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Biomedical subjects

C A Williams

Publications and source records attributed to C A Williams.

At least 91 records · Page 5Linked to original sources
PubMed1994

Hallucinatory experiences of psychiatric patients in seclusion.

Seclusion is a common treatment method in psychiatry. However, there are contradictory reports about the effects of the sensory deprivation involved in seclusion on the distortions of perceptions seen in some psychiatric patients. This descriptive study explored the seclusion experiences of seriously ill psychiatric patients; described the hallucinatory experiences of these patients during seclusion; and examined the relationship between hallucinations and sensory stimulation, as reflected in staff visits and length of time secluded. Consenting adult male and female psychiatric inpatients (n = 25), with DSM III-R diagnoses of schizophrenia or schizoaffective disorder were interviewed within 5 days after a seclusion experience, using a modification of Richardson's structured interview guide. Approximately half of the patients hallucinated in seclusion; however, 70% of these had also hallucinated before seclusion. There were no significant relationships between hallucinating in seclusion and frequency of staff visits or length of time secluded; however, patients who hallucinated received significantly more "as needed" (PRN) medications and had more therapeutic visits than patients who did not hallucinate.

Adult↗
PubMed1994

Methylated C-glycosylflavones as taxonomic markers in orchids of the subtribe Ornithocephalinae.

In a leaf flavonoid survey of 15 Brazilian orchid species from the subtribe Ornithocephalinae, flavone C-glycosides were found to be the major constituents in all except two Ornithocephalus taxa. In Zygostates cornuta a rare glycoside, apigenin 7,4'-dimethyl ether 6-C-glucoside-2"-O-rhamnoside, was identified. This also occurred in Z. alleniana, Z. lunata, Z. pellucida and Z. pustulata. Two further similar apigenin 7,4'-dimethyl ether C-glycoside-O-rhamnosides, possibly with different C-linked sugars, were detected in Z. multiflora and Z. grandiflora. In Z. cornuta, apigenin 4'-methyl ether 6-C-glucoside-2"-O-rhamnoside was found to co-occur with the apigenin 7,4'-dimethyl ether derivative. Ornithocephalus myrticola was distinguished by the presence of an apigenin 8-C-methylpentoside and three apigenin 7-methyl ether 8-C-glycoside derivatives. In O. bicornis and O. kruegeri, another apigenin 7,4'-dimethyl ether C-glycoside was found, while from Phymatidum falcifolium, apigenin 7,4'-dimethyl ether and apigenin 7-methyl ether C-glycosides and their O-arabinosides were isolated. Chytroglossa marileoniae also contained an apigenin 7,4'-dimethyl ether C-glycoside, which appeared to be the same as that in P. falcifolium. Rauhiella silvana, on the other hand, could be distinguished from all the other taxa studied by the absence of methylated C-glycosylflavones and presence of isovitexin. 6-Hydroxyflavone O-glycosides, which are characteristic leaf constituents of some Oncidium species in the related subtribe Oncidinae were not detected in the present sample.(ABSTRACT TRUNCATED AT 250 WORDS)

Carbohydrate Sequence↗
PubMed1994

Familial atrioventricular septal defect: possible genetic mechanisms.

BACKGROUND: Most non-chromosomal congenital heart defects are thought to be caused by the interaction of genetic factors involving multiple genes and environmental factors. Families that have several affected members have been reported, however, which suggests that a single autosomal dominant or recessive gene may cause the cardiac defects. A family in which atrioventricular septal defect seemed to be a single gene disorder is reported. OBSERVATIONS: A family in which the mother and her two daughters from different fathers had atrioventricular septal defect not associated with trisomy 21 is reported. CONCLUSIONS: This family raises the possibility that cytoplasmic or mitochondrial inheritance may be involved in the causation of atrioventricular septal defects. The available data from pedigrees from other cases of familial atrioventricular septal defect do not support this genetic mechanism, but suggest that there is a subgroup without trisomy 21 that has a single gene disorder.

Adolescent↗
PubMed1994

The effects of an immunomodulatory LFA3-IgG1 fusion protein on nonhuman primates.

