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Biomedical subjects

G Williams

Publications and source records attributed to G Williams.

At least 757 records · Page 42Linked to original sources
PubMed1981

Tuberculosis in patients undergoing maintenance haemodialysis and renal transplantation.

The difficulty in diagnosis of tuberculosis in patients with chronic renal failure or on immunosuppressive therapy is discussed. Anti-tuberculous therapy was required in 19 out of 315 patients who received a renal transplant in the Urology Unit, Hammersmith Hospital, between February 1961 and December 1979. Twelve patients were from overseas. Their management and the effect of anti-tuberculous therapy on the immunosuppressed patient were also studied. The disease was treated successfully in 18 patients, even though there were problems with diagnosis. The patient who died had active tuberculosis on post-morten examination. Prophylaxis should be considered in patients who have had tuberculosis in the past and may have received inadequate treatment.

Adult↗
PubMed1981

Mammoplasty for tubular breasts.

Tubular or nipple breasts are descriptive of an unusual deformity in which a hypoplastic mammary gland is situated under a stretched out areola, giving the breast a tubular shape. Six patients, age 17 to 21 years, have undergone surgical correction of this deformity. The one-stage procedure involves excision of excess areola, augmentation through the areolar incision, correction of asymmetry by means of asymmetric implants, and cruciate incisions on the posterior aspect of the breast to improve the contoural defect. The complication rate has been no greater than that of routine augmentation, and patient satisfaction has been good.

Adolescent↗
PubMed1981

Empyema presenting over thirty years after pulmonary tuberculosis.

Four patients are described who presented with empyema between 32 and 53 years after pulmonary tuberculosis had been treated by artificial pneumothorax (A.P.) without chemotherapy. Diagnostic problems included non-specific radiographic features and failure to find a causative organism. Empyema should be considered when patients with old pulmonary tuberculosis deteriorate and there are non-specific radiographic changes. Antituberculosis chemotherapy, or even decortication, may be indicated if a pyogenic organism cannot be found.

Aged↗
PubMed1981

Vesicoureteric reflux following renal transplantation: a simple method of ureteric implantation.

We have used a simple method of ureteroneocystostomy in renal transplant patients. This entails a no-tunnel "drop-in" with a long free segment protruding into the bladder lumen. The incidence of vesicoureteric reflux was investigated in 81 transplant patients who had a follow-up period ranging from 4 months to 15 years (mean 3.7 years); 29 of these patients had recurrent urinary tract infections. Micturating cystography demonstrated reflux in 6 patients (7.4%). In these 6 patients the presence of reflux had no deleterious effect on renal function and the infections were easily controlled with long-term antibiotics. In the 52 patients without injury infection no reflux was demonstrated. The conclusions based on this study indicate that (1) in the absence of recurrent infection there are no indications for micturating cystography and (2) this method of ureteroneocystostomy is expedient and has a low incidence of reflux.

Follow-Up Studies↗
PubMed1981

Suppressive effects of surgical stress on circulating androgens during and after prostatectomy.

Changes in circulating testosterone (T) and dihydrotestosterone (DHT) levels were investigated 2 days before and 2, 7, 30 and 60 days after retropubic prostatectomy in 28 patients with benign prostatic hypertrophy. Following operation the concentrations of both steroids declined and reached minimal levels 2 days after surgery. One month post-operatively testosterone had recovered to its pre-operative value, whilst the recovery of dihydrotestosterone to its pre-operative level required a minimum period of 2 months. These data indicate the need for careful interpretation of any androgen measurement following surgery.

Aged↗
PubMed1981

Short-term antibiotic prophylaxis and prostatectomy.

Two hundred patients undergoing prostatic surgery at 2 hospitals were randomly allocated into 4 equal groups. The groups were a control, cephalexin, co-trimoxazole and carfecillin treated groups. The incidence of urinary tract infections and other complications of prostatic surgery were studied in each group after a short-term prophylactic regime of 3 doses of the antibiotic. The incidence of urinary infection was significantly improved from 28% in the control group to 8% and 16% in the co-trimoxazole and cephalexin groups respectively. Carfecillin was not effective in reducing urinary infection. However, all 3 antibiotics reduced the incidence of other infective sequelae.

Anti-Bacterial Agents↗
PubMed1981

Two chambered left ventricle. Three new varieties.

