Patient-oriented management.
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Biomedical subjects
Publications and source records attributed to C Wilson.
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A randomised, double-blind, placebo controlled study of morbidity and mortality was carried out using heparin, atenolol, and a combination of both drugs, in 214 patients with the intermediate coronary syndrome. During the trial period, transmural myocardial infarction developed in 9 (17%) out of 54 patients on placebo, 8 (13%) out of 60 on atenolol, 1 (2%) out of 51 on heparin, and 2 (4%) out of 49 on heparin and atenolol combined (p = 0.024). The improved prognosis in the heparin-treated patients was was maintained at follow-up. All five deaths occurred among patients who did not receive heparin. These results show that intravenous heparin therapy was of benefit in preventing myocardial infarction in patients with the intermediate coronary syndrome.
1. The responses of guinea pig left atrial tension and right atrial rate to histamine receptor agonists and histamine were compared. 2. Single doses of histamine and another non-selective agonist, N,N-dimethylhistamine, produced biophasic inotropic responses, with an initial increase in tension and a secondary sustained tension increase separated by a negative inotropic component. 3. Selective H1-receptor agonists -- 2-methylhistamine, 3-methylhistamine and 2-pyridylethylamine (2-PEA) -- also exhibited biphasic inotropic responses. 2-PEA did so only after blockade with propranolol or in atria from reserpine-pretreated animals, indicating an additional release of endogenous catecholamines which masked the biophasic response. 4. Selective H2-receptor agonists -- 4-methylhistamine and dimaprit -- failed to produce biphasic responses except at high concentrations only in the case of 4-methylhistamine. 5. The biophasic responses were converted to monophasic responses by mepyramine. This was a result of antagonism of the initial positive component and the secondary negative component which were therefore mediated via H1-receptors. The production of a biphasic inotropic response therefore depends upon these two components which were exhibited preferentially by the H1-receptor-selective agonists.
Neuronal recordings from occipital cortex and hippocampus during a seizure originating in the occipital lobe of a patient with an occipito-temporal tumor demonstrated that the visual aura resulted from neuronal activation of medial peristriate and possibly other occipital lobe neurons while the psychomotor automatisms followed 10-20 sec later and were caused by recruitment of hippocampal neurons bilaterally. This confirmed that the complex seizure symptoms were caused by propagation from an occipital lobe focus. The psychomotor symptoms have not recurred for the 6 months since interruption of occipito-temporal connections; however, the spared medial occipital neurons still produce visual auras.
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This article described the Occupational Therapy programs at Bloorview Children's Hospital. The Hospital itself and the structure within which Occupational Therapy operates are outlined. The numerous group programs are detailed, including objectives, target populations, activities and approach used.
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The smoking habits of 1501 cigarette smokers attending 28 general practitioners in five group practices in London were assessed. Prevalence of smoking, daily cigarette consumption, and the use of cigars, untipped cigarettes, and hand-rolled cigarettes were lower in the women. After controlling for consumption the proportions of men and women who smoked every day were similar. Women who smoked 20 or more a day were similar to men in their self-reported inhaling habits and use of low-nicotine cigarettes. The results suggest that women differ from men in those aspects of smoking that are determined predominantly by social factors but that their smoking habits become similar when pharmacological motivation takes over. This apparently occurs when consumption reaches about 20 cigarettes a day, when smoking almost inevitably becomes a regular event and the sex differences disappear.