LFA3TIP, a fusion protein comprised of the first extracellular domain of LFA-3 fused to the hinge, CH2 and CH3 domains of human IgG1, inhibits proliferation of human T cells in vitro. LFA3TIP also inhibits responses of human CD2 transgenic mice by rapidly and totally depleting peripheral T cells. These effects require binding of the LFA-3 and CH2 domains of LFA3TIP to CD2+ T cells and Fc gamma R+ accessory cells, respectively. As CD2 is well conserved in primate species, we evaluated the effects of LFA3TIP in nonhuman primates. We report in vitro results leading to the selection of the baboon as a model for analysis of LFA3TIP, and in vivo effects of single and multidose regimens of LFA3TIP administration. This is the first report of the in vivo administration of an immunomodulatory fusion protein to primates. LFA3TIP is shown to mediate effects on primate T lymphocytes without apparent related toxicities or immunogenicity. Results are discussed in context of potential mechanisms of LFA3TIP immunotherapy.

Adjuvants, Immunologic↗
PubMed1994

Advanced practice models: a comparison of clinical nurse specialist and nurse practitioner activities.

The purposes of this article are to present advanced practice nursing models, explore similarities and differences in roles of clinical nurse specialists (CNSs) and nurse practitioners (NPs) in South Carolina, and relate findings to the advanced practice nursing models. A questionnaire was mailed to advanced practice nurses (APNs) listed with the board of nursing, which yielded a convenience sample of 228 nurses; sixty-two percent were classified as CNSs and 30% as NPs. CNSs spent significantly less time in direct practice and more time in education, consultation, research, and administration than did NPs. Satisfaction was high for both CNSs and NPs and was related to the quality of perceived support for the role and to relationships with key staff. Respondents were engaged in a variety of revenue-generating activities and provided additional suggestions for ways in which APNs could generate additional revenue. Results support previous literature suggesting greater ambiguity in the CNS role as compared with the NP, but also suggest that differences in role are primarily related to relative emphasis on direct practice. Findings tend to support viewing CNS and NP roles as dual pathways to advanced practice or as overlapping roles, with areas of shared and unique activity.

Humans↗
PubMed1993

Congenital diaphragmatic hernia in the Brachmann-de Lange syndrome.

We present 12 children with typical Brachmann-de Lange syndrome and congenital diaphragmatic hernia. Affected children were more likely to be of low birth weight and to have major upper limb malformations. Hernia repair was attempted in 4 of these children, and only one survived past 12 months. Newborn infants with congenital diaphragmatic hernia should be examined carefully for evidence of the Brachmann-de Lange syndrome because diagnosis of this condition may influence their clinical management and prognosis.

De Lange Syndrome↗
PubMed1993

Preaxial acrofacial dysostosis (Nager syndrome) associated with an inherited and apparently balanced X;9 translocation: prenatal and postnatal late replication studies.

We report on an infant with preaxial acrofacial dysostosis (Nager syndrome) who was diagnosed prenatally as having an apparently balanced X/autosome translocation [46,X,t(X;9)(p22.1;q32)mat] inherited from a previously diagnosed mosaic translocation carrier mother [46,XX/46,X,t(X;9)(p22.1;q32)]. Replication studies on amniocytes showed the normal X chromosome to be late replicating while the same studies repeated on the infant's lymphocytes showed the translocated X chromosome to be late replicating in most cells. Late replication studies of the mother's lymphocytes demonstrated that the normal X chromosome was late replicating in most cells. The presence of Nager syndrome in this infant may be the result of critical breakpoints and/or position effects on chromosome 9, inducing expression of a gene responsible for the syndrome.

Amniotic Fluid↗
PubMed1993

Cytogenetic and molecular analysis in Angelman syndrome.

