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Biomedical subjects

C Phillips

Publications and source records attributed to C Phillips.

At least 163 records · Page 9Linked to original sources
PubMed1995

Non-invasive management of organic impotence.

OBJECTIVE: To establish the efficacy of a vacuum device (ErecAid) in the management of organic impotence. DESIGN: Cohort study; questionnaire before and after a 6-month study period. SETTING: Groote Schuur Hospital, Cape Town. PARTICIPANTS: A total of 19 men with organic impotence, 8 diabetic and 11 with previous pelvic surgery or radiotherapy. INTERVENTION: Vacuum device (ErecAid, Osbon Medical Systems). OUTCOME MEASURE: Efficacy of ErecAid. RESULTS: Six of 8 diabetics and 6 of 11 non-diabetics reported successful intercourse, while 16 of the participants would recommend the device to others. Some difficulty with the device was experienced by 11 and only 9 described an increase in self-esteem. CONCLUSION: Although some difficulties may be experienced in the use of the ErecAid, it clearly has a role to play in the management of patients with organic impotence, who ideally should be able to select their preferred form of therapy.

Adult↗
PubMed1995

Perception of facial attractiveness by patients, peers, and professionals.

Self-perception of facial attractiveness of 19 women (15 with Class II malocclusion and four with Class I malocculsion) was compared to the perceptions of the patient's peers, five orthodontists, and five oral surgeons. Each respondent ranked a set of four standardized facial photographs of each patient from most (1) to least (19) attractive. A surgical treatment plan was recommended for all of the Class II patients. However, only nine accepted surgery; six elected to undergo camouflaging orthodontics only. There was a statistically significant difference in the distribution of ranks given to the Class I, Class II camouflage-only, and Class II surgery groups by the panels. Overall, the Class I patients were judged most attractive. The Class II patients who elected to undergo orthodontics only were given mid-ranks, and the patients who elected surgery were ranked least attractive, although the distributions for overjet, point A-nasion-point B, and motivations for treatment were similar in the two groups. The distribution of self-ranks given by the patients were not significantly different among the three groups, although than the Class II patients perceived themselves as less attractive than the Class I patients.

Adult↗
PubMed1995

Long-term stability of two-jaw surgery for treatment of mandibular deficiency and vertical maxillary excess.

Changes in cephalometric landmark positions and relationships were evaluated more than 5 years postsurgically in 26 patients whose long-face condition had been treated with a combination of superior repositioning of the maxilla and mandibular advancement. All the patients had a least 2-mm surgical intrusion of the maxilla and 2-mm lengthening of the mandible with wire osteosynthesis, maxillomandibular fixation, and skeletal suspension wires. On the average, a small amount of downward and backward rotation of the mandible occurred long term. The mean change in overjet was less than 1 mm. Most of the changes occurred in a minority of the patients: 20% of the group had 2 to 4-mm downward movement of menton, and the mandibular plane angle increased more than 2 degrees in 25% of the patients. On clinical evaluation, a tendency toward opening of the bite beyond 1 year postsurgery was noted in 5 of the 26 patients (19%), and one patient had a greater than 4-mm decrease in overbite. The condylion-pogonion distance decreased 2 to 4 mm in three patients, two of whom had shown greater than 4-mm shortening of this distance during the first postsurgical year. It appears that long-term shortening of the condylar process is not a highly prevalent problem, but changes of 2 to 4 mm in condylion-pogonion associated with modest clinical relapse may occur beyond 1 year postsurgery in 5 to 10% of these two-jaw surgery patients.

Adolescent↗
PubMed1994

An investigation of the HUMVWA31A locus in British Caucasians.

A number of short tandem repeat (STR) loci are currently being examined for their usefulness as markers of identity; HUMVWA31A is one such locus. We used a high-sieving agarose technique to type 200 British Caucasians for this locus. Comparison of the resultant allele frequencies with other published databases showed that their distributions were similar. Observed heterozygosity was similar to that reported in other population studies but significantly lower than expected. A goodness of fit analysis of observed and expected genotypes was highly significant, suggesting a deviation from Hardy-Weinberg equilibrium, although reports from other populations appeared not to show such differences. The possibility that mistyping had led to an erroneous statistic was investigated by detailed examination of samples within our own laboratory and in two other laboratories, involving verification of the agarose typing by both automated fluorescent detection techniques, and sequencing. Other reported deviations from Hardy-Weinberg equilibrium in STR systems are discussed.

Alleles↗
PubMed1994

Crystallographic study of coenzyme, coenzyme analogue and substrate binding in 6-phosphogluconate dehydrogenase: implications for NADP specificity and the enzyme mechanism.

