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Biomedical subjects

M E Phillips

Publications and source records attributed to M E Phillips.

At least 55 records · Page 3Linked to original sources
PubMed1983

An evaluation of dental pain using visual analogue scales and the Mcgill Pain Questionnaire.

A verbal and a visual scale to assess pain, the McGill Pain Questionnaire and the Visual Analogue Scales, were administered to 50 patients suffering from pulpitis and 50 patients suffering from pericoronitis. The results show that words chosen to describe dental pain of different etiologies include throbbing, sharp, aching, and annoying. Additional descriptive words used by patients with pulpitis, pericoronitis, and postoperative dental pain are sore and shooting and tender. Women who have pulpitis and pericoronitis report higher levels of pain than do men. The greater sensitivity of the scores obtained from the variables, number of words chosen, and pain rating intensity scale not only showed a significant difference between males and females, but also could distinguish between the two dental conditions. The value of the MPQ as a diagnostic tool in cases where it is difficult to elucidate the cause is limited.

Adult↗
PubMed1983

Histopathology of delayed-onset hypersensitivities in contact-sensitive guinea pigs.

We have studied the specificity of macroscopic responses and the corresponding cellular infiltrates in Giemsa-stained, glycol methacrylate embedded tissue sections of delayed skin reactions elicited by contact sensitizers, homologous and heterologous hapten-protein conjugates, and tuberculin (PPD) in guinea pigs. The animals were sensitized with contact sensitizers emulsified in Freund's complete adjuvant and tested at 19 days and, after repeated contact testing with homologous sensitizer, at 48 days after sensitization. At both times, all delayed reactions contained numerous mononuclear cells. The reactions elicited by contact sensitizer or hapten-protein conjugate also contained significant numbers of basophils which were lacking in PPD reactions. Contact reactions were highly specific macroscopically and microscopically while reactions elicited by conjugates displayed considerable macroscopic and microscopic cross-reactivity. The greater cross-reactivity of conjugate-elicited reactions compared to contact reactions may reflect differences in mechanism of initiation or mediation of these two reactions.

Animals↗
PubMed1983

Heparin inactivation, acidosis and copper poisoning due to presumed acid contamination of water in a hemodialysis unit.

An accident in a hemodialysis unit involving 13 patients is reported. Circumstantial evidence suggests that acid contamination of the water supply to the unit resulted in inactivation of heparin with widespread extracorporeal clotting and secondary copper intoxication which proved fatal in one patient. Serum copper concentrations were raised in 6 of the 11 patients and whole blood copper concentrations were raised in 4 patients. Results of serum ceruloplasmin, whole blood lead and zinc analyses are reported together with tissue analyses for copper in the fatal case. The majority of the patients showed evidence of a metabolic acidosis.

Acidosis↗
PubMed1982

Acute haemolysis due to concentrated dialysis fluid.

Fatal acute haemolysis occurred in a 65-year-old man undergoing regular home haemodialysis for terminal renal failure. Circumstantial evidence indicating that the haemolysis resulted from exposure to concentrated dialysis solution was supported by in-vitro studies. Frank haemolysis in blood samples occurred at a dilution of greater than or equal to 1/2 of dialysis fluid. Osmotic fragility tests of surviving red blood cells showed 47% haemolysis at a dilution of 1/2 and greater than 90% haemolysis at a dilution of 1/1. Urgent design modifications to the proportionating machine are being undertaken to prevent such an accident recurring.

Aged↗
PubMed1982

Prophylaxis against hypomagnesaemia induced by cis-platinum combination chemotherapy.

Hypomagnesaemia is recognised as a feature of the renal tubular defect produced by cis-platinum therapy for cancer. It may be sufficiently severe to cause tetany and grand mal fits. Attempts to correct established hypomagnesaemia whilst continuing cis-platinum therapy have not proved satisfactory. We have therefore investigated the prophylactic addition of 3 g magnesium sulphate to the high-dose platinum regimen with which metastatic malignant teratoma is treated in this unit. Serum magnesium levels have been measured in eight patients treated in this way and compared with those recorded for eight matched patients previously treated without routine magnesium supplements. Magnesium levels fell into the range frequently associated with clinical manifestation in five of the eight unsupplemented patients and only one of those given magnesium prophylactically. Mean serum magnesium levels were significantly higher in the supplemented group when compared using the paired t-test (P less than 0.01). Routine supplementation with intravenous magnesium sulphate is a simple and effective way of preventing symptomatic hypomagnesaemia associated with cis-platinum therapy.

Adolescent↗
PubMed1982

The role of parathyroidectomy in the management of hyperparathyroidism in patients on maintenance haemodialysis and after renal transplantation.

