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Biomedical subjects

T Phillips

Publications and source records attributed to T Phillips.

At least 19 recordsLinked to original sources
PubMed1992

Detection of feline immunodeficiency virus (FIV) nucleic acids in FIV-seronegative cats.

A study was undertaken to determine the rate of viral transmission among naive specific-pathogen-free (SPF) cats living in close contact with feline immunodeficiency virus (FIV)-infected cats. Twenty SPF cats were housed in the same rooms with experimentally FIV-infected seropositive and virus culture-positive cats for 2 to 4 years and were monitored for the presence of FIV nucleic acids and antibodies. Only 1 of the 20 cats became seropositive and virus culture positive and developed signs of disease. Genomic DNA from bone marrow and peripheral blood mononuclear cells (PBMC) of 10 of 19 healthy-appearing seronegative cats became positive for FIV DNA by the polymerase chain reaction. Twenty-eight SPF cats housed as groups in separate quarters and never exposed to FIV-infected cats were uniformly negative for FIV DNA. FIV RNA transcripts were detected in concanavalin A-stimulated PBMC cultures from 4 of 10 FIV DNA-positive, seronegative cats by in situ hybridization. PBMC from three of four naive SPF cats acquired FIV nucleic acids after the cats were transfused with blood and bone marrow from FIV genome-positive, seronegative donors. Three of five FIV-seronegative cats housed for years with naturally FIV-infected cats in a private household were also found to harbor FIV DNA, indicating that the same phenomenon occurred in the field. These findings demonstrate that cats living in close contact with FIV-infected seropositive cats can acquire FIV nucleic acids without developing detectable levels of serum antibodies or disease.

Animals↗
PubMed1992

Voices from family medicine: Theodore Phillips. Interview by William B. Ventres and John J. Frey.

Ted Phillips has had a remarkable career in medicine. He practiced in a rural Alaskan town, helped build the University of Washington's Department of Family Medicine as its founding chair, labored as an associate and acting dean at the university, and, more recently, returned to clinical practice part time on a small island in Washington state and travels to the University of Washington to direct the course on introduction to clinical medicine. Dr. Phillips was president of the Society of Teachers of Family Medicine in 1978-1979 and received the Society's Certificate of Excellence in 1981. He currently serves as the only community-based physician on the National Advisory Council of the Agency for Health Care Policy and Research. This transcript is an abridged version of interviews conducted in April and June 1992.

Family Practice↗
PubMed1991

Clinical trials with etanidazole (SR-2508) by the Radiation Therapy Oncology Group (RTOG).

Following the completion of a phase I study of etanidazole (SR 2508), a new hypoxic cell sensitizer, the RTOG, began a phase II/III trial. The objectives of the study were to determine the toxicity and efficacy of SR 2508, combined with conventional radiotherapy for the management of unresectable stage III and IV head and neck squamous carcinomas. During the first step (or the Phase II portion) of the study, 33 patients received radiotherapy plus SR 2508 (RT + SR 2508). The incidence of drug toxicities was modest; including 24% grade I peripheral neuropathy (PN), 6% grade II PN, 27% grade I or II nausea and vomiting, 9% allergy and 15% reversible neutropenia. Because observed toxicities were deemed acceptable, the second step (or phase III portion) was then activated. Patients were randomized to receive either RT or RT + SR 2508. As of November 20, 1989, a total of 242 patients have been entered onto the Phase III portion of the study. One hundred twenty-two patients were randomized to the RT + SR 2508 arm and 120 patients were randomized to the RT alone arm. The analyses presented in this report are based on data available. The incidence of drug toxicities has been low, with 18% grade I or II PN, 26% nausea and vomiting (including one grade III), 14% allergy (including one grade III) and 13% reversible neutropenia.(ABSTRACT TRUNCATED AT 250 WORDS)

Carcinoma, Squamous Cell↗
PubMed1991

Rapidly alternating radiotherapy and high dose cisplatin chemotherapy in stage IIIB non-small cell lung cancer: results of a phase I/II study.

Alternating radiotherapy and chemotherapy increases tumor cure rates in some animal models with reduced normal tissue damage compared to sequential use of these modalities. To test this concept in non-small cell lung cancer, 23 patients with predominantly Stage IIIB disease were treated on a Northern California Oncology Group pilot study of alternating radiotherapy and high dose cisplatin. Radiotherapy consisted of 6000 cGy delivered in three separate 10-day courses of 200 cGy/fraction/day during weeks 1 and 2, 5 and 6, and 9 and 10. High dose cisplatin, 100 mg/m2 in 3% saline, was administered on weeks 3 and 4, 7 and 8, 11 and 12, and 15 and 16. The response rate in 22 eligible patients is 73% (16/22) with four complete responses and 12 partial responses. Feasibility of this approach is demonstrated by 20/22 patients completing radiotherapy and a median of 2.5 courses of chemotherapy administered. Median survival time is 14.2 months (range 2-40+ months). One- and 2-year survival rates are 64% (14/22) and 41% (9/22), respectively. Hematologic, renal, and radiation-related toxicities were significant but manageable. We conclude that rapid alternation of radiotherapy and a high dose intensity cisplatin regimen is feasible in Stage IIIB non-small cell lung cancer, with a high response rate and acceptable toxicity. The long-term impact on local control and survival remains unclear, although preliminary survival data are encouraging in this poor prognosis population. Further studies of this concept are warranted.

