Smoking and insulin absorption.
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Absorption↗
Biomedical subjects
G Williams
Publications and source records attributed to G Williams.
Treatment of advanced carcinoma of the prostate.
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Castration↗
Failure of long term luteinising hormone releasing hormone treatment for prostatic cancer to suppress serum luteinising hormone and testosterone.
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Gonadotropin-Releasing Hormone↗
A community training scheme in cardiopulmonary resuscitation.
Community instruction in basic life support and resuscitation techniques has been offered in Brighton Health District since 1978. Classes are held frequently for the general public and businesses, schools, and other organisations. First aid care for unconscious patients, the treatment of respiratory obstruction or failure, and the recognition and management of cardiac arrest is taught in a single two hour session. Over 20 000 people have been taught, up to 40 at a time in multiple groups of six to eight, by lay instructors usually supervised by ambulancemen trained to "paramedic" standards. Fifty four incidents have been reported to us in which techniques learnt in the classes have been implemented. Five patients recovered after first aid support but subsequently did not seek medical treatment. Of the 34 patients reviewed in hospital, at least 20 survived to be discharged. We believe that intervention may have been life saving in 16 instances. The benefit of cardiopulmonary resuscitation for victims who may have been asystolic is, however, difficult to quantify because the outcome without intervention cannot be predicted accurately. Community training in basic life support should be considered in association with ambulances equipped for resuscitation and hospital intensive care and cardiac care units as an integrated service for the victims of sudden circulatory or respiratory emergencies. The results achieved so far in Brighton and in other more advanced schemes, particularly in the United States of America, may encourage other health authorities to adopt similar programmes.
Adolescent↗
The effect of previous endocrine therapy on responses to a single dose of an LHRH analogue.
Serum concentrations of gonadotropins, testosterone and dehydrotestosterone were determined in patients receiving conventional endocrine therapy for advanced metastatic adenocarcinoma of prostate. The effect over 4 h of a single dose of a long acting analogue of LHRH was determined in these patients and compared to the response in patients receiving the analogues as first choice of treatment. Oestrogen therapy was found to suppress basal and stimulated gonadotropins and testicular androgens. Cyproterone therapy only partially reduced basal hormone concentrations and the response to the LHRH analogue was delayed. Orchidectomy resulted in elevated gonadotropins and an exaggerated response to the analogue. As patients who relapse while failing conventional therapy, may subsequently be treated by further endocrine manipulation, precise determination of their endocrine status should predict any expected benefit. Patients previously treated with stilboestrol are unlikely to respond to orchidectomy or LHRH analogue.
Adenocarcinoma↗
Reactions of mitochondrial cytochrome c with iron-polyaminocarboxylate complexes.
The binding of Fe(III)-polyaminocarboxylate (pac) complexes to mitochondrial ferricytochrome c and ferrocytochrome c has been studied by NMR and four binding sites on cytochrome c have been defined. These sites have different binding preferences for different pac complexes and these are not correlated with the kinetic classification of Wei and Ryan [J. Inorg. Biochem. 17, 237-246 (1982]. It is suggested that the classification of Wei and Ryan is faulty because an assumption made by these authors is incorrect. This assumption is that the reduction of ferricytochrome c by Fe(II)-(pac) complexes proceeds in all cases with similar electron transfer mechanisms with each of the pac complexes having similar self-exchange rates.
Carboxylic Acids↗
Tumour infarction after pre-operative embolisation of renal carcinoma.
Thirty kidneys containing renal carcinoma became available for complete histological examination 2-8 days after therapeutic embolisation with various combinations of gel-foam, dura mater, steel coils and thrombin. There was extensive tumour infarction (greater than 50%) in 25 kidneys and in the other five kidneys there was no tumour infarction detected histologically. In the 24 kidneys with a single renal artery, the number with tumour infarction exceeding 50% was significantly higher in cases where the post-embolisation arteriogram had shown complete occlusion of the renal artery close to its origin than in cases where the renal artery had been incompletely occluded (P = 0.0016). Fragments of gel-foam or dura mater were significantly less likely to produce complete arterial occlusion on the post-embolisation arteriogram than mixtures of embolic material containing coils (P = 0.016) or thrombin (P = 0.042). In the six kidneys with two renal arteries, tumour infarction exceeded 50% in the five kidneys where the post-embolisation arteriogram had shown complete occlusion of both renal arteries, and there was no tumour infarction in the single case where an accessory renal artery had been left patent. It is concluded that complete occlusion of the renal artery (or arteries) is essential if tumour infarction in excess of 50% is to be guaranteed, and that this is more readily achieved with mixtures of embolic materials containing fragments of gel-foam or dura mater plus coils or thrombin than with fragments of gel-foam or dura mater on their own.
