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Biomedical subjects

J M Phillips

Publications and source records attributed to J M Phillips.

At least 91 records · Page 5Linked to original sources
PubMed1989

The hemodynamic and cardiovascular effects of near-drowning in hypotonic, isotonic, or hypertonic solutions.

It has been postulated that near-drowning in fresh water may cause hemodilution and hypervolemia due to the hypotonicity of the aspirated water. In contrast, near-drowning in seawater, because of its hypertonicity, may lead to hypovolemic shock. We evaluated the hemodynamic effects of the instillation of 20 mL/kg of solutions of various tonicities (sterile water, 0.225% sodium chloride, 0.45% sodium chloride, normal saline, 2% sodium chloride, and 3% sodium chloride) into the lungs of anesthetized dogs and compared the results with those for control animals who were made anoxic for five minutes. There was no difference in the hemodynamic effects of hypotonic, isotonic, or hypertonic solutions when compared with anoxic controls. There was an immediate fall in cardiac output and increase in pulmonary capillary wedge pressure, central venous pressure, and pulmonary vascular resistance, regardless of the solution, which was statistically the same as the changes in the anoxic controls (P greater than .02). Likewise, the effective dynamic compliance of the lungs decreased precipitously, was indistinguishable between solutions, and was not statistically different from the anoxic controls (P greater than .10). The pulmonary capillary wedge pressure and central venous pressure peaked at ten minutes and then declined gradually over four hours independent of the tonicity of the aspirated fluid. The cardiac output and effective dynamic compliance of the lung dropped rapidly and remained depressed throughout the experiment, and the pulmonary vascular resistance gradually worsened throughout the four hours of study. Similar results occurred with the anoxic controls. The cardiovascular changes that occur with near-drowning and aspiration of water are not dependent on the tonicity of the aspirated fluid but are the direct result of anoxia.

Animals↗
PubMed1988

Remission induction in non-Hodgkin lymphoma with reshaped human monoclonal antibody CAMPATH-1H.

A genetically reshaped human IgG1 monoclonal antibody (CAMPATH-1H) was used to treat two patients with non-Hodgkin lymphoma. Doses of 1-20 mg daily were given intravenously for up to 43 days. In both patients lymphoma cells were cleared from the blood and bone marrow and splenomegaly resolved. One patient had lymphadenopathy which also resolved. These effects were achieved without myelosuppression, and normal haemopoeisis was restored during the course of treatment, partially in one patient and completely in the other. No antiglobulin response was detected in either patient. CAMPATH-1H is a potent lympholytic antibody which might have an important use in the treatment of lymphoproliferative disorders and additionally as an immunosuppressive agent.

Aged↗
PubMed1988

The immune response to nematode parasites: modulation of mast cell numbers and function during Strongyloides stercoralis infections in nonhuman primates.

Mucosal mast cell numbers are modulated in the intestines of rodents during parasitic infections. These mast cells can degranulate in response to worm antigens, and this event has been suggested to play a protective role for the host. To examine whether mast cells in higher animals play a role in protecting from disseminated parasitic disease, mast cell numbers and responsiveness to parasite antigens were evaluated in 5 Erythrocebus patas infected with the human intestinal nematode Strongyloides stercoralis. Initial infection and subsequent challenge infections were associated with increase in jejunal histamine and mast cell numbers, and these mast cells could release histamine in response to parasite antigens. Jejunal mast cell numbers returned to normal during a chronic phase of infection. The cells lost their ability to respond to antigenic stimulation following limited steroid treatment. Subsequent activation of chronic infections to fatal disseminated disease by more prolonged steroid treatment was associated with a marked decrease in jejunal mast cell numbers and histamine. In one animal which succumbed to severe disease without steroid treatment, jejunal mast cells were refractory to worm antigens.

Animals↗
PubMed1987

Effects of tonicities of saline solutions on pulmonary injury in drowning.

