PubMed Health⌕ Search

Biomedical subjects

A J Phillips

Publications and source records attributed to A J Phillips.

At least 19 recordsLinked to original sources
PubMed2005

Recurrent hepatocellular carcinoma after liver transplantation mimicking post-transplantation lymphoproliferative disorder.

Approximately 5% of patients with end-stage cirrhosis undergoing orthotopic liver transplantation have occult hepatocellular carcinoma. Careful follow up is required to detect recurrent tumour, and knowledge of the patterns of recurrence may avoid diagnostic confusion with other malignancies, such as post-transplantation lymphoproliferative disorder. This case report illustrates an unusual presentation of recurrent hepatocellular carcinoma in a 56-year-old man presenting with a para-aortic soft tissue mass, thought clinically and radiologically to represent lymphoma or post-transplantation lymphoproliferative disorder. This case demonstrates that recurrent hepatocellular carcinoma can present late after transplantation as retroperitoneal lymphadenopathy, and should alert physicians and radiologists to be aware of the radiological appearances of recurrence and of the need for early biopsy to avoid diagnostic confusion with other malignancies.

Carcinoma, Hepatocellular↗
PubMed2004

Defaecation and weight of the gastrointestinal tract contents after feed and water withdrawal in broilers.

1. Broilers were held under constant light for up to 24 h with access to feed and water, access to water only, or access to neither feed nor water. 2. Birds given continuous access to feed ate evenly over the 24-h period. Feed deprivation reduced drinking behaviour to about half of that when feed was available. Deprivation of feed, or of feed and water, had similar effects on defaecation and the reduction in the weight of the gut contents. It reduced the overall number of defaecations over the 24-h period to about 40% of that in birds given food and water, and the weight of the contents by about 75%. The maximum effect of deprivation on defaecation was seen after about 4 h, and on gut contents weight after about 12 h. 3. With longer fasting the contents of most parts of the gut, except the caeca, became wetter. 4. The findings may have implications for the practice of preslaughter food withdrawal to reduce the potential for soiling of the live birds and contamination of the carcase after slaughter. However, the likelihood is that relatively short overall feed deprivation times of not more than 8 to 12 h before killing may be desirable, but specifying firm recommendations on optimal feed withdrawal times requires further work.

Animals↗
PubMed2003

Cleanliness of broilers when they arrive at poultry processing plants.

An eight-point photographic scale from 1 (very clean) to 8 (very dirty) was used to assess the cleanliness of the plumage of 69,783 live broiler chickens delivered in 54 loads to three processing plants which were each visited in spring, summer and winter. There were considerable variations between the plants and between the visits, but most birds were given scores of 6 or 7. The average plant scores were 6.07, 6.56 and 6.84, which were associated with frequencies of birds with scores of 7 or more of approximately 38, 56 and 73 per cent. There was some indication that longer feed-withdrawal times of up to 10 hours were associated with dirtier birds.

Animals↗
PubMed2001

The challenge of gene therapy and DNA delivery.

It is 10 years since the first gene therapeutic was administered to patients. Since that time approximately 3500 patients have been treated and although some evidence of gene transfer has been seen it has generally been inadequate for a meaningful clinical response. The major challenges have been delivery of DNA to the target cells and duration of expression. A variety of gene transfer systems have been evaluated and these are summarized with their advantages and disadvantages. Encouraging data have been obtained recently by a number of workers and there is some optimism that the enormous potential of gene therapy will be realized in the second decade of its development.

Drug Delivery Systems↗
PubMed2001

Effect of electrical stun/kill method, interval between killing and neck cutting and blood vessels cut on blood loss and meat quality in broilers.

