Biomedical subjects
Publications and source records attributed to G A Williams.
Four cases of synchronous carcinoma of the cervix and ovary are reported. In all cases the ovarian and cervical tumours were adenocarcinoma. Surgical management was determined by the extent of the tumours and the need for intracavitary radiotherapy. The dilema in determining whether the tumours were separate primaries or one primary with metastasis is discussed.
Sister Joseph's nodule is a rare feature of advanced cervical carcinoma. This case is reported from a Nigerian teaching hospital where over 100 new cases of cervical carcinoma are seen annually.
OBJECTIVE: To assay the proteolytic activity of plasmin on the vitreoretinal junction and to assess a potential facilitating effect on posterior vitreous detachment. METHODS: We injected 1 U of plasmin into the vitreous of rabbits. Some eyes underwent vitrectomy after plasmin injection. Electroretinography and electron microscopy were performed. RESULTS: In plasmin-treated eyes, electroretinography displayed a transient (3 days) decreased b-wave amplitude. Histologic examination demonstrated posterior vitreous detachment in eyes that received intravitreal plasmin followed by vitrectomy. CONCLUSION: Plasmin may prove to be a useful biochemical adjunct to mechanical vitrectomy.
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Data are presented on the duration of survival of platypus held in the collections of the 5 Australian zoos displaying the species over the period 1987-1991. Of 10 living platypus, five had survived for 7 or more years. Similarly, of 10 captive animals that died during the period, six had survived for 6 or more years. Five purpose-caught animals were integrated into captive collections over the period; all of these were alive at the end of 1991. The high survival of captive platypus documented in this study contrasts with the conclusion of Whittington (1991) that the duration of survival of platypus in captivity is generally short. This primarily reflects differences in the nature of the two sets of data: Whittington's analysis was based on incomplete records dating back to 1934, and also categorised as 'managed in captivity' those wild platypus that died at zoos while under veterinary care. A series of recommendations on current captive management issues includes the need for improved veterinary knowledge of platypus.
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The Early Treatment Diabetic Retinopathy Study, a randomized clinical trial supported by the National Eye Institute, was designed to assess the effect of photocoagulation and aspirin in 3711 patients with mild to severe nonproliferative or early proliferative diabetic retinopathy. Although the primary goal of the study was to evaluate the effect of photocoagulation and aspirin on diabetic retinopathy, the study also provided an opportunity to evaluate the effects of aspirin on the development of cataract. No evidence showed that aspirin use reduced the risk of development of cataract requiring extraction (4.1% vs 4.3% in patients assigned to aspirin or placebo treatment, respectively; Mantel-Cox P = .77; relative risk, 1.05; 99% confidence interval, 0.73 to 1.51). Aspirin use also did not reduce the risk of less extensive but visually significant lens opacities developing (29.6% vs 28.3%; Mantel-Cox P = .76; relative risk, 0.99; 99% confidence interval, 0.85 to 1.15). Early Treatment Diabetic Retinopathy Study results do not support the hypothesis that aspirin (at a dose of 650 mg/d) reduces the risk of cataract development in this diabetic population.
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The Australian Government plans to rehabilitate the former nuclear weapons testing ranges at Maralinga and Emu in South Australia and to allow access to the areas for the Pitjantjatjara (Aboriginal) people who are the traditional owners of the land. The major radiological hazard posed by reoccupation of the ranges arises from inhalation of residual plutonium. The committed effective dose that these people might receive from inhalation on reoccupation of the lands is computed for a range of sites. The estimated doses for permanent occupancy range up to 300 mSv y-1 indicating the need for substantial rehabilitation before these areas are suitable for unrestricted access.
The cases of 4 patients with clinical signs of intraocular large cell lymphoma are described. Initial cytopathologic examination of vitrectomy specimens failed to establish the malignant character of the vitreous infiltrates. Three of the four patients eventually developed solid central nervous system tumors, intracranial biopsy samples of which revealed large cell lymphoma, 13 months to 42 months after initial examination. In one patient, transscleral retinochoroidal biopsy confirmed the diagnosis at the same time as negative vitreous cytologic examination. Results of cytopathologic examination alone of vitreous biopsy specimens may not be sufficient to make a diagnosis in certain cases of large cell lymphoma that are subsequently documented by CNS biopsy. Careful attention should be paid to the handling, processing, and interpretation of vitrectomy specimens from patients suspected of having intraocular large cell lymphoma. Consideration should be given to immunocytologic staining and interpretation by centers that are highly experienced in vitreous cytopathology.
In 1989 a national survey was carried out on children aged 3 to 4 years attending nursery schools, to investigate the prevalence of caries experience, nursing bottle caries and enamel defects in the primary dentition, and these children's dentally related habits. In the first part of the study, examination of 482 Antiguan children showed that the dmft and dmfs values were 0.80 and 1.26 respectively, and that 77 per cent of the children were caries free; 4.6 per cent of children had nursing bottle caries; and enamel defects occurred in 24 per cent of children. No significant difference was found in oral health between urban and rural samples. In the second part, which was an interview survey, habits such as thumb sucking (13 per cent), not brushing their teeth (3 per cent), and swallowing fluoride toothpaste (13 per cent) were found among 369 children. In the third (a questionnaire) survey, a response rate of 63 per cent was obtained. Significantly more of the children with nursing bottle caries (78.6 per cent) had the habit of sleeping with a feeding bottle than occurred in caries free children (25.6 per cent), but there was no difference in the infant feeding pattern. The children with enamel defects were breast fed for a shorter period and had an earlier introduction to bottle feeding, compared with children without enamel defects. In the final part of the survey, an assessment of snack eating habits at school, a 58 per cent response rate was achieved. The majority of children often brought healthier snacks, together with daily sugar-rich drinks. Significantly more caries free children brought sugary snacks less frequently than children with caries experience.
