Search PubMed⌕ Search

Biomedical subjects

L Williams

Publications and source records attributed to L Williams.

At least 127 records · Page 7Linked to original sources
PubMed1996

Molecular analysis of the Huntington's disease gene in New Zealand.

AIMS: To establish and validate a polymerase chain reaction (PCR)-based diagnostic test in New Zealand, which enables the number of CAG repeats present in the Huntington's disease (HD) gene to be determined with speed and accuracy. To develop procedures for reporting and counselling probands and families. METHODS: The analysis of the CAG repeat region in Huntington's disease and normal chromosomes involved PCR amplification of genomic DNA using either the incorporation of radioactive deoxynucleotides or fluorescent oligonucleotide primers. RESULTS: The molecular analysis of the CAG repeat sequence in the Huntington's disease gene of over 100 New Zealand individuals has been performed. Huntington's disease chromosomes contained 37-70 (median 44) repeats whereas normal chromosomes contained 9-27 (median 18) repeats. Six individuals from three families had an allele in the intermediate range (30-36 repeats). Instability of the CAG repeat upon transmission from generation to generation was also observed. A comparison of the results obtained using radioactive and fluorescent assays indicates that while both methods are reliable, the latter method is more rapid and allows for automation to be incorporated in the scoring of allele sizes. CONCLUSIONS: Our analysis of Huntington's disease alleles has shown a profile of CAG repeat lengths that is consistent with those reported internationally. In addition, reporting and counselling procedures have been established for presymptomatic testing of Huntington's disease in New Zealand.

DNA↗
PubMed1996

The epidemic of dieting women: the need for a sociological approach to food and nutrition.

The social construction of overweight has meant that dieting is an experience of being a woman in Western society. Health promotion fails to counteract the cult of slimness and reinforces medicalized notions of the "problem" of overweight, legitimizing unnecessary dieting practices. The limitations of the health promotion approach are examined through medicalization and healthism critiques. The negative consequences for women of dieting to control weight are highlighted in this article through the concepts of gendered food and gendered bodies. The issue of gender and dieting is used here to illustrate the need for interdisciplinary and qualitative approaches to the study of food and nutrition practices, before intervening to change those practices. An examination of the social implications of health promotion in the area of weight control exposes the need for a moratorium on such strategies until a database of qualitative research is established through sociological studies on food and nutrition.

Body Weight↗
PubMed1996

Developing patient and family education programs for a transplant center.

Patient and family education is an important component of the organ transplant programs at the University of Nebraska Medical Center. The Medical Center is in the process of planning a new transplant center which will employ the family-centered, educationally-intensive cooperative care concept. This approach was chosen as the model for the delivery of care at the Lied Transplant Center because it emphasizes efficient, effective clinical care by requiring active participation by the family or essential other, thereby better preparing both the patient and the family for the transition to home and to the community. This article presents the evolution of patient education in our transplant programs, discusses the educational needs of transplant patients across the continuum of care, provides insight into the process of planning educational programs for the new center and provides a sample module for teaching which is based on the Cooperative Care concept.

Curriculum↗
PubMed1996

International bank for foot-and-mouth disease vaccine: assessment of Montanide ISA 25 and ISA 206, two commercially available oil adjuvants.

The International Vaccine Bank at Pirbright has recently installed large-scale vaccine formulation equipment for the preparation of oil-adjuvanted vaccines. Such vaccines are claimed to offer a number of advantages over Al(OH)3, particularly their ability to raise better immunity in pigs. This paper reports on the potency in pigs, cattle and guinea-pigs of foot-and-mouth disease vaccines prepared with two novel oil adjuvants, Montanide ISA 25 and 206 (Seppic, Paris). The results indicate that vaccines adjuvanted with these oils retain potency for a longer period than our conventional aqueous formulation, following storage at +4 degrees C, and elicit good antibody responses in both pigs and cattle regardless of injection route. In addition they gave no evidence of toxicity or prolonged pyrexia following their administration. Local reactions at the site of inoculation were not observed in cattle vaccinated intramuscularly, even following a booster dose. Pigs vaccinated intramuscularly only showed local reactions if the volume administered exceeded the 2.0 ml dose or the animals received a second vaccination. These observations on the efficacy of such oil formulated vaccines suggest that they have potential as an alternative to the current aqueous formulation.