BACKGROUND: The nicotinamide adenine dinucleotide phosphate (NADP)-dependent oxidative decarboxylase, 6-phosphogluconate dehydrogenase, is a major source of reduced coenzyme for synthesis. Enzymes later in the pentose phosphate pathway convert the reaction product, ribulose 5-phosphate, to ribose 5-phosphate. Crystallographic study of complexes with coenzyme and substrate explain the NADP dependence which determines the enzyme's metabolic role and support the proposed general base-general acid mechanism. RESULTS: The refined structures of binary coenzyme/analogue complexes show that Arg33 is ordered by binding the 2'-phosphate, and provides one face of the adenine site. The nicotinamide, while less tightly bound, is more extended when reduced than when oxidized. All substrate binding residues are conserved; the 3-hydroxyl of 6-phosphogluconate is hydrogen bonded to N zeta of Lys183 and the 3-hydrogen points towards the oxidized nicotinamide. The 6-phosphate replaces a tightly bound sulphate in the apo-enzyme. CONCLUSIONS: NADP specificity is achieved primarily by Arg33 which binds the 2'-phosphate but, in its absence, obscures the adenine pocket. The bound oxidized nicotinamide is syn; hydride transfer from bound substrate to the nicotinamide si- face is achieved with a small movement of the nicotinamide nucleotide. Lys183 may act as general base. A water bound to Gly130 in the coenzyme domain is the most likely acid required in decarboxylation. The dihydronicotinamide ring of NADPH competes for ligands with the 1-carboxyl of 6-phosphogluconate.

Animals↗
PubMed1994

Overexpression in Escherichia coli and purification of the 6-phosphogluconate dehydrogenase of Trypanosoma brucei.

The gene encoding 6-phosphogluconate dehydrogenase (EC 1.1.1.44) from Trypanosoma brucei was cloned into the overexpression vector pET3a which utilizes the T7 polymerase gene expression system. Up to 40% of total cell protein consisted of the trypanosome enzyme when expression was induced in Escherichia coli host strains at 28 degrees C. The enzyme was rapidly degraded at temperatures higher than 30 degrees C. The T. brucei enzyme was purified to near homogeneity (as judged by SDS-polyacrylamide gel electrophoresis) using a two-step purification method, involving a DE-52 cellulose batch preparation followed by 2' AMP-agarose affinity chromatography. The purified protein crystallized readily. A molecular model of the trypanosome enzyme based on its mammalian counterpart revealed differences between the two enzymes in residues involved in cofactor binding.

Animals↗
PubMed1994

Level of agreement in clinicians' perceptions of Class II malocclusions.

To evaluate the extent to which surgeons and orthodontists agree on the nature and severity of dentofacial problems requiring orthognathic surgery, three clinicians active in a specialized clinic for treatment of dentofacial deformities scored the pretreatment records of 37 adult class II patients. Each clinician first indicated whether a skeletal/dental problem existed in the maxilla and mandible and then rated the severity of the problem on a visual analog scale. The level of agreement among the three clinicians was highest for dental problems and lowest for skeletal anteroposterior measures. There was a significant difference among the clinicians in the percentage of patients identified as having a retrusive midface and excessive facial thirds. The agreement on the severity of the problem was generally low even for those patients for whom the clinicians agreed on the type of problem. The data suggest that personal experience and clinical background play a major role in diagnosis and treatment planning. Joint treatment planning conferences between the surgeon and orthodontist offer an opportunity for different plans to be discussed, with the preferred treatment option selected for an individual patient.

Adolescent↗
PubMed1994

Lumbar vertebral and femoral neck bone mineral density are higher in postmenopausal women with the alpha 2HS-glycoprotein 2 phenotype.

alpha 2HS-glycoprotein (AHSG) is a plasma protein which becomes concentrated in the organic matrix of bone. The two most common alleles, AHSG*1 and AHSG*2, give rise to three common phenotypes. A recent report showed that a group of postmenopausal white North American women with different AHSG phenotypes differed significantly with respect to their oestrogen status. We have studied variations in bone mineral density, measured by DEXA, and levels of sex hormones and biochemical markers of bone metabolism in a group of 88 post-menopausal women unselected as to their health status. Lumbar vertebral and femoral neck bone mineral density (BMD), and the free oestradiol index were all significantly higher (P < 0.05) in women with the AHSG 2 phenotype. Values of these three parameters were lowest in the AHSG 1 phenotype and intermediate in the AHSG 2-1 phenotype. Because the differences in BMD between the AHSG 2 and 1 phenotypes represent at least a 40% difference in fracture risk, the AHSG phenotype may be of some clinical relevance as a risk factor for osteoporosis.

Aged↗
PubMed1994

Skeletal jaw relationships: a quantitative assessment using elliptical Fourier functions.

