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Biomedical subjects

A L Williams

Publications and source records attributed to A L Williams.

At least 55 records · Page 3Linked to original sources

Ratio of serum aspartate to alanine aminotransferase in chronic hepatitis. Relationship to cirrhosis.

The ratio of the serum aspartate to alanine amino-transferase levels (AST/ALT) is often used as a clue to the etiology of the underlying liver disease. This ratio is usually greater than 2.0 in alcoholic liver disease and less than 1.0 in patients with chronic hepatitis and chronic cholestatic syndromes. We analyzed the AST/ALT ratio in 177 patients with various forms of nonalcoholic chronic liver disease who underwent medical evaluation and percutaneous liver biopsy. In the majority of cases of chronic viral hepatitis, the AST/ALT ratio was less than 1.0. However, there was a statistically significant correlation between the AST/ALT ratio and the presence of cirrhosis. Among 100 patients with chronic type B hepatitis, the mean AST/ALT ratio was 0.59 in those without cirrhosis and 1.02 in those with cirrhosis. Furthermore, the AST/ALT ratio often rose to greater than 1.0 when cirrhosis first became manifest. Thus, the finding of an AST/ALT ratio of greater than 1.0 in a patient with nonalcoholic liver disease should suggest the presence of cirrhosis. In addition, the use of the AST/ALT ratio as a means of separating alcoholic and nonalcoholic liver disease must be tempered with the knowledge that this ratio may be less helpful in the presence of cirrhosis.

Adult↗

Special advisory service for immunisation.

Among steps to improve immunisation rates in Clwyd an advisory service was introduced for children with immunisation problems. We report on setting up the service and the first two years of running it; during this time 191 children attended. Influencing parental and professional attitudes through education, counselling, and the demonstration of good practice is emphasised.

Adolescent↗

Sensitivity of Gd-DTPA-enhanced MR imaging of benign extraaxial tumors.

The effect of gadolinium diethylenetriaminepentaacetic acid (DTPA) on the sensitivity of cranial magnetic resonance (MR) imaging was measured in a prospective blinded study. Twenty-two consecutive patients with benign extraaxial tumors underwent MR imaging on a 1.5-T system without and with intravenous administration of Gd-DTPA. Readers independently interpreted the unenhanced and enhanced images without clinical information. The interpretations were compared with the anatomically verified diagnoses. Gd-DTPA improved the sensitivity of MR imaging for benign extraaxial tumors, especially in cases of residual or recurrent acoustic neuromas, multiple tumors (e.g., neurofibromatosis), or inconclusive unenhanced MR images. Enhancement with Gd-DTPA impaired the identification of a skull base tumor.

Adenoma↗

Cervical neural foramina: correlative anatomic and MR imaging study.

Accurate diagnosis of diseases affecting the cervical neural foramina with magnetic resonance (MR) imaging requires an appreciation of the normal anatomic appearance of the foramen. The MR appearance of the foramen was studied in cadavers and healthy volunteers and was correlated with cadaver cryomicrotome sections. With gradient-echo techniques, foraminal soft tissues are highlighted relative to adjacent bone, making gradient-echo images valuable for evaluating the overall size and contents of the neural foramina. Intravenously administered gadolinium DTPA produces enhancement of all foraminal soft tissues, including the dorsal root ganglion. The nerve roots do not enhance with Gd-DTPA. Gradient-echo pulse sequences and intravenous use of Gd-DTPA represent promising techniques for the evaluation of the cervical foramina.

Cervical Vertebrae↗

MR imaging of the cavernous sinus: value of spin echo and gradient recalled echo images.

A detailed evaluation of the MR appearance of the pituitary gland-cavernous sinus junction has not been described. In a series of coronal T1-weighted spin echo images without and with IV gadolinium, we noted the variable size and signal intensity of cavernous venous spaces adjacent to the pituitary gland and the inconsistent visualization of the dural membrane just lateral to the gland. Correlation of coronal T1-weighted spin echo and gradient recalled echo images (the latter with high-signal-intensity vascular structures) proved to be an effective means of identifying cavernous venous spaces, connective tissue and cranial nerves, and the lateral margins of the pituitary gland, and of differentiating tumor tissue from cavernous venous spaces. Further work is needed to develop criteria to distinguish cavernous sinus compression from actual tumor invasion.

Adenoma↗

Benign extraaxial tumors: contrast enhancement with Gd-DTPA.

Meningiomas, acoustic neuromas, and other benign extraaxial tumors have little contrast with adjacent brain tissue on conventional magnetic resonance (MR) images. The contrast enhancement produced by intravenous administration of 0.1 mmol/kg of gadolinium-DTPA in these tumors was measured on T1 MR images. Acoustic neuromas showed the greatest enhancement (average, 310%), meningiomas the next greatest (average, 180%), and neurofibromas, glomus tumors, and pituitary microadenomas the least enhancement. The degree of enhancement was almost always greater at 3 minutes than at 25 or 55 minutes. Contrast between the tumor and adjacent tissue resulted from tumor enhancement in neuromas, meningiomas, and neurofibromas and from enhancement of the surrounding tissue in pituitary microadenomas.

Adenoma↗

MR detection of tumor in the internal auditory canal.

The MR appearance of 15 tumors within or near the internal auditory canal was analyzed in detail and compared with the subsequent surgical observations. In most cases, nonenhanced MR showed the precise extent of the intracanalicular and extracanalicular tumor despite minor variations in appearance. In a case of facial nerve neurinoma, the extent to which the tumor invaded the canal was underestimated by MR. Gadolinium-DTPA enhancement is expected to eliminate uncertainties in MR imaging of the internal auditory canal.

