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Biomedical subjects

P J Phillips

Publications and source records attributed to P J Phillips.

At least 19 recordsLinked to original sources

The increasing prevalence of diabetes in South Australia: the relationship with population ageing and obesity.

OBJECTIVES: To use representative population surveillance data to monitor and project changes in the prevalence of diabetes for different age and body mass index (BMI) groups. STUDY DESIGN: Representative, annual, face-to-face South Australian Health Omnibus Surveys, 1991-2003 (n=3000 per year). METHODS: Trends in self-reported diabetes prevalence by age group and BMI were examined. Separate projections were made on the basis of predicted changes in population demography and diabetes prevalence. RESULTS: The age-sex standardized absolute prevalence of self-reported diabetes among people aged 15 years and over increased from 3.5% in 1991 to 6.7% in 2003. If this current trend continues, the prevalence is expected to increase to 10.5% by 2016. The prevalence of diabetes was significantly higher among those classified as obese (6.5% in 1991 to 12.2% in 2003) than those with normal BMI. The greatest relative percentage increase in prevalence between 1991 and 2003 (169%) was seen among people aged 15-39 years. Taking both age group and BMI classification into account, the greatest relative percentage increases over this time were seen among those with normal BMI aged 60 years or older (148%), and those who were obese and aged less than 60 years (139%). CONCLUSIONS: The prevalence of diabetes and obesity increased significantly between 1991 and 2003. Population ageing and an increase in diabetes prevalence in the future will further increase the burden of diabetes. Future increases in diabetes prevalence are not inevitable, however, if investments are made in public health prevention programmes, particularly those addressing obesity.

Adolescent↗

HPLC-NMR with severe column overloading: fast-track metabolite identification in urine and bile samples from rat and dog treated with [14C]-ZD6126.

The subject of this study was the determination of the major urinary and biliary metabolites of [(14)C]-ZD6126 following i.v. administration to female and male bile duct cannulated rats at 10 mg/kg and 20 mg/kg, respectively, and male bile duct cannulated dogs at 6 mg/kg by HPLC-NMR spectroscopy. ZD6126 is a phosphorylated pro-drug, which is rapidly hydrolysed to the active metabolite, ZD6126 phenol. The results presented here demonstrate that [(14)C]-ZD6126 phenol is subsequently metabolised extensively by male dogs and both, male and female rats. Recovery of the dose in bile and urine was determined utilising the radiolabel, revealing biliary excretion as the major route of excretion (93%) in dog, with the majority of the radioactivity recovered in both biofluids in the first 6 h. In the rat, greater than 92% recovery was obtained within the first 24 h. The major route of excretion was via the bile 51-93% within the first 12 h. The administered phosphorylated pro-drug was not observed in any of the excreta samples. Metabolite profiles of bile and urine samples were determined by high performance liquid chromatography with radiochemical detection (HPLC-RAD), which revealed a number of radiolabelled components in each of the biofluids. The individual metabolites were subsequently identified by HPLC-NMR spectroscopy and HPLC-MS. In the male dog, the major component in urine and bile was the [(14)C]-ZD6126 phenol glucuronide, which accounted for 3% and 77% of the dose, respectively. [(14)C]-ZD6126 phenol was observed in urine at 1% of dose, but was not observed in bile. A sulphate conjugate of demethylated [(14)C]-ZD6126 phenol was identified in bile by HPLC-NMR and confirmed by HPLC-MS. In the rat, the bile contained two major radiolabelled components. One was identified as the [(14)C]-ZD6126 phenol glucuronide, the other as a glucuronide conjugate of demethylated [(14)C]-ZD6126 phenol. However, a marked difference in the proportions of these two components was observed between male and female rats, either due to a sex difference in metabolism or a difference in dose level. The glucuronide conjugate of the demethylated [(14)C]-ZD6126 phenol was present at higher concentration in the bile of male rats (4-34%), while the phenol glucuronide was present at higher concentration in the bile of female rats (8-70%) over a 0-6 h collection period. A third component was only observed in the bile samples (0-6 h and 6-12 h) of male rats. This was identified as being the same sulphate conjugate of demethylated [(14)C]-ZD6126 phenol as the one observed in dog bile. The rat urines contained two main metabolites in greatly varying concentrations, namely the demethylated [(14)C]-ZD6126 phenol glucuronide and the glucuronide of [(14)C]-ZD6126 phenol. Again, the differences in relative amounts between male and female rats were observed, the major metabolite in the urines from male rats being the demethylated [(14)C]-ZD6126 phenol (0-17% in 0-24 h), whilst the phenol glucuronide, accounting for 0.5-50% of the dose over 0-24 h, was the major metabolite in females. Methanolic extracts of the pooled biofluid samples were submitted for HPLC-NMR for the quick identification of the major metabolites. Following a single injection of the equivalent of 6-28 ml of the biofluids directly onto the HPLC-column with minimal sample preparation, the metabolites could be largely successfully isolated. Despite severe column overloading, the major metabolites of [(14)C]-ZD6126 could be positively identified, and the results are presented in this paper.

