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Biomedical subjects

D H Wilson

Publications and source records attributed to D H Wilson.

At least 91 records · Page 5Linked to original sources
PubMed1980

Auditory pattern perception in 'split brain' patients.

Three "split brain" subjects with normal peripheral hearing were tested on identifying monaurally presented auditory intensity and frequency patterns. One subject was tested before commissurotomy, ten days later, and one year after surgery. Results indicated that sectioning the corpus callosum dramatically affects the ability to verbally report both intensity and frequency patterns. However, the ability of the subjects to correctly "hum" frequency patterns was not impaired. Thus, it appears for a correct verbal report of an auditory pattern, interhemispheric transfer of acoustic information is required, while "humming" the pattern does not. Further application of this finding implicates auditory pattern tasks as as a potentially valuable test for detecting problems of higher auditory processing, particularly those affecting interhemispheric interaction.

Auditory Pathways↗
PubMed1980

Clindamycin in the treatment of soft tissue infections: a review of 15 019 patients.

A retrospective survey of 15 019 patients treated with clindamycin for a soft tissue infection was carried out to determine whether the incidence of serious side effects was sufficient to preclude the continuing use of this antibiotic. Thirteen patients were found to have had severe diarrhoea and 2 of these required inpatient treatment for pseudomembranous colitis. Certain limitations of the use of clindamycin are suggested but, in view of the recently improved understanding of the nature of pseudomembranous colitis and more effective methods of treatment of this complication, it is concluded that this antibiotic still has a useful role to play in the treatment of acute soft tissue infection.

Adolescent↗
PubMed1980

Presentation of cancer to hospital as 'acute abdominal pain'.

In a survey of 5675 patients presenting to five hospitals in England, Scotland and Denmark with acute undiagnosed abdominal pain, 106 patients later proved to have intraabdominal cancer. The risk of cancer was age-dependent: amongst patients over 50 years with 'non-specific' pain the risk of cancer was 10 per cent. The commonest primary cancer site (in 57 cases, 53.8 per cent) was the large bowel. Most cancers neither perforated nor obstructed: 73 patients merely presented with a short history of unexplained abdominal pain. Of those patients with cancer presenting with 'unexplained' pain, half (37/73, 50.7 per cent) left hospital without a diagnosis of cancer having been made. Subsequently, a computer-aided system was constructed to discriminate (in patients over the age of 50) between those with unexplained acute abdominal pain who did and did not have cancer. Overall accuracy was 84.7 per cent in 138 cases. The most helpful clinical features in making this discrimination are listed. It is suggested (a) that cancer is now a relatively common cause of acute abdominal pain, (b) that the diagnosis is frequently difficult and (c) that urgent screening of all patients over 50 with non-specific acute abdominal pain may be warranted.

Abdomen, Acute↗
PubMed1979

AID for lesbians.

Explore the source record for details and available documents.

Ethics, Medical↗
PubMed1979

SSW and dichotic digit results pre- and post-commissurotomy: a case report.

A 19-year-old right-handed male with normal peripheral hearing bilaterally, was tested on the SSW and dichotic digits before and after commissurotomy. SSW results showed a definite deficit for words presented to the left ear in both the competing and noncompeting conditions. Dichotic digit results showed complete inability on the part of the subject to report the digits presented to the left ear. These findings are similar to other dichotic test results previously reported on split-brain patients.

Adult↗
PubMed1979

Plasticity in speech organization following commissurotomy.

For three-and-a-half years we have been studying the cognitive and conscious mechanisms in a remarkable 18-year-old man: Case P.S. This unique individual had his corpus callosum divided in order to control intractable epilepsy. Although for some time after the operation he appeared like other split-brain patients, unable to describe verbally stimuli directed to his mute right hemisphere, he behaved as if he was capable of comprehending a wide range of language-related stimuli directed to that hemisphere. Spelling by choosing the appropriate letters with his left hand, he could process nouns, verbs, rhymes, antonyms, and superordinate concepts. When asked about tachistoscopic presentations delivered to his left visual field, he either said he had seen nothing, or only a flash of light. He was also unable to identify verbally tactile 'sterognostic' inputs to his left hand. In the last year P.S. has begun to speak about stimuli directed to his right hemisphere. This series of experiments suggests that this speech is not interhemispheric transfer within the visual modality. Further, plotting the relative increased proficiency of verbal description of inputs directed to the right hemisphere, this speech system seems to be in a process of continuing development.

Cerebral Cortex↗
PubMed1979

Microsurgical lumbar discectomy: preliminary report of 83 consecutive cases.

The application of microsurgical technique to lumbar discectomy may be of dual value: minimal disruption of the integrity of normal anatomy and meticulous hemostasis may help to speed the process of convalescence, and the retention of epidural fat around the nerve root may help to prevent adhesions, a common cause of the late, "failed disc" syndrome. The authors report their experience with 83 consecutive microdiscectomies for lumbar disc protrusions. The results must be considered as tentative because the follow-up period has been short and the authors found it difficult to quantify the quality of health during the convalescent phase, although this seemed to be excellent. Their short term results are similar to those of the larger series reported by Williams, whose experience with microsurgical lumbar discectomies began 6 years ago. No other series have been reported. The authors describe their technique and compare it to that of Williams.