1. Broiler chickens were killed using either an electrical waterbath (WB system) delivering 120 mA per bird (50 Hz, alternating current, AC) for 4 s or an alternative stun/kill method (ASK system); where head-only stunning for 1 s was immediately followed by head-to-body (vent) application for 1 s (150 mA, 50 Hz sine wave AC). Within each stun/kill system, the neck was cut ventrally or unilaterally 20, 60, or 180 s after killing. In addition, a control group of broilers was stunned with 100 mA per bird in a waterbath using 1500 Hz AC for 4 s and were bled by a ventral neck cut within 20 s. 2. Blood leaving the neck cut was collected for 90 s in a bin placed on an electronic balance and blood loss (g/kg body weight) calculated. 3. Individually identified, unplucked and uneviscerated carcases were held at ambient temperature until the end of the experimental day and then stored overnight in an air chiller (5 degrees C). The carcases were dissected and the incidence of broken furculum and coracoid bones, haemorrhaging in P. minor and P. major muscles, and discolouration of P. major muscles were determined. 4. When neck cutting was performed in broilers 20 s after the stun or kill, the ASK and WB systems, in comparison with high frequency stunning, produced on average about 10 g per kg less bleed out. Within the stun/kill systems, broilers killed by ASK had a greater bleed out than in the WB system. Neck cutting at 20 s or 60 s post-kill resulted in a greater bleed out than when performed after a delay of 180 s. Ventral or unilateral neck cutting resulted in a similar bleed out. 5. Stunning broilers with 1500 Hz AC resulted in lower incidences of broken bones, haemorrhaging in breast muscles and muscle discolouration post mortem than the stun/kill systems. These defects were significantly lower in the ASK than in the WB system. Delayed neck cutting increased the severity of discolouration occurring Post mortem in the breast muscles. 6. It is suggested that broilers killed by ASK can be neck cut with a delay of up to 180 s without compromising bleed out. The incidence of broken bones and haemorrhaging in breast muscles are significantly less with ASK than WB. 7. Owing to the commercial benefits and potential for improved welfare at slaughter, ASK would appear to be a better method than WB.

Abattoirs↗
PubMed2000

Pregnancy-associated osteoporosis: does the skeleton recover?

Osteoporosis in pregnancy is a rare clinical problem of unknown cause. If the bone loss results from the pregnancy alone it should improve toward normal after delivery; in contrast, where bone density was low before pregnancy, due to some other secondary cause, significant postpartum improvement might not be expected. Thirteen women (age 23-37 years) with pregnancy-associated osteoporosis presenting with either pain in the back and vertebral collapse (8 subjects) or pain in the hip (5 subjects) had consecutive dual-energy X-ray absorptiometry measurements of bone mineral density (BMD) for up to 8 years after an affected pregnancy. The BMD results were expressed as a Z-score in relation to an age-matched mean. The mean initial (0-6 months postpartum) BMD was low in both groups and at both sites. In the back pain group the mean spine Z-score (Ll-L4) was -3.34 (range -2.25 to -4.66) and mean total hip Z-score was -2.41 (range -1.44 to -3.82). In the hip pain group the mean spine Z-score was -2.00 (range -1.48 to -2.65) and mean hip Z-score was -2.19 (range -1.12 to -3.26). Subsequent mean hip and spine BMD increased significantly toward the lower end of the normal range. We conclude that a reversible part of the bone loss is related to the pregnancy itself. A low BMD before pregnancy cannot be excluded. Knowledge that the bone density increases after an affected pregnancy, combined with the known rarity of recurrent symptoms in subsequent pregnancies, is important in prognosis.

Adult↗
PubMed2000

CT-guided cutting needle biopsy of lung lesions--safety and efficacy of an out-patient service.

AIM: To determine the safety and efficacy of CT-guided cutting needle biopsy of lung lesions as an out-patient procedure. MATERIALS AND METHODS: A total of 185 consecutive biopsies were performed under CT guidance on 183 patients between January 1991 and December 1998 using 20-gauge (n= 33), 18-gauge (n= 151) or 14-gauge (n= 1) core biopsy needles. A chest radiograph was taken after observation in the Radiology department for 1 h and asymptomatic patients were discharged. RESULTS: The histology was malignant in 150 biopsies (81. 1%) and benign in 23 (12.4%) with 12 false-negative results (6.5%); there were no false-positive results. The sensitivity was 92.6%; specificity 100%; negative predictive value 65.7%; and overall accuracy 93.5%. Pneumothoraces occurred in 48 patients (25.9%); one required aspiration only and four required insertion of an intercostal drain. One patient developed a pneumothorax after discharge. Small haemoptyses occurred in 13 patients without pneumothorax (7.0%), one of whom was admitted. In-patient treatment was required in 10 patients (5.4%). CONCLUSION: Computed tomography-guided cutting needle biopsy of pulmonary lesions is a safe technique with a diagnostic accuracy and complication rate comparable to reported figures for fine needle aspiration biopsy. It can be safely performed on an out-patient basis.