Animals↗

Spin relaxation by transient monopolar and bipolar optical orientation.

We have used two-color time-resolved spectroscopy to measure the relaxation of electron spin polarizations in a bulk semiconductor. The circularly polarized pump beam induces a polarization either by direct excitation from the valence band, or by free-carrier (Drude) absorption when tuned to an energy below the band gap. We find that the spin relaxation time, measured with picosecond time resolution by resonant induced Faraday rotation in both cases, increases in the presence of photogenerated holes. In the case of the material chosen, n-InSb, the increase was from 14 to 38 ps.

Journal Article↗

Stimulated terahertz stokes emission of silicon crystals doped with antimony donors.

Stimulated Stokes emission has been observed from silicon crystals doped by antimony donors when optically excited by radiation from a tunable infrared free electron laser. The photon energy of the emission is equal to the pump photon energy reduced by the energy of the intervalley transverse acoustic (TA) g phonon in silicon (approximately 2.92 THz). The emission frequency covers the range of 4.6-5.8 THz. The laser process occurs due to a resonant coupling of the 1s(E) and 1s(A1) donor states (separation approximately 2.97 THz) via the g-TA phonon, which conserves momentum and energy within a single impurity center.

Journal Article↗

Cytochrome P450-dependent metabolism of gefitinib.

The in vitro metabolism of [(14)C]-gefitinib (1-3 microM) was investigated using human liver microsomes and a range of expressed human cytochrome P450 enzymes, with particular focus on the formation of O-desmethyl-gefitinib (M523595), the major metabolite observed in human plasma. High-performance liquid chromatography with ultraviolet light, radiochemical and mass spectral analysis, together with the availability of authentic standards, enabled quantification and structural identification of metabolites. On incubation with pooled human liver microsomes, [(14)C]-gefitinib underwent rapid and extensive metabolism to a number of metabolites, although M523595 was only a minor microsomal product. Formation of most metabolites was markedly decreased by ketoconazole, but M523595 production was inhibited only by quinidine. Gefitinib was metabolized extensively by expressed CYP3A4, producing a similar range of metabolites to liver microsomes, but M523595 was not formed. CYP1A2, 2C9 and 2C19 produced no measurable metabolism of gefitinib, while CYP3A5 produced a range of metabolites similar to CYP3A4, but to a much lower degree. In contrast, CYP2D6 catalysed rapid and extensive metabolism of gefitinib to M523595. While formation of M523595 was CYP2D6 mediated, the overall metabolism of gefitinib was dependent primarily on CYP3A4, and this was not obviously diminished in liver microsomes from CYP2D6 poor metabolizers.

Cells, Cultured↗

Osteoporosis screening in people with airways disease.

