Search PubMed⌕ Search

Biomedical subjects

G Williams

Publications and source records attributed to G Williams.

At least 541 records · Page 30Linked to original sources
PubMed1988

A prospective randomized controlled trial of perioperative antibiotic prophylaxis in renal transplantation.

We have carried out a prospective, randomized controlled trial of perioperative prophylaxis with cefuroxime and piperacillin in 53 recipients of renal allografts. Twenty-seven patients received antibiotic prophylaxis with three doses of cefuroxime 750 mg and piperacillin 4 g, and 26 patients received no prophylaxis. Risk factors for infection were well matched. Infection rates were analysed for the periods 0-5 days and 0-14 days post-transplant. In the first 5 days, patients receiving antibiotics had fewer infections (3 vs. 11, P = 0.04) but by 14 days this difference was no longer apparent (21 vs. 30, P = NS). There was a total of 15 wound infections, which were more common in the control group both at 5 days (1 vs. 5, P = NS) and at 14 days (4 vs. 11, P = 0.027). Urinary infections were unaffected by prophylaxis. We conclude that perioperative antibiotic prophylaxis results in a modest but worthwhile reduction in the incidence of wound infections after renal transplantation.

Adult↗
PubMed1988

Serum alpha-tocopherol, all-trans retinol, total lipids and cholesterol in the black rhinoceros (Diceros bicornis).

1. Mean concentration of serum alpha-tocopherol (Vitamin E) in 28 free-living black rhinoceroses sedated during translocation in Zimbabwe was 1.92 (SD, 0.43) mg/l. 2. Alpha-tocopherol was not detectable (less than 0.15 mg/l) in five captive black rhinoceroses held at London Zoo. 3. Circulating levels of all-trans retinol (Vitamin A) were not different between the two groups. 4. The low level of alpha-tocopherol in captive rhinoceroses suggests a risk of acute haemolytic anaemia.

Anemia, Hemolytic↗
PubMed1988

Plasma retinol and alpha-tocopherol levels in captive wild animals.

1. The plasma retinol and alpha-tocopherol levels of a number of captive wild animals on defined vitamins A and E intake were determined. 2. In all the species examined they appeared to be low in relation to intake and as compared with recorded values of some domesticated species.

Animals↗
PubMed1988

Mitosis counting in seminoma: an exercise of questionable significance.

Two pathologists reviewed and classified 45 cases of testicular seminoma, evaluating each case for multiple histologic variables, including mitotic rate. In addition to recording the mitotic count for each of thirty 0.1963-mm2 high-power fields, the investigators recorded the distribution of mitotic counts in many non-spermatocytic seminomas. Statistically significant differences for mitotic rate in the nonspermatocytic tumors were noted between the observers; one observer found a mean mitotic rate of 1.815/high-power field for 43 such tumors, whereas the other noted a mean mitotic rate of 1.388/high-power field (p = 0.001). These differences led to disagreement on the classification of 3 tumors. Of the 4 cases considered to be high-mitotic-rate seminomas by one or both observers, all patients had presented with stage I disease. Three of the patients were followed up for 23, 55, and 56 months, and all were free of disease; the fourth was lost to follow-up. The patient with the highest mitotic rate was free of disease at 55 months of follow-up. On the basis of our findings we question the value of the designation high-mitotic-rate seminoma. Analysis of the distribution of mitotic counts within the tumors revealed them to be Poisson distributed. With these data and other empirically derived data, it was possible to estimate the probability of misclassification of seminoma based on mitotic rate, the diagnostic mitotic rate threshold, and the number of fields counted for mitoses. Similar analysis might be valuable for other tumors, particularly those of smooth muscle origin, in which mitotic rate is of diagnostic or prognostic value.

Adult↗
PubMed1988

Structure-activity relationships among analogues of pemedolac, cis-1-ethyl-1,3,4,9-tetrahydro-4-(phenylmethyl)pyrano[3,4-b]indo le-1-a cetic acid, a potent analgesic agent.

The syntheses of analogues of pemedolac (cis-1-ethyl-1,3,4,9-tetrahydro-4-(phenylmethyl)pyrano[3,4-b]indol e-1-acetic acid), a potent analgesic, are described. They were tested for analgesic and antiinflammatory effects in vivo and for inhibition of prostaglandin production in vitro. Analysis of structure-activity relationships shows that analgesic activity in this series is associated with 1S-cis stereochemistry, the presence of a pi-system (allyl or benzyl) at position 4, and a log P value greater than 4.0.

Animals↗
PubMed1988

The relationship of body weight to response to endocrine therapy, steroid hormone receptors and survival of patients with advanced cancer of the breast.