We studied the degree of pulmonary and hemodynamic compromise induced by six saline solutions of varying tonicities (0%, 0.225%, 0.45%, 0.9%, 2%, and 3%) instilled down the trachea. We also attempted to resuscitate the dogs after a simulated wet drowning in each of the solutions, with and without chlorine. A control study with similar degree of anoxia but no fluid in the lungs was also performed. For the pulmonary variables of alveolar-arterial oxygen pressure difference, intrapulmonary shunt fraction, and PaO2/fraction of inspired oxygen, the 0.225% NaCl solution was significantly (p less than .001) less injurious to the lungs, especially compared with sterile water. The 0.225% and 0.45% NaCl solutions were the least disruptive to pulmonary function; the pulmonary injury they produced was similar to injury in the control dogs. Chlorine in the solution at one to two parts per million did not influence the data. The 0.9% (isotonic, normal saline), 2%, and 3% NaCl drowning solutions showed little difference from one another in terms of pulmonary injury. They were significantly (p less than .05) better than sterile water and significantly (p less than .05) worse than the 0.225% and 0.45% NaCl solutions. Sterile water, whether chlorinated or not, was the most injurious to the lungs. The hemodynamic effects of the drowning solutions were explainable solely by the effects of anoxia.

Animals↗
PubMed1987

American Association of Gynecologic Laparoscopists' 1985 membership survey.

The 1985 membership survey of the American Association of Gynecologic Laparoscopists (AAGL) revealed that the membership performed dramatically fewer laparoscopic sterilizations in 1985 than were reported in any previous AAGL survey. The distribution of laparoscopic sterilizations by method of tubal occlusion has changed, with the percentage of mechanical methods of occlusion showing a relative increase and the percentage of electrocoagulation procedures showing a relative decrease. Whereas bipolar coagulation without division continues to be the most popular technique, only 6% of respondents reported using unipolar coagulation. The data suggest that the relative likelihood of ectopic pregnancy after laparoscopic sterilization may be greater after coagulation methods than after mechanical ones. Members often used conservative surgical approaches to ectopic gestation, with 39% managed with salpingotomy and 7% managed with laparoscopy alone. The likelihood that sterilization reversal would be performed varied by method of occlusion, with reversal most likely to be performed (71%) after spring clip application.

Data Collection↗
PubMed1985

Progesterone, cortisol and oestradiol-17 beta in the initiation of human parturition: partitioning between free and bound hormone in plasma.

The concentrations of total and free progesterone, oestradiol-17 beta, and cortisol were measured in the plasma of 24 pregnant women from 10-17 days prepartum, during labour, and for 2-3 days postpartum. All the women were delivered vaginally, and their hormonal profiles were similar, whether they initiated labour spontaneously (n = 11) or were induced by rupture of the fetal membranes (n = 13). Before labour, the plasma concentrations of total radioimmunoassayable progesterone, oestradiol-17 beta and cortisol were 557.3 (SEM 70.3) nmol/l and 590.0 (SEM 76.7) nmol/l, 94.3 (SEM 18.7) nmol/l and 111.6 (SEM 19.8) nmol/l, and 1087.2 (SEM 103.7) nmol/l and 1020.7 (SEM 100.7) nmol/l, for the spontaneous and induced groups, respectively. During labour progesterone and oestradiol-17 beta declined in maternal plasma to around 130 nmol/l and 30 nmol/l in both groups by the end of the third stage. The free fractions of progesterone and oestradiol-17 beta remained constant throughout labour and over the entire study period at 2-3% and 1-2%, respectively. Total plasma cortisol rose to 1243.7 (SEM 83.3) nmol/l (P less than 0.02, spontaneous group) and 1247.5 (SEM 97.4) nmol/l (P less than 0.001, induced group) by the end of the first stage of labour. Concomitantly, free cortisol increased from 4.5-5.5% to 7.2-8.2% over this period so that its concentration increased by approximately 2.5-fold in both groups of women during labour. We conclude that the total and physiologically-active free concentrations of progesterone and oestradiol-17 beta in maternal plasma do not change immediately before the onset of labour.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

1983 AAGL survey. Professional profile of the membership. AAGL Research and Survey Committee.

The average AAGL physician does general obstetrics and gynecology, with 135 deliveries, 41 hysterectomies and 38 IUD insertions a year in addition to about 50 laparoscopies for sterilization and 43 for diagnosis. About 1 in 10 will experience a major complication, and 1 in 25 will undergo medicolegal actions, although their complication rates as a group are no higher than those of the total membership.