Between March 1964 and March 1980, 36 (34 dialysis, 2 transplant) of 327 patients accepted for the maintenance dialysis/transplantation programme at Charing Cross Hospital were submitted to parathyroidectomy. There were four main indications: persistent hypercalcaemia, progressive phalangeal erosions, aseptic necrosis of the femoral head and height loss with abnormal bone biopsy despite normal hand radiographs. At parathyroidectomy, 4 glands were removed in 1 patient, 3 1/2 glands in 24, 3 glands in 7, 2 glands in 3 and a single large gland in 1 patient. The operation was followed by improvement in 28 patients, no change in 5, and progression of hyperparathyroidism in 3.2 of the 28 patients who improved later relapsed and were treated with 1,25-(OH)2 vitamin D3. 4 patients were submitted to a further parathyroidectomy and improved considerably. We would conclude that, although parathyroidectomy is an effective and safe procedure, it is to be hoped that careful monitoring of bone state and early administration of 1,25-(OH)2 vitamin D3 may reduce the need for parathyroidectomy.

Adult↗
PubMed1982

Immune responses to mouse neuroblastoma C1300. II. Cell-mediated kinetics and specificity studies.

A 51Cr microcytotoxicity assay was used to study the kinetics of lymph-node- and spleen-cell-mediated cytotoxicity of A/JAX hosts following a single inoculum of the in vivo grown syngeneic neuroblastoma C1300. Lymph node cells (LNCs) demonstrated cytotoxicity which peaked at day 9, decreased as the tumor approached the 0.5-gram weight and increased again as the tumors grew. The increase in cytotoxicity following the depressed state was significantly greater than the initial peak, particularly in those mice bearing large tumors. Three groups of A/JAX mice were evaluated: mice receiving tumor cells alone; mice that were either thymectomized or splenectomized prior to inoculation, and mice that rejected the tumor. The C57Bl/6 served as an allogeneic comparison. Significant cytotoxicity was detected earlier with allogeneic LNCs than with spleen cells. Thymectomy and splenectomy elicited syngeneic LNC immune responses below or equal to the level found in nonimmune A/JAX hosts.

Animals↗
PubMed1981

Double-blind trial of oral 1,25-dihydroxy vitamin D3 versus placebo in asymptomatic hyperparathyroidism in patients receiving maintenance haemodialysis.

Fifty-seven patients who had been receiving maintenance haemodialysis for a mean of 4.6 years were given 0.25-0.5 microgram oral 1,25-dihydroxy (1,25-(OH)2) vitamin D3 or a placebo in a double-blind manner for one to two years. In patients with normal radiographs (mean plasma parathyroid hormone concentration 205 microliterEq/ml) 1,25-(OH)2 vitamin D3 prevented the development of the radiological appearances of hyperparathyroidism. In patients with abnormal radiographs (mean plasma parathyroid concentration 709 microliterEq/ml) 1,25-(OH)2 vitamin D3 arrested or reversed the radiological changes of hyperparathyroidism. Nevertheless, the response was slow and the concentration of the hormone remained considerably raised (mean 445 microliterEq/ml). It is concluded from these results that giving 1,25-(OH)2 vitamin D3 to patients receiving maintenance haemodialysis who have normal hand radiographs or minimal erosions is beneficial. In patients with more advanced hyperparathyroidism parathyroidectomy should be considered unless there is a rapid response.

Adult↗
PubMed1981

Characterisation of breast skin temperature rhythms of women in relation to menstrual status.

Circadian breast skin temperature rhythms were characterised throughout the menstrual cycle, for various locations on the left breast of ambulatory women. All subjects exhibited highly significant circadian rhythms (P less than 0.001). Changes in rhythm parameters, such as the mesor, amplitude and acrophase, were observed during the menstrual cycle. No consistent trend in these rhythm parameters was observed between subjects in relation to menstrual cycle stage. Experimental and statistical techniques used to characterise circadian rhythms in pre-menopausal women were applied to a post-menopausal woman with primary breast cancer. Comparison of rhythm parameters associated with the tumour area and corresponding site on the contralateral breast showed abnormal thermal characteristics such as elevated mesor values, decreased amplitude as well as changes in the timing of the acrophase. These properties may be exploited for the early detection of breast cancer. The project also involved the design and testing of an ambulatory device, known as the 'chronobra', for the measurement of breast skin temperature. The performance of the chronobra was in close agreement with reliable, conventional equipment. The chronobra now allows studies of breast skin temperature rhythms associated with breast disease to be extended.

Adolescent↗
PubMed1980

The relationship of perceived latitude of choice to morale in a nursing home environment.

An Importance, Locus and Range of Activities Checklist (The Perceived Latitude of Choice Scale) and the Philadelphia Geriatric Center Morale Scale were administered to 17 institutionalized elderly women. The Perceived Latitude of Choice instrument contained 37 items representing activities of daily life which subjects rated for personal importance and range of choice available. The morale scale contained 17 items presented in a dichotomous format that would indicate high or low morale. A number of positive correlations were observed between morale and perceived degree of choice, with Attitude Toward Own Aging the factor on the morale scale showing the strongest relationships to choice. The degree of choice available for privacy stood out as one of the most important items related to morale. A number of methodological considerations were discussed relating to the use of correlations, restrictions of range of scores and selection of subjects from populations.

