was recommended for all of the Class II patients. However, only nine accepted surgery; six elected to undergo camouflaging orthodontics only. There was a statistically significant difference in the distribution of ranks given to the Class I, Class II camouflage-only, and Class II surgery groups by the panels. Overall, the Class I patients were judged most attractive. The Class II patients who elected to undergo orthodontics only were given mid-ranks, and the patients who elected surgery were ranked least attractive, although the distributions for overjet, point A-nasion-point B, and motivations for treatment were similar in the two groups. The distribution of self-ranks given by the patients were not significantly different among the three groups, although than the Class II patients perceived themselves as less attractive than the Class I patients.

Adult↗
PubMed1995

Long-term stability of two-jaw surgery for treatment of mandibular deficiency and vertical maxillary excess.

Changes in cephalometric landmark positions and relationships were evaluated more than 5 years postsurgically in 26 patients whose long-face condition had been treated with a combination of superior repositioning of the maxilla and mandibular advancement. All the patients had a least 2-mm surgical intrusion of the maxilla and 2-mm lengthening of the mandible with wire osteosynthesis, maxillomandibular fixation, and skeletal suspension wires. On the average, a small amount of downward and backward rotation of the mandible occurred long term. The mean change in overjet was less than 1 mm. Most of the changes occurred in a minority of the patients: 20% of the group had 2 to 4-mm downward movement of menton, and the mandibular plane angle increased more than 2 degrees in 25% of the patients. On clinical evaluation, a tendency toward opening of the bite beyond 1 year postsurgery was noted in 5 of the 26 patients (19%), and one patient had a greater than 4-mm decrease in overbite. The condylion-pogonion distance decreased 2 to 4 mm in three patients, two of whom had shown greater than 4-mm shortening of this distance during the first postsurgical year. It appears that long-term shortening of the condylar process is not a highly prevalent problem, but changes of 2 to 4 mm in condylion-pogonion associated with modest clinical relapse may occur beyond 1 year postsurgery in 5 to 10% of these two-jaw surgery patients.

Adolescent↗
PubMed1994

An investigation of the HUMVWA31A locus in British Caucasians.

A number of short tandem repeat (STR) loci are currently being examined for their usefulness as markers of identity; HUMVWA31A is one such locus. We used a high-sieving agarose technique to type 200 British Caucasians for this locus. Comparison of the resultant allele frequencies with other published databases showed that their distributions were similar. Observed heterozygosity was similar to that reported in other population studies but significantly lower than expected. A goodness of fit analysis of observed and expected genotypes was highly significant, suggesting a deviation from Hardy-Weinberg equilibrium, although reports from other populations appeared not to show such differences. The possibility that mistyping had led to an erroneous statistic was investigated by detailed examination of samples within our own laboratory and in two other laboratories, involving verification of the agarose typing by both automated fluorescent detection techniques, and sequencing. Other reported deviations from Hardy-Weinberg equilibrium in STR systems are discussed.

Alleles↗
PubMed1994

Crystallographic study of coenzyme, coenzyme analogue and substrate binding in 6-phosphogluconate dehydrogenase: implications for NADP specificity and the enzyme mechanism.

BACKGROUND: The nicotinamide adenine dinucleotide phosphate (NADP)-dependent oxidative decarboxylase, 6-phosphogluconate dehydrogenase, is a major source of reduced coenzyme for synthesis. Enzymes later in the pentose phosphate pathway convert the reaction product, ribulose 5-phosphate, to ribose 5-phosphate. Crystallographic study of complexes with coenzyme and substrate explain the NADP dependence which determines the enzyme's metabolic role and support the proposed general base-general acid mechanism. RESULTS: The refined structures of binary coenzyme/analogue complexes show that Arg33 is ordered by binding the 2'-phosphate, and provides one face of the adenine site. The nicotinamide, while less tightly bound, is more extended when reduced than when oxidized. All substrate binding residues are conserved; the 3-hydroxyl of 6-phosphogluconate is hydrogen bonded to N zeta of Lys183 and the 3-hydrogen points towards the oxidized nicotinamide. The 6-phosphate replaces a tightly bound sulphate in the apo-enzyme. CONCLUSIONS: NADP specificity is achieved primarily by Arg33 which binds the 2'-phosphate but, in its absence, obscures the adenine pocket. The bound oxidized nicotinamide is syn; hydride transfer from bound substrate to the nicotinamide si- face is achieved with a small movement of the nicotinamide nucleotide. Lys183 may act as general base. A water bound to Gly130 in the coenzyme domain is the most likely acid required in decarboxylation. The dihydronicotinamide ring of NADPH competes for ligands with the 1-carboxyl of 6-phosphogluconate.