Adjuvants, Immunologic↗
PubMed1996

"Through-glass" injuries.

This prospective trial collected all cases where injuries had resulted from the hand passing through or striking glass and had been referred to a hand injury service during 1 year. Eighty-seven cases were referred and the factors relating to these injuries were examined. A record was made of the structures damaged, the surgery performed and prevailing socioeconomic factors. These injuries were very costly in terms of morbidity, surgical effort and time, with significant resource implications. The study appears to confirm other reports that current legislation on glazing safety was too long delayed and is inadequate now that it is in place.

Adolescent↗
PubMed1996

Coronary restenosis.

Return of angina within 6 months of a catheter-based treatment of coronary artery disease usually reflects restenosis due to an overly aggressive local healing response to the procedure-related arterial injury. The restenotic lesion should be treated aggressively. Patients with preexisting diabetes mellitus, renal failure requiring hemodialysis, and left anterior descending artery lesions should be considered to be at exceedingly high risk for clinically significant restenosis. Exercise testing is indicated for all patients who experience a return of their angina within 6 months of an interventional procedure. Nurse practitioners in the primary care setting may be the first clinicians to hear of the return of angina. Patients should always be reassured that repeat intervention is almost always possible and is generally effective in providing long-term relief. New devices (in particular the Palmaz-Schatz stent) may help reduce the likelihood of restenosis, to the extent that they provide a large acute post-treatment lumen diameter that is more tolerant of intimal hyperplasia without producing significant narrowing. Until adjunctive drug therapy is found that effectively reduces the local tissue response to interventional therapy, all clinicians involved in caring for patients following such procedures will need to be vigilant and knowledgeable about recognizing and treating restenosis.

Angioplasty, Balloon, Coronary↗
PubMed1996

New features of the locust optic lobe: evidence of a role for nitric oxide in insect vision

The enzyme nitric oxide synthase can be localised by NADPH-diaphorase histochemistry. Here we have applied this technique to the optic lobe of the locust Schistocerca gregaria and revealed new features of the insect visual system. Extensive but locally intense staining is associated with identified tracts, distinct neuropiles and cell body groups, and a detailed analysis of stained elements is provided here. The most striking staining occurs in the anterior lobe of the lobula complex and its connection with the medulla by means of the dorsal uncrossed bundle. Eleven groups of cell bodies are identified and their contribution to fibre tracts and neuropile areas is described. Diaphorase-positive fibre tracts pass between all major subdivisions of the optic lobe, but there are no conspicuous fibre connections from the optic lobe to the brain. The widespread distribution of NADPH-diaphorase staining in the optic lobe suggests that nitric oxide is likely to play an important role in information processing in insect vision.

Journal Article↗
PubMed1996

Prevalence of tobacco use among first-term Air Force personnel before and after basic military training.

To support the goal of a tobacco-free Air Force, a longitudinal study of 3,531 first-term airmen was conducted during basic military training (BMT) at Lackland Air Force Base, Texas. Tobacco use is currently prohibited during the 6-week period of BMT. Three self-reported surveys to determine tobacco use prevalence and behaviors were administered at the beginning, end, and 90 days post-BMT. Results indicate that 36% of men and 29% of women used some form of tobacco prior to BMT. Within 90 days after completing BMT, 74% of matched males and females resumed tobacco use and 6% of matched males and females initiated tobacco use. Regression analysis found that several survey questions could predict 85% of tobacco use and 88% of non-tobacco use after BMT. We conclude that tobacco prohibition during BMT has a small, beneficial effect on post-BMT tobacco use. Further efforts, however, are needed to meet the goal of a tobacco-free Air Force.

