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Biomedical subjects

M J Phillips

Publications and source records attributed to M J Phillips.

At least 37 records · Page 2Linked to original sources

In vivo expression profile of an endothelial nitric oxide synthase promoter-reporter transgene.

Endothelium-derived nitric oxide (NO) is primarily attributable to constitutive expression of the endothelial nitric oxide synthase (eNOS) gene. Although a more comprehensive understanding of transcriptional regulation of eNOS is emerging with respect to in vitro regulatory pathways, their relevance in vivo warrants assessment. In this regard, promoter-reporter insertional transgenic murine lines were created containing 5,200 bp of the native murine eNOS promoter directing transcription of nuclear-localized beta-galactosidase. Examination of beta-galactosidase expression in heart, lung, kidney, liver, spleen, and brain of adult mice demonstrated robust signal in large and medium-sized blood vessels. Small arterioles, capillaries, and venules of the microvasculature were notably negative, with the exception of the vasa recta of the medullary circulation of the kidney, which was strongly positive. Only in the brain was the reporter expressed in non-endothelial cell types, such as the CA1 region of the hippocampus. Epithelial cells of the bronchi, bronchioles, and alveoli were scored as negative, as was renal tubular epithelium. Cardiac myocytes, skeletal muscle, and smooth muscle of both vascular and nonvascular sources failed to demonstrate beta-galactosidase staining. Expression was uniform across multiple founders and was not significantly affected by genomic integration site. These transgenic eNOS promoter-reporter lines will be a valuable resource for ongoing studies addressing the regulated expression of eNOS in vivo in both health and disease.

Animals↗

Multiple sclerosis, dental caries and fillings: a case-control study.

OBJECTIVES: To investigate the association between multiple sclerosis, dental caries, amalgam fillings, body mercury and lead. DESIGN: Matched case-control study. SETTING: Leicestershire in the years 1989-1990. SUBJECTS: Thirty-nine females with multiple sclerosis (of recent onset) were matched with 62 controls for age, sex and general practitioner. METHODS: Home interview of cases and controls within which there was an assessment of the DMFT index and blood and urine mercury and lead levels. RESULTS: The odds of being a MS case increased multiplicatively by 1.09 (95% CI 1.00, 1.18) for every additional unit of DMFT index of dental caries. This represents an odds ratio of 1.213 or a 21% increase in risk of MS in relation to dental caries in this population. There was no difference between cases and controls in the number of amalgam fillings or in body mercury or lead levels. There was a significant correlation between body mercury levels and the number of teeth filled with amalgam (controls: r = +0.430, P = 0.006, cases: r = +0.596, P = 0.001). CONCLUSION: There was evidence of excess dental caries among MS cases compared with the controls. This finding supports the strong geographical correlation between the two diseases. A further study of this association is recommended.

Adult↗

The nucleocapsid protein of murine hepatitis virus type 3 induces transcription of the novel fgl2 prothrombinase gene.

Using a set of parental and recombinant murine hepatitis virus strains, we demonstrate that the nucleocapsid protein induces transcription of the novel fgl2 prothrombinase gene and elevated procoagulant activity in those strains that produce fulminant hepatitis. Chinese hamster ovary cells cotransfected with a construct expressing nucleocapsid protein from susceptible strains and with a luciferase reporter construct containing the fgl2 promoter showed a 6-fold increase in luciferase activity compared with nontransfected cells or cells cotransfected with a construct expressing nucleocapsid protein from resistant strains. Two deletions found at coding sites 111-123 and 1143-1145 of structural domains I and III, respectively, of the nucleocapsid gene may account for the differences between pathogenic and nonpathogenic strains. Preliminary mapping of the fgl2 promoter has defined a region from -372 to -306 upstream from the ATG translation initiation site to be responsive to nucleocapsid protein. Hence, mapping of genetic determinants in parental and recombinant strains demonstrates that the nucleocapsid protein of strains that induce fulminant hepatitis is responsible for transcription of the fgl2 prothrombinase gene. These studies provide new insights into the role of the nucleocapsid gene in the pathogenesis of viral hepatitis.

