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Biomedical subjects

J M Phillips

Publications and source records attributed to J M Phillips.

At least 19 recordsLinked to original sources
PubMed1992

Intrauterine intravascular transfusion for fetal haemolytic anaemia: the Western Australian experience.

OBJECTIVE: To report the first four years' clinical experience with fetal intravascular blood transfusion for the treatment of fetal haemolytic anaemia in Western Australia. SETTING: King Edward Memorial Hospital, Perth, which is the sole tertiary level perinatal centre in Western Australia with a referral base of approximately 25,000 pregnancies each year. METHODS: Transfusion was by injection of packed cells from Rh-negative donors into the fetal umbilical vein near the site of insertion into the placenta. Fetal haemoglobin levels were measured before and after each transfusion. In most cases, the fetus was paralysed by intramuscular tubocurarine. RESULTS: Sixty intravenous transfusions were performed in 20 pregnancies. At the time of the initial transfusion, the mean haemoglobin level was 5.8 g/dL (range, 2.5-8.5 g/dL) and six fetuses had signs of hydrops. The case survival rate was 80% and the procedure survival rate was 93%. Three of the deaths occurred in the first five cases. Caesarean section was performed during two of the procedures, one because of bleeding from the cord puncture site and one because of tamponade of the umbilical vessels. CONCLUSION: Fetal intravascular transfusion is a highly effective treatment for fetal alloimmunisation and allows pregnancies to continue to term and to be delivered vaginally. However, the procedure may be difficult and requires a team approach with ready access to fetal monitoring and emergency caesarean section. Our results suggest that increasing experience of the team is a major factor in improved outcome.

Adult↗
PubMed1992

Reduced blood clearance and increased urinary excretion of N-nitrosodimethylamine in patas monkeys exposed to ethanol or isopropyl alcohol.

Low concentrations of N-nitrosodimethylamine are metabolized in rodent and human liver by cytochrome P450IIE1, an activity competitively inhibitable by ethanol. In rodents coadministration of ethanol with N-nitrosodimethylamine results in increased tumorigenicity in extrahepatic organs, probably as a result of reduced hepatic clearance. To test this concept in a primate, the effects of ethanol cotreatment on the pharmacokinetics of N-nitrosodimethylamine were measured in male patas monkeys. Ethanol, 1.2 g/kg given p.o. before i.v. N-nitrosodimethylamine (1 mg/kg) or concurrently with an intragastric dose resulted in a 10-50-fold increase in the area under the blood concentration versus time curves and a 4-13-fold increase in mean residence times for N-nitrosodimethylamine. Isopropyl alcohol, 3.2 g/kg 24 h before N-nitrosodimethylamine, also increased these parameters 7-10-fold; this effect was associated with persistence of isopropyl alcohol and its metabolic product acetone, both IIE1 inhibitors, in the blood. While no N-nitrosodimethylamine was detected in expired air, trace amounts were found in urine. Ethanol and isopropyl alcohol pretreatment increased the maximum urinary N-nitrosodimethylamine concentration 15-50-fold and the percentage of the dose excreted in the urine by 100-800-fold. Thus ethanol and isopropyl alcohol greatly increase systemic exposure of extrahepatic organs to N-nitrosodimethylamine in a primate.

1-Propanol↗
PubMed1992

Management of ovarian masses. AAGL 1990 survey.

The American Association of Gynecologic Laparoscopists (AAGL) membership was surveyed on the use of laparoscopy in the management of persistent ovarian masses in 1990. A total of 13,739 laparoscopies were performed for this indication. Ninety-six percent of the respondents performed laparoscopy for this indication on premenopausal women only. Among respondents performing laparoscopy for suspected cancer, there was a 14% conversion rate to laparotomy, compared to 9% among those who performed direct laparotomies when cancer was suspected. An overall incidence of 4 per 1,000 cases of stage I ovarian cancer was found, and about 70% of women with persistent adnexal masses were managed by laparoscopy alone. The risks to women with cancer, as well as the benefits to those without, are discussed.

Female↗
PubMed1991

Attempts to transmit hepatitis B virus to chimpanzees by arthropods.

