Biomedical subjects
M Phillips
Publications and source records attributed to M Phillips.
A technique to estimate the apparent surface pressure of emulsion particles using apolipoproteins as probes.
The apparent pressures in the surface monolayer of emulsion particles can be estimated by comparing the absorption of an apolipoprotein to planar lipid monolayers and to emulsions. Lipids are spread at an air-water interface in a Pockels/Langmuir surface balance and the adsorption of [14C]-labeled apolipoproteins placed in the subphase is studied as a function of surface pressure using the surface radioactivity method. An apoprotein surface concentration/initial lipid surface pressure curve (gamma/pi i) is constructed. The maximum apolipoprotein surface concentration gamma e of emulsions is derived from standard emulsion/apolipoprotein binding isotherms. The apparent emulsion surface pressure is then estimated by comparing gamma e to the gamma/pi i curve. Apolipoprotein A-I has been used as an example of a probe to estimate the effective surface pressure in approximately 1000 A diameter egg yolk phosphatidylcholine/cholesterol/triolein emulsion particles. When the cholesterol content of emulsions is low, the surface pressure of the emulsion is about 17 dyne cm-1. At high cholesterol concentrations (0.49 cholesterol/phospholipid mole ratio) the surface pressure is increased to 25 dyne cm-1. The addition of the maximum amounts of apoA-I to these particles raises the effective surface pressure of the emulsion to about 30 dyne cm-1 and stabilizes the particles.
Idarubicin cardiotoxicity in acute myeloid leukaemia.
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The use of race in medical research.
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Thigh-thinner's thecitis.
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Serious intercurrent disease in healthy volunteers in clinical pharmacological research.
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The use of placebos in controlled trials.
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Leukemia clusters around nuclear facilities in Britain.
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Detection of carbon disulfide in breath and air: a possible new risk factor for coronary artery disease.
Carbon disulfide (CS2) is toxic to the heart and arteries; chronic exposure can result in accelerated atherosclerosis and coronary artery disease in humans and animals. Exposure to CS2 was investigated in normal volunteers working in New York City, using a new and highly sensitive assay. Volatile organic compounds in breath and air were captured in adsorbent traps containing graphitized carbon and molecular sieve, then thermally desorbed, concentrated by two-stage cryofocusing, and assayed for CS2 by gas chromatography/mass spectroscopy. Breath CS2 assays were performed in 42 normal volunteers, as well as in room air and in outdoor air collected at sites in and around New York City. The assay was linear, reproducible, and sensitive to picomolar (10(-12) mol/l) quantities. CS2 was detected in all samples of breath and indoor and outdoor air (mean concentrations were 5.25 pmol/l, SD = 3.89 in breath, 8.26 pmol/l in indoor air, and 3.92 pmol/l in outdoor air) (NS). The alveolar CS2 gradient (alveolar-inspired CS2) ranged from -20.0 to 8.0 nmol/l, separating subjects into either "excreters" or "retainers" of CS2. In view of the known toxicity of CS2, atmospheric pollution with CS2 merits attention as a possible new risk factor for the development of accelerated atherosclerosis and coronary artery disease.
Breath tests in medicine.
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The use of hypnotic age progressions as interventions with acute psychosomatic conditions.
Patients with the physical manifestations and physiological disturbances engendered by serious psychosomatic conditions often present with special needs in therapy. On a conscious level, these patients may have pessimistic views of the future, including the specter of imminent death, which, for some, is a real possibility. In this paper we review four clinical cases in which hypnotic age progressions reveal the patients' deepest positive hopes for survival and serve as ego-strengthening, integrating, and prognostic tools in the face of ominous symptoms of physical distress.
The use of hypnotic age progressions as prognostic, ego-strengthening, and integrating techniques.
Age progression as a hypnotherapeutic technique is mentioned infrequently in the literature when compared with its counterpart, age regression. In this paper we explore the use of progressions, or "views of the future," as prognostic indicators of therapeutic progress and as valuable tools for ego strengthening and for the integration of clinical material. Age progressions vary in the types of suggestions given and can be used to promote growth on multiple levels, facilitating treatment goals and deepening the working-through process. We present six cases in which we used different types of age progressions, and we discuss the significance of the progressions used in each case, within the context of relevant clinical material. We conclude from our observations that the use of hypnotic progressions can be a sustaining, valuable aspect of hypnotherapy, particularly in providing an index of the current direction and progression of the therapy process itself.
Case report: metastatic germ cell tumor presenting with thromboembolism and bilateral pneumothorax.
Germ cell tumors usually present with symptoms that are attributed to their location. This article describes a patient who had an extragonadal tumor that was not discovered until he experienced several tumor-related complications.
Opsonophagocytosis of Pneumocystis carinii.
The interaction of Pneumocystis carinii purified from rat lungs with rat peritoneal macrophages and human circulating polymorphonuclear leucocytes was studied by amplified chemiluminescence and examination of stained cytospin preparations. A polyclonal rat antiserum to P. carinii was opsonic with both types of phagocyte. Complement had no opsonic properties alone but produced a synergic effect in combination with antibody.
Dose-ranging study of depot disulfiram in alcohol abusers.