This study was designed to determine whether children with mild mental retardation understand the concept of loneliness, whether their feelings of loneliness at school can be reliably assessed, and whether there are differences in loneliness between children with and without mental retardation. Results from a sample of 62 students with mild mental retardation and 62 students without retardation, ages 8 through 13, indicated that (a) high percentages of both groups understood what loneliness means, (b) a loneliness questionnaire yielded satisfactory internal reliability with both groups, and (c) boys but not girls with mental retardation reported significantly more loneliness than did children without mental retardation. Suggestions were made for future research on loneliness in school settings.
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Atrial pacing was performed with two-dimensional (2-D) echocardiography and thallium 201 scintigraphy in 40 men with stable chest pain. Coronary angiography showed significant (one or more lesions greater than or equal to 50%) coronary artery disease (CAD) in 36 patients and no or insignificant CAD in 4. Two dimensional echocardiography showed a left ventricular wall motion abnormality (WMA) either at rest or with pacing in 28 (78%) patients with CAD, with 17 (47%) showing a new or worsened WMA with pacing. A thallium scan showing abnormality (reversible or fixed perfusion defect) was seen in 26 (72%) patients with CAD; 18 (50%) had a reversible defect. In all, 34 of the 36 patients with CAD (94%) had a WMA, a perfusion defect, or both (specificity 50%). Occurrence of both a WMA and a perfusion defect in individual segments ranged from 10 of 25 patients with septal abnormalities to 0 of 12 with abnormalities of the lateral segment. Sensitivity of 2-D echocardiography for identifying CAD in specific vessels was 81% for the left anterior descending (LAD) artery, 30% for the right coronary artery, and 20% for the circumflex artery (both p less than .001 compared with the LAD artery). Corresponding sensitivities for thallium 201 imaging were 54% (p less than .05 compared with 2-D echocardiography), 27%, and 8% (both p less than .05 compared with the LAD artery). When combined with atrial pacing, 2-D echocardiography and thallium 201 perfusion imaging are of similar value for diagnosing the presence of CAD in patients with stable chest pain. Two-dimensional echocardiography is superior to thallium 201 imaging for identifying the presence of significant CAD in the LAD artery, but both tests are limited in their ability to detect lesions of the right coronary or circumflex arteries.
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We investigated the effect of panretinal cryotherapy on blood clearance and on the inflammatory cellular response in rabbit eyes with experimental vitreous hemorrhage. Eyes treated with cryotherapy demonstrated less extensive vitreous opacity and more rapid clearance of blood than untreated eyes. The peak inflammatory cellular response measured by counts or radiolabeled cells in the optic nerve was 2.5 times greater in the cryotherapy-treated eyes. Panretinal cryotherapy may promote the clearance of vitreous hemorrhage by stimulating the influx of increased numbers of phagocytic inflammatory cells.
Functional and anatomic success after relaxing retinotomy may be limited by recurrent retinal detachment or severe hypotony. Fifty-four consecutive eyes undergoing relaxing retinotomy for proliferative vitreoretinopathy (42 eyes) and trauma (12 eyes) were analyzed to determine whether perioperative factors, including size and location of the retinotomy, influenced visual or anatomic outcome. After 6 months' minimum follow-up, anatomic success (retina attached posterior to buckle and an intraocular pressure of 3 mm Hg or more) was achieved in 35 eyes (64%). Functional success (visual acuity of 5/200 or better) was achieved in 14 eyes (26%). Factors predicting functional success by stepwise logistic regression analysis included a preoperative visual acuity of hand motions or better and location of the retinotomy in the superior four clock hours of the fundus. Causes of anatomic failure included proliferative vitreoretinopathy (11 eyes) and severe hypotony or phthisis (8 eyes). Superior location of the retinotomy and visual acuity of hand motions or better favorably influenced visual outcome after relaxing retinotomy.
Preoperative assessment of cardiac risk using thallium-201 scintigraphy and atrial pacing (n = 42) or dipyridamole stress testing (n = 35) was performed in 77 patients (mean age 65 +/- 7 years), who subsequently underwent elective nonvascular surgery. All patients were at low cardiac risk by clinical criteria; none could perform exercise stress testing due to physical limitations. ST depression consistent with ischemia occurred in 11 patients during atrial pacing and in 1 patient during dipyridamole stress testing (p less than 0.01). Nine patients had reversible perfusion defects with atrial pacing, and 10 patients with dipyridamole stress testing; fixed defects were present in 15 and 8 patients, respectively. Only one patient (fixed perfusion defect with atrial pacing, left main disease on coronary angiography) underwent preoperative coronary revascularization. Two patients subsequently had postoperative cardiac events. One patient (reversible perfusion defect with dipyridamole stress testing) experienced sudden death after a nonvascular procedure, while a second patient (normal thallium images with dipyridamole testing) had a nonfatal myocardial infarction. In patients having atrial pacing or dipyridamole stress testing, thallium-201 scans that are normal or show only a fixed perfusion defect confirm a low risk of cardiac complications following nonvascular surgery. The presence of a reversible perfusion defect does not preclude a postoperative course free of cardiac complications in patients at low cardiac risk by clinical criteria.