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Biomedical subjects

R Phillips

Publications and source records attributed to R Phillips.

At least 37 records · Page 2Linked to original sources
PubMed2004

Longitudinal mapping of protective CD4+ T cell responses against HCV: analysis of fluctuating dominant and subdominant HLA-DR11 restricted epitopes.

Cellular immunity plays an important role in the control of persistent virus infections such as hepatitis C virus (HCV). Antiviral CD4(+) T cell responses have been shown to accompany resolution of acute disease and there is also a consistent association between HLA Class II genes, notably HLADRB1*1101 (and the closely linked HLADQB1*0301) and disease resolution. We initially mapped longitudinal CD4(+) T cell responses in an individual after spontaneous resolution of acute HCV, and identified three HLA-DR11-restricted responses which vary in immunodominance over time. Functional assays and HLA Class II tetramer staining revealed one to be a response to a commonly recognized epitope, NS3(1248-1261), although cytokine capture assays showed these specific cells to be at a very low frequency. In this patient, and in others reported, this most frequently recognized HLA-DR11 restricted epitope is not immunodominant. We analysed whether sequence variability within and between genotypes might account for differences in recognition of HLA-DR11 restricted epitopes. We found that a limited number, including NS3(1248-1261), showed extreme sequence conservation. Within NS3, the ability of peptides to accept amino acid substitutions was clearly related to the structure of the protein. Overall the data provide a deeper understanding of the relationship between protein structure and variability of HLA-DR11 restricted peptides and may explain the apparent dominance of responses to NS3(1248-1261) across studies but not within an individual immune response.

Antigens, Viral↗
PubMed2004

Gene expression profiles associated with survival of individual rat dentate cells after endogenous corticosteroid deprivation.

Removal of circulating corticosterone by adrenalectomy (ADX) leads to apoptosis after 3 days in a small population of rat dentate granule neurons, whereas most surrounding cells remain viable. Interestingly, a specific expression profile is triggered in surviving granule cells that may enhance their survival. Hippocampal slices prepared 1, 2 or 3 days after ADX or sham operation were stained ex vivo with Hoechst 33258, which serves to identify apoptotic neurons. After electrophysiological analysis, multiple gene expression in surviving individual granule cells was assessed by linear antisense RNA amplification and hybridization to slot blots containing various neuronal cDNAs. Hierarchical clustering and principal component analysis was performed on two physiological variables and 14 mRNA ratios from ADX cells from every time point. Our results indicate that surviving 3-day ADX granule cells display lower membrane capacitance, lower relative N-methyl-d-aspartate (NMDA) R1 mRNA expression and higher relative mineralocorticoid receptor (MR), alpha1A voltage-gated Ca-channel, Bcl-2 and NMDA R2C mRNA expression. Some 1- and 2-day ADX cells cluster with these 3-day survivors; therefore, one or more components of their mRNA expression profile may represent predictive markers for apoptosis resistance. The functional relevance of two candidate genes was tested by in vivo local over-expression in the same model system; of these, Bcl-2 conferred partial protection when induced shortly before ADX. Therefore, removal of corticosteroids triggers a specific gene expression profile in surviving dentate granule cells; key components of this profile may be associated with their survival.

Adrenalectomy↗
PubMed2004

Pilot randomized double-blind trial of treatment of Mycobacterium ulcerans disease (Buruli ulcer) with topical nitrogen oxides.

Mycobacterium ulcerans disease (Buruli ulcer) is a serious ulcerating skin disease which is common in many tropical countries. Standard treatment, by extensive excision and skin grafting, is not available in rural communities where the disease is common. We evaluated the efficacy and safety of treatment with topical nitrogen oxides. Thirty-seven patients with a clinical diagnosis of Buruli ulcer caused by M. ulcerans disease were randomly assigned to one of two groups. In one group, two creams containing sodium nitrite (6%, wt/wt) or citric acid monohydrate (9%, wt/wt) were applied daily for 6 weeks, while the other group received a placebo. In the second 6 weeks, both groups received the nitrogen oxide-generating combination of creams. Treatment was continued for another 4 weeks for patients whose ulcers were not healed after 12 weeks. The ulcer surface area was monitored by weekly tracings made by assessors blinded to the treatment. In the first 6 weeks, patients on sodium nitrite and citric acid monohydrate (group I, active treatment) showed a rapid decrease in ulcer size from 28.6 +/- 5.6 cm2 (mean +/- standard error) to 12.6 +/- 3.2 cm2, a decrease significantly greater than that in group II (from 15.3 +/- 3.1 to 11.7 +/- 3.7 cm2; P = 0.03). Five ulcers in the placebo group enlarged during this period, compared with one in the active group. In the second 6 weeks (both groups on active treatment), the rates of healing were similar for the two groups and there was a significant reduction in ulcer size in group II (previously on placebo) compared to the first 6 weeks. Yellow pigmentation of the skin, which disappeared 3 days after treatment was stopped, was the only side effect to date. We conclude that creams releasing nitrogen oxides increase the healing rate of ulcers caused by M. ulcerans infection with minimal adverse events. This is the first controlled trial of any form of therapy which demonstrates efficacy in treating this disease.