Adenocarcinoma↗
PubMed1991

Role of diagnostic techniques in the initial evaluation of stab wounds to the anterior abdomen, back, and flank.

Despite the widespread availability of firearms, stab wounds to the abdomen, back, and flank continue to account for a significant number of injuries. The proper sequencing of diagnostic modalities in this patient group is constantly undergoing change. We report our experience with these injuries and present a new algorithm for the use of currently available diagnostic procedures. In 1987, 162 patients were seen, 103 with anterior abdominal wounds and 59 with back and flank wounds. Patients with shock, peritonitis, and evisceration were resuscitated and explored. The remainder of the cohort underwent tap and lavage, and patients with a negative study were observed. Patients with back and flank wounds underwent contrast enhanced computerized tomographic enemas (CECTE). Seventeen patients underwent immediate exploration and 108 of the 162 patients were spared exploration. Fifty-four patients were explored with six negative laparotomies. Of the 126 taps and lavages, the false positive rate was zero, and only one patient had a false negative study. Of the 47 CECTE studies, only three were interpreted as an indication for angiography which proved negative, and all patients were safely observed. The overall mortality was 4.3%, including three patients without vital signs on admission and four who expired intraoperatively due to irreversible shock. We concluded that this algorithm can be safely applied to patients with these injuries with a high degree of specificity and sensitivity.

Abdominal Injuries↗
PubMed1990

Increased expression of a putative adenoma-associated antigen in pre-colonoscopic effluent of patients with colorectal cancer.

A monoclonal antibody Adnab-9, was raised against antigens derived from benign polyps of the colon. Adnab-9 was tested against pre-colonoscopic effluent material obtained from groups of patients with a macroscopically normal colonscopic examination, histologically confirmed adenomatous polyps and patients with colorectal cancer (CRC). The resultant binding levels displayed little overlap between the CRC group and the normal, and the difference was statistically significant. Since this putative early neoplasia associated antigen is essentially not expressed in CRC extracts, it may originate from a region of the colon predisposed to neoplasia, increasing in expression as the tendency to malignancy progresses, useful in the diagnosis of early stage malignancy.

Adenoma↗
PubMed1990

Preliminary results of concurrent radiotherapy and chemotherapy in advanced cervical carcinoma: a phase I-II prospective intergroup NCOG-RTOG Study.

Thirty-eight patients with advanced carcinoma of the cervix were prospectively treated with a concurrent combination of radiotherapy (RT) and chemotherapy (CT) using the drugs 5-fluorouracil (5FU), mitomycin C and cis-platinum as part of a Northern California Oncology Group (NCOG) and Radiation Therapy Oncology Group (RTOG) intergroup study. RT consisted of 36.00 Gy to the pelvis in 4 weeks followed by a 9.00-Gy parametrial boost. This was followed by two intracavitary applications for a total of 4000 mg hr of radium equivalent when possible. 5FU (1000 mg/m2/24 hr for 96 hr by iv infusion) and mitomycin C (10 mg/m2/iv bolus) were given during the second week of external RT. 5FU (dose as above) and cis-platinum (75 mg/m2/iv over 6 hr) were given during the first intracavitary application. Of 36 patients evaluable for toxicity, 11% had grade 3 nonhematological toxicity and 11% had reversible grade 4 hematological toxicity. There were no toxic deaths. A complete response rate of 62.5% was obtained overall (median survival not reached). This study suggests that this particular combination of RT and CT in advanced cervical carcinoma is effective and well tolerated.

Adult↗
PubMed1990

A CT-based computerized treatment planning system for I-125 stereotactic brain implants.

A computer program has been developed at the University of California, San Francisco, as an aid in planning and evaluating stereotactic brain implants made with 125I seeds. The program allows images of seeds and catheters to be positioned in the target volume revealed by CT. It then generates and displays the resulting isodose distributions. Catheters may be changed interactively until an optimum implant is achieved. From the geometry of a stereotactic implant frame as measured by CT, the program calculates the approach angles of the catheters in the frame coordinate system. After the seeds are implanted, films made with a fiducial marker box can be used to generate true seed positions and hence true isodoses. This paper describes mathematically the geometrical transformations used by the program, and also outlines its many features and options. In its first 2 years of use the program has proved to be a valuable contributor to improved patient care.