Cerebellar Neoplasms↗

Differentiation of intramedullary neoplasms and cysts by MR.

To determine the MR criteria that are effective for differentiating intramedullary neoplasms from syringo- or hydromyelia, we reviewed MR scans made on prototype and commercial imagers of 33 patients with surgically confirmed cord abnormalities, including nine intramedullary neoplasms and 20 cysts (syringo- or hydromyelia). Two radiologists who did not know the clinical and radiologic diagnoses were asked to evaluate the scans with respect to cord expansion, distinctness of the disease margin, homogeneity, and signal intensity. These observations were correlated with the proved diagnoses. The combination of distinct margins and uniform signal intensity equal to that of CSF correlated consistently (88%) with spinal cord cysts. Other combinations were less reliable for diagnosing a cyst or tumor.

Diagnosis, Differential↗

Vacuum ultraviolet circular dichroism as an indicator of helical handedness in nucleic acids.

Calculated circular dichroism spectra are presented for double-stranded polynucleotides of regular sequences in A-RNA, A-DNA, B-DNA, and Z-DNA conformations. Quantum mechanical matrix method calculations were carried out in the near and vacuum ultraviolet regions. In the near UV, the calculated spectra agreed qualitatively with the measured spectra. However in the far and vacuum UV, the calculated CD compared nearly quantitatively with the experimental spectra. The calculations show that the sign of the CD in the vacuum UV, in contrast to that in the near UV, can be correlated with the handedness of the helix.

Adenine↗

Regulation of acetohydroxy acid synthase activities in Escherichia coli K-12 by small metabolites.

The effects of several metabolites (indole acetic acid, imidazole acetic acid and indole) on acetohydroxy acid synthase activities have been examined in both cya+ and cya- strains. Specifically, indole acetic acid caused an increase in the rate of acetohydroxy acid synthase synthesis under both in vivo and in vitro conditions. Taken together, these data suggest that small metabolites, other than cAMP, can alter acetohydroxy acid synthase gene expression.

Acetolactate Synthase↗

A dynamic programming algorithm for finding alternative RNA secondary structures.

Dynamic programming algorithms that predict RNA secondary structure by minimizing the free energy have had one important limitation. They were able to predict only one optimal structure. Given the uncertainties of the thermodynamic data and the effects of proteins and other environmental factors on structure, the optimal structure predicted by these methods may not have biological significance. We present a dynamic programming algorithm that can determine optimal and suboptimal secondary structures for an RNA. The power and utility of the method is demonstrated in the folding of the intervening sequence of the rRNA of Tetrahymena. By first identifying the major secondary structures corresponding to the lowest free energy minima, a secondary structure of possible biological significance is derived.

Animals↗

Technical factors in MR image quality.

We studied the subjective rating of MR image quality as field strength, slice thickness, number of acquisitions and matrix size were varied. Matrix and number of acquisitions had the most significant effect on image quality. Therefore, in comparisons of image quality, technique must not be disregarded.

Brain↗

Trigeminal nerve: anatomic correlation with MR imaging.

Through correlation with cryomicrotic sections, the appearance of the trigeminal nerve and its branches on magnetic resonance images is described in healthy individuals and in patients with tumors involving this nerve. Coronal images are best for defining the different parts of the nerve and for making a side-to-side comparison. Sagittal images are useful to demonstrate tumors involving the gasserian ganglion.

Cavernous Sinus↗

Cranial tissues: normal MR appearance after intravenous injection of Gd-DTPA.

The effect of intravenously administered gadolinium DTPA on signal intensity of normal intracranial structures was analyzed in 25 patients. Magnetic resonance (MR) image enhancement with Gd-DTPA differs from image enhancement on computed tomography with aqueous iodinated contrast media. Marked contrast enhancement owing to Gd-DTPA was observed in the pituitary gland, infundibulum, cavernous sinus, cranial nerves, choroid plexus, and nasal mucosa. Enhancement was not visible routinely in the falx cerebri, tentorium cerebelli, dura, or rapidly flowing blood. The efficacy of Gd-DTPA in any individual MR study may be assessed by observing the signal intensity of the pituitary gland, pituitary stalk, or nasal mucosa.

Arcuate Nucleus of Hypothalamus↗

A blinded clinical comparison of MR imaging and CT in neuroradiology.

The sensitivity and specificity of magnetic resonance (MR) imaging and computed tomography (CT) were compared in blinded readings of images of a consecutive series of patients with subsequently proved diagnoses. Overall, MR imaging was less sensitive than CT because of its lower sensitivity in detecting benign tumors. With a similar experimental protocol, the effects of technical refinements or contrast media on the sensitivity of MR imaging can be determined.

Aged↗

Pituitary and adrenal CT of Cushing syndrome.

Determination of the site of excessive hormone production in Cushing syndrome is possible with biochemical tests in 80% of cases. High-resolution CT of both the pituitary and adrenal glands was used to evaluate eight patients with surgically verified ACTH-secreting pituitary microadenomas and one patient with ectopic Cushing syndrome. Three ACTH-secreting microadenomas were demonstrated by CT. Adrenal CT was normal in six of the eight patients with pituitary tumors. The patient with ectopic ACTH production had mild unilateral adrenal gland enlargement and a normal pituitary CT scan. Normal adrenal or pituitary CT scans do not exclude Cushing syndrome.

Adenocarcinoma↗