We tested associations between risk factors and bone mineral density in airways disease subjects, and developed a clinical screening tool to identify people who could benefit from bone mineral density testing. Subjects were recruited through hospital outpatients and pharmacies (Newcastle, n = 172). With survey refinement, we then tested a revised tool in a second sample (Adelaide, n = 317). Study factors included oral/inhaled corticosteroid use, asthma severity, respiratory admissions, physical activity, percent predicted forced expiratory volume in one second (FEV1), body mass index, and smoking history. Outcomes were bone mineral density of lumbar vertebra (L2-4) and total (or neck of) femur. Analysis was logistic regression with generation of a simple screening algorithm based upon coefficients. Scoring algorithm risk factors for T-score of < - 2.0: age > or = 68 = 10 points, bone mineral density < 20 = 25, weight < 60 kg = 20, 60-69 kg = 10, > or = 80 cigarette pack years = 15, low-level leisure activity = 5, area under receiver operator curve 0.83. For a cut-off score of 10, sensitivity was 91.2%, specificity 53.9%, positive and negative predictive values 52.3 and 91.7%, and 67.2% were correctly classified. In conclusions, our model has acceptable sensitivity, although limited specificity. Use of this tool may reduce unnecessary referrals for bone mineral density measurement.

Absorptiometry, Photon↗

Randomized controlled trial of alendronate in airways disease and low bone mineral density.

BACKGROUND: Patients with airways disease have been demonstrated to be at risk of osteoporosis, and this is likely to be multifactorial. Our aim was to identify patients with low bone mineral density (BMD) using a screening program, and then evaluate the benefit of daily alendronate. METHOD: Subjects with hip or lumbar spine baseline T-scores < - 2.5, or Z-score < - 1.0 commenced on alendronate/calcium (10 mg/600 mg day) or placebo/calcium, in a double blind randomized controlled trial. BMD by dual emission X-ray absorptiometry (lumbar vertebrae 2-4, neck of femur, total femur) was repeated after 12 months, with adverse events recorded. RESULTS: 145 subjects (74 male, 71 female, mean age 67, median FEV1 1.0 litres = 43% of predicted) were enrolled; 66 alendronate/calcium, 79 placebo/calcium with 24 and 26 withdrawals, respectively. Per protocol but not intention to treat analysis of covariance demonstrated statistically significant improvements in T and Z scores for lumbar spine bone mineral density (P = 0.035, P = 0.040), with no improvement demonstrated at the hip. CONCLUSIONS: Improvement in bone mineral density has been demonstrated at the lumbar spine, but not hip, by per protocol analysis, with daily alendronate, at 12 months.

Absorptiometry, Photon↗

PLD1b in IIC9 fibroblasts is selectively activated in the nucleus and not in the Golgi apparatus.

Mitogen-induced activation of a nuclear-acting PC-phospholipase D (PLD) is mediated, at least in part, by the translocation of RhoA to the nucleus. A remaining question is whether PLD in all subcellular compartments is regulated in the same manner. To address this question, we identified PLD in another subcellular compartment and determined whether its activity was influenced by alpha-thrombin in a RhoA-dependent manner. The data in this manuscript show that nuclear PLD is selectively regulated. alpha-Thrombin stimulates an increase in PLD activity in IIC9 fibroblast nuclei while Golgi PLD activity is unaffected. We cloned PLD1 from IIC9s (hamPLD1b) to show that it is present in both nuclei and Golgi. Interestingly, only nuclear PLD1 is modulated by alpha-thrombin, demonstrating that this activity is selectively regulated. These data provide support for the physiological importance of agonist-induced nuclear signalling enzymes.

ADP-Ribosylation Factors↗

Skeletal site bone mineral density heterogeneity in women and men.

The heterogeneity of skeletal bone mineral density, measured on a single dual-energy X-ray absorptiometer, was examined in a large cohort of 7050 women and 702 men referred for investigation of osteoporosis. The men were significantly older (64.8 +/- 13.2 vs 60.2 +/- 11.5 years) and had an increased prevalence of nontraumatic fractures (ODR: 2.18; 95% CI: 1.82-2.61). The detection rate (sensitivity) for any osteoporosis (spine or hip) in women was 87.1% and 45.1% when assessed at the anteroposterior (AP) spine and femoral neck respectively. The corresponding osteoporosis detection rate in men was 69.3% and 67.5% at the AP spine and femoral neck respectively. Age-related AP spine degenerative changes increased significantly and at a similar rate for both women and men. Misclassification, that is osteoporosis (T-score < -2.5) at one site and normal (T-score > -1) bone mass at the other, was low in both genders (< 4.5%), but 3.1 (95% CI: 2.1-4.6) times more likely in women when the diagnosis was based on the femoral neck compared with the AP spine. Our findings suggest that there are significant age- and gender-related bone mineral density differences between the spine and hip skeletal sites which have to be considered if only one site is selected for investigation.