Brachytherapy↗
PubMed1989

Ventilatory response to an inhaled constant CO2 load and added dead space in healthy men, awake and asleep.

Experiments were conducted in ten adult men to determine if rapid-eye-movement sleep (REMS) reduced the ventilatory response to two 'steady-state' respiratory loads compared to slow wave sleep (SWS). A constant addition of 150 (or 200) ml/min pure CO2 to the inspirate (7 subjects) and 230 ml of added dead space (5 subjects) were the two respiratory loads. Inspiratory ventilation was measured by pneumotachygraph for at least five continuous minutes in wakefulness, SWS and REMS. The increase in ventilation to both stimuli was equal in SWS and REMS with no suggestion of an impaired response during the latter: increases in ventilation during CO2 loading being 49 and 51%, SWS and REMS, respectively, and during additional dead space they were 53 and 59%, SWS and REMS, respectively. Following the addition of extra dead space, end tidal PCO2 levels did not rise significantly more during REMS compared to SWS (P greater than 0.5). These findings show that when ventilatory responses to CO2 are considered across the whole of REMS (including periods with and without actual eye-movements) then they do not appear to be blunted compared to SWS.

Adult↗
PubMed1989

Intra-epidermal neutrophilic IgA dermatosis with colitis.

We report the association of an intra-epidermal blistering disease of the skin with colitis. Both the skin and large bowel epithelium were infiltrated by neutrophils and eosinophils, and showed intra-epithelial deposition of IgA in an intercellular pattern. The colitis and the blisters responded well to treatment with dapsone.

Aged↗
PubMed1988

Postmortem stability of somatostatin in brain tissue.

The stability of somatostatin (SS) in brain tissue was studied in human material obtained post-mortem and in the rat. In both human and rat brain, loss of SS was found to occur in tissue frozen to -70 degrees C. In the rat, this loss varied from 26 to 70 percent depending on the type of tissue processing used. These data suggest that, for the study of SS in post-mortem brain, use of frozen material should be avoided.

Adult↗
PubMed1988

Improved dose distribution with customized I-125 source loading in temporary interstitial implants.

I-125 sources are being used in temporary interstitial implants of various sites. Radiation safety considerations favor its use over other available radioisotopes. Cost containment is achieved by using the same sources for a number of patients. Loading I-125 seeds into implant catheters at our institutions permit customized source arrangement to optimize the implant dose patterns. Clinical examples are given for which the dose distributions achieved with customized source loading are superior to those achievable with standard Ir-192 ribbons.

Brachytherapy↗
PubMed1988

Primary intraocular lymphoma (ocular reticulum cell sarcoma) diagnosis and management.

The authors retrospectively reviewed the diagnosis and management of 20 intraocular lymphoma patients who initially presented with either ocular or central nervous system (CNS) disease. As the ophthalmic community has become more aware of this entity, the interval between symptoms and diagnosis has significantly shortened. Diagnosis can usually be made on cytopathologic examination of vitreous cells. However, in three cases more than one vitreous biopsy was necessary. Results of cytologic examination appeared to be more accurate than those of conventional lymphocyte surface marker studies in the diagnosis of an intraocular lymphoma. Long-term survival occurred in some patients treated with a combination of intrathecal chemotherapy and ocular/CNS irradiation.

Adult↗
PubMed1988

Exposure of the internal carotid artery near the skull base: the posterolateral anatomic approach.

Internal carotid injuries in zone III near the base of the skull are technically the most challenging of the carotid injuries. Diagnostic angiography is important to evaluate the exact site and extent of injury and the presence or absence of prograde flow in the injured segment. Vascular repair in this area is highly dependent on the adequacy of surgical exposure. Previous approaches have emphasized displacement of the mandible either by subluxation or mandibulotomy. Problems related to mandibulotomy, such as intraoral contamination, infection, and nonunion, are potential complications of this approach to the high carotid artery. In addition, it does not give adequate exposure of the internal carotid artery at the critical area, near the base of the skull. Experience gained from the extended radical neck dissection exposing the internal carotid artery up to the skull base has demonstrated that a posterolateral anatomic approach can provide superior exposure of the high carotid artery with lower morbidity and shortened operative time. This surgical approach involves cutting the sternomastoid muscle close to the mastoid and dissecting all the tissues away from the surface of the mastoid. Dividing the posterior belly of the digastric and styloid group of muscles assists in exposure of the internal carotid artery. Rarely, dissection of the facial nerve and removal of the tail of parotid add additional access to this area. This article describes the stepwise anatomic approach to the internal carotid artery near the base of the skull.

Adult↗