Adult↗
The role of preoperative embolization in renal cell carcinoma.
A prospective study was done to assess the effect of embolization on the technical ease of nephrectomy, change in the immunological status of the patient and subsequent behavior of tumors and/or metastases in 55 patients with renal cell carcinoma. We found that embolization makes the operation easier technically. No changes in responses to delayed hypersensitivity skin tests were found after embolization with or without nephrectomy. There may be a response following embolization and adjuvant radical nephrectomy in some patients with limited lung metastases. No significant regression of renal cell carcinoma and/or metastases after embolization alone or with nephrectomy and hormonal/chemotherapeutic treatment was demonstrated. Survival of patients with metastatic renal cell carcinoma was longer for those who underwent embolization and nephrectomy than for those who underwent embolization alone.
Adenocarcinoma↗
Persistence of DNA single-strand breaks and other tests as indicators of the liver carcinogenicity of 1-nitroso-5,6-dihydrouracil and the noncarcinogenicity of 1-nitroso-5,6-dihydrothymine.
The cyclic nitrosourea 1-nitroso-5,6-dihydrothymine [(NDHT) 1-nitrosodihydrothymine] was not significantly carcinogenic when it was administered for 1 year in drinking water (206 mg/liter) to MRC-Wistar rats. In acute toxicity tests, ip injection of saline solutions of 1-nitroso-5,6-dihydrouracil [(NDHU) CAS: 16813-36-8; 1-nitrosohydrouracil], a strong liver carcinogen in rats, produced only mild liver toxicity but marked focal degeneration of myocardial fibers. NDHU injected ip in water solution produced subcapsular liver damage. NDHU, but not NDHT, induced unscheduled DNA synthesis in hepatocyte primary cultures. NDHU, NDHT, and methylnitrosourea [(MNU) CAS: 684-93-5; N-methyl-N-nitrosourea], a liver carcinogen only under special conditions, were tested for their ability, when injected ip into rats, to produce liver DNA damage measured as strand breaks by alkaline sucrose gradient centrifugation. The three nitrosoureas produced similar maximum DNA damage of 2.2-3.2 strand breaks/10(8) daltons. Eighty percent of the damage due to NDHU persisted for 7 days, and the damage at that time was significantly greater than that produced by NDHT and MNU. The varying persistence of liver DNA damage may explain why NDHU, but not NDHT, is a liver carcinogen.
Animals↗
The genesis of chronic illness: narrative re-construction.
In this paper I demonstrate the way in which people's beliefs about the aetiology of their particular affliction (arthritis) need to be understood as part of a more comprehensive imaginative enterprise which I refer to as narrative reconstruction. The intrinsically teleological form of this enterprise means that identified 'causes' represent only putative efficient connexions between the disease and antecedent factors but also narrative reference points between the individual and society in an unfolding process which has become profoundly disrupted. Through the presentation of case material taken from lengthy interviews I illustrate the way in which my question to the subjects about the cause of their disease: 'Why do you think you got arthritis?' was translated by them into a narrative reconstruction of their changing relationship to the world in which they live and the genesis of illness within it.
Adult↗
Scanning electron microscopy of normal, neoplastic and inflamed human bladder.
Scanning electron microscopy (SEM) was used to compare the topographic fine structure of urothelium from normal, neoplastic and inflamed human bladders. The three groups of patients show different patterns. The normal bladder lining is characterized by regularly arranged large superficial cells with ridged surfaces. By contrast, the surface cells of a transitional cell carcinoma are rounded up and covered with microvilli. In some patients with cystitis or post inflammatory hyperplasia SEM appearances intermediate between normal and neoplastic patterns are encountered. However, except in extremely severe cystitis it is possible on SEM to differentiate between inflamed and neoplastic urothelium. Surface microvilli provide a useful malignant marker for transitional cell carcinoma. However, severe inflammation of the bladder, when diagnosed on cystoscopic examination, can and must be excluded by light microscopy before this marker is considered diagnostic for neoplasia.
Adenocarcinoma↗
Scanning electron microscopy in early human bladder neoplasia.
Biopsies of healthy looking urothelium from 61 patients with transitional cell carcinoma (TCC) of bladder were examined by scanning electron microscopy (SEM) and light microscopy. A proportion (40%) showed abnormal features on SEM, in particular pleomorphic microvilli (PMV) in at least one area. SEM appearances were graded into four categories depending upon divergence from normal. Patients were followed up at cystoscopy and one year later a strong correlation was noted between original abnormal SEM appearances and subsequent tumour recurrence. These early results suggest that SEM could be helpful in the diagnosis, assessment, and clinical management of the unstable urothelium.
Carcinoma, Transitional Cell↗
Prostaglandin E1 accelerates subcutaneous insulin absorption in insulin-dependent diabetic patients.