Gynecology↗
PubMed1985

[Esophageal rupture as a complication of the use of a Sengstaken-Blakemore tube].

We are describing a complication of the usage of Sengstaken-Blakemore tubes. Premature inflation of the gastric balloon in the esophagus can lead to rupture of the esophagus. This hazard can be avoided by checking the position of the tube with a chest radiograph before attempting to inflate the tamponading balloons.

Esophageal and Gastric Varices↗
PubMed1984

The neurotoxicity of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine in the monkey and man.

1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) selectively destroys dopaminergic neurons in the pars compacta of the substantia nigra (A8 and A9 cells). MPTP or its metabolite enters nerve cells at the level of their terminals in the caudate nucleus and putamen leading to a disturbance in axoplasmic flow and retrograde degeneration. The species-dependent neurotoxicity of MPTP (primate vs. rodent) suggests that a biochemical property of the cell related to neuromelanin may be important in the mechanism of cell injury.

1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine↗
PubMed1984

Tubal sterilizations performed in freestanding, ambulatory-care surgical facilities in the United States in 1980.

In 1981 the American Association of Gynecologic Laparoscopists and the Division of Reproductive Health, Centers for Disease Control, jointly conducted a study of tubal sterilizations performed in 141 freestanding, ambulatory-care surgical facilities in 1980 in the United States. Information was collected through mailed questionnaires and telephone interviews. Of 330 potential responding facilities, 141 we identified as freestanding, ambulatory-care surgical facilities. About 16,500 tubal sterilizations were performed in these facilities in 1980. The mean number of tubal sterilizations per freestanding, ambulatory-care surgical facility was 212. Sixty-seven percent of tubal sterilizations were performed in the south and west. General anesthesia was the anesthetic method used in 97% of the procedures. Nearly 91% of tubal sterilizations were done via laparoscopy, with bipolar electrocoagulation the tubal-occlusion method used most frequently. After tubal sterilization the patients were observed for an average of 2.4 hours before discharge. The average cost of laparoscopic tubal sterilization was $801; for nonlaparoscopic tubal sterilization it was $850.

Adult↗
PubMed1984

American Association of Gynecologic Laparoscopists' 1982 membership survey.

A survey of 1,024 U.S. members of the American Association of Gynecologic Laparoscopists (AAGL) concerning 1982 practice revealed that 125,560 laparoscopic sterilizations had been performed. The bipolar method was the most frequent one, used by 65%. The band was used by 21%, the clip by 4% and the unipolar method by 11%. Local anesthesia was used in 4% of cases and open laparoscopy in 4%. No correlation was possible between technique used and the incidence of hemorrhage (0.45 per 1,000), bowel injury (0.42 per 1,000), postoperative pelvic infection (0.42 per 1,000) or anesthetic complications (0.16 per 1,000).

Anesthesia↗
PubMed1983

Prediction and prevention of child abuse--an empty hope?

The effectiveness of the use of objective data available at birth to predict and prevent child abuse was assessed in a group of 2802 non-Asian infants born in Bradford in 1979. Two-thirds of the actual abuse occurred in the 18% predicted to be at risk, but supportive measures did not prevent abuse. Those who needed and received the most attention from social workers and health visitors fared worst. Other indices suggested poor parenting in the at-risk families. Child abuse seems to be predictable but prevention is more difficult.

Child Abuse↗
PubMed1983

Categorization of pediatric neoplasms by immunostaining with antiprekeratin and antivimentin antisera.

Forty-six tumors in children were examined using light microscopy and subsequently frozen sections were stained with antiprekeratin and antivimentin antisera, so that the tumors could be classified by tissue of origin. Except for two adrenal cortical carcinomas and four liver tumors, most epithelial neoplasms continued to produce prekeratin filaments, a characteristic of normal epithelial cells. Tumors and cells of epithelial origin did not produce vimentin filaments, whereas normal and neoplastic mesenchymal cells did. Tumors with both epithelial and mesenchymal components produced vimentin filaments in mesenchymal areas and prekeratin in epithelial areas. Tumors of lymphoid origin showed variable production of vimentin filaments, depending on the amount of cell cytoplasm, but did not contain prekeratin filaments. Of the neuroectodermal tumors, only the ganglioneuroma contained vimentin filaments and none contained prekeratin filaments. Thus, antibodies to both prekeratin and vimentin filaments are useful in diagnosing childhood neoplasms and studying their histogenesis.

