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Biomedical subjects

W Murphy

Publications and source records attributed to W Murphy.

16 recordsLinked to original sources
PubMed1992

Apparent lack of synergism between heparin and dihydroergotamine in prevention of deep vein thrombosis after elective hip replacement: a randomised double-blind trial reported in conjunction with an overview of previous results.

We report the results of a double-blind, randomised trial of venous thrombosis (VT) prevention in 117 patients having elective hip replacement where low dose heparin alone (5,000 IU sodium heparin given subcutaneously [sc] 8 hourly until the seventh postoperative day) was compared with low dose heparin plus dihydroergotamine (DHE; 0.5 mg, given 8 hourly by sc injection). The trial end point consisted of VT discovered through bilateral ascending venography done routinely on the seventh postoperative day. VT developed in 34% of patients given heparin/DHE (95% confidence interval = 22% - 47%) compared with 24% in those given low dose heparin alone (95% confidence interval = 14% - 37%; p = 0.34), difference = 10% (95% confidence interval = -7% to +26%). Corresponding figures for the incidence of proximal (above-knee) thrombosis were 17% and 14% (95% confidence intervals = 8% - 29% and 6% - 25% respectively). These results are discussed in the context of a detailed overview of published evidence concerning VT prevention with heparin/DHE after hip replacement and we conclude it is unlikely that heparin/DHE is markedly superior to low dose heparin alone in this clinical setting.

Aged↗
PubMed1992

Guidelines for the use of fresh frozen plasma. British Committee for Standards in Haematology, Working Party of the Blood Transfusion Task Force.

Fresh frozen plasma should only be used to treat bleeding episodes or prepare patients for surgery in certain defined situations. Definite indications for the use of FFP: 1. Replacement of single coagulation factor deficiencies, where a specific or combined factor concentrate is unavailable. 2. Immediate reversal or warfarin effect. 3. Acute disseminated intravascular coagulation (DIC). 4. Thrombotic thrombocytopenic purpura (TTP). Conditional uses: FFP only indicated in the presence of bleeding and disturbed coagulation: 1. Massive transfusion. 2. Liver disease. 3. cardiopulmonary bypass surgery. 4. Special paediatric indications. No justification for the use of FFP: 1. Hypovolaemia. 2. Plasma exchange procedures. 3. 'Formula' replacement. 4. Nutritional support. 5. Treatment of immunodeficiency states.

Adult↗
PubMed1992

Guidelines for platelet transfusions. British Committee for Standards in Haematology, Working Party of the Blood Transfusion Task Force.

Recommendations for the optimal transfusion support of patients likely to receive repeated platelet transfusions. 1. Determine policy for prophylactic platelet support, and select the platelet count below which platelet transfusions will be used. 2. Consider using leucocyte depletion of red cell and platelet concentrates to prevent HLA alloimmunization from the outset. 3. Type patients for HLA-A and B antigens at an early stage. 4. Use random donor platelet concentrates for initial platelet support (either single or multiple donor, depending on availability). 5. If refractoriness occurs, determine whether clinical factors, which may be associated with non-immune consumption of platelets, are present and test the patient's serum for HLA antibodies. 6. Use HLA-matched platelet transfusions if HLA alloimmunization is the most likely cause of refractoriness. 7. If there is no improvement with HLA-matched transfusions, platelet crossmatching may identify the cause of the problem and help with the selection of compatible donors. 8. Discontinue prophylactic platelet support if a compatible donor cannot be found. Use platelet transfusions from random donors to control bleeding and increase the dose, if necessary.

Blood Coagulation Disorders↗
PubMed1991

Healing of residual screw holes after plate removal.

A single photon absorptiometric method of imaging residual screw holes after plate removal is described. Application of this technique to seven patients demonstrated that ingrowth into these defects is a protracted process which remained incomplete at 18 weeks in all seven patients. Bone mass at the site of the screw holes was, however, close to normal at 18 weeks in four young adults, lending support to the AO-ASIF recommendation that athletic activity should be avoided for 4 months after plate removal.

Absorptiometry, Photon↗
PubMed1991

Angular and linear comparisons with unilateral mandibular asymmetry.