The object of this early Phase 2 study was to determine the dosage of depot disulfiram (DSF) required to induce sustained sensitivity to alcohol. Sixteen abstinent alcohol abusers were studied in an unblinded ascending-dose trial of DSF suspended in either (1) 5% methylcellulose or (2) 0.1% polysorbate 80. Five pairs of subjects received a single subcutaneous dose of Formulation A (1.0, 2.0, 2.5, 3.0, or 3.5 g). Three pairs were treated with Formulation B (60, 75, or 90 mg/kg) plus an oral loading dose of DSF (15 mg/kg). Subjects were challenged with oral alcohol (0.15 g/kg) before treatment, and on days 7, 14, 21, and 28. Subjective and objective responses to alcohol challenges (skin temperature, breath acetaldehyde, pulse rate, and blood pressure) were measured, and mobilization of DSF was assessed by carbon disulfide levels in breath. Treatment with Formulation B (75 or 90 mg/kg) plus an oral-loading dose (15 mg/kg) was consistently followed by sustained sensitivity to alcohol. Some subjects experienced the subjective and objective features of the DSF-ethanol reaction for 28 days, but these reactions achieved statistical significance only on day 7 for objective changes and on days 7 and 14 for subjective discomfort. Breath carbon disulfide was detectable until day 28 in all subjects receiving more than 1.0 g DSF, demonstrating sustained release of the drug. Treatment with depot DSF merits further study for its potential benefits in chronic alcohol abuse.
Impaired motor function (clumsiness) in 5 year old children: correlation with neonatal ultrasound scans.
All 155 surviving children from a cohort of 200 very low birthweight infants originally studied in 1984-5 were traced. These infants had careful sequential ultrasound examinations in the neonatal period. The children were examined again at entry into school at 5 years of age. The test of motor impairment (TOMI) and the vocabulary subscale of the Wechsler preschool and primary scale of intelligence (WPPSI) were administered to 152 of the index cohort and 144 control children of the same age in the same class at school. Twelve of the cohort had cerebral palsy, but eight of these were in mainstream schools. The index group scored significantly higher on both the TOMI and the WPPSI subscale compared with the controls. The index cases were subdivided on the basis of their neonatal ultrasound scans into four groups: group 1, consistently normal; group 2, 'prolonged flare'; group 3, germinal matrix haemorrhage-intraventricular haemorrhage (GMH-IVH), without parenchymal haemorrhage, but no evidence of prolonged flare; and group 4, both GMH-IVH and prolonged flare. The group of index children with consistently normal ultrasound scans had a higher TOMI and lower WPPSI compared with their controls. There was a statistically significant increase in the TOMI subscore 1 (manual dexterity) in group 4 infants compared with group 1, but not differences between the other groups. Regression analysis suggests that neither prolonged flare nor GMH-IVH has an important individual contribution to the variation, but the low birth weight does have a significant relationship with motor impairment. It appears that relatively minor ultrasound appearances such as prolonged flare and GMH-IVH are associated with motor impairment (clumsiness) at 5 years, but this has a small effect compared with low birth weight.
Phase I trial of intraperitoneal taxol: a Gynecoloic Oncology Group study.
PURPOSE: To evaluate the safety and pharmacology of the intraperitoneal (IP) administration of the antineoplastic agent taxol. PATIENTS AND METHODS: Twenty-five pretreated patients who were entered onto a phase I clinical trial; 24 had advanced ovarian cancer. Patients were treated with taxol administered IP in 2 L of normal saline every 3 to 4 weeks. The starting dose was 25 mg/m2. There were no intrapatient dose escalations. RESULTS: The dose-limiting toxicity was the development of severe abdominal pain at taxol doses more than 175 mg/m2. Moderate leukopenia (WBC count less than 2,000/mm3) was observed at IP doses of greater than or equal to 175 mg/m2. The exposure of the peritoneal cavity (peak levels and area under the time-versus-concentration curve [AUC]) to taxol after IP delivery exceeded that of the plasma by approximately 1,000-fold. However, concentrations of the agent previously shown to produce cytotoxicity in experimental systems were demonstrated in the systemic compartment after regional delivery, which was considered important. Significant concentrations of taxol persisted within the peritoneal cavity for more than 24 to 48 hours after a single IP installation. Several antitumor responses, which included control of platinum-refractory ascites, were documented. CONCLUSION: Taxol can be delivered by the IP route with both an acceptable toxicity profile and a major pharmacokinetic advantage for cavity exposure.
Diabetes in Mexico--a serious and growing problem.
According to a recent national health survey, the prevalence of self-reported diabetes in Mexico is 1.2%, but this figure reflects the relative youth of the Mexican population. Age-specific estimates are similar to those for the United States of America, where crude prevalence is higher. Given that self-reporting usually underestimates prevalence by at least 50%, there may be as many as 1.7 million persons with diabetes in Mexico, with a prevalence of approximately 6% in the age range 30-64 years. The average age at death for Mexicans with diabetes is 57 years, compared to 69 years for the population as a whole. Diabetes is the fifth most important cause of death in the Mexican population, and the third cause in people over 45 years of age, in whom it accounts for 10% of all deaths. There is evidence for important increases in diabetes-related mortality over time. Most studies indicate high rates of complications in Mexicans with diabetes and data show that their average length of hospital stay is almost twice as long as for non-diabetic patients. The annual cost of diabetes to Mexican society may be estimated at US$ 15 million for metabolic control, US$ 85 million for additional health services and US$ 330 million for indirect costs--in total, approximately three-quarters of all government spending on health care, or approximately US$ 450 per known diabetic person per year.