Child↗
PubMed1982

Metabolic clearance rate and plasma half-life of radioiodinated corticotropin releasing factor in a primate.

Corticotropin releasing factor (CRF) has recently been identified, purified and shown to be a 41-amino acid polypeptide that stimulates secretion of beta-endorphin and ACTH. The metabolic clearance rates (MCR) of I125-CRF and I125-TyroCRF were measured in cynomologus monkeys using the pulse injection and the continuous infusion methods. Hunter-Bolton reagent was used for iodination of CRF and the chloramine-T method for Tyro-CRF. Gel chromatography was used to separate free iodine (and radioiodinated small fragments) from iodinated CRF in plasma samples. Disappearance of I125-CRF or I125-Tyro-CRF could be modeled with two components (bi-exponential). Plasma half-life of I125-CRF was 17.1 +/- 2.44 min (mean +/- SE, n=4) for the fast component and 198 +/- 5.3 min for the slow component. The MCR of I125-CRF using the pulse injection technique was 0.44 +/- 0.06 L/Kg/d, n=4 and the volume of distribution 213.5 +/- 12 ml, n=4, roughly equal to the plasma volume. Continuous infusion of I125-CRF and of I125-Tyro-CRF gave MCR's ranging between 2.23 -= 5.08 L/Kg/d, n=4. I125-ACTH MCR, measured for comparison using the same technique, was 5-10 fold higher. Thus, the plasma half-life of CRF is longer than for all other known hypothalamic peptides and its metabolic clearance rate relatively low and considerably less all other known hypothalamic peptides and its metabolic clearance rate relatively low and considerably less than that of ACTH. Strong binding of CRF to plasma proteins may be responsible for the small volume of distribution and lower MCR values for the pulse injection method.

Adrenocorticotropic Hormone↗
PubMed1981

Ion diffusion modified by tortuosity and volume fraction in the extracellular microenvironment of the rat cerebellum.

1. The validity of the macroscopic laws of ion diffusion was critically examined within the microenvironment of the extracellular space in the rat cerebellum using ion-selective micropipettes and ionophoretic point sources. 2. The concepts of volume averaging, volume fraction (alpha) and tortuosity (lambda) were defined and shown to be theoretically appropriate for quantifying diffusion in a complex medium such as the brain. 3. Diffusion studies were made with the cations tetramethylammonium and tetraethylammonium and the anions alpha-naphthalene sulphonate and hexafluoro-arsenate, all of which remained essentially extracellular during the measurements. Diffusion parameters were measured for a period of 50s and over distances of the order of 0.1 mm. 4. Measurements of the diffusion coefficients of the ions in agar gel gave values that were very close to those derivable from the literature, thus confirming the validity of the method. 5. Measurements in the cerebellum did not reveal any systematic influences of ionophoretic current strength, electrode separation, anisotropy, inhomogeneity, charge discrimination or uptake, within the limits tested. 6. The pooled data from measurements with all the ions gave alpha = 0.21 +/- 0.02 (mean +/- S.E. of mean) and lambda = 1.55 +/- 0.05 (mean +/- S.E. of mean). 7. These results show that the extracellular space occupies about 20% of the rat cerebellum and that the diffusion coefficient for small monovalent extracellular ions is reduced by a factor of 2.4 (i.e. lambda 2) without regard to charge sign. The over-all effect of this is to increase the apparent strength of any ionic source in the cerebellum by a factor of lambda 2/alpha, about 12-fold in the present case, and to modify the time course of diffusion. 8. These conclusions confirm that the laws of macroscopic diffusion are closely obeyed in the cerebellum for small ions in the extracellular space, provided that volume fraction and tortuosity are explicitly taken into account. It is likely that these conclusions are generally applicable to other brain regions and other diffusing substances.

Animals↗