Absorptiometry, Photon↗

Reproducibility of DXA: potential impact on serial measurements and misclassification of osteoporosis.

The reproducibility of bone mineral density (BMD) measurements by dual-energy X-ray absorptiometry (DXA), based on 12 successive monthly determinations, was assessed in a group of 24 subjects (23 postmenopausal women, 1 man) using six trained operators. The variability (S2A) was calculated from both duplicate operator measurements and the standard error of estimate from nonparametric regression of the individual subject series. Robust estimates of SA from the 90th percentile of the sampling distribution of variances were calculated for the spine (25 mg/cm2), femur neck (20 mg/cm2) and total femur (15.5 mg/cm2) using the bootstrap technique. The critical difference for a significant decrease (p = 0.05) at the spine, femoral neck and total femur was estimated at 57, 46 and 36 mg/cm2 respectively. Estimation of S2A allowed calculation of the probability that the true BMD, for an observed BMD near the osteoporosis diagnostic threshold (T-score < -2.5), is not misclassified. Analysis of covariance established a significant operator-subject interaction at all sites, but only the total femur was associated with a significant difference between operators. The percentage of body fat was a significant covariate for the spine and total femur regions. ANOVA showed that the greater proportion of variance was instrument-related. The limitations of DXA as an analytical method are discussed.

Absorptiometry, Photon↗

Computational and performance aspects of PCA-based face-recognition algorithms.

Algorithms based on principal component analysis (PCA) form the basis of numerous studies in the psychological and algorithmic face-recognition literature. PCA is a statistical technique and its incorporation into a face-recognition algorithm requires numerous design decisions. We explicitly state the design decisions by introducing a generic modular PCA-algorithm. This allows us to investigate these decisions, including those not documented in the literature. We experimented with different implementations of each module, and evaluated the different implementations using the September 1996 FERET evaluation protocol (the de facto standard for evaluating face-recognition algorithms). We experimented with (i) changing the illumination normalization procedure; (ii) studying effects on algorithm performance of compressing images with JPEG and wavelet compression algorithms; (iii) varying the number of eigenvectors in the representation; and (iv) changing the similarity measure in the classification process. We performed two experiments. In the first experiment, we obtained performance results on the standard September 1996 FERET large-gallery image sets. In the second experiment, we examined the variability in algorithm performance on different sets of facial images. The study was performed on 100 randomly generated image sets (galleries) of the same size. Our two most significant results are (i) changing the similarity measure produced the greatest change in performance, and (ii) that difference in performance of +/- 10% is needed to distinguish between algorithms.

Algorithms↗

Familial corticosteroid-binding globulin deficiency due to a novel null mutation: association with fatigue and relative hypotension.

Corticosteroid-binding globulin is a 383-amino acid glycoprotein that serves a hormone transport role and may have functions related to the stress response and inflammation. We describe a 39-member Italian-Australian family with a novel complete loss of function (null) mutation of the corticosteroid-binding globulin gene. A second, previously described, mutation (Lyon) segregated independently in the same kindred. The novel exon 2 mutation led to a premature termination codon corresponding to residue -12 of the procorticosteroid-binding globulin molecule (c.121G-->A). Among 32 family members there were 3 null homozygotes, 19 null heterozygotes, 2 compound heterozygotes, 3 Lyon heterozygotes, and 5 individuals without corticosteroid-binding globulin mutations. Plasma immunoreactive corticosteroid-binding globulin was undetectable in null homozygotes, and mean corticosteroid-binding globulin levels were reduced by approximately 50% at 18.7 +/- 1.3 microg/ml (reference range, 30-52 microg/ml) in null heterozygotes. Morning total plasma cortisol levels were less than 1.8 microg/dl in homozygotes and were positively correlated to the plasma corticosteroid-binding globulin level in heterozygotes. Homozygotes and heterozygote null mutation subjects had a high prevalence of hypotension and fatigue. Among 19 adults with the null mutation, the systolic blood pressure z-score was 12.1 +/- 3.5; 11 of 19 subjects (54%) had a systolic blood pressure below the third percentile. The mean diastolic blood pressure z-score was 18.1 +/- 3.4; 8 of 19 subjects (42%) had a diastolic blood pressure z-score below 10. Idiopathic chronic fatigue was present in 12 of 14 adult null heterozygote subjects (86%) and in 2 of 3 null homozygotes. Five cases met the Centers for Disease Control criteria for chronic fatigue syndrome. Fatigue questionnaires revealed scores of 25.1 +/- 2.5 in 18 adults with the mutation vs. 4.2 +/- 1.5 in 23 healthy controls (P < 0.0001). Compound heterozygosity for both mutations resulted in plasma cortisol levels comparable to those in null homozygotes. Abnormal corticosteroid-binding globulin concentrations or binding affinity may lead to the misdiagnosis of isolated ACTH deficiency. The mechanism of the association between fatigue and relative hypotension is not established by these studies. As idiopathic fatigue disorders are associated with relatively low plasma cortisol, abnormalities of corticosteroid-binding globulin may be pathogenic.