Animals↗
PubMed1994

Overexpression in Escherichia coli and purification of the 6-phosphogluconate dehydrogenase of Trypanosoma brucei.

The gene encoding 6-phosphogluconate dehydrogenase (EC 1.1.1.44) from Trypanosoma brucei was cloned into the overexpression vector pET3a which utilizes the T7 polymerase gene expression system. Up to 40% of total cell protein consisted of the trypanosome enzyme when expression was induced in Escherichia coli host strains at 28 degrees C. The enzyme was rapidly degraded at temperatures higher than 30 degrees C. The T. brucei enzyme was purified to near homogeneity (as judged by SDS-polyacrylamide gel electrophoresis) using a two-step purification method, involving a DE-52 cellulose batch preparation followed by 2' AMP-agarose affinity chromatography. The purified protein crystallized readily. A molecular model of the trypanosome enzyme based on its mammalian counterpart revealed differences between the two enzymes in residues involved in cofactor binding.

Animals↗
PubMed1994

Level of agreement in clinicians' perceptions of Class II malocclusions.

To evaluate the extent to which surgeons and orthodontists agree on the nature and severity of dentofacial problems requiring orthognathic surgery, three clinicians active in a specialized clinic for treatment of dentofacial deformities scored the pretreatment records of 37 adult class II patients. Each clinician first indicated whether a skeletal/dental problem existed in the maxilla and mandible and then rated the severity of the problem on a visual analog scale. The level of agreement among the three clinicians was highest for dental problems and lowest for skeletal anteroposterior measures. There was a significant difference among the clinicians in the percentage of patients identified as having a retrusive midface and excessive facial thirds. The agreement on the severity of the problem was generally low even for those patients for whom the clinicians agreed on the type of problem. The data suggest that personal experience and clinical background play a major role in diagnosis and treatment planning. Joint treatment planning conferences between the surgeon and orthodontist offer an opportunity for different plans to be discussed, with the preferred treatment option selected for an individual patient.

Adolescent↗
PubMed1994

Lumbar vertebral and femoral neck bone mineral density are higher in postmenopausal women with the alpha 2HS-glycoprotein 2 phenotype.

alpha 2HS-glycoprotein (AHSG) is a plasma protein which becomes concentrated in the organic matrix of bone. The two most common alleles, AHSG*1 and AHSG*2, give rise to three common phenotypes. A recent report showed that a group of postmenopausal white North American women with different AHSG phenotypes differed significantly with respect to their oestrogen status. We have studied variations in bone mineral density, measured by DEXA, and levels of sex hormones and biochemical markers of bone metabolism in a group of 88 post-menopausal women unselected as to their health status. Lumbar vertebral and femoral neck bone mineral density (BMD), and the free oestradiol index were all significantly higher (P < 0.05) in women with the AHSG 2 phenotype. Values of these three parameters were lowest in the AHSG 1 phenotype and intermediate in the AHSG 2-1 phenotype. Because the differences in BMD between the AHSG 2 and 1 phenotypes represent at least a 40% difference in fracture risk, the AHSG phenotype may be of some clinical relevance as a risk factor for osteoporosis.

Aged↗
PubMed1994

Skeletal jaw relationships: a quantitative assessment using elliptical Fourier functions.

Elliptical Fourier functions (EFF) were generated for the boundary outlines of the hard tissue craniofacial complex including the maxilla, mandible, and cranial base in order to quantitatively describe adult patients (n = 98) who were initially classified into nine skeletal groups by a combination of conventional cephalometric measures and clinical judgement. The mean residual fit of the EFF-predicted points and the original digitized data for the individual subjects ranged from .42 mm to .61 mm with a mean of .52 mm suggesting an accurate fit. Visual inspection of the individual plots confirmed this. Predicted classifications from a step-wise discriminant analysis based on EFF amplitudes were compared with the original classifications. The discordance rates for A-P and vertical plane classification were 21% and 13% respectively with an overall discordance rate of 33%. In general, a cluster analysis using EFF amplitudes did not identify clusters very similar in membership to the original groups; however, it was marginally successful in identifying members of the more severe groups and, like discriminant analysis, appeared to be more sensitive to vertical morphological differences. The overall lack of agreement between classifications and clusters based on EFF amplitudes and the original classifications may indicate that traditional skeletal categories such as those used in this study do not actually represent discrete groups.

Adolescent↗