Animals↗

Lymphocyte targeting of the brain in adoptive transfer cryolesion-EAE.

Lymphocyte infiltration and microglial activation in experimental autoimmune encephalomyelitis (EAE) are mainly centred on the spinal cord. However, a cryolesion to one cerebral hemisphere (cryolesion-EAE) induces six-fold enhancement of EAE in the cerebral hemispheres and removal of the cervical lymph nodes reduces such enhancement by 40 per cent. This study tests the hypothesis that lymphocytes from donor rats with cryolesion-EAE will selectively target the brain rather than the spinal cord when transferred to naive recipients. Acute EAE was induced in 15 Lewis rats (donors); ten donors received a cryolesion to the left cerebral hemisphere 8 days post-inoculation of antigen and adjuvant. Five rats with EAE received no cryolesion. Lymphocytes from cryolesion-EAE donors or from EAE-only donors were cultured for 72 h in medium containing myelin basic protein and then injected into a total of 21 naive recipients, which were killed 8 days later. The severity of EAE in brains and spinal cords was assessed in immunocytochemically stained sections by quantifying the number of vessels showing lymphocyte cuffs (W3/13 antibody) and the level of MHC class II antigen expression by microglia (OX6 antibody). When compared with recipients of EAE-only donor lymphocytes, the severity of cerebral EAE was increased 2- to 2.6-fold in the recipients of crylesion-EAE donor lymphocytes (p < 0.01); EAE in the spinal cord was reduced. These results suggest that lymphocytes from cryolesion-EAE donors preferentially target the brain in recipient animals in preference to the spinal cord. By analogy with cryolesion-EAE, focal central nervous system (CNS) damage with drainage of auto-antigens to regional lymph nodes in man may play a role in determining the site and timing of initial and recurrent multiple sclerosis lesions.

Acute Disease↗

Buspirone treatment of alcoholism: age of onset, and cerebrospinal fluid 5-hydroxyindolacetic acid and homovanillic acid concentrations, but not medication treatment, predict return to drinking.

Disturbances in central nervous system serotonin (5-HT) have been implicated in the pathophysiology of alcoholism. To test the hypothesis that increasing 5-HT function could promote treatment compliance, we randomized patients who had completed a 5-week inpatient treatment program for alcoholism to receive either buspirone or placebo for 1 year. Ten of the 49 patients remained in the study for the entire year. The days to relapse did not differ significantly between patients receiving buspirone or placebo. Regardless of the medication, late-onset alcoholics had a longer time to relapse than early-onset alcoholics. Cerebrospinal fluid showed that patients with high concentrations of both the 5-HT metabolite, 5-hydroxyindoleacetic acid, and the dopamine metabolite, homovanillic acid, were more likely to relapse, compared with patients with low concentrations of cerebrospinal fluid 5-hydroxyindoleacetic acid and homovanillic acid.

Adult↗

Prospective comparison of whole-blood- and plasma-based hepatitis C virus RNA detection systems: improved detection using whole blood as the source of viral RNA.

We previously demonstrated that whole blood contains significantly more hepatitis C virus (HCV) RNA than plasma. To validate the whole-blood-based HCV RNA detection method, a prospective comparison of HCV RNA detection in whole blood and plasma from 50 patients with chronic liver disease was undertaken. Whole-blood and plasma aliquots were independently tested for HCV RNA by reverse transcriptase (RT) PCR assay, and plasma was tested by the Roche Amplicor assay. HCV RNA was detected in 35 of 50 (70%) whole-blood samples by RT-PCR but in only 26 of 50 (52%) plasma samples tested by the Amplicor assay (P < 0.01). HCV RNA was detected in 85% of HCV antibody-positive patients by the whole-blood method compared with 74% of plasma samples by the Amplicor method. The five HCV antibody-positive subjects who were negative by whole-blood-based RT-PCR assay were all receiving interferon therapy and had normal transaminases at the time of testing. HCV RNA was detected in 38% of HCV antibody-negative subjects by the whole-blood-based RT-PCR assay compared with 6.25% of these patients by the Amplicor assay (P < 0. 05). There were nine samples in which HCV RNA was detected in whole blood but the Amplicor test was negative. Eight of the nine RNAs prepared from these whole-blood samples tested positive in the Amplicor assay, thus confirming the specificity of our results. This study demonstrates that whole-blood-based HCV RNA detection is more sensitive than currently available commercial tests and that whole-blood RNA is suitable for use in commercial assays.