Adrenocorticotropic Hormone↗

The clinical role of quantitative ultrasound in assessing fracture risk and bone status.

Quantitative ultrasound (QUS) analysis of calcaneal bone is useful to quantify fracture risk, and in monitoring response to treatment and identifying bone changes associated with disease and medication. However, diagnosis of osteoporosis by QUS measurements remains contentious, but the problems are due to the limitations of the present T-scores rather than the technique. QUS offers the potential for the widespread detection of low bone mass and subsequent management and prevention of fracture.

Absorptiometry, Photon↗

Traumatic hyphema: a critical review of the scientifically catastrophic history of steroid treatment therefore; and A report of 24 additional cases with no rebleeding after treatment with the Yasuna systemic steroid, no touch PLUS protocol.

PURPOSE: To establish a detailed history of steroid therapy administered either systemically or topically for traumatic hyphema (TH) over the past 40 years. To this literature, we report and add another 24 TH cases treated with the Yasuna systemic steroid No Touch PLUS protocol. METHODS: Review of all reports in Medline since its inception in 1966 and such reports not in Medline but retrievable by successive reference and various alternate sources. Retrospective review of charts of all cases of TH at the University of Florida from 1980-1987. Of 135 cases so retrieved, 24 were found who had received this treatment protocol properly. (Ethical, moral and liability aspects prohibited a formal comparative study of a no medical treatment control group since this is unconscionable and abusive at the present state of knowledge.) RESULTS: The historical review revealed that there is general ignorance of the salutary effect of both topical and systemic steroids in reducing the rebleed rate in TH. This is so marked that at least five experiments reported in the literature are invalidated to a variable degree because all patients, in both the experimental and control groups, had received topical steroids. Further, that the remarkable reduction in the rebleed rates for control groups of theoretically medically untreated TH, from the vicinity of 25% or more to the vicinity of 10-15% appears to be due primarily, if not solely, to this now ubiquitous administration of topical steroids in TH. In addition, in retrospect, there are also a remarkable number (at least 5) of major statistical errors in this literature and another 6 studies of outpatients in which compliance with therapy as outpatients is not even considered. Therefore at least 16 (57%) of the 28 papers reviewed have serious flaws and doubtful or uncertain results or conclusions. Of the 9 papers which lead one to wrongful conclusions, 5 are prejudicial against systemic steroid treatment (and 2 against systemic ACA treatment, and 2 against systemic TXA treatment). All but one of the nine are, as a corollary, prejudicial in favor of non medical treatment of TH. In our 24 cases studied, none suffered a rebleeding episode. CONCLUSIONS: The "continuing controversy" about medical treatment of TH is the direct result of poor science and poor scientific methods in clinical trials. Because no method has yet been devised to determine which traumatic hyphemas will rebleed, but preventing rebleeding is about all that we can do maximize the outcome, we recommend that all patients with TH receive the Yasuna systemic steroids no touch and/or PLUS protocol in addition to current conventional treatment (bed rest, hospitalization for all patients under 18 years of age)

Antifibrinolytic Agents↗