Adult↗
PubMed1978

Block design performance following callosal sectioning. Observations on functional recovery.

A patient with complete surgical section of the corpus callosum was tested on a constructional task 17 months post-operatively. The left and right hands were separately tested under conditions of free visual exposure and lateralized visual field exposure. The results suggest that the typically observed improved performance of the right hand with increasing postoperative time is attributable to the acquisition of homolateral control over the right hand by the right hemisphere. The implications for left-right brain organization and the syndrome of constructional apraxia are considered.

Adolescent↗
PubMed1978

Division of the corpus callosum for uncontrollable epilepsy.

Cerebral commissurotomy, the "split-brain" procedure, has been employed for the control of intractable seizures, in conjunction with moderate doses of anticonvulsant drugs. The results have been encouraging in several small series. The use of microsurgical techniques and the restriction of surgery to one commissure, the corpus callosum, has reduced morbidity without apparent change in result. The eight patients in our first series who underwent the prescribed division of several forebrain commissures are compared to the four patients in our second series who underwent division of the corpus callosum alone. The technique of callosotomy is described.

Adult↗
PubMed1978

Surgery of the carpal tunnel. Technical note.

The authors describe a modified technique for surgery of the carpal tunnel. The primary cause of the carpal tunnel syndrome is the same as other entrapment neuropathies: an enlarged nerve within a tight tunnel. Electrical studies have shown that the area of compression is in the middle of the tunnel. Treatment is surgical: a palmar incision, which begins at the wrist medial to the palmaris longus, to avoid damage to the sensory branch of the median nerve; and selection of the retinaculum from the exit of the tunnel toward the entrance.

Carpal Tunnel Syndrome↗
PubMed1977

The generation of killer cells to trinitrophenyl-modified allogeneic targets by lymphocyte populations negatively selected to strong alloantigens.

Negatively selected mouse and rat lymphocyte populations, specifically deprived of alloreactivity to a particular major histocompatibility complex (MHC) haplotype, are nevertheless fully capable of responding to trinitrophenyl (TNP)-modified allogeneic stimulator cells and developing cytotoxic T-lymphocyte activity to TNP-altered allogeneic target cells. As for syngeneic systems, lytic expression of those responder killer cells also requires MHC identity between the target and stimulator cell populations. Such a finding argues strongly against two variations of the dual recognition hypothesis: like-like interactions and adaptive differentiation. Instead, these data favor either the altered self model or a third variation of the dual receptor model, where one of the relevent receptors is specific for the modifying antigen and the second is a low affinity receptor unable to be triggered in the absence of a modifying antigen.

Animals↗
PubMed1977

A divided mind: observations on the conscious properties of the separated hemispheres.

Each cerebral hemisphere in Patient O.S., a callosum-sectioned patient, appears to possess mental properties deserving of conscious status. The observations seem to answer many questions concerning the issue of whether the mechanisms of consciousness can be split and doubled by split-brain surgery. As P.S. is the first split-brain patient clearly to possess double conscious processes as well as the first with extensive bilateral linguistic skills, the observations suggest that the special nature of human conscious experience is closely tied to linguistic processes.

Child↗
PubMed1977

Diagnosis of acute abdominal pain in the accident and emergency department.

This paper reports the findings in a study involving 1537 patients with 'acute abdominal pain' presenting over a 13-month period to the Accident and Emergency Department of the General Infirmary at Leeds. Of these, 341 patients who proved to have pain of greater duration than a week, pain incidental to some other identifiable condition or no pain at the time of their attendance were excluded. The remaining 1196 were diagnosed clinically (using a structured case sheet) and subsequently by a Bayesian computer system. Feedback of the results of clinical and computer systems was given to clinicians at regular intervals. Clinical diagnostic accuracy in patients with surgical disorders rose from 40 per cent before the study to 61 per cent. Computer accuracy in these patients was 69-9 per cent. The proportion of patients sent home without ill effects rose from 20 per cent to 39 per cent. In other areas (e.g. gynaecology) the effects were less marked. It is suggested that the introduction of a simple postgraduate educational service, aided by a small computer, might prove of practical benefit in this clinical situation.

Abdomen, Acute↗
PubMed1977

Computer-aided diagnosis of lower abdominal pain in women.

This paper describes the use of a system of computer aided diagnosis in an unselected, prospective survey of 393 women suffering from lower abdominal pain of less than 1 week's duration. An accurate diagnosis was made by clinicians at first patient contact in 68-5 per cent of the group of patients. The computer's diagnostic prediction (based on the same data) matched the final diagnosis in 81-6 per cent of the patients. During this survey a marked improvement in diagnostic accuracy was observed amongst the junior clinicians. It is suggested that this is because of the discipline of data collection imposed and the intermittent feedback received, and also that this educational aspect of computer usage may be of wider benefit.

Abdomen↗