Cloning, Molecular↗

A new technique for determining proper mechanical axis alignment during total knee arthroplasty: progress toward computer-assisted TKA.

Successful total knee arthroplasty (TKA) relies on proper positioning of prosthetic components to restore the mechanical axis of the lower extremity. This report presents and analyzes a new noninvasive method using the Optotrack (Northern Digital Inc, Ontario, Canada) to accurately determine the center of the femoral head. This method, together with direct digitization of the bony landmarks of the knee and ankle intraoperatively, permits placement of the lower extremity in proper alignment intraoperatively. It also permits the surgeon to follow all the angles of movement or rotation and all displacements that occur at each step of the operative procedure. knee intraoperatively via a customized Windows-based program. In addition to presenting our first case, which, importantly, represents the first computer-assisted TKA in a patient, we report on the accuracy and reproducibility of the technique for locating the center of the femoral head obtained during an extensive series of cadaver studies. Location of the femoral head, a major aspect of effecting neutral mechanical axis alignment, appears to be possible to within 2-4 mm, which corresponds to an angular accuracy of better than 1 degree. This method requires no computed tomography scans or other preliminary marker placement. The only basic requirement other than the instrumentation described is a freely mobile hip, which is generally present in TKA patients.

Arthroplasty, Replacement, Knee↗

Ribavirin inhibits viral-induced macrophage production of TNF, IL-1, the procoagulant fgl2 prothrombinase and preserves Th1 cytokine production but inhibits Th2 cytokine response.

Ribavirin, a synthetic guanosine analogue, possesses a broad spectrum of activity against DNA and RNA viruses. It has been previously shown to attenuate the course of fulminant hepatitis in mice produced by murine hepatitis virus strain 3. We therefore studied the effects of ribavirin on murine hepatitis virus strain 3 replication, macrophage production of proinflammatory mediators including TNF, IL-1, and the procoagulant activity (PCA), fgl2 prothrombinase; and Th1/Th2 cytokine production. Although ribavirin had inhibitory effects on viral replication (<1 log), even at high concentrations complete eradication of the virus was not seen. In contrast, at physiologic concentrations (up to 500 microg/ml), ribavirin markedly reduced viral-induced parameters of macrophage activation. With ribavirin treatment, the concentrations of PCA, TNF-alpha and IL-1beta all decreased to basal concentrations: PCA from 941 +/- 80 to 34 +/- 11 mU/10(6) cells; TNF-alpha from 10.73 +/- 2.15 to 2.74 +/- 0.93 ng/ml; and IL-1beta from 155.91 +/- 22.62 to 5.74 +/- 0.70 pg/ml. The inhibitory effects of ribavirin were at the level of gene transcription as evidenced by Northern analysis. Both in vitro and in vivo, ribavirin inhibited the production of IL-4 by Th2 cells, whereas it did not diminish the production of IFN-gamma in Th1 cells. In contrast, ribavirin had no inhibitory effect on TNF-alpha and IL-1beta production in LPS-stimulated macrophages. These results suggest that the beneficial effects of ribavirin are mediated by inhibition of induction of macrophage proinflammatory cytokines and Th2 cytokines while preserving Th1 cytokines.

Animals↗

Effect of interferon therapy on hepatitis C virus RNA in whole blood, plasma, and peripheral blood mononuclear cells.