High body weight is associated with increased production of oestrogens which may influence the clinical behaviour of breast cancer. We have examined the influence of body weight on the response to endocrine therapy, steroid hormone receptor content and survival in 227 women who either presented with or developed advanced cancer of the breast. One hundred and thirty-three (59%) patients presented with operable disease and 94 (41%) with locally advanced tumours. Two hundred (88%) were treated by tamoxifen and 27 (12%) by ovarian ablation. High body weight was correlated with advanced tumour stage (P = 0.002) and progesterone receptor (PR) positivity (P = 0.01), but not with the presence of oestrogen receptor (ER P = 0.21). The association between high body weight and PR positivity was particularly noticeable among ER positive tumours. There was no significant relationship between the nature of the response to therapy and weight (P = 0.57). There was no significant difference in survival from the start of endocrine therapy (P = 0.95), nor the time to progression of disease (P = 0.29) between patients above and below the median weight of 64 kg. Among the patients with operable disease, there was no difference in overall survival (P = 0.42), relapse free survival (P = 0.69), and survival from the start of endocrine therapy (P = 0.85) according to body weight.

Body Weight↗
PubMed1988

Potent and comparable vasodilator actions of A- and B-calcitonin-gene-related peptides on the superficial subcutaneous vasculature of man.

1. Vasoactivity of human A- and B-calcitonin-gene-related peptides was studied in normal subjects, using reflectance plethysmography to measure relative changes in blood flow produced by superficial subcutaneous injections of the peptides. 2. Injection of 10(-11) mol of either peptide caused an immediate 200% increase in local blood flow and prolonged hyperaemia lasting up to 3 h. The hyperaemic response to 10(-13) mol of each peptide was significantly (P less than 0.01) smaller and shorter in duration than that elicited by 10(-11) mol of the same peptide, and 10(-15) mol of both peptides produced no hyperaemia other than that attributable to needle insertion alone. 3. At all three dosages examined, there were no significant differences between A- and B-calcitonin-gene-related peptides in magnitude or time course of the hyperaemic response. 4. Human A- and B-calcitonin-gene-related peptides are therefore potent vasodilators in man, causing comparable dose-related vasodilatation in the superficial tissues.

Adolescent↗
PubMed1988

Postprandial glycaemic effects of a long-acting somatostatin analogue (octreotide) in non-insulin dependent diabetes mellitus.

Postprandial changes in blood glucose, insulin and glucagon were examined in 7 non-insulin dependent diabetic patients, before and after 3 days' treatment with the somatostatin analogue, octreotide (50 ug injected subcutaneously thricedaily). After octreotide injection, postprandial rises in plasma insulin and glucagon were significantly flattened. The postprandial glycaemic rise was delayed but the area under the glycaemic curve was not increased. Animal studies have suggested that octreotide inhibits growth hormone and glucagon secretion much more powerfully than native somatostatin, while relatively sparing insulin secretion. However, the present findings suggest that this analogue is not sufficiently selective to be therapeutically useful in non-insulin dependent diabetes.

Aged↗
PubMed1988

Reduced hypothalamic somatostatin and neuropeptide Y concentrations in the spontaneously-diabetic Chinese hamster.

Hypothalamic concentrations of six regulatory peptides having central effects on appetite and/or glucoregulation were measured by radioimmunoassay in spontaneously-diabetic Chinese hamsters and in age- and sex-matched non-diabetic control animals. In the diabetic hamsters, hypothalamic concentrations of somatostatin and neuropeptide Y were significantly reduced by 25-30% below controls. None of the other four peptides examined (bombesin, galanin, neurotensin and vasoactive intestinal peptide) differed significantly between the two groups. Disturbances in neuropeptide Y (the most potent central appetite stimulant yet discovered) and in somatostatin could be related to hyperphagia, an early and possibly primary abnormality of the diabetic syndrome in the Chinese hamster.

Animals↗
PubMed1988

An open study of the safety and efficacy of enoxacin in complicated urinary tract infections.

Thirty-one patients with serious or complicated urinary tract infections were treated with oral enoxacin for between four and eight days. Twenty-five patients with microbiologically confirmed infections completed treatment with 400 mg enoxacin twice daily and at the end of treatment all urine cultures were negative. At short term follow-up, five to nine days after therapy, 21 of the 25 patients were still infection free. In total, reinfection or relapse occurred in 12 patients during the four to six weeks follow up period after termination of treatment. Significant side-effects (nausea and vomiting) occurred in only one patient.

Adult↗
PubMed1988

Decreased uterine perfusion--a cause of infertility.

There have been several causes of infertility attributed to gamete quality, congenital anatomical abnormalities and surgical complications. Published research into the reasons for failure of implantation of embryos has been confined to histochemical and histological studies of the endometrium. This paper presents preliminary data from an ongoing study to test the hypothesis that poor uterine perfusion is a cause of failure of implantation of embryos. It would follow that poor uterine perfusion is a cause of infertility. One-hundred-and-fifty-three patients who had been unsuccessful in conceiving despite three previous in-vitro fertilization attempts have been studied. Doppler ultrasound studies of the ascending branch of the uterine artery, during spontaneous ovarian cycles, revealed a poor mid-secretory uterine response in 48% of patients studied. Patients with poor mid-secretory uterine response were treated with orally administered hormone therapy to improve the mid-secretory uterine response prior to subsequent embryo replacement. The results of subsequent in-vitro fertilization therapy in patients with good uterine response and in women with improved uterine response after hormone therapy are presented. The numbers of patients in each group are insufficient for statistical analyses, but the trends observed support the hypothesis that poor uterine blood flow is a cause of infertility. Further evaluation is warranted.