Adult↗
PubMed2000

Variation in the colour of broiler breast fillets in the UK.

1. The normal range in colour of broiler breast muscle was assessed using an objective (instrumental) measure of colour in portioned breast fillets at a commercial processing plant. In addition, the relationship between colour and ultimate muscle pH (pH(ult)) was also examined. 2. Considerable variation in colour was evident although minimal inter-flock variation was found. The exceptions were 2 free range flocks which produced breast fillets significantly lighter and less red. 3. Extremes of colour are likely to be discriminated against at the point of purchase. 4. A clear relationship between pH(ult) and L* values was found which provides more evidence for the existence of a PSE like condition in broiler breast meat.

Animals↗
PubMed1999

Effect on young calves of a one-hour feeding stop during a 19-hour road journey.

This study examined the effects of transporting calves less than four weeks of age on a journey at the limit of the maximum time laid down by recent EU legislation. In both summer and winter, 45 calves were transported by road for 19 hours. The journey included a one-hour break on the lorry in which the calves were given either a glucose/electrolyte solution, water, or nothing at all. Control groups of 15 calves remained on farm and were fed normally. The effects of the journey were greater during winter when liveweight loss was greater and more prolonged, and the calves suffered a depression in body temperature. Mid-journey feeding was of minimal benefit. Feeding electrolytes reduced the extent of dehydration as measured by changes in plasma total protein and albumin concentrations, but there was some indication that giving water alone was detrimental. Most of the variables which changed during the journey had recovered in line with the values in the control animals within 24 hours of the end of the journey, but the calves' liveweight and plasma creatine kinase activity took up to seven days to stabilise. The study highlighted the problem that young calves have in maintaining body temperature during transport, especially during colder weather.

Animal Feed↗
PubMed1999

Ultrasound detection of pneumothorax.

OBJECTIVE: To determine the accuracy of ultrasound in the detection of pneumothorax. METHODS: Prospective blinded study comparing ultrasound, CT and radiographic findings in 29 patients following 41 CT-guided lung biopsies. Ultrasound examination of the chest was limited to the biopsy needle entry site. RESULTS: Thirteen patients developed a post-biopsy pneumothorax demonstrated by CT. Seven of these were detected by ultrasound and six were visible on erect chest radiographs. Six of the 13 pneumothoraces were not detected by ultrasound, but five of these were loculated away from the biopsy needle entry site and were therefore in areas not examined during the limited ultrasound examination. There were no false-positive diagnoses of pneumothorax using ultrasound. The positive predictive value for ultrasound was 100% and the negative predictive value was 82%. CONCLUSION: In this patient group, ultrasound was more sensitive than erect chest radiography in the detection of pneumothorax. Both have a specificity of 100%. This study suggests that ultrasound may prove valuable in pneumothorax detection when rapid conventional radiography is not possible or practical, and in circumstances where ultrasound is readily available, such as during ultrasound-guided interventional procedures.

Biopsy, Needle↗
PubMed1998

Human cytomegalovirus infection downregulates expression of the cellular aminopeptidases CD10 and CD13.

During the course of a productive infection, human cytomegalovirus (HCMV) has a sophisticated relationship with its host cell. An increasing number of virus-encoded genes are being identified which act specifically to usurp or modulate functions in the host cell associated with transcriptional control, cell signalling, and protein synthesis. While HCMV infection is associated with a general upregulation of cellular gene expression, the expression a small subset of cellular proteins, including the MHC-1 heavy chain and fibronectin, is downregulated. This study now identifies two additional cellular proteins, aminopeptidase N (CD13) and neutral endopeptidase (CD10), that are downregulated during HCMV infection. While aminopeptidase N and neutral endopeptidase exhibit no significant sequence homology, both are expressed on the cell surface and have very similar enzymatic properties. HCMV infection was associated with reduced surface expression and enzyme activity of CD13 and CD10, an apparent decrease in the rate of synthesis of both proteins in metabolic-labelling experiments, and inhibited glycosylation of the nascent CD13 and CD10 polypeptide chains that were synthesized. Levels of CD10 poly A+ RNA were suppressed efficiently at all stages of virus infection; however, the reduction in CD13 poly A+ RNA levels was much less pronounced. This differential effect suggests that HCMV may be downregulating expression of CD10 and CD13 by independent mechanisms. Indeed, treatment of cells with an inhibitor of viral DNA synthesis blocks downregulation of CD13, whilst downregulation of CD10 is unaffected. While it is not yet clear what advantage is bestowed on the virus by downregulating expression of CD13 and CD10, aminopeptidases are known to have a role in peptide processing in both the MHC class I the MHC class II antigen presentation pathways.