Fifty-two patients with chronic hepatitis C virus (HCV) infection were treated with standard doses of interferon alfa-2b. During treatment, HCV RNA detection was studied in samples of whole blood (WB), plasma (Pl), and peripheral blood mononuclear cells (PBMCs). Individuals were classified as sustained responders (SRs), complete responders with relapse (CRs), partial responders (PRs), or nonresponders (NRs) according to normalization of serum alanine transaminase (ALT) during treatment and follow-up. Before treatment, 100% of WB samples and more than 95% of Pl and PBMC samples were positive for HCV RNA. During treatment, there was progressive clearance of HCV RNA from Pl and PBMCs in SRs and CRs, but CRs had significantly more positive WB samples during and following treatment (P <.0001). At 6 months, only 10% of CR patients were positive by Pl assay, but 50% were positive by WB assay (P <.01). In the PR group, all WB samples remained positive throughout treatment, although 25% to 40% of PBMC and Pl samples became negative for HCV RNA during the first 2 months of therapy (WB > Pl or PBMC; P < .001). However, at later times during treatment most Pl and PBMC samples in the PR group were positive. Samples from the NR group showed no clearance of HCV RNA from WB, Pl, or PBMC fractions. These data document the increased sensitivity of WB assays for detecting HCV RNA in the peripheral blood of patients during interferon therapy. Furthermore, our findings suggest that WB analysis of HCV RNA may be a useful parameter to monitor in determining the end point of interferon therapy.

Adult↗

A survey of lead-based paint abatement projects performed in public buildings in Erie and Crawford Counties, Pennsylvania, during the time period 1995-1997.

A survey of lead-based paint abatement projects in public buildings of Crawford and Erie Counties, Pennsylvania, was conducted during the time period January 1995 to March 1997. These survey results suggest that few lead abatement projects were performed during this time period. Projects that were performed commonly did not employ proper lead abatement practices as described by the U.S. Occupational Safety and Health Administration, U.S. Environmental Protection Agency, and U.S. Department of Housing and Urban Development. These data suggest that most contractors and public officials have misunderstandings of both environmental regulations and required procedures for safe and effective lead-based paint abatement.

Air Pollution, Indoor↗

Expression of the fgl2 and its protein product (prothrombinase) in tissues during murine hepatitis virus strain-3 (MHV-3) infection.

Murine Hepatitis Virus Strain 3 (MHV-3) produces fulminant hepatitis with 80-90% mortality in Balb/cJ mice. Previous studies in our laboratory have shown that peritoneal macrophages from MHV-3 infected mice produce a procoagulant (PCA) which has the ability to cleave prothrombin to thrombin (prothrombinase) encoded by the gene fgl2 located on chromosome 5. PCA accounts for sinusoidal thrombosis and hepatic necrosis and the necrosis and mortality can be prevented by treatment of animals with a monoclonal antibody to PCA. These present studies were designed to examine the expression of this gene (mRNA by Northern analysis and in situ hybridization) and the gene product PCA (immunochemistry) in tissues recovered from MHV-3 infected Balb/cJ mice in an attempt to explain the liver specific nature of MHV-3 disease. Fgl2 gene expression was detected as early as 8 hours after MHV-3 infection which persisted to 48 hours in the liver, spleen and lungs whereas no gene expression was seen in the brain or kidneys despite the fact that equivalent viral titers were detected in all tissues at all times. In the liver, fgl2 gene expression was confined to endothelial and Kupffer cells with no expression in hepatocytes. Immunochemistry localized the PCA protein to Kupffer cells and endothelial cells and necrotic foci within the liver. No PCA protein was detected by immunochemistry in any other tissues at any time during the course of MHV-3 infection. These results explain the liver specific nature (fulminant hepatitis) of MHV-3 infection and provides further evidence for the role of PCA in the pathogenesis of fulminant hepatitis. MHV-3 induces selective transcription of the gene fgl2 and only hepatic reticuloendothelial cells produce functional protein (PCA) which is known to account for fulminant hepatic failure produced by MHV-3.

Animals↗

Stenting therapy for stenosing airway diseases.

