Biomedical subjects
Publications and source records attributed to H Phillips.
A microcomputer based system has been designed to obtain spatial information for orthopaedic measurements, using three potentiometers as the transducer. Both hardware and software are described, including algorithms for converting the raw data to lengths and angles in three dimensional space.
An electrocardiographic-triggered radiographic technique for obtaining a single image of the heart at both end-systole and end-diastole was used in conjunction with upright bicycle exercise to detect stress-induced changes in 1) systolic and diastolic cardiac transverse diameter, and 2) regional motion of the free left ventricular wall. Twenty-one patients were studied; 10 had normal coronary arteries and 11 had significant coronary artery disease. Twenty patients (10 with normal coronary arteries and 10 with coronary artery disease) also had multigated radionuclide blood pool scans at rest and with exercise. All patients without coronary disease showed a decrease in systolic cardiac transverse diameter with exercise and a slight increase in amplitude of motion of the left ventricular free wall. Eight (73%) of the 11 patients with coronary artery disease showed an increase in systolic transverse cardiac diameter with exercise (p less than 0.001), and 5 developed either new regional left ventricular asynergy or deterioration of segments with rest asynergy. Eight of the 10 patients with coronary artery disease who had rest and exercise radionuclide scans had an abnormal ejection fraction response to exercise. However, only 4 of the 10 control patients who had multigated scans had a normal ejection fraction response, although all showed normal regional wall motion with exercise. This new approach is inexpensive and easily performed. These preliminary data suggest that it may be a useful adjunct to cardiac stress testing and is worthy of further study.
The hairless mouse was used to investigate the effects of a combination of glucocorticosteroid with either dithranol or tar on epidermal DNA synthesis, in order to determine whether such combinations reduce epidermal DNA synthesis more effectively than the single agents. Dithranol alone produced a significant local inhibition of DNA synthesis at concentrations of 0.1% and 0.05% but not at lower concentrations. Dose-response data for dilutions of clobetasol propionate and betamethasone 17-valerate showed progressive diminution of both local and systemic effects with decreasing concentrations. An additive effect was found from combining clobetasol propionate with dithranol and from combining betamethasone 17-valerate with liquor picis carbonis. These combined preparations were tested again after storage for 6 months and 2 months respectively and showed no loss of efficacy. These results lend justification to the use of these combined preparations in the treatment of psoriasis.
We analyzed the clinical outcomes in 688 patients with isolated stenosis of one major coronary artery. The survival rate among patients with disease of the right coronary artery (RCA) was higher than that among patients with left anterior descending (LAD) or left circumflex coronary artery (LCA) disease. The survival rate among patients in all three anatomic subgroups exceeded 90% at 5 years. The presence of a lesion proximal to the first septal perforator of the LAD was associated with decreased survival compared with the presence of a more distal lesion. For the entire group of one-vessel disease patients, total ischemic events (death and nonfatal infarction) occurred at similar rates regardless of the anatomic location of the lesion. Left ventricular ejection fraction was the baseline descriptor most strongly associated with survival, and the characteristics of the angina had the strongest relationship with nonfatal myocardial infarction. No differences in survival or total cardiac event rates were found with surgical or nonsurgical therapy. The relief of angina was superior with surgical therapy, although the majority of nonsurgically treated patients had significant relief of angina. The survival rate of patients with one-vessel coronary disease is excellent, and the risk of nonfatal infarction is low. Clinical strategies for the care of these patients must consider the long-term clinical course of one-vessel coronary disease.
To determine a schedule for continuous suppression of epidermal cell DNA synthesis, 0.05% fluocinonide ointment was applied either twice daily or once on alternate days to hairless mouse skin for 174 hours. Suppression occurred similarly for both regimens for 78 hours followed by an increase in DNA synthesis despite continued application of fluocinonide. The systemic effect was less marked with the alternate-day schedule. The effect of a single application of the fluocinonide ointment was also studied over 174 hours. Substantial inhibition of DNA synthesis occurred but for a shorter period followed by an increase and then return to normal values. Experiments were performed where second applications were made at various time intervals after the first. These did not appear to affect events until 192 hours had elapsed, when a second application caused profound inhibition of DNA synthesis once more.
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The clinical and pathological features of a tumor of the temporamandibular joint occurring in a 55 year old man, and subsequently identified as a calcium pyrophosphate dihydrate (CPPD) arthropathy, are reported. Crystalline deposits were identified by compensated light microscopy and confirmed with X-ray diffraction, transmission, and scanning electron microscopy. The relationship of this unique case to other clinical presentations of CPPD deposition disease and the implications of the histological features to the pathogenesis of pseudogout are discussed. This case demonstrates that CPPD arthropathy should be included in the differential diagnosis of an arthrosis or of a tumor involving the temporomandibular joint.
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Eighty-three Walldius arthroplasties, performed by one surgeon as salvage operation on the knee joint between 1966 and 1972, were independently reviewed. The fifty-seven living patients with sixty-seven arthroplasties were interviewed and examined and the clinical records of the deceased patients were inspected. Sixty-seven arthroplasties (81 per cent) were successful and sixteen failed (19 per cent). Acrylic cement was used to secure the prosthesis on eight occasions only. There were two primary infections (2-4 per cent) and two delayed (2-4 per cent). Major loosening occurred in three arthroplasties (3-6 per cent). Minor loosening was compatible with a good result. Arthrodesis was successful on the two occasions on which it became necessary to remove the implant. There were no disasters. On the basis of these results it is considered that the Walldius arthroplasty can justifiably be offered as an alternative to primary arthrodesis of the knee.
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A pilot study has shown that there is usually but not invariably a fall in systemic arterial blood pressure within 90 seconds of implanting acrylic cement into the femoral shaft during hip arthroplasty. There is usually no change in arterial blood pressure on implanting acrylic cement into the acetabulum. The observed hypotension may be due to absorption of monomer or additives into the circulation, but the role of other factors needs investigation.
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