Twelve patients (mean age 24 years) presenting with facial asymmetry, thought to represent unilateral mandibular condylar hyperplasia, were included in this study. Two distinct patient groups were noted: (1) with apparent condylar hyperplasia and (2) with unilateral internal derangements. Six patients were found to have normal TMJs bilaterally and six had unilateral internal derangement occurring on the short side. Angular and linear measurements were compared using Student's t test for discrete variables between the two groups and ANOVA for continuous variables; however, they were unable to demonstrate any set of circumstances that would suggest differences between the two groups. The only clear distinction was the presence of degenerative joint disease on the short side. This suggests that standard radiographs would be helpful if other imaging studies were not performed.

Adolescent↗
PubMed1978

Serial multiple-site biopsies in patients with bladder cancer.

A prospective study was done on 52 patients with bladder cancer to determine the incidence of atypia, carcinoma in situ and carcinoma in selected site biopsies from normal-appearing mucosa at the time of initial and subsequent endoscopy. Biopsies at initial endoscopy revealed abnormalities in 33 per cent of the patients, while 77 per cent of 43 patients undergoing 3-month selected site biopsies had at least 1 abnormal biopsy during a 1-year period.

Adult↗
PubMed1977

Molecular and genetic approaches to the analysis of the informational content of the mitochondrial genome in mammalian cells.

Our laboratory has been involved in the last few years in investigations aiming at analysing by molecular approaches the informational content of the mitochondrial genome in mammalian cells and the mechanisms and control of its expression, H eLa cells and other mammalian cell lines have been utilized for these studies. These investigations, as well as work carried out in other laboratories, have yielded a considerable amount of information concerning the mechanism, products and regulation of transcription of mitochondrial DNA (mit-DNA), the apparatus and products of mitochondria-specific protein synthesis in animal cells, and the number and topology of the sites on mit-DNA which code for the primary gene products identified so far. It is the purpose of the present report to summarize the latest observations in this area, as well as some recent results on the isolation and characterization of chloramphenicol-resistant variants of a human cell line. Reference is made to previous review articles 1,2,3 for the earlier work.

Amino Acyl-tRNA Synthetases↗
PubMed1977

Hypercalcemic hyperparathyroidism in hypophosphatemic rickets.

A 25-year-old white woman with sporadic hypophosphatemic rickets presented with a 7 year history of chronic mild hypercalcemia, osteitis fibrosa cystic and hypercalcemic nephropathy. Serum immunoreactive parathyroid hormone was elevated by greater than 100-fold and a 3.5 g parathyroid tumor was found at operation. Survey of the literature reveals that of 9 previous cases in which hypercalcemic hyperparathyroidism occurred in association with hypophosphatemic rickets, only two had classical x-linked familial hypophosphatemic rickets. It appears more than likely that this unusual combination of skeletal diseases represents the chance occurrence of primary hyperparathyroidism in patients with underlying x-linked familial hypophosphatemic rickets rather than a complication of phosphate therapy.

Adolescent↗
PubMed1976

Nonsurgical closure of large arteriovenous fistulas.

We report a nonsurgical closure of large postnephrectomy arteriovenous fistulas in two patients. To out knowledge, this method has not previously been attempted because of the large size of the communication and the risk of pulmonary embolization. However, the development of new embolization techniques makes a nonsurgical approach feasible and safe.

Adolescent↗
PubMed1976

An electron microscope study of the relative positions of the 4S and ribosomal RNA genes in HeLa cells mitochondrial DNA.

The 4S RNA genes in HeLa mitochondrial DNA (mtDNA) have been mapped by electron microscopy using the electron-opaque label ferritin. This method is based on the high affinity interaction between the protein, avidin,and biotin. 4S RNA, covalently coupled to biotin, was hybridized to single-stranded mtDNA. The hybrids were then labeled with ferritin-avidin conjugates. The positions of ferritin-labeled 4S RNA genes were determined relative to the rRNA genes on both heavy (H) and light (L) strands of mtDNA. This region was recognized as a duplex segment after hybridization either with rRNA in the case of H strands or with DNA complementary to rRNA in the case of L strands. Our studies suggest that at least nineteen 4S RNA genes are present in the HeLa mitochondrial genome. On the H strand, we have confirmed the nine map positions found in a previous electron microscope mapping study (Wu et al., 1972) and obtained evidence for three additional 4S RNA genes. On the L strand, seven 4S RNA genes have been mapped. The nineteen genes are distributed more or less uniformly around the genome. There is a pair of closely spaced genes, approximately 150 nucleotides apart, on the H strand, and another closely spaced pair on the L strand.

Chromosome Mapping↗