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Biomedical subjects

R M Williams

Publications and source records attributed to R M Williams.

At least 19 recordsLinked to original sources
PubMed1992

Inhibition of NK cell-mediated cytotoxicity by oxysterols.

Some of the oxidation products of cholesterol (oxysterols) have profound effects on plasma membrane structure and function. The present studies were undertaken to determine the effects of oxysterols on NK cell-mediated cytotoxicity. When mouse spleen cells were preincubated with certain oxysterols, NK cell cytotoxicity was inhibited without loss of effector cell viability. The strongest inhibition was observed with oxysterols that are oxidized at the C-5, C-6, or C-7 positions of the sterol nucleus. Among these, 7 beta-hydroxycholesterol caused more inhibition than 7 alpha-hydroxycholesterol suggesting that the spatial orientation of the hydroxyl group in the beta-position results in a greater perturbation in plasma membrane structure than that oriented in the alpha-position. In contrast, oxysterols that are oxidized at the C-20 and C-25 positions that are located on the C-17 acyl chain had little or no inhibitory effect, suggesting that oxidation in the cholesterol nucleus which is situated closer to the phospholipid headgroups at the lipid bilayer-aqueous interface results in a more profound effect on the plasma membrane physical structure. These results suggest that the lytic function of NK cell is sensitive to alterations in the physical state of its plasma membrane induced by oxysterols.

Animals↗
PubMed1992

Impalpable breast lesions: marking of surgical specimens for pathology.

A simple method is described to indicate the abnormal area in breast biopsy specimens excised following mammographic localization of impalpable lesions. A hypodermic needle is inserted into the specimen through the abnormality immediately following specimen radiography, removing the need to radiograph individual tissue slices. The technique has proved successful in 121 out of 122 specimens.

Biopsy↗
PubMed1992

Actinomycosis associated with pilonidal sinus of the penis.

We report a case of actinomycosis associated with a penile pilonidal sinus. This association does not appear to have been described previously. We recommend the submission of biopsies of unusual lumps in the genital region (fresh biopsies for bacteriological examination and fixed biopsies for histomorphological assessment).

Actinomycosis↗
PubMed1992

Preliminary studies on the vascular anatomy of the equine superficial digital flexor tendon.

The vascular and microvascular anatomy of normal equine superficial digital flexor tendons was studied by dissection of vinyl-perfused specimens and by microangiography on high detail film. The presence of an extensive intratendinous vascular latticework was confirmed, and a 'nutrient artery' described closely associated with the accessory ligament of the superficial digital flexor tendon (proximal check ligament). Circumferential stripping of the paratenon from the tendon to eliminate afferent vessels was performed bilaterally in three horses and unilaterally in a fourth, followed by a treadmill training regimen. No resulting intratendