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Biomedical subjects

S J Phillips

Publications and source records attributed to S J Phillips.

At least 91 records · Page 5Linked to original sources
PubMed1987

Heparin therapy for recent transient focal cerebral ischemia.

The Mayo Clinic medical records and records linkage system were used to identify stroke-free residents of Rochester, Minnesota, who were examined within 30 days after the first transient cerebral ischemic attack (TIA) during the period 1955 through 1979. The patients were divided into two groups: those given heparin within 30 days after the first attack and those not given heparin. Death, stroke, and either stroke or TIA were separate endpoints in Kaplan-Meier analyses of data from the day of initial examination through the 30th day thereafter. The probabilities of survival, survival free from stroke, and survival free from TIA for the heparin-treated group were not significantly different from those probabilities for the comparison group. The rate of hemorrhagic complications was 3.2 per 100 person-days of heparin therapy. Retroperitoneal hemorrhage, the most serious complication, was the cause of one death and one case of femoral neuropathy.

Aged↗
PubMed1987

The step cycle organization of infant walkers.

To walk independently, the human infant must coordinate its multisegmented body to achieve both postural stability and forward mobility. In this experiment, we sought evidence of the form this coordination takes in infants who have been walking 3 to 10 months. Using the Philippson phases to represent the step cycle, we analyzed film records of infants and adults walking at speeds from 2 to 4 km/hr. Our results reveal a clear relationship between walking speed and the F and E(3) Philippson phases of the step cycle in both the young walkers and the adults. Indeed, across all four phases of the step cycle, the infants exhibited an organization that was almost identical to that of the mature walkers.

Journal Article↗
PubMed1987

The putative oncogene Pim-1 in the mouse: its linkage and variation among t haplotypes.

Pim-1, a putative oncogene involved in T-cell lymphomagenesis, was mapped between the pseudo-alpha globin gene Hba-4ps and the alpha-crystallin gene Crya-1 on mouse chromosome 17 and therefore within the t complex. Pim-1 restriction fragment variants were identified among t haplotypes. Analysis of restriction fragment sizes obtained with 12 endonucleases demonstrated that the Pim-1 genes in some t haplotypes were indistinguishable from the sizes for the Pim-1b allele in BALB/c inbred mice. There are now three genes, Pim-1, Crya-1 and H-2 I-E, that vary among independently derived t haplotypes and that have indistinguishable alleles in t haplotypes and inbred strains. These genes are closely linked within the distal inversion of the t complex. Because it is unlikely that these variants arose independently in t haplotypes and their wild-type homologues, we propose that an exchange of chromosomal segments, probably through double crossingover, was responsible for indistinguishable Pim-1 genes shared by certain t haplotypes and their wild-type homologues. There was, however, no apparent association between variant alleles of these three genes among t haplotypes as would be expected if a single exchange introduced these alleles into t haplotypes. If these variant alleles can be shown to be identical to the wild-type allele, then lack of association suggests that multiple exchanges have occurred during the evolution of the t complex.

Animals↗
PubMed1986

Reperfusion protocol and results in 738 patients with evolving myocardial infarction.

Reperfusion is an accepted therapy for evolving myocardial infarction (MI), as successful reperfusion reduces morbidity and mortality. A team approach between the cardiologists and cardiac surgeons must be applied to achieve reperfusion within a finite time from the onset of coronary thrombosis. Analysis of 738 patients grouped them by successful reperfusion in the catheterization laboratory versus the operating room. Factors that predict wall motion recovery related to the onset of clinical symptoms, time to reperfusion, coronary anatomy, and collateral network were reviewed. Comparisons were made between patients with stable versus unstable hemodynamics and successful or unsuccessful reperfusion. Of the 738 patients, the initial attempt at reperfusion was made in the catheterization laboratory with success in 331. These patients all had primarily single-vessel disease. With multiple-vessel disease identified at catheterization, 189 patients were immediately treated by surgical reperfusion. This method also was used for an additional 72 patients in whom reperfusion could not be achieved in the catheterization laboratory. Of the entire group of 738 patients, 146 (20%) could not be reperfused. Overall mortality for the 592 patients reperfused was 4.9% compared with 17% for those who could not be reperfused. Time was critical for wall motion recovery if no collaterals were demonstrated on angiography. If collaterals were present, time to reperfusion was not critical. Wall motion recovered in 90% of the patients if the endocardial anatomy on the initial angiogram was smooth. However, if the endocardial anatomy looked mottled and irregular, less than 10% of patients had recovery of wall motion.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

Vein of Galen malformation with cerebral calcification: a reversible cause of neurodegenerative disease.

This paper reports two children who had mental retardation as the predominant manifestation of vein of Galen malformations. C.T. scans demonstrated extensive intracerebral calcification. Surgery reversed the progressive downhill course in one patient and may have arrested further deterioration in the other. The pathophysiological mechanisms underlying the clinical and radiographic features are discussed.

Brain↗
PubMed1986

Percutaneous cardiopulmonary bypass and innovations in clinical counterpulsation.

This report points out the progress that has been made with cardiac support devices since they were first clinically applied in the mid-1960s. Advances in technology have allowed the development of PBY. Innovatively applied modifications of existing support systems have allowed patient survival when conventional systems could not be utilized. Continued refinements in design, materials, and power sources will allow circulatory assistance to progress as an extremely useful clinical tool for the treatment of patients with acute and chronic ventricular failure.

Adolescent↗
PubMed1984

The complete nucleotide sequence of a beta-globin-like structure, beta h2, from the [Hbb]d mouse BALB/c.

We have determined the complete nucleotide sequence of beta h2, a pseudogene in the mouse beta-globin gene complex. The structure of beta h2 is analogous to that of a normal beta-globin gene, and its nucleotide sequence shares 72% homology with the coding regions of a reference mouse adult beta-globin gene. A frame shift occurs in the first coding region for which a compensatory splicing scheme can be devised. The reading frame is not otherwise disrupted. All of the recognized transcription, translation, and splicing signals in beta h2 are intact, with the exception of the " CCAAT box," which has been altered to GTAAC . We compared the predicted amino acid sequence of beta h2 with other beta-globin sequences. Evidence for a period of divergence without selection in the history of beta h2 was found in a set of codons that are usually highly conserved in productive beta-globin genes. An evolutionary tree constructed from nucleotide sequence suggests that beta h2 originated from the adult genes at least 60 million years ago. After some period as a productive gene, beta h2 was inactivated and has subsequently diverged without selection. Hybridization experiments demonstrated that beta h2 and the surrounding region occur without major alteration in other rodent species. The sequence ( AGCCA - 4n - GTGT ) occurs 5' of the CCAAT box in beta h2 and in many productive globin genes.

Animals↗
PubMed1984

Two mouse early embryonic beta-globin gene sequences. Evolution of the nonadult beta-globins.

We have determined the complete nucleotide sequence of two early embryonic beta-globin genes of the BALB/c mouse: beta h0 and beta h1 X beta h1 codes for the embryonic z protein, while the beta h0 gene may be a minor early embryonic beta-globin gene. The general sequence organization of both genes is entirely analogous to other functional globin genes. There is, however, a 220-base pair insertion of unique sequence within the first intron of beta h0 X beta h0 and beta h1 are 96% homologous for 260 base pairs 5' to the AUG initiation codon, and 93% homologous throughout their coding regions. Analysis of the 5'-flanking sequence demonstrates that these genes are more nonadult-like than adult-like. The sequences show evidence for gene conversions among the mouse nonadult beta-globin genes that were limited to individual exons, presumably by the presence of non-homologous introns. We propose that this arrangement has the beneficial evolutionary effect of allowing gene conversion to act independently on regions of the protein with different structural or functional responsibilities. beta h0 and beta h1 are evolutionary homologs to the human fetal and rabbit beta 3 genes, while their manner of expression is similar to rabbit beta 3 and dissimilar to human fetal expression. The evolutionary history of the human beta-globin genes, therefore, includes the recruitment of an embryonic gene to fetal developmental control.

Animals↗
PubMed1984

Natural history of surgically treated ventricular aneurysm.

Forty-one patients underwent resection of a postinfarction ventricular aneurysm. Thirty-seven of them had associated saphenous vein grafting procedures (average, 2.3 grafts per patient). Thirty-five patients sustained left ventricular dysfunction preoperatively. Forty patients were followed until death or for a minimum of five years (1 was lost to follow-up), and functional status was evaluated. Hospital mortality was 12%. Twenty-four patients survived five years or longer, and 20 patients were alive after a mean follow-up of 84 months. Eighty percent of the nonsurvivors died of atherosclerosis-related events. Forty-nine percent of the patients who survived the operation sustained severe atherosclerotic events postoperatively. Only 2 of 15 nonsurvivors ever regained functional status as judged by return to work. Twelve of the 20 long-term survivors returned to work. Of those patients less than 50 years old at operation, only 17% returned to work. Preoperative left ventricular function was a significant predictor of long-term functional results of aneurysmectomy and saphenous vein grafting. All patients remained at high risk for continued events related to atherosclerotic cardiovascular disease, and only 37% returned to full-time, preoperative work status. Return to productive status was especially disappointing in patients less than 50 years old.

Adult↗
PubMed1984

A technique for immediate manual external aortic counterpulsation during cardiac surgery.

Intraaortic balloon pump counterpulsation is well established as a lifesaving measure. Aortic counterpulsation may be achieved externally as well as internally. A simple technique for manual external aortic counterpulsation during cardiovascular surgical procedures is presented. This technique is available on immediate demand and identical in effect to intraaortic balloon pumping, and it may be lifesaving in patients with acute cardiovascular decompensation since it allows time for institution of necessary emergency therapy.

Aorta↗
PubMed1984

Immediate coronary bypass following failed streptokinase infusion in evolving myocardial infarction.

Since December of 1980, 184 patients with evolving myocardial infarction (EMI) have undergone streptokinase infusion, with associated percutaneous transluminal coronary angioplasty (PTCA) in 68 patients. Emergency coronary bypass was deemed necessary in 24 of these patients. All 24 patients had severe triple-vessel disease and moderate to marked ventricular dysfunction, with eight (33%) requiring intra-aortic balloon pump (IABP) support for profound cardiac decompensation preoperatively. All 24 patients underwent immediate coronary bypass (average 4.1 grafts/patient), with four operative and two late deaths. Average postoperative blood loss was 1,453 ml, and average blood transfusion postoperatively was 8.2 units per patient. Thirteen patients had normal clotting studies immediately postoperatively, and only two patients developed frank coagulopathy (hyperfibrinolysis). Four patients required reexploration; two for coagulopathy, one for surgical bleeding, and one to rule out tamponade (negative). In those patients with EMI in whom streptokinase fails to result in adequate reperfusion, immediate emergency saphenous vein bypass grafting may be performed with reasonable morbidity and with acceptable hematologic consequences.

Adult↗
PubMed1984

Inflammatory epicardial reaction to processed bovine pericardium: case report.

Processed bovine pericardium is increasingly used as a pericardial substitute. It is allegedly nonreactive with epicardium, but adequate clinical data are lacking on this subject. A case report is presented wherein a dense epicardial reaction to processed bovine pericardium was found at reoperation. Histologic examination confirmed the presence of a severe inflammatory response.

Animals↗
PubMed1983

Quantification of intersegmental reactions during rapid swing motion.

A simple mathematical model was developed to quantify the non-muscular reactions between two adjacent segments undergoing rapid free-segment motion. Newtonian equations of motion were used to simulate the trajectories of the two segments using the input parameters of linear acceleration and muscular moment acting only about the proximal end of the proximal link. The intersegmental muscular force and moment were mathematically considered to be zero, and no constraints were placed on the motion of the two segments. The motion of the thigh and shank during the swing phase of running was simulated by the model and compared to the real motion obtained from cinematographic records. The simulation demonstrated that proximal thigh motion has a significant effect on the distal shank motion. Depending on the initial conditions, intersegmental reactions alone can produce large increases in distal segment speed. The role of the knee musculature in preventing these reactions during the swing phase of running was inferred.

Biomechanical Phenomena↗