The powerful vasodilator, prostaglandin E1 (PGE1), was added to Actrapid insulin to try to accelerate the early phase of subcutaneous insulin absorption through increasing injection site blood flow. Actrapid insulin alone (6U) and insulin containing PGE1 (7.5 X 10(-6) M) were injected on different days into 13 fasting insulin-dependent diabetics. With the insulin/PGE1 mixture, increases in both free and total plasma insulin concentrations were greater at all times up to 120 minutes after injection than with insulin alone, with significant differences in the first 40 minutes. With insulin/PGE1 the area under the total plasma insulin curve increased significantly more rapidly between 80 and 120 minutes. Plasma glucose concentrations fell consistently more rapidly with insulin/PGE1 than with insulin alone although the differences were small (mean fall +/- S.E.M. at 120 minutes: 4.9 +/- 0.5 mmol/l vs 4.0 +/- 0.6; p = 0.02). Addition of local hyperaemic agents to short-acting insulin preparations could be therapeutically useful in hastening insulin entry to the circulation at mealtimes.
Adolescent↗
Illness in horses following spraying with amitraz.
Sickness occurred in 3 of 4 horses within 24 h of being sprayed with an 0.025% w/v aqueous suspension of amitraz. The latter consisted of a portion of an amitraz aqueous suspension made up some 3 weeks previously, to which some freshly prepared spray fluid had been added. It seemed likely that the amitraz in the older solution had broken down to the highly toxic N-3, 5- dimethylphenyl N-methyl formamadine derivative and that this was in fact the main cause of the untoward effects observed. The horses displayed typical clinical signs of tranquillisation, depression, ataxia, muscular incoordination and impaction colic lasting up to 6 days. Subcutaneous oedema of the face occurred in one horse. The syndrome was accompanied by mild dehydration and acidosis. All horses survived after persistent symptomatic treatment including the giving of intravenous fluids, enemas, analgesics every 3 h, multiple doses of paraffin oil per os and dexamethasone intravenously. Following the eventual relief of constipation the horses scoured profusely for 24 h before their condition returned to normal.
Animals↗
Health promotion--caring concern or slick salesmanship?
There is an increasing tendency for administrators and government to expect both the health services and the education service to 'show results' for the investment of public money in them. One response to this has been the growing commitment to 'health promotion', where measurable objectives may be set in terms of desired behaviour (stopping smoking, breast self-examination, child immunisation etc) and where evaluation can be made on the evidence of statistical improvement. Health workers use the term 'promotion' in a variety of ways which seem to be as confusing to them as they are to their clients --the general public. Since successful promotion is likely to depend on the 'hard sell' (and since the methodology and aims of this may be incompatible with those of health education) this paper looks at some of the questions which the customer might wish to ask the salesman before deciding whether or not to buy.
Australia↗
Bayesian probability analysis: a prospective demonstration of its clinical utility in diagnosing coronary disease.
One hundred fifty-four patients referred for coronary arteriography were prospectively studied with stress electrocardiography, stress thallium scintigraphy, cine fluoroscopy (for coronary calcifications), and coronary angiography. Pretest probabilities of coronary disease were determined based on age, sex, and type of chest pain. These and pooled literature values for the conditional probabilities of test results based on disease state were used in Bayes' theorem to calculate posttest probabilities of disease. The results of the three noninvasive tests were compared for statistical independence, a necessary condition for their simultaneous use in Bayes' theorem. The test results were found to demonstrate pairwise independence in patients with and those without disease. Some dependencies that were observed between the test results and the clinical variables of age and sex were not sufficient to invalidate application of the theorem. Sixty-eight of the study patients had at least one major coronary artery obstruction of greater than 50%. When these patients were divided into low-, intermediate-, and high-probability subgroups according to their pretest probabilities, noninvasive test results analyzed by Bayesian probability analysis appropriately advanced 17 of them by at least one probability subgroup while only seven were moved backward. Of the 76 patients without disease, 34 were appropriately moved into a lower probability subgroup while 10 were incorrectly moved up. We conclude that posttest probabilities calculated from Bayes' theorem more accurately classified patients with and without disease than did pretest probabilities, thus demonstrating the utility of the theorem in this application.
Angiography↗
Bipolar intimal tacking device.
A bipolar electrocoagulating device has been designed to thermally tack arterial intimal flaps to the artery wall. The device was tested on intimal flaps created in the rabbit descending aorta. The vascular segments were tested for patency and the thermal tack points were examined on a scanning electron microscope. The tack points were shown to be of sufficient tensile strength and to have minimal thrombogenicity.
Animals↗
Adjuvant chemotherapy in urological tumors.
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Aged↗