Elliptical Fourier functions (EFF) were generated for the boundary outlines of the hard tissue craniofacial complex including the maxilla, mandible, and cranial base in order to quantitatively describe adult patients (n = 98) who were initially classified into nine skeletal groups by a combination of conventional cephalometric measures and clinical judgement. The mean residual fit of the EFF-predicted points and the original digitized data for the individual subjects ranged from .42 mm to .61 mm with a mean of .52 mm suggesting an accurate fit. Visual inspection of the individual plots confirmed this. Predicted classifications from a step-wise discriminant analysis based on EFF amplitudes were compared with the original classifications. The discordance rates for A-P and vertical plane classification were 21% and 13% respectively with an overall discordance rate of 33%. In general, a cluster analysis using EFF amplitudes did not identify clusters very similar in membership to the original groups; however, it was marginally successful in identifying members of the more severe groups and, like discriminant analysis, appeared to be more sensitive to vertical morphological differences. The overall lack of agreement between classifications and clusters based on EFF amplitudes and the original classifications may indicate that traditional skeletal categories such as those used in this study do not actually represent discrete groups.

Adolescent↗
PubMed1994

Changes in vertical tooth position and face height related to long term anterior repositioning splint therapy.

This study evaluates whether extended full-time wear of a partial coverage mandibular anterior repositioning splint (MORA) causes intrusion of posterior teeth and determines the effect on jaw position. Sixty-four patients from two private orthodontic practices were studied using cephalometric radiographs to measure vertical change in position of the anterior and posterior teeth and the mandible. The splint wear time ranged from a minimum of one half year to a maximum of 4.8 years, with a mean of 1.33 years. No significant change was recorded in the distance from the mandibular molar to the mandibular plane. On average, the maxillary incisor and maxillary molar extruded about 1 mm, while the mandibular molar was unchanged and the mandibular incisor intruded about 0.6 mm. Posterior face height increased an average of 1.6 mm, and anterior face height increased an average of 2.7 mms. In 20% of the patients, intrusion of the mandibular molars of 1 mm or more occurred. In 41%, extrusion of the maxillary incisors of 1 mm or more was noted. Intrusion of the upper molars or extrusion of the lower incisors occurred in only 5% of the patients. The data indicates that only a very small proportion of patients having long term splint therapy using the MORA have clinically significant molar intrusion. Change in mandibular position was expressed in a vertical increase in posterior and anterior face height. Only very small changes occurred in antero-posterior position.

Adolescent↗
PubMed1994

MDS Cognitive Performance Scale.

BACKGROUND: Chronic cognitive impairment is a major problem in U.S. nursing homes, yet traditional assessment systems in most facilities included only limited information on cognitive status. Following the Congressional mandate in the Omnibus Reconciliation Act of 1987 (OBRA '87), U.S. nursing homes now complete the Minimum Data Set (MDS), a standardized, comprehensive assessment of each resident's functional, medical, psychosocial, and cognitive status. We designed a Cognitive Performance Scale (CPS) that uses MDS data to assign residents into easily understood cognitive performance categories. METHODS: Information was drawn from three data sets, including two multistate data sets constructed for the Health Care Financing Administration. The prevalence and reliability of the MDS cognitive performance variables were established when assessed by trained nursing personnel. Five selected MDS items were combined to create the single, functionally meaningful seven-category hierarchical Cognitive Performance Scale. RESULTS: The CPS scale corresponded closely with scores generated by the Mini-Mental State Examination and the Test for Severe Impairment, nursing judgments of disorientation, and neurological diagnoses of Alzheimer's disease and other dementias. CONCLUSIONS: The new CPS provides a functional view of cognitive performance, using readily available MDS data. It should prove useful to clinicians and investigators using the MDS to determine a resident's cognitive assets.

Activities of Daily Living↗
PubMed1994

Insulin syringe disposal practices of pediatric patients with insulin-dependent diabetes mellitus.

Pediatric patients with insulin-dependent diabetes mellitus were surveyed over a 5-month period to determine disposal practices of insulin syringes. Eighty-nine (79.5%) of 112 patients surveyed responded. Thirty-three percent of the responders disposed of syringes in accordance with recommendations of the local health department and the American Diabetes Association, while the remaining patients did not. Fifty-two percent of the patients rendered the syringes useless before disposal. The study revealed a need to educate and inform patients on the proper procedures that should be followed when disposing of syringes in the home.

Adolescent↗
PubMed1994

The burden and outcomes associated with dehydration among US elderly, 1991.

