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Biomedical subjects

E Phillips

Publications and source records attributed to E Phillips.

At least 19 recordsLinked to original sources

Characterization of a recombinant fragment that contains a carbohydrate recognition domain of the filamentous hemagglutinin.

The filamentous hemagglutinin (FHA) of Bordetella pertussis plays an important role in establishing infection by attaching the bacteria to the ciliated respiratory epithelial cells. Expression of DNA encoding residues 1141 to 1279 of FHA in Escherichia coli yields a protein of 18,000 Da that exhibits some of the carbohydrate recognition properties of FHA (S. M. Prasad, Y. Yin, E. Rodzinski, E. I. Tuomanen, and H. R. Masure, Infect. Immun. 61:2780-2785, 1993). We have constructed an E. coli strain that expresses this protein, designated fragment A, in a soluble form at markedly elevated levels. Fragment A could be purified with high purity and yields and was immunogenic in mice. Both fragment A and anti-fragment A sera inhibited the binding of B. pertussis to asialo-GM2 and to rabbit ciliated cells. These observations demonstrate that this fragment of FHA contains a cellular binding domain capable of eliciting functional antibodies.

Adhesins, Bacterial

Electrophysiological findings during the menstrual cycle in women with and without late luteal phase dysphoric disorder: relationship to risk for alcoholism?

This study evaluated electrophysiological (EEG, ERGs), and cognitive (neuropsychological testing) responses in patients with late luteal phase dysphoric disorder (LLPDD, DSM-III-R) and controls over the menstrual cycle. In both groups, the frequency and stability of electroencephalogram (EEG) alpha activity significantly differed over the menstrual cycle. The latency of the P3 components of the auditory event-related potentials (ERPs) did not vary as a function of the menstrual cycle, but the P3 latency was found to be later in LLPDD subjects as a group. When the LLPDD subjects were assessed based on family history of alcoholism, it was found that those with alcoholic relatives had more high-frequency alpha (9-12 Hz) in their EEG, lower P3 component amplitudes, and longer P3 component latencies when compared to LLPDD subjects without alcoholic relatives or controls. These data suggest that LLPDD may have persistent neurophysiological correlates, some of which are also in common with risk for alcoholism.

Adult

Effect of patient position upon success in placing central venous catheters.

BACKGROUND: There is little consensus regarding the most efficient or the safest method by which to place a central venous catheter (CVC). METHODS: A single house officer prospectively evaluated 140 patients for whom he was requested to place CVCs. One hundred and eight patients participated in a randomized study of positioning. Of the 140 patients, 7 had emergency line placement; 105 randomized patients undergoing elective CVC placement form the basis for this report (power > 80% to detect change of one needle pass between groups). Patient positions were termed "bump" (head turned to the contralateral side and a rolled towel placed vertically between the scapulas) and "no bump" (head facing forward and no towel placed in the back.) RESULTS: Ninety-three of 105 patients had successful catheter placement. Catheters were more often successfully introduced in the bump group than no bump group (98% versus 83%, P < 0.04). For patients with difficult CVC placement (those > 160 pounds, those with a weight-to-height ratio > 29, those with previous unsuccessful catheterization), the bump position was superior with respect to increased likelihood of venous blood return, decreased likelihood of arterial blood return, and increased likelihood of successful catheterization, although differences did not reach statistical significance (P < 0.05) in individual analyses. Of patients with successful catheterization, 97% had three or fewer needle passes. Those with more than three needle passes were less likely to have successful catheter placement (P < 0.01), were more likely to have arterial blood return (P < 0.01) and pneumothorax (P = 0.12). CONCLUSIONS: The bump position improves the likelihood of successful central venous catheter placement. No more than three needle passes ought to be attempted.

Aged

Personality traits in LLPDD and normal controls during follicular and luteal menstrual-cycle phases.

In 15 women with Late Luteal Phase Dysphoric Disorder (LLPDD) and in 15 normal control subjects, personality traits were assessed using the Millon Clinical Multiaxial Inventory (MCMI) during follicular and luteal menstrual-cycle phases. Compared with controls, LLPDD subjects had less compulsive but more passive/aggressive and borderline/cycloid traits, and more depression and hypomania. Menstrual-cycle phase did not significantly affect personality variables in either group. In particular, depression and hypomania in LLPDD subjects suggests a relationship with affective disorders.