Activities of Daily Living↗
PubMed1980

Aminoaciduria in chronic renal failure--its relationship to vitamin D and parathyroid status.

Fractional clearances of amino acids in 24 patients with chronic renal failure indicate that aminoaciduria is common and often severe. Eleven studies have also been carried out in ten patients with stable renal failure before and during treatment with different metabolites of vitamin D. Sequential measurements of fractional clearance of amino acids, plasma 25-hydroxy-vitamin D (25-(OH)D) and serum parathyroid hormone were made. All patients initially had hyperaminoaciduria, secondary hyperparathyroidism and osteomalacia. Treatment with 1,25-dihydroxycholecalciferol (1,25-(OH)2D3) or 1 alpha-hydroxycholecalciferol (1 alpha(OH)D3) significantly improved amino acid reabsorption irrespective of the initial degree of aminoaciduria. Cholecalciferol or 25-hydroxycholecalciferol(25(OH)D3) improved amino acid transport in patients with initially mild hyperaminoaciduria, but not in patients with severe hyperaminoaciduria. Reduction in aminoaciduria during treatment with 25(OH)D3 may have depended on a variable ability to synthesize 1,25(OH)2D3. Changes in amino acid transport did not correlate with changes in serum parathyroid hormone. It is suggested that defective amino acid reabsorption in patients with chronic renal failure is due at least in part to deficiency of 1,25(OH)2D3.

Amino Acids↗
PubMed1980

Enteroviruses in Vermont, 1969-1978: an important cause of illness throughout the year.

Enteroviruses continue to play an important role in both epidemic and sporadic febrile diseases. Of the clinical specimens submitted for diagnosis during a 10-year period (1969-1978) at the Medical Center of Vermont Hospital, Burlington, a wide variety of diseases were associated with the isolation of enteroviruses. Among these diseases were aseptic meningitis, hand-foot-and-mouth disease, diarrhea, pleurodynia, myocarditis, herpangia, and fevers. In 1972 a single enterovirus serotype, coxsackievirus B5, WAS SOLELY RESPONSIBLE FOR EPIDEMIC DISEASE. During the other nine years of the study, a variety of enteroviruses were isolated during epidemics. Although epidemics were always seen during the summer and early fall, enteroviruses which may cause sporadic disease were isolated in each of the 12 months. An awareness by both practicing physicians and health officers not only of the epidemic potential of enteroviruses in summer and fall but also throughout the year will aid in the diagnosis and therapy of these illnesses.

Adolescent↗
PubMed1980

Aminoaciduria--its relationship to vitamin D and parathyroid hormone.

Early reports of patients with metabolic bone diseases such as nutritional osteomalacia, Fanconi syndrome, indicated an association with aminoaciduria. This association has since been described in osteomalacia of G. I. or hepatic origin, secondary to anticonvulsant therapy, tumors, and chronic renal failure. Aminoaciduria also occurs in primary hyperparathyroidism. In nutritional osteomalacia, vitamin D deficiency was thought to be responsible for the renal tubular abnormality, since it responded to treatment with vitamin D. However, since the description of aminoaciduria in hyperparathyroidism, the literature has been divided concerning the etiology of aminoacidura in conditions associated with abnormal vitamin D metabolism because secondary hyperparathyroidism often occurs in these conditions. Recently, some cases of Fanconi syndrome and a case of tumor-associated osteomalacia have been described with low or absent plasma 1,25-dihydroxycholecalciferol levels, normal serum PTH, and aminoaciduria. In one of these cases, and more recently in patients with chronic renal failure, it has been demonstrated that treatment with 1,25(OH)2D3 can improve amino acid transport independently from changes in serum PTH levels. 1,25(OH)2D3 therefore normally opposes the aminoaciduric effect of PTH. This is an agreement with observations which demonstrate that 1,25(OH)2D3 also opposes the phosphaturic action of parathyroid hormone.

Humans↗
PubMed1979

A microcytotoxicity assay using 51Cr for measuring specific cell-mediated and humoral immune responses.

A microcytotoxicity assay (MCA) for measuring in vitro cell-mediated cytotoxicity (CMC) and humoral cytotoxicity which uses 51Cr-labelled target cells is described. Data is presented to show the uptake and rentention of 51Cr by various viable cultured cells. The CMC determined by 51Cr-labelled target cell retention in microtest II plate wells was verified by microscopic observation. Comparisons between the CMC observed 24 and 48 h after incubation of immune and normal lymphoid cells with 51Cr-labelled target cells were made. The factors, including savings in time and expense, which may make this modified MCA superior to other MCAs in use, are discussed.

Animals↗