OBJECTIVES: Dehydration has been underappreciated as a cause of hospitalization and increased hospital-associated mortality in older people. This study used national data to analyze the burden and outcomes following hospitalizations with dehydration in the elderly. METHODS: Data from 1991 Medicare files were used to calculate rates of hospitalization with dehydration, to examine demographic characteristics and concomitant diagnoses associated with dehydration, and to analyze the contribution of dehydration to mortality. RESULTS: In 1991, 6.7% (731,695) of Medicare hospitalizations had dehydration listed as one of the five reported diagnoses, a rate of 236.2/10,000 elderly Medicare beneficiaries. In 1991, Medicare reimbursed over $446 million for hospitalizations with dehydration as the principal diagnosis. Older people, men, and Blacks had elevated risks for hospitalization with dehydration. Acute infections, such as pneumonia and urinary tract infections, were frequent concomitant diagnoses. About 50% of elderly Medicare beneficiaries hospitalized with dehydration died within a year of admission. CONCLUSIONS: Hospitalization of elderly people with dehydration is a serious and costly medical problem. Attention should be focused on understanding predisposing factors and devising strategies for prevention.

Age Factors↗
PubMed1994

Research utilization in critical care: an exemplar.

The authors describe the process and outcome of implementing a research-based pain management protocol in four adult critical care units at a large, Midwestern tertiary care center. The project was initiated and directed by members of the divisional research committee. Strategies used to change practice included determining if pain management was a problem via quality assessment monitors, surveying nurses regarding their knowledge and attitude toward pain management, educating staff members about the research base for the practice change, using change champions in each unit, and developing a core group of nurses in each unit to facilitate the change. Outcomes of this research utilization project include a 41% decline in the number of patients in pain, a 44% decline in pain intensity, and improvement in nurses knowledge about pain.

Clinical Nursing Research↗
PubMed1994

Analysis of condylar position changes: a test of validity of posteroanterior cephalometric and 20-degree lateral cephalometric techniques enhanced by digital subtraction.

This preclinical study was designed to evaluate 20-degree lateral cephalometric and posteroanterior cephalometric techniques with digital subtraction enhancement for their ability to detect 1-, 2-, and 3-mm shifts in condylar position in two of three planes of space (horizontal or transverse and vertical). The model used was a dry human skull with a complete mandible mounted on a microscopic stage with positioning accuracy to 0.1 mm in x, y, and z planes. Analysis of variance showed no significant difference from expected values in the transverse plane (posteroanterior cephalogram only). There were significant differences in the sagittal plane (20-degree lateral cephalogram only) for the 2- and 3-mm shifts (P < .001). There were no significant differences among expected values in the vertical plane for individual increments or for increment comparisons. The magnitude of standard deviations and of the absolute value of differences indicates markedly increased variability for both techniques as compared to tomograms produced with cephalostat repositioning. The authors conclude that even with precise repositioning and digital subtraction enhancement, cephalometric radiographs are inadequate for clinical monitoring of condylar position.

Analysis of Variance↗
PubMed1994

Stability following superior repositioning of the maxilla by Le Fort I osteotomy: five-year follow-up.

Changes in dental and skeletal relationships were evaluated 5 years postsurgically in 49 patients whose maxilla had been superiorly repositioned by a Le Fort I osteotomy. All of the patients had at least 2 mm of intrusion at the maxillary incisor and molar; none had a mandibular ramus osteotomy or other osteotomy except genioplasty. Only 6.5% had 2 mm or greater of net vertical change in skeletal or dental landmarks at 1 year postsurgery. From 1 to 5 years postsurgery, minimal changes in skeletal and dental landmarks occurred in the majority of the patients, but approximately 25% of the patients showed 2 mm or more of downward movement of the maxilla and/or eruption of maxillary teeth, leading to downward-backward rotation of the mandible. Only one patient had more than 1 mm of open bite on long-term follow-up. An increase in overbite, resulting from incisor eruption, was noted in 14%, and an increase in overjet occurred in 12% as the mandible rotated. It appears that modest long-term skeletal and dental changes occur in some surgically treated long-face patients. The likelihood of long-term change was not related to the age of the patient, stability during the first postsurgical year, or segmentation of the maxilla at surgery.

Adolescent↗
PubMed1993

Preliminary crystallographic study of 6-phosphogluconate dehydrogenase from Trypanosoma brucei.

We have obtained well-ordered single crystals of 6-phosphogluconate dehydrogenase, an enzyme of the oxidative branch of the pentose phosphate pathway, from Trypanosoma brucei. The crystals are trigonal rhombs with unit cell dimensions a = b = 135.1 A, c = 116.7 A and belong to one of the enantiomorphic pair of space groups P3(1)21/P3(2)21. X-ray diffraction to better than 2.8 A has been recorded using a rotating anode CuK alpha source. Elucidation of the three-dimensional structure of the T. brucei enzyme will, by indicating structural differences from the known sheep enzyme structure, aid the design of mutants to probe the active site. Knowledge of the structure will also assist in assessing the potential use of rationally designed compounds to inhibit this enzyme specifically.

Animals↗