CD13 Antigens↗
PubMed1998

Osteoporosis during pregnancy and its management.

Osteoporosis leading to fracture can occur during pregnancy. Bone density may be low before pregnancy due to recognised causes such as coeliac disease, osteogenesis imperfecta and previous anorexia nervosa (secondary osteoporosis). In some patients there is no identifiable cause. This condition is referred to as "pregnancy associated or pregnancy related osteoporosis"; it is not known whether pregnancy causes the osteoporosis or merely coincides with it. Typically the loss of bone leads to vertebral fracture with loss of height or pain in the hips also sometimes with fracture. Symptoms most often begin in the third trimester of the first pregnancy and improve after delivery; they do not usually recur in subsequent pregnancies. The cause is unknown and there is no specific treatment; follow up bone density measurements show that the osteoporosis slowly improves post partum. Recent research in non osteoporotic women shows that breast feeding maintains a low bone density; it is therefore contraindicated in pregnancy associated osteoporosis.

Adult↗
PubMed1998

Morphological variants in keratoconus: anatomical observation or aetiologically significant?

PURPOSE: Two morphological cone variants are identified in keratoconus; nipple and oval. The present study was designed to assess the impact of aetiological factors on cone morphology. METHODS: As part of a prospective controlled study, keratoconic subjects from a suburban practice (n = 89) underwent videokeratograph examination and completed a questionnaire detailing aetiological factors. RESULTS: Comparison of 95% confidence limits (CL; bootstrap method) for apical power between the two cone morphology groups showed no statistical significance. Oval cones were located at a greater eccentricity than nipple cones, as their definitions suggest. Associations between aetiological factors examined and the morphology of the cone were not significant (bootstrapped 95% CL). CONCLUSION: Despite the suggestion of morphological variants in keratoconus, the results of the present study suggest a common cone aetiology.

Age of Onset↗
PubMed1998

Direct percutaneous transrenal embolization for renal artery injury following percutaneous nephrostomy.

The use is reported of percutaneous transrenal embolization for renal artery injury during percutaneous nephrostomy. If a nephrostomy catheter is seen to transfix the renal pelvis, the possibility of injury to a large renal artery must be considered. The misplaced nephrostomy catheter should be withdrawn over a guidewire. Percutaneous renal artery embolization may enable rapid arrest of life threatening haemorrhage.

Aged↗
PubMed1997

Effects on calves less than one month old of feeding or not feeding them during road transport of up to 24 hours.

Two trials, each involving 56 calves less than one month old, demonstrated that the responses of calves to food and water deprivation during 24 hours of transport were similar to those observed in older cattle and lambs. There was increasing utilisation of body reserves and a measurable increase in dehydration, coupled with an increased loss of liveweight. Feeding 1 litre of glucose/electrolyte solution at eight-hour intervals did reduce the effects of food and water deprivation, but it is suggested that the minor benefits of mid-transport feeding during a 24-hour journey would not justify the disruption that would be caused by unloading and feeding. It would be better to complete the journey in as short a time as possible, providing the calves were carried under suitable conditions. Liveweight and the levels of plasma beta-hydroxybutyrate, non-esterified fatty acids, total protein and albumin had all returned to approximately pre-transport values after 24 hours of recovery. However, the calves had not started to gain in liveweight until some time after 24 but before 72 hours of recovery. The calves did not show the same marked responses in heart rate, plasma cortisol and plasma glucose that are observed in older cattle and in other species. They also appeared to be unable to regulate their body temperature closely, when they were transported during the winter. It is suggested that their lack of response to transport was not because they were unaffected but because they were physiologically unadapted to coping with transport.

Adaptation, Biological↗