Bedbugs (Cimex lectularius L.) were fed on an infective blood-hepatitis B virus (HBV) mixture. Further bedbugs and tampan ticks (Ornithodoros moubata [Murray]) were fed on HBV-carrier chimpanzees. After a 10-13 day interval for oviposition, tests done on samples of individual arthropods showed that 53-85% of the bugs were HBsAg-positive and none HBeAg-positive, while 100% of the ticks were HBsAg-positive and 88% HBeAg-positive. The remaining arthropods were fed on 3 susceptible chimpanzees, which had failed to develop HBV infection after 11 months, indicating no transmission had occurred. Subsequently the presence of viable virus in the original infective meals was confirmed by inoculation of the relevant donor sera directly into the 3 still susceptible chimpanzees. HBV infections quickly followed in each animal. It is concluded that, while mechanical transmission of HBV is most unlikely after a 10-13-day interval between feedings in bedbugs and tampans, it is still possible that mechanical transmission between humans might occur during interrupted feeds.

Animals↗
PubMed1991

Benign nasal polyposis presenting as an intracranial mass: case report.

An interesting case of benign nasal polyposis with intracranial extension and subsequent abscess formation is described. Its diagnosis and treatment are presented and the pathology is demonstrated. The literature related to this rare disease process is discussed in detail.

Brain Abscess↗
PubMed1991

Immunofluorescent localization of three Na,K-ATPase isozymes in the rat central nervous system: both neurons and glia can express more than one Na,K-ATPase.

In the CNS, there are multiple isozymes of the sodium and potassium ion-stimulated adenosine triphosphatase (Na,K-ATPase) that have differences in affinity for Na+, ATP, and cardiac glycosides. Three forms of the catalytic subunit (designated alpha 1, alpha 2, and alpha 3) are known to be derived from different genes, but little is known of the cellular distributions of the proteins or their physiological roles. Isozyme-specific monoclonal antibodies permitted the immunofluorescent localization of the 3 Na,K-ATPases in the rat CNS, and markedly different patterns of staining were seen. All 3 isozymes were detected, singly or in combination, in 1 or more neuronal structures, while both alpha 1 and alpha 2 were detected in glia. Many different neuroanatomic structures or cell types stained for more than 1 isozyme. Even when a structure or region stained for more than 1 isozyme, the pattern of staining was frequently dissimilar, suggesting complex differences in gene expression and cellular localization.

Animals↗
PubMed1990

American Association of Gynecologic Laparoscopists' 1988 membership survey on laparoscopic sterilization.

The 1988 membership survey of the American Association of Gynecologic Laparoscopists (AAGL) indicated that the membership continued to perform fewer sterilizations than previously reported. The respondents reported performing 30,480 sterilizations, 41,160 diagnostic laparoscopies and 13,920 hysteroscopies. The distribution of laparoscopic sterilizations by method of tubal occlusion did not change appreciably since 1985. Complications from diagnostic laparoscopy were consistently higher than those after sterilization; two deaths (4.8 per 100,000 procedures) were identified after diagnostic laparoscopy, and no deaths were reported after sterilization. The relative likelihood of ectopic pregnancy was substantially greater after coagulation procedures than after mechanical ones. The decrease in the membership's performance of laparoscopic sterilization was occurring during a relative increase in the performance of newer diagnostic and therapeutic endoscopic procedures.

Female↗
PubMed1990

American Association of Gynecologic Laparoscopists' 1988 membership survey on operative laparoscopy.

The American Association of Gynecologic Laparoscopists' (AAGL) 1988 membership survey on operative laparoscopy had a response rate of 24%. A total of 880 respondents reported performing 36,928 operative laparoscopy procedures. A total of 75% of the respondents reported performing 47 or fewer procedures. The most frequently reported conditions managed with operative laparoscopy were endometrial implants, extensive adhesions and ovarian cysts. Most operative laparoscopies were performed because of infertility (40%) or pelvic pain (41%). The overall serious complication rate was 15.4 per 1,000 procedures. Complications that occurred in greater than 1 per 1,000 procedures included hospitalization greater than 72 hours, persistent human chorionic gonadotropin titer elevation after ectopic pregnancy, hospital readmission and unintended laparotomy to manage bowel injury, urinary tract injury or hemorrhage. Two deaths (5.4 per 100,000 procedures) were reported.

Gynecology↗
PubMed1990

American Association of Gynecologic Laparoscopists 1988 Membership Survey on Operative Laparoscopy.

The American Association of Gynecologic Laparoscopists' (AAGL) 1988 Membership Survey on Operative Laparoscopy had a response rate of 24%. A total of 880 respondents reported performing 36928 operative laparoscopy procedures. A total of 75% of the respondents reported performing 47 or fewer operative laparoscopy procedures. A total of 75% of the respondents reported performing 47 or fewer procedures. The most frequently conditions managed by operative laparoscopy were endometrial implants, extensive adhesions, and ovarian cysts. Most operative laparoscopies were performed because of infertility (40%) or pelvic pain (41%). The overall serious complication rate was 15.4 per 1,000 procedures. Complications which occurred in more than 1 per 1,000 procedures included hospitalization greater than 72 hours, persistent HCG titer elevation after ectopic pregnancy, hospital readmission, and unintended laparotomy to manage bowel injury, urinary tract injury, and hemorrhage. Two deaths (5.4 per 100,000 procedures) were reported.