Tracheobronchial stents have proved very valuable in the management of airway stenosis due to a variety of causes, both benign and malignant. These include benign strictures which are post-traumatic (e.g. after intubation), post anastomotic (e.g. after lung transplantation), or post inflammatory (e.g. after inflammatory conditions such as tuberculosis or Wegener's granulomatosis); as well as narrowing due to malignant involvement of large airways. In addition, airway stents have been used to treat tracheobronchomalacia and oesophageal-airway fistulae. The insertion of the stent may need to be combined with other procedures such as airway dilatation, laser photocoagulation, brachytherapy or a mixture of these treatment modalities. Stents have been fashioned out of silicone, wire mesh or a combination of these materials, but the perfect stent has yet to be devised. Common problems include displacement and obstruction with secretions or granulation tissue. Less commonly the stent may perforate the airway wall, sometimes into the accompanying blood vessel. Nonetheless, airway stents are valuable tools in the management of airway narrowing.

Bronchial Diseases↗

Resistance to murine hepatitis virus strain 3 is dependent on production of nitric oxide.

The strain-specific spectrum of liver disease following murine hepatitis virus type 3 (MHV-3) infection is dependent on inflammatory mediators released by macrophages. Production of nitric oxide (NO) by macrophages has been implicated in resistance to a number of viruses, including ectromelia virus, vaccinia virus, and herpes simplex virus type 1. This study was undertaken to define the role of NO in MHV-3 infection. Gamma interferon-induced production of NO inhibited growth of MHV-3 in a murine macrophage cell line (RAW 264.7). Viral inhibitory activity was reproduced by the NO donor S-nitroso-N-acetyl-DL-penicillamine (SNAP), whereas N-acetyl-DL-pencillamine (NAP), an inactive analog of SNAP, had no effect. Electron microscopy studies confirmed the inhibitory effects of NO on viral replication. Peritoneal macrophages isolated from A/J mice known to be resistant to MHV-3 produced a fivefold-higher level of NO and higher levels of mRNA transcripts of inducible NO synthase in response to gamma interferon than macrophages from susceptible BALB/cJ mice. SNAP inhibited growth of MHV-3 in macrophages from both strains of mice to similar degrees. In vivo inhibition of NO by N-monomethyl-L-arginine resulted in loss of resistance to MHV-3 in A/J mice. These results collectively demonstrate a defect in the production of NO in macrophages from susceptible BALB/cJ mice and define the importance of endogenous NO in resistance to MHV-3 infection in resistant A/J mice.

Animals↗

Role of cervical lymph nodes in autoimmune encephalomyelitis in the Lewis rat.

Lymphocytes enter the central nervous system (CNS) in response to virus infections and in autoimmune diseases, such as multiple sclerosis (MS), but the origin of such lymphocytes is unclear. This study investigates the role of the cervical lymph nodes as a source of lymphocytes involved in experimental autoimmune disease of the brain. Acute active experimental autoimmune encephalomyelitis (EAE) is used as a model for the autoimmune aspects of MS and is characterized by lymphocyte and monocyte invasion and microglial activation, mainly in the spinal cord, 12-15 days post-inoculation (dpi) of antigen. Few lesions occur in the cerebral hemispheres in acute EAE, but a cryolesion to the surface of the brain 8 dpi results in a six-fold enhancement of cerebral EAE. The present study tests the hypothesis that cervical lymphadenectomy will reduce the enhancement of cerebral EAE induced by a cryolesion. Acute EAE was induced in 25 Lewis rats and a cryolesion to the brain, 8 dpi, in 16 rats was immediately followed by either cervical lymphadenectomy (n = 8) or sham lymphadenectomy (n = 8). The severity of EAE at 15 dpi, in the brain and spinal cord, was evaluated using immunocytochemistry for T lymphocytes (W3/13) and MHC class II expression (OX6). The results of the study showed that cervical lymphadenectomy reduced the level of cerebral EAE induced by a cryolesion by 40 per cent when compared with the sham-operated animals (P < 0.01). This suggests that cervical lymph nodes play a pivotal role in the induction of EAE in the brain, possibly as a site for 'priming' T cells to target the brain. Investigation of the interrelationships between cervical lymph nodes and the brain in man may lead to new therapeutic strategies for multiple sclerosis.