Administration, Topical↗
PubMed2004

In vitro killing of Mycobacterium ulcerans by acidified nitrite.

Mycobacterium ulcerans, which causes Buruli ulcer, was exposed to acidified nitrite or to acid alone for 10 or 20 min. Killing was rapid, and viable counts were reduced below detectable limits within 10 min of exposure to 40 mM acidified nitrite. M. ulcerans is highly susceptible to acidified nitrite in vitro.

Acids↗
PubMed2003

Porcine stentless bioprostheses: prevention of aortic wall calcification by dye-mediated photo-oxidation.

PURPOSE: Aortic wall calcification is problematic in stentless porcine valves. We evaluated the possible anticalcification effect of photo-oxidation on the aortic wall portion of porcine stentless bioprostheses. A comparison with glutaraldehyde-fixed tissue was made. METHODS: Six Photofix and six Freestyle valves were implanted in juvenile sheep in pulmonary position. Valves were explanted after 3 or 6 months and examined macroscopically, by x-ray, light, and transmission electron microscopy. Calcium content was determined by atomic absorption spectrometry. RESULTS: The aortic wall portion of all Photofix valves remained free from calcification, while the wall portion of glutaraldehyde-fixed valves calcified strongly, both after 3 and 6 months. Calcium content of the aortic wall portion was: 0.71 +/- 1.27 in the Photofix valves versus 10.78 +/- 77.22 in the Freestyle valves (P < 0.05). CONCLUSION: Photo-oxidation of a porcine stentless valve prevents calcification not only in the cusps but also in the aortic wall portion.

Animals↗
PubMed2003

General anaesthesia or conscious sedation for painful procedures in childhood cancer: the family's perspective.

BACKGROUND: Until recently, midazolam sedation was routinely used in our institution for bone marrow aspirates and lumbar punctures in children with cancer. It has been perceived by many doctors and nurses as being well tolerated by children and their families. AIM: To compare the efficacy of inhalational general anaesthesia and midazolam sedation for these procedures. METHODS: A total of 96 children with neoplastic disorders, who received either inhalational general anaesthesia with sevoflurane, nitrous oxide, and oxygen (GA) or sedation with oral or nasal midazolam (SED) as part of their routine preparation for procedures were studied. The experiences of these children were examined during their current procedure and during their first ever procedure. Main outcome measures were the degree of physical restraint used on the child, and the levels of distress and pain experienced by the child during the current procedure and during the first procedure. The family's preference for future procedures was also determined. RESULTS: During 102 procedures under GA, restraint was needed on four occasions (4%) when the anaesthetic mask was first applied, minimal pain was reported, and children were reported as distressed about 25% of the time. During 80 SED procedures, restraint was required in 94%, firm restraint was required in 66%, the child could not be restrained in 14%, median pain score was 6 (scale 0 (no pain) to 6 (maximum pain)), and 90% of the parents reported distress in their child. Ninety per cent of families wanted GA for future procedures. Many families reported dissatisfaction with the sedation regime and raised concerns about the restraint used on their child. CONCLUSIONS: This general anaesthetic regime minimised the need for restraint and was associated with low levels of pain and distress. The sedation regime, by contrast, was much less effective. There was a significant disparity between the perceptions of health professionals and those of families with respect to how children coped with painful procedures.

Adolescent↗
PubMed2003

Stereo visualization of 3D trabecular bone structures produced by bone remodelling simulation.