Adult

Antimicrobial and toxic effects of established and potential root canal irrigants.

Three dilutions of the commonly used irrigant sodium hypochlorite (0.5%, 2.5%, and 5.25%) and the potential irrigants Peridex, chlorhexidine gluconate (0.12%), and Therasol were tested. Alcohol and saline served as controls also. The in vitro portion of this study used four different microorganisms (Streptococcus mutans, Peptostreptococcus micros, Prevotella intermedius, and Porphyromonas gingivalis) to determine antimicrobial effect. Presterilized 7-mm diameter Whatman paper disks soaked with the test solution were prepared, and disks were placed onto the previously seeded agar petri dishes. Each dish was incubated aerobically or anaerobically according to the microorganisms used. An in vivo animal model (guinea pig) was used to examine subcutaneous local tissue reactions using the same materials; 0.1 ml of each test solution was injected subcutaneously into predetermined locations on the animal dorsum. Test site histological examination was done 2 h, 2 days, and 2 wk after the injections. The results of this comparative study indicate Peridex (chlorhexidine gluconate) and Therasol may have good potential for endodontic usage.

Animals

Immunocytological analysis of the Tn associated antigen 83D4 in serous effusions from patients with cancer: comparison with Tn soluble glycoprotein.

AIMS: To determine whether the monoclonal antibody (MoAb) 83D4, previously shown to be highly specific for carcinoma cells, can be used as an immunocytological marker to discriminate between benign and malignant cells in serous effusions; and to test for a correlation between expression of the antigen reacting with MoAb 83D4 on effusion cells and the amount of soluble 83D4 antigen in effusion fluids. METHODS: Thirty three pleural and 23 peritoneal effusions from 56 cancer patients with metastatic disease were tested for the presence of Tn associated 83D4 antigen by immunocytochemical staining, and for the presence of soluble antigen in supernatants. The patients had undergone various chemotherapy and radiation therapy protocols. RESULTS: As a result of the various types of treatment, the cytological characteristics of the cells were often modified and the antigenic epitopes may have been altered. Positive staining for 83D4 MoAb was obtained in 36 (97%) of the 37 malignant effusions, eight (73%) of 11 suspect effusions, and three (38%) of the eight apparently benign effusions (free of malignant cells). In these latter cases, cytological reassessment showed a few suspect cells in two cases. 83D4 soluble antigen was detected in 30 of 37 malignant effusions (81%), five of 11 suspected infusions (46%), and five of eight apparently benign effusions (63%). CONCLUSIONS: Immunocytochemical staining with anti-83D4 antibody is useful for differentiating reactive or atypical mesothelial cells from epithelial cells, especially in breast cancer effusions.

Adenocarcinoma

Molecular studies on kinin receptors.

We describe the results of functional studies on DNA clones encoding functional bradykinin receptors derived from human, rat, and mouse sources and including both genomic and complementary DNA clones. In both the Xenopus oocyte and the COS cell expression systems, the receptors from human and rat showed the pharmacological properties of B2 receptors, but receptors from mouse displayed both B1- and B2-like pharmacological properties. We further investigated the molecular relationship between the B1 and B2 receptor subtypes expressed by a human fibroblast cell line, and we demonstrate that these two receptor subtypes are encoded by distinct mRNA species.

Amino Acid Sequence

Evaluation of a rapid specific ward based assay for creatinine in blood.

We have evaluated a dry reagent stick test for the quantitation of creatinine in plasma employing a whole blood sample. The assay was found to be specific for creatinine and correlated well (r = 0.993) with an established laboratory procedure. The precision found indicated that the method was suitable for use in the diagnosis and monitoring of renal disease.

Clinical Enzyme Tests

Standard of care.

Did you know that a nurse may be held to the same standard of care as a physician? In a 1989 Indiana case, Planned Parenthood of Northwest Indiana, Inc. v. Vines 543 N.E. 2d 654 (Ind. App. 3 Dist. 1989), a patient and her husband sued a clinic and a nurse for negligence in the insertion of an intrauterine device. The Indiana Court of Appeals upheld a lower court's finding that the nurse-practitioner be held to the standard of care of a physician in performing this procedure.