We report on cytogenetic and molecular analyses of 29 Angelman syndrome (AS) individuals ascertained in 1990 through the first National Angelman Syndrome Conference. High resolution GTG- and GBG-banded chromosomes were studied. Standard molecular analysis with six 15q11q13 DNA sequences was used to analyze copy number and parental origin of 15q11q13. Concordance between molecular and cytogenetic data was excellent. The combined data showed that 23 of the 27 probands (85%) on whom we had definitive results have deletions of the chromosome 15q11q13 region. Two classes of deletion were detected molecularly: most patients were deleted for the 5 more proximal probes, but in 2 cases the deletion extended distally to include in sixth probe. In the 13 cases where the parental origin of the deleted chromosome 15 could be established, it was maternal. There were no cases of uniparental disomy. Cytological observations of the relative sizes of the heterochromatic regions of the short arm of chromosome 15 suggested that chromosomes with large heterochromatic blocks may be more prone to de novo deletion.

Angelman Syndrome↗
PubMed1993

Angelman and Prader-Willi syndrome: a magnetic resonance imaging study of differences in cerebral structure.

Recent improvements in magnetic resonance imaging techniques now allow the developing brain to be visualized in sufficient detail to perform "in vivo neuropathology." In this study we compared the cortical morphology in six children with Angelman and four with Prader-Willi syndrome. These two syndromes are of special interest because, although they are both caused by deletions in the same region of chromosome 15, Angelman children are far more severely affected, and do not speak. We measured the length of the banks of the Sylvian fissure in a gapless series of thin sagittal images. Angelman children had a significantly larger proportion (75%) of anomalous fissures than the Prader-Willi children (12%). Anomalous cortical growth could result from mistimed expression and recognition of macromolecules involved in axonal guidance, target recognition, and pruning. We hypothesize that misrouting of long projection axons may be related to the Sylvian fissure anomalies and the language disorder in Angelman syndrome.

Angelman Syndrome↗
PubMed1993

Communication, cognition, and social interaction in the Angelman syndrome.

Persons with Angelman syndrome (AS) have mental retardation, epilepsy, and a characteristic "puppet-like" gait. Behaviorally, they are distinctive because they have no speech and have excessive laughter. A speech and communication evaluation of 7 persons with AS was performed to provide improved understanding of the speech deficit. Assessments included prelanguage and language development, oral motor abilities, and cognitive and social interaction skills. Results indicate that the typical lack of speech may not be due to mental retardation alone. Oral motor dyspraxia, and deficits in social interaction and attention were characteristic of AS and contributed to the lack of speech.

Adult↗
PubMed1993

Concurrence of supravalvular aortic stenosis and peripheral pulmonary stenosis in three generations of a family: a form of arterial dysplasia.

Isolated supravalvular aortic stenosis (SVAS) commonly is an autosomal dominant trait; it may also occur in the Williams syndrome (WS). While peripheral pulmonary stenosis (PPS) can occur in the same individual with familial isolated SVAS, concurrence of these lesions in different relatives of a family is uncommon. We describe five affected individuals in one family; three had isolated SVAS, one had isolated PPS, and one had SVAS and PPS. Based on this family and review of literature, we suggest that SVAS is a form of arterial dysplasia encompassing PPS in its spectrum. It is developmentally distinct from other left heart obstructive lesions that are hypothesized to be related to blood flow abnormalities in the developing embryo. We also conclude that the clinical disorder in this family represents one that is distinct from WS.

Abnormalities, Multiple↗
PubMed1993

The relative toxicity of disease-modifying antirheumatic drugs.

OBJECTIVE: To compare the toxicities of commonly employed disease-modifying antirheumatic drugs (DMARDs) in rheumatoid arthritis (RA). METHODS: Toxicity Index scores, computed from symptoms, laboratory abnormalities, and hospitalizations attributable to DMARD therapy, were assessed in 2,747 patients with RA receiving 3,053 courses of 6 DMARDs and 1,309 courses of prednisone over 7,278 patient-years. Results were adjusted for severity of illness and other covariates. RESULTS: Least toxic was hydroxychloroquine (mean +/- SEM score 1.38 +/- 0.15), followed by intramuscular gold (2.27 +/- 0.17) and the closely grouped D-penicillamine (3.38 +/- 0.36), methotrexate (3.82 +/- 0.35), and azathioprine (3.92 +/- 0.39). Auranofin (5.25 +/- 0.32) was most toxic, but this toxicity resulted from a high frequency of minor complications. Hospitalizations because of auranofin or hydroxychloroquine therapy were not noted. Prednisone (3.83 +/- 0.39) was of comparable toxicity, although it is likely that not all events of prednisone toxicity were captured. For reference, the toxicity of methotrexate and azathioprine was similar to that of the most toxic nonsteroidal antiinflammatory drugs (NSAIDs) (indomethacin 3.99, tolmetin sodium 3.96, and meclofenamate 3.86). Hydroxychloroquine showed less toxicity than the most commonly used prescription NSAIDs. CONCLUSION: There are substantial differences in toxicity among DMARDs and less important differences in toxicity between specific DMARDs and specific NSAIDs.