Adult↗
PubMed1996

Rapid heparin anticoagulation: use of a weight-based nomogram.

The rapidity with which heparin anticoagulation is achieved is essential to a positive clinical outcome in patients with deep venous thrombosis or pulmonary embolus. However, adequate anticoagulation is frequently not achieved, either as a result of dosing regimens that do not take heparin kinetics into account or because of clinicians' wariness of possible hemorrhagic complications associated with elevated activated activated partial thromboplastin times. Obese patients are at particularly greater risk for subtherapeutic heparin dosing because their pharmacokinetic volumes of distribution differ from those in nonobese patients. Traditional empiric heparin dosing schemes may have pitfalls; methods that take into account the patient's weight are more likely to allow rapid anticoagulation. A nomogram that uses pharmacokinetic and volume of distribution principles to predict therapeutic levels of anticoagulation is presented.

Anticoagulants↗
PubMed1996

Phase I study of continuous-infusion recombinant macrophage colony-stimulating factor in patients with metastatic melanoma.

Macrophage colony-stimulating factor (M-CSF) is a lineage-specific, homodimeric growth factor that supports the proliferation and maturation of bone marrow progenitors and the survival and function of mononuclear/macrophage cells. In vitro studies have demonstrated antitumor activity of macrophage colony-stimulating factor-treated monocytes against melanoma target cells. A Phase I study was conducted by administering the glycosylated form of the protein to patients with metastatic melanoma as two 7-day continuous i.v. infusions separated by a 2-week rest. Cohorts of three patients per dose level received escalating doses of 10-160 microgram/kg/day. Safety, clinical, and biological effects were evaluated. The infusions were well tolerated with occasional maximum grade 2 nonhematological toxicity. Rapidly reversible thrombocytopenia was the major hematological adverse effect. Its etiology may in part be explained by proliferation and activation of monocyte/macrophage cells in bone marrow samples. Evidence for a biological effect on tumors was suggested by the delayed, complete disappearance of multiple lesions in one patient and a decrease in the size of one marker lesion in a second patient with a mixed response. Fasting serum cholesterol levels decreased during the infusions and may represent an additional therapeutic application for this growth factor.

Adult↗
PubMed1996

Immunization of melanoma patients with BEC2 anti-idiotypic monoclonal antibody that mimics GD3 ganglioside: enhanced immunogenicity when combined with adjuvant.

Previous attempts to immunize melanoma patients against GD3 ganglioside have been unsuccessful because of the poor immunogenicity of GD3. BEC2, an anti-idiotypic monoclonal antibody that mimics GD3, can induce anti-GD3 IgG in rabbits. Since clinical trials with BEC2 in melanoma patients demonstrated that BEC2 alone is not highly immunogenic, we have carried out sequential clinical trials exploring the use of two immunological adjuvants, BCG and QS21, administered with BEC2. Melanoma patients free of disease after surgical resection but at high risk for recurrence were immunized either with BEC2/BCG (14 patients) or BEC2/QS21 (6 patients). All patients developed high-titer IgG antibodies against BEC2, demonstrating that both adjuvants effectively enhanced the immunogenicity of BEC2. Anti-GD3 antibodies were induced in 3 of 14 patients immunized with BEC2/BCG; no patient immunized with BEC2/QS21 developed detectable anti-GD3 antibodies. After a median follow-up of 2.4 years, 71% of the patients immunized with BEC2/BCG remain alive and 64% are free of disease. In patients immunized with BEC2/BCG, no apparent association was observed between class II HLA type and either development of anti-GD3 antibodies or survival. We are encouraged by the results with BEC2/BCG, which suggest that further enhancement of the immune response to BEC2 will result in more frequent anti-GD3 antibody responses among immunized patients.

Adjuvants, Immunologic↗