Humans

Laparoendoscopy (laparoscopy assisted enteroscopy) and partial resection of small bowel.

We investigated laparoendoscopy (laparoscopy-assisted small bowel enteroscopy) as an aid in managing the challenging diagnostic problem of occult small bowel hemorrhage. We performed laparoendoscopy on five nonconditioned dogs and five conditioned dogs. In each case, we laparoscopically inspected the small bowel from the ligament of Treitz to the ileocecal valve. Small bowel was exteriorized, an enterotomy was performed, and an Olympus CL-100L colonoscope was inserted and advanced proximally to the stomach and distally to the ileocecal valve. A segment of small bowel was arbitrarily designated as the site of bleeding, was exteriorized, and was resected. Bowel continuity was restored with a stapled anastomosis. The animals were euthanized and autopsied immediately after the procedure (n = 5) or a week following the procedure (n = 5), at which time the anastomoses were tested for leakage and patency. The entire small bowel was visualized in all animals. There were no anastomotic leaks. Laparoendoscopy may be of value in identifying and treating hemorrhagic origin of small bowel. Clinical trials are warranted.

Anastomosis, Surgical

Residual retroperitoneal mass following chemotherapy for infantile yolk sac tumor.

A child treated with chemotherapy for disseminated yolk sac tumor had a residual retroperitoneal mass after normalization of serum alpha-fetoprotein. The mass was excised and histologically showed only fibrous tissue, necrosis and calcification. To our knowledge this is the first case reported of a prepubertal yolk sac tumor associated with a residual retroperitoneal mass.

Antineoplastic Combined Chemotherapy Protocols

B1 and B2 bradykinin receptors encoded by distinct mRNAs.

Bradykinin receptors have been subdivided into at least two major pharmacological subtypes, B1 and B2. The cDNAs encoding functional B2 receptors have recently been cloned, but no molecular information exists at present on the B1 receptor. In this article, we describe experiments examining the possible relationship between the mRNAs encoding the B1 and B2 types of receptor. We showed previously that the human fibroblast cell line WI38 expresses both B1 and B2 receptors. In this report, we describe oocyte expression experiments showing that the B1 receptor in WI38 human fibroblast cells is encoded by a distinct mRNA approximately 2 kb shorter than that encoding the B2 receptor. We have used an antisense approach in conjunction with the oocyte expression system to demonstrate that the two messages differ in sequence at several locations throughout the length of the B2 sequence. Taken together with the mixed pharmacology exhibited in some expression systems by the cloned mouse receptor, the data indicate that B1-type pharmacology may arise from two independent molecular mechanisms.

Amino Acid Sequence

What are the clinical determinants of early energy expenditure in critically injured adults?

The clinical determinants of energy expenditure in critically injured adults require definition. Among adult blunt trauma victims who required mechanical ventilation, the resting energy expenditure was calculated with the Harris-Benedict equation (HBEE) and the early (< or = 5 days postinjury) energy expenditure was measured by indirect calorimetry (MEE) (n = 115). The MEE was 2052 +/- 531 kcal/day and MEE/HBEE ("stress factor") was 1.24 +/- 0.2. The MEE was correlated with HBEE, age, height, weight, sex, temperature, and paralytic agents (p < 0.01). However, MEE did not correlate with ISS, admission GCS score, admission base deficit, initial systolic blood pressure, or the number of units of packed red blood cells transfused in the first 24 hours after injury (p = NS). Temperature and paralysis correlated with MEE/HBEE (p < 0.01). A regression model of MEE was developed with the clinical variables HBEE, temperature, and the presence or absence of paralytic agents (r2 = 0.62; p < 0.001): MEE (kcal/d) = 1.4(HBEE) + 71.4(temperature) + 274(paralytics; + = 1, - = 2) - 3485. In mechanically ventilated trauma victims, both the early energy expenditure and the stress factor are determined by host factors but are independent of the severity of the anatomic and physiologic insult. The degree of hypermetabolism observed in this population was less than previously reported.

Adult