Anti-Inflammatory Agents↗
PubMed1993

Monoclonal antibodies to the integrin alpha-4 subunit inhibit the murine contact hypersensitivity response.

Lymphocyte-endothelial cell recognition is an active multistep process central to the pathophysiology of inflammation. In vitro models of lymphocyte adhesion predict that the beta 1 integrin very late antigen-4 (VLA-4), an activation-dependent adhesion receptor, can mediate the firm sustained attachment required for the extravasation of memory lymphocytes. We have used murine contact hypersensitivity as an in vivo model in which to evaluate the role of alpha-4 integrins in an evolving inflammatory response. We demonstrate that the intravenous administration of 75 micrograms of the anti-alpha-4 specific monoclonal antibodies R1-2 or PS/2 4-6 h prior to challenge significantly inhibits the efferent response of 2,4 dinitrofluorobenzene, or oxazolone-sensitized mice. The disease-modifying effect of anti-alpha 4 treatment was evident as a 50-60% reduction in the ear swelling response. By histological analysis treated animals scored lower for edema, number of epidermal lesions and degree of leukocyte infiltration. Antibody-treated animals have elevated numbers of circulating mononuclear leukocytes present in the same relative ratio as untreated control animals, suggesting that the inhibitory effect was not due to antibody-dependent cellular depletion of effector lymphocytes. These data are consistent with a central role for VLA-4 in the pathophysiologic process of inflammation.

Animals↗
PubMed1993

Release of immunoreactive neuropeptide Y from brainstem sites in the cat during isometric contractions.

Fatiguing isometric contractions of the left hind-limb muscles in cats anesthetized with alpha-chloralose caused mean arterial pressure to increase by 82 +/- 18 mmHg above resting and post-contraction levels and heart rates to increase by 15 +/- 5 beats/min. Contractions were performed by stimulating the tibial nerve via a microprocessor-controlled stimulator. Glass microprobes, coated with antibody specific for neuropeptide Y (NPY) were inserted bilaterally into the periaqueductal grey (P 0.5-1.0, LR 2.0 mm) or into the right ventrolateral medulla (3.0 mm rostral to obex; LR 3.5 mm) prior to, during and following fatiguing contractions to determine whether immunoreactive NPY was released. No release of immunoreactive NPY was detected from the site in the ventrolateral medulla. Immunoreactive NPY was released from the contralateral but not the ipsilateral periaqueductal grey during the isometric contractions, suggesting that NPY-like substances maybe involved with the integration of muscle afferent input into this area of the brainstem.

Animals↗
PubMed1993

The relative toxicity of alternative therapies for rheumatoid arthritis: implications for the therapeutic progression.

The traditional pyramid for the therapeutic progression in rheumatoid arthritis (RA) is based on assumptions that RA is a mild disease, that nonsteroidal antiinflammatory drugs (NSAIDs) have low toxicity, and that disease-modifying antirheumatic drugs (DMARDs) are extremely toxic. This article reviews data from ARAMIS (Arthritis, Rheumatism, and Aging Medical Information System), casting strong doubt on these assumptions. NSAIDs result in 1.3% excess gastrointestinal hospitalizations per year. Mortality rates in RA are far above those expected from age- and sex-matched populations. Individual NSAIDs show widely different overall quantitative toxicity indices, as do individual DMARDs. However, the ranges of toxicity of the two classes of drugs show nearly complete overlap. It is suggested that the new therapeutic progression in RA should emphasize initial use of DMARDs, beginning with the least toxic.

Anti-Inflammatory Agents↗