A short review of two chambered left ventricle is given, and this rare condition is briefly compared and contrasted with the more common condition involving the right ventricle. Three cases are described, each of which presents a new variety of subdivision of the left ventricle; in two of these the condition was first shown by angiocardiography. The first case had left heart hypoplasia with dysplastic stenosis of the mitral and aortic valves and severe endocardial fibroelastosis of the main left ventricular cavity. The second case also showed dysplasia of the left sided valves with pronounced endocardial fibroelastosis, and in addition there was a congenital malformation of the left lung. The third case showed a bizarre ventricular subdivision without other congenital malformations. The role of the intertrabecular myocardial sinusoids in the pathogenesis of some types of two chambered ventricle is discussed and this is considered to have been of significance in the first two cases. The third case possibly represented an intramyocardial aneurysm of obscure aetiology.

Female↗
PubMed1981

Cryptogenic obliterative bronchiolitis in adults.

Patients referred for assessment of severe chronic airflow obstruction over a three-year period were reviewed, and when all smokers and ex-smokers, those with asthma, chronic bronchitis, emphysema, and other specific pulmonary diagnoses were excluded 10 patients remained. Their clinical, lung function, and bronchographic features were consistent with obliterative bronchiolitis. Nine were women, five had rheumatoid arthritis, and five had survived for more than 10 years after first symptoms. Obliterative bronchiolitis has not previously been considered as a cause of chronic airflow obstruction but the distinctive features suggest that it is a true disease entity.

Adult↗
PubMed1981

Rheumatoid arthritis and pseudo-rheumatoid arthritis in calcium pyrophosphate dihydrate crystal deposition disease.

Calcium pyrophosphate dihydrate (CPPD) crystal deposition disease can lead to many clinical syndromes. One syndrome simulates rheumatoid arthritis and is thus called "pseudo-rheumatoid arthritis." Since some patients have true rheumatoid arthritis with CPPD crystal deposition disease, the clinician may have difficulty differentiating those patients from others who have the pseudo-rheumatoid syndrome. Such a diagnostic problem can be solved radiographically. Eleven patients with CPPD crystal deposition disease were studied; five had true rheumatoid arthritis and six had pseudo-rheumatoid arthritis. Because osseous erosions were not apparent in the arthropathy of uncomplicated CPPD crystal deposition disease, the detection of skeletal erosive changes indicated a true rheumatoid arthritis process.

Aged↗
PubMed1981

Complement and glomerular disease - a natural history study.

Over a 5-year period we have performed sequential measurements of a range of complement components in 127 patients. Each had a well-characterised glomerular lesion and there was no evidence of an underlying connective tissue disorder. In 17 patients with varied histopathology, who did not have C3 nephritic factor, there was a persisting complement defect which was present during remission in the patients we were able to study. The finding of such defects is consistent with the thesis that primary complement system abnormalities predispose to the development of glomerular lesions. Interestingly, these abnormalities did not influence the prognosis of our patients. In 12 other cases without C3 nephritic factor, complement levels were below the normal range when the glomerular lesion was active but returned to it in remission; these were secondary changes. We showed by discriminant analysis that some circulating complement component levels, assessed in relation to each other and without reference to a statistically derived 'normal' range, discriminated between histological subgroups and had prognostic significance as well. These patterns could not be distinguished until the data were stored and analysed by computer.

Analysis of Variance↗
PubMed1981

Relationship between prostatic cytoplasmic and nuclear androgen receptors in patients with carcinoma of the prostate.

Cytoplasmic and nuclear androgen receptors were measured in benign prostatic hypertrophy, untreated malignant prostates and diethylstilboestrol-treated malignant prostates. The levels of total androgen receptors in benign prostatic hypertrophy were not statistically different from those in the untreated or treated malignant prostates. Free cytoplasmic androgen receptors constituted only a small proportion of the total receptor concentration. A significantly higher level of free cytoplasmic receptors were present in the treated malignant prostates in comparison to the untreated ones. A significant positive correlation was observed between the total cytoplasmic and nuclear androgen receptors in both treated and untreated patients. A significant correlation was also observed between free cytoplasmic and total nuclear androgen receptors in untreated patients.

Cell Nucleus↗
PubMed1981

Micturition with headache: phaeochromocytoma of the bladder.

A patient with a 20-year history of severe frontal headaches when passing urine was found to be severely hypertensive. Investigations confirmed a clinical diagnosis of phaeochromocytoma of the bladder. Treatment by a partial cystectomy and transuretero-ureterostomy resulted in a complete removal of the tumour, control of his hypertension and resolution of the headaches.

Adult↗