Adult↗
PubMed1988

The clinical and endocrine assessment of three different antiandrogen regimens combined with a very long-acting gonadotrophin-releasing hormone analogue.

Tumor flare is reported in up to 40% of patients treated with gonadotrophin-releasing hormone analogues for prostate cancer. In order to investigate the optimal way to eliminate tumor flare, we have treated patients with one of three different antiandrogen regimens used in combination with gonadotrophin-releasing hormone (GnRH) agonist. The early results of this study are presented here. Thirty patients with advanced symptomatic disease were randomized to receive either cyproterone acetate 50 or 100 mg three times daily or flutamide 250 mg three times daily given for 1 week before and during the first month of GnRH agonist treatment. The endocrine profiles of these patients were compared with those of historic controls treated with depot agonist alone. Three patients treated with low-dose cyproterone acetate and one with flutamide developed a transient exacerbation of their disease. No patients treated with the higher-dose cyproterone acetate regimen developed tumor flare. No patients treated with cyproterone acetate had an increase in serum testosterone above baseline following depot GnRH agonist implantation. All patients treated with flutamide had increases in serum testosterone, but this did not significantly increase further with implantation. This study suggests that all patients receiving GnRH agonist treatment should be pretreated with cyproterone acetate 100 mg three times daily for 1 week before implantation and for the first treatment month.

Aged↗
PubMed1988

The incidence of immunosuppression-related skin disease in long-term transplant patients.

One hundred and twenty-one patients who had received a renal allograft between 4 months and 21 years previously (mean +/- SD, 71 +/- 62 months) were studied. Seventy-two patients were conventionally immunosuppressed with azathioprine and prednisolone, and 36 had been exposed to the current regime of cyclosporine, azathioprine, and prednisolone. Forty-five patients had viral warts, of whom 20 had more than 10 warts. The presence of viral warts was significantly associated with pale skin type, excess sun exposure, and with duration of allograft. Viral warts were significantly more common in those on conventional immunosuppressive therapy, but this could be solely a reflection of the difference in duration of transplant between the 2 groups. Twelve patients were found to have developed dysplastic or neoplastic skin lesions since transplantation. The incidence of dysplasia increased with increasing age and was significantly associated with pale skin type, excess sun exposure, and duration of allograft. Despite the shorter duration of treatment in those on the new treatment regime, there was no difference between the 2 groups in the proportion of patients with dysplastic skin lesions. Immunosuppression-related skin disease may be a significant problem in allograft recipients in this country, and we suspect that patients taking cyclosporine will have similar problems to those on conventional immunosuppressive drugs alone. Immunosuppressed patients should be advised to avoid sun exposure, to use sunscreens, and should be monitored carefully for the development of dysplastic lesions.

Dermatomycoses↗
PubMed1988

Laryngographic investigation of postoperative hoarseness.

This study investigates postoperative hoarseness by comparing the patient's subjective assessment of change in voice following intubation with objective measures made using the laryngograph. Twenty-five patients admitted for routine surgery were assessed pre- and postoperatively. An Fx histogram was recorded on the laryngograph. A linear analogue self-assessment scale was used to quantify hoarseness subjectively. The objective measure of hoarseness (spread or standard deviation of Fx histogram) correlated well with the patients' subjective assessment of hoarseness. Six patients showed a bi- or trimodal histogram following intubation. This is known to represent asymmetric muscular activity. It is concluded that change in voice following intubation correlates well with the measures of vocal fold trauma. These measures can be recorded as the change in spread, standard deviation of the Fx histogram. The transient postoperative hoarseness following intubation is due to laryngeal damage. This damage has 2 mechanisms; in most cases it is due to direct mucosal trauma but in other cases a deeper muscular damage occurs.

Adolescent↗
PubMed1988

Response of the benign hypertrophied prostate to treatment with an LHRH analogue.

Twenty patients with outflow tract obstruction secondary to benign prostatic hypertrophy were treated with an LHRH analogue, buserelin, for up to 6 months. Despite maintaining castrate levels of testosterone and achieving a significant reduction in tissue levels of dihydrotestosterone, no significant improvement was seen in flow rate or residual volume.

Buserelin↗
PubMed1988

Should pT1 transitional cell cancers of the bladder still be classified as superficial?

Of 171 patients consecutively presenting with newly diagnosed transitional cell cancer (TCC) of the bladder, 107 were "superficial"; 98 have been followed up for 2 years and 84 for 3 years. No patient with pTa TCC developed muscle infiltrating recurrences, although 15% progressed to pT1 category by 3 years. At 2 and 3 years respectively, 33 and 46% of the pT1 TCC had progressed to infiltrate muscle. The use of the term "superficial" to describe pTa and pT1 category TCC together in one grouping should be reconsidered.

Adult↗