Female↗
PubMed1990

American Association of Gynecologic Laparoscopists 1988 Membership Survey on Laparoscopic Sterilization.

The 1988 Membership Survey of the American Association of Gynecologic Laparoscopists (AAGL) indicated that the membership continues to perform fewer sterilizations than previously reported. The respondents reported performing 30,480 sterilizations, 41,160 diagnostic laparoscopies and 13,920 hysteroscopies. The distribution of laparoscopic sterilizations by method of tubal occlusion has not changed appreciably since 1985. Complications from diagnostic laparoscopy are consistently higher than those after sterilization; two deaths (4.8 deaths per 100,000 procedures) were identified after diagnostic laparoscopy and no deaths were reported after sterilization. The relative likelihood of ectopic pregnancy is substantially greater after coagulation procedures than after mechanical ones. The decrease in membership performance of laparoscopic sterilization is occurring at the same time as a relative increase in the performance of newer diagnostic and therapeutic endoscopic procedures.

Female↗
PubMed1990

American Association of Gynecologic Laparoscopists 1988 Membership Survey on Operative Hysteroscopy [correction of hysterectomy].

The 1988 American Association of Gynecologic Laparoscopists' (AAGL) Membership Survey on Operative Hysteroscopy had a 19% response rate. A total of 377 respondents reported performing 7,293 operative hysteroscopies. The number of procedures reported per respondent ranged from 1 to 325; 75% of physicians reported performing 20 or fewer procedures. In 1988, a small number of practitioners performed a large number of procedures. Directed biopsy and polypectomy through the hysteroscope were the procedures most commonly reported. Most operative hysteroscopies were performed for a complaint of either abnormal bleeding (57%) or infertility (27%). The most frequently reported complication was uterine perforation not requiring transfusion (13 per 1,000 procedures). More serious complications which occurred in at least 1 per 1,000 procedures included water intoxication or pulmonary edema, hospital readmission, hospitalization greater than 72 hours, and transfusion for hemorrhage.

Female↗
PubMed1990

American Association of Gynecologic Laparoscopists' 1988 membership survey on operative hysteroscopy.

The 1988 American Association of Gynecologic Laparoscopists' membership survey on operative hysteroscopy had a 19% response rate. A total of 377 respondents reported performing 7,293 operative hysteroscopies. The number of procedures reported per respondent ranged from 1 to 325; 75% of physicians reported performing 20 or fewer procedures. In 1988 a small number of practitioners performed a large number of procedures. Directed biopsy and polypectomy through the hysteroscope were the procedures reported most commonly. Most operative hysteroscopies were performed for a complaint of either abnormal bleeding (57%) or infertility (27%). The complication reported most frequently was uterine perforation not requiring a transfusion (13 per 1,000 procedures). More serious complications that occurred in at least 1 per 1,000 procedures included water intoxication or pulmonary edema, hospital readmission, hospitalization greater than 72 hours and transfusion for hemorrhage.

Gynecology↗
PubMed1988

The immune response to nematode parasites: modulation of mast cell numbers and function during Strongyloides stercoralis infections in nonhuman primates.

Mucosal mast cell numbers are modulated in the intestines of rodents during parasitic infections. These mast cells can degranulate in response to worm antigens, and this event has been suggested to play a protective role for the host. To examine whether mast cells in higher animals play a role in protecting from disseminated parasitic disease, mast cell numbers and responsiveness to parasite antigens were evaluated in 5 Erythrocebus patas infected with the human intestinal nematode Strongyloides stercoralis. Initial infection and subsequent challenge infections were associated with increase in jejunal histamine and mast cell numbers, and these mast cells could release histamine in response to parasite antigens. Jejunal mast cell numbers returned to normal during a chronic phase of infection. The cells lost their ability to respond to antigenic stimulation following limited steroid treatment. Subsequent activation of chronic infections to fatal disseminated disease by more prolonged steroid treatment was associated with a marked decrease in jejunal mast cell numbers and histamine. In one animal which succumbed to severe disease without steroid treatment, jejunal mast cells were refractory to worm antigens.

Animals↗