Adult human bone is constantly being renewed by a process known as remodelling. For cancellous bone this renewal process occurs at the interface between bone and marrow where bone is depleted by osteoclasts and rebuilt by osteoblasts. This remodelling process allows bone to repair itself. Software simulators for bone remodelling provide insight into the bone remodelling process; they allow investigation into bone form and structural properties, and they also allow the emulation of bone diseases and possible treatments for these diseases over long periods of time. BONESIM is a software that simulates bone remodelling in terms of Basic Multi-cellular Units (BMUs). 3D visualization of trabecular bone and its attributes is an essential tool in understanding this remodelling process for cancellous bone. It enables the bone researcher to quickly understand the dynamic behaviour of remodelling, the resulting geometry of the bone structure and it allows alternative remodelling scenarios to be compared. This paper presents the volume visualization technique that has been developed to provide this visualization tool.

Adult↗
PubMed2002

Isolation of an Escherichia coil strain mutant unable to form biofilm on polystyrene and to adhere to human pneumocyte cells: involvement of tryptophanase.

Escherichia coli adherence to biotic and abiotic surfaces constitutes the first step of infection by promoting colonization and biofilm formation. The aim of this study was to gain a better understanding of the relationship between E. coli adherence to different biotic surfaces and biofilm formation on abiotic surfaces. We isolated mutants defective in A549 pneumocyte cells adherence, fibronectin adherence, and biofilm formation by random transposition mutagenesis and sequential passages over A549 cell monolayers. Among the 97 mutants tested, 80 were decreased in biofilm formation, 8 were decreased in A549 cells adherence, 7 were decreased in their adherence to fibronectin, and 17 had no perturbations in either of the three phenotypes. We observed a correlation between adherence to fibronectin or A549 cells and biofilm formation, indicating that biotic adhesive factors are involved in biofilm formation by E. coli. Molecular analysis of the mutants revealed that a transposon insertion in the tnaA gene encoding for tryptophanase was associated with a decrease in both A549 cells adherence and biofilm formation by E. coli. The complementation of the tnaA mutant with plasmid-located wild-type tnaA restored the tryptophanase activity, epithelial cells adherence, and biofilm formation on polystyrene. The possible mechanism of tryptophanase involvement in E. coli adherence and biofilm formation is discussed.

Bacterial Adhesion↗
PubMed2002

Smoothing of pixelated finite element models of cancellous bone structures and the effect on the predicted structural properties of the bone.

Many areas of biomedical engineering involve the modelling of biological systems, often using data from medical scanning techniques such as computed microtomography (microCT), and the prediction of the mechanical properties of these systems via finite element models. These models, and also those produced from remodelling simulations on idealized bone structures, are inherently highly pixelated and therefore have a high degree of surface roughness. The purpose of this paper is to demonstrate that this surface roughness need not necessarily have an influence on the predicted properties of the object under examination. To demonstrate this, two-dimensional idealized models of cancellous bone structures were used that were initially depleted and then rebuilt stochastically. A hysteresis effect was observed such that a significant amount of rebuilding beyond the original density was required to regain the initial intact stiffness. To ensure that this effect was not an artefact of the high degree of surface roughness of the rebuilt structures, a two-stage smoothing procedure was applied to assess if this had any effect on the stiffness of the structures. The superpixelation of the structures appeared to have a more profound effect than the smoothing procedures, although the smoothed structures still had stiffness and density values similar to those of the original structures, with a hysteresis effect still evident. This proves that the pixelization of the structures does not have a significant effect on the predicted mechanical properties of the structures. This work has important implications for other models that exhibit a high degree of surface roughness.

Artifacts↗
PubMed2002

Recovery of distal hole axis in intramedullary nail trajectory planning.

In intramedullary nail (IMN) surgical operations, one of the main efforts for surgeons is to find the axes of two distal holes. Two distal holes on an IMN, which are inside the intramedullary canal of a patient's femur, can only be seen in a lateral X-ray view. For the standard surgical procedure, the localization of the distal hole axes is a trial-and-error process which results in a long surgical time and large dose of X-ray exposure. In this paper, an algorithm to derive the three-dimensional position and orientation of the distal hole axis was developed. The algorithm first derives the nail axis through two X-ray images. Then the distal hole axis is calculated through projecting back the hole boundary on the X-ray image from a lateral view to three-dimensional space. A least-squares method is used to determine the centres of the front hole and the back hole through iteration. The algorithm has been tested with real data and it was robust.