Hairy cells from 5 patients with greater than 25% hairy cells in the peripheral blood (4 had greater than 45% hairy cells and white blood cell counts (WBC) greater than 10,000/mm3) were studied for surface immunoglobulin (SIg) presence and distribution by two methods, for lectin-induced cap formation, and for phagocytosis of zymosan. Hairy cells from all 5 cases were found to have distinct monoclonal patterns, 2 Gk, 1 MDk, 1 Dk, and 1 GMDk, as well as cap formation with SIg. All 5 cases showed distinct lectin-induced cap formation in a percentage of cells similar to the percentage of hairy cells, and 2 of the 5 patients had hairy cells which phagocytosed zymosan. These findings contrasted with the malignant cells from 4 patients with CLL, which had monoclonal SIg but no SIg cap formation and no significant percentage of lectin-induced cap formation. Cells from 2 cases of T cell lymphomas had no SIg and no lectin-induced cap formation as did cells from 2 cases of non-lymphocytic leukemia. Hairy cells not only appear to have SIg cap formation similar to some B-lymphocytes, which in some patients also phagocytose zymosan, but also demonstrate strong lectin-induced cap formation.
Studies of xenon-enhanced CT for detecting cerebral demyelination have produced conflicting results. Therefore, we studied the effect of xenon inhalation on the CT appearance of five demyelinated plaques. The plaques and the surrounding white matter increased commensurately in attenuation during xenon inhalation. Therefore, xenon enhancement does not generally increase the sensitivity of CT for detecting cerebral demyelination.
1. The uptake of radiolabelled 14C-histamine into guinea-pig isolated left atria was determined. 2. Mepyramine up to 10(-7) M had no significant effect upon the uptake of total radioactivity. Metiamide (10(-4) M) produced a small but not significant inhibition of uptake. SK & F 91581 (10(-4) M) and amodiaquine (10(-4) M) both significantly inhibited uptake by 48.2 +/- 4.2 and 56.7 +/- 1.2% respectively. 3. The metabolism profiles of radiolabelled histamine after 5 and 30 min incubation were examined by thin-layer chromatography. 4. SK & F 91581 (10(-4) M) and amodiaquine (10(-4) M) reduced the proportion of N tau-methylhistamine and acid metabolites after a 30 min incubation. The levels of unmetabolized histamine were elevated. This may explain their inhibitory action upon histamine uptake. 5. The effects of mepyramine, metiamide, SK & F 91581 and amodiaquine were then examined upon the positive inotropic and chronotropic responses of isolated left and right atria to histamine. 6. Mepyramine (10(-7) M) inhibited the positive inotropic responses only (H1), whereas metiamide (10(-4) M) inhibited the positive chronotropic responses only (H2). SK & F 91581 (10(-4) M) had no effect upon these responses and amodiaquine (10(-5) M) depressed the maxima of the rate response dose-response curves. 7. The relationship between uptake and metabolism of histamine and its pharmacological response is discussed.
(1) The effect of phosphodiesterase inhibitors was studied on right artial rate, left atrial tension and left ventricular papillary muscle tension responses to histamine and isoprenaline. (2) Only responses mediated via beta-adrenoceptors and H2-receptors were potentiated by theophylline. This is proposed to be due to its phosphodiesterase inhibiting properties and therefore indicates the involvement of cAMP in these responses. (3) 3-Isobutyl-1-methylxanthine was approximately 30 times more potent than theophylline in producing leftward shifts of isoprenaline left atrial tension curves. The potentiating effect of papaverine was masked by an opposing depressant action. (4) Left ventricular papillary muscle tension responses to histamine were enhanced by the phosphodiesterase inhibitors confirming the reported involvement of cAMP in the right ventricle. (5) The left artial tension dose-response curves to histamine were not potentiated. Single doses revealed a biphasic response consisting of an H1-receptor mediated component and one resistant to both H1- and H2-receptor anagonists. Neither component was potentiated suggesting no involvement of cAMP.
Cytogenetic analysis of 1000 spontaneous abortions showed 463 to have an abnormal chromosome constitution. The proportion of chromosome abnormalities varied with the gestational age of the abortus and the type of tissue cultured but was not significantly different among the five racial groups represented in the study population. It was suggested that differences in the rate of chromosome abnormalities among cytogenetic studies of spontaneous abortions were the result of methodological differences in sample selection rather than real biological variation among study populations. The only factor found to be unequivocally associated with the aetiology of chromosome abnormalities in spontaneous abortions was increasing maternal age in trisomies.