Animals↗

Large adrenal cysts in teenage girls: diagnosis and management.

Large adrenal cysts usually occur in the fifth and sixth decades of a patient's life but are rare in the first two decades. This paper presents the clinical, cross-sectional imaging, surgical, pathological and follow-up data of three teenage girls with large adrenal cysts. Two had vague upper abdominal pain and, in the other, the cyst was found incidentally. The cysts were surgically removed in two patients, while in the third, follow-up imaging has shown no change in the cyst over a 4-year period, suggesting that conservative management is a reasonable option.

Adolescent↗

Biliary atresia: should all patients undergo a portoenterostomy?

PURPOSE: The management of noncorrectable extra hepatic biliary atresia includes portoenterostomy, although the results of the surgery are variable. This study was done to develop criteria that could successfully predict the outcome of surgery based on preoperative data, including percutaneous liver biopsy, allowing a more selective approach to the care of these babies. METHODS: The charts and biopsy results of 31 patients who underwent a Kasai procedure for biliary atresia between 1984 and 1994 were reviewed. Values for preoperative albumin, bilirubin, age of patient at Kasai, and lowest postoperative bilirubin were recorded. Surgical success was defined as postoperative bilirubin that returned to normal. A pathologist blinded to the child's eventual outcome graded the pre-Kasai needle liver biopsy results according to duct proliferation, ductal plate lesion, bile in ducts, lobular inflammation, giant cells, syncitial giant cells, focal necrosis, bridging necrosis, hepatocyte ballooning, bile in zone 1, 2, and 3, cholangitis, and end-stage cirrhosis. Clinical outcome was then predicted. RESULTS: Success after portoenterostomy could not reliably be predicted based on gender, age at Kasai, preoperative bilirubin or albumin levels. Histological criteria, however, predicted outcome in 27 of 31 patients (P < .01). Fifteen of 17 clinical successes were correctly predicted; as were 12 of 14 clinical failures (sensitivity, 86%; specificity, 88%). Individually, the presence of syncitial giant cells, lobular inflammation, focal necrosis, bridging necrosis, and cholangitis, were each associated with failure of the portoenterostomy (P < .05). Bile in zone 1 was associated with clinical success of the procedure (P < .05). CONCLUSIONS: Based on the predictive information available in a liver biopsy, we conclude that those patients who will not benefit from a Kasai procedure can be identified preoperatively, and channeled immediately to transplantation.

Biliary Atresia↗

Fulminant hepatic failure in murine hepatitis virus strain 3 infection: tissue-specific expression of a novel fgl2 prothrombinase.

Activation of the immune coagulation system has been implicated in the pathogenesis of fulminant liver failure caused by murine hepatitis virus strain 3 (MHV-3). The recent discovery of the fgl2 gene, which encodes for MHV-3-induced prothrombinase (fgl2 prothrombinase), allows for fundamental studies to determine the molecular basis for fulminant liver failure. Transcription of the fgl2 gene and translation of the protein it encodes were examined in the liver and other organs of susceptible mice following MHV-3 infection. No constitutive expression of the fgl2 gene or the fgl2 prothrombinase was detected. Within 12 to 24 h of MHV-3 infection, however, fgl2 gene transcripts were detected in large amounts in the liver, spleen, and lungs, all of which are rich in reticuloendothelial cells, but were only focally present in small amounts in the kidney and brain. There was sequential detection of fgl2 prothrombinase in the liver, where it was localized specifically to the endothelium of intrahepatic veins and hepatic sinusoids; this was allowed by fibrin deposition, which resulted in confluent hepatocellular necrosis. These results provide further evidence for the role of the selective expression of this novel fgl2 prothrombinase in the pathogenesis of MHV-3-induced fulminant liver failure.

Animals↗