Bone Nails↗
PubMed2002

A virtual fluoroscopy system and its use for image guidance in unicompartmental knee surgery.

The C-arm fluoroscope is an indispensable intraoperative 2D imaging device for orthopaedic surgery. However, its frequent use in an operation presents a significant radiation hazard to the theatre staff and patient. A recent technique known as virtual fluoroscopy (VF) enhances the fluoroscope's capability for image guided surgery by tracking optically the position of the C-arm, surgical instruments and the patient. Virtuality is achieved by overlay of surgical instruments onto one or more previously captured fluoroscopic images. A key benefit of VF is that it reduces considerably the radiation hazard. This paper reports on a new VF technique for tracking and calibration of the fluoroscopic C-arm. Also reported is the use of our VF system to provide a new image guided technique for the accurate placement of the femoral component of unicompartmental knee prosthesis.

Arthroplasty, Replacement, Knee↗
PubMed2001

Furin initiates gelsolin familial amyloidosis in the Golgi through a defect in Ca(2+) stabilization.

Hereditary familial amyloidosis of Finnish type (FAF) leading to amyloid in the peripheral and central nervous systems stems from deposition of a 71 residue fragment generated from the D187N/Y variants of plasma gelsolin by two sequential endoproteolytic events. We identify the protease accomplishing the first cleavage as furin, a proprotein convertase. Endoproteolysis of plasma gelsolin occurs in the trans-Golgi network due to the inability of the FAF variants to bind and be stabilized by Ca(2+). Secretion and processing of the FAF variants by furin can be uncoupled by blocking the convergence of the exocytic pathway transporting plasma gelsolin and the endocytic recycling of furin. We propose that coincidence of membrane trafficking pathways contributes to the development of proteolysis-initiated amyloid disease.

Amyloidosis, Familial↗
PubMed2001

Germline mutations in BMPR1A/ALK3 cause a subset of cases of juvenile polyposis syndrome and of Cowden and Bannayan-Riley-Ruvalcaba syndromes.

Juvenile polyposis syndrome (JPS) is an inherited hamartomatous-polyposis syndrome with a risk for colon cancer. JPS is a clinical diagnosis by exclusion, and, before susceptibility genes were identified, JPS could easily be confused with other inherited hamartoma syndromes, such as Bannayan-Riley-Ruvalcaba syndrome (BRRS) and Cowden syndrome (CS). Germline mutations of MADH4 (SMAD4) have been described in a variable number of probands with JPS. A series of familial and isolated European probands without MADH4 mutations were analyzed for germline mutations in BMPR1A, a member of the transforming growth-factor beta-receptor superfamily, upstream from the SMAD pathway. Overall, 10 (38%) probands were found to have germline BMPR1A mutations, 8 of which resulted in truncated receptors and 2 of which resulted in missense alterations (C124R and C376Y). Almost all available component tumors from mutation-positive cases showed loss of heterozygosity (LOH) in the BMPR1A region, whereas those from mutation-negative cases did not. One proband with CS/CS-like phenotype was also found to have a germline BMPR1A missense mutation (A338D). Thus, germline BMPR1A mutations cause a significant proportion of cases of JPS and might define a small subset of cases of CS/BRRS with specific colonic phenotype.

Abnormalities, Multiple↗
PubMed2001

Calbindin overexpression buffers hippocampal cultures from the energetic impairments caused by glutamate.

A dramatic rise in free cytosolic calcium concentration is thought to be a central event in the pathogenesis of glutamate excitotoxicity in neurons. We have previously demonstrated that gene transfer of the calcium-binding protein calbindin D28k via a Herpes simplex amplicon vector decreases the rise in intracellular calcium and promotes cell survival following glutamatergic challenge. This study explores the effect of calbindin transgene expression on cellular metabolism following glutamate excitotoxicity. Because excitotoxic insults are often energetic in nature, and because calcium sequestering and extrusion place heavy energy demands on a cell, we hypothesized that calbindin overexpression may help preserve cellular energy levels during an insult. We overexpressed calbindin in primary hippocampal cultures, using a Herpes simplex amplicon vector system. We found that calbindin overexpression protected neurons from the decline in ATP levels, mitochondrial potential and metabolic rate following a glutamatergic insult. These results indicate that calbindin expression helps preserve cellular energy state following glutamate excitotoxicity. This illustrates the energetic load placed on neurons by increased free cytosolic calcium and may help explain the neuroprotective effects of calbindin.

Adenosine Triphosphate↗
PubMed2001

Successful surgical rehabilitation of children with traumatic corneal laceration and cataract.

OBJECTIVE: To evaluate the visual and refractive outcome of corneal transplant surgery, cataract extraction, and intraocular lens (IOL) implantation in children with traumatic corneal laceration and cataract. DESIGN: Retrospective, noncomparative case series. PARTICIPANTS: Five patients, 7 years of age or younger, who underwent penetrating keratoplasty, cataract extraction, and IOL implantation for traumatic corneal laceration and cataract were identified. MAIN OUTCOME MEASURES: Each case was analyzed retrospectively for the following factors: preoperative findings; surgical technique, including management of the posterior capsule; measurement of axial length and keratometry; calculation of IOL power, style, and type of IOL implanted; graft clarity; final visual acuity; and final refraction. RESULTS: The five children ranged from 3 to 7 years of age at the time of trauma. All had primary repair of their injury before referral. Each patient was observed for more than 2 years. Each had a posterior chamber IOL placed in the sulcus. After surgery, no severe complications were observed. The preoperative visual acuity ranged from 20/400 to light perception. After surgery, all five patients had clear grafts and an improved visual acuity ranging from 20/20 to 20/400. The final spherical refraction in each patient was within 3.75 diopters (D) of plano, with 1.50 to 3.25 D of cylinder. CONCLUSIONS: Successful surgical rehabilitation was accomplished in these patients. Despite their young age and the difficulty in determining IOL power, combining surgery and aggressive amblyopia therapy resulted in visual rehabilitation with refractions approaching emmetropia.

Cataract↗
PubMed2001

Enhancement of fluoroscopic images with varying contrast.

A heuristic algorithm for enhancement of fluoroscopic images of varying contrast is proposed. The new technique aims at identifying a suitable type of enhancement for different locations in an image. The estimation relies on simple preliminary classification of image parts into one of the following types: uniform, sharp (with sufficient contrast), detail-containing (structure present) and unknown (for the cases where it is difficult to make a decision). Different smoothing techniques are applied locally in the different types of image parts. For those parts that are classified as detail-containing, probable object boundaries are identified and local sharpening is carried out to increase the contrast at these places. The adopted approach attempts to improve the quality of an image by reducing available noise and simultaneously increasing the contrast at probable object boundaries without increasing the overall dynamic range. In addition, it allows noise to be cleaned, that at some locations is stronger than the fine structure at other locations, whilst preserving the details.

Algorithms↗
PubMed2001

Chromosome evolution in the Salmonidae (Pisces): an update.

The karyotypes of salmonid fishes including taxa in the three subfamilies Coregoninae, Thymallinae and Salmoninae are described. This review is an update of the (Hartley, 1987) review of the chromosomes of salmonid fishes. As described in the previous review, the karyotypes of salmonid fishes fall into two main categories based on chromosome numbers: the type A karyotypes have diploid numbers close to 80 with approximately 100 chromosome arms (2n = 80, NF = 100), and the type B karyotypes have diploid numbers close to 60 with approximately 100 chromosome arms (2n = 60, NF = 100). In this paper we have proposed additional sub categories based on variation in the number of chromosome arms: the A' type with NF = 110-120, the A" type with NF greater than 140, and the B' type with NF less than 80. Two modes of chromosome evolution are found in the salmonids: in the Coregoninae and the Salmoninae the chromosomes have evolved by centric fusions of the Robertsonian type decreasing chromosome numbers (2n) while retaining chromosome arm numbers (NF) close to that found in the hypothetical tetraploid ancestor so that most extant taxa have either type A or type B karyotypes. In the Thymallinae, the chromosomes have evolved by inversions so that chromosome arm numbers (NF) have increased but chromosome numbers (2n) close to the karyotype of the hypothetical tetraploid ancestor have been retained and all taxa have type A' karyotypes. Most of the taxa with type B karyotypes in the Coregoninae and Salmoninae are members of the genus Oncorhynchus, although at least one example of type B karyotypes is found in all of the other genera. These taxa either have an anadromous life history or are found in specialized lacustrine environments. Selection for increases or decreases in genetic recombination as proposed by Qumsiyeh, 1994 could have been involved in the evolution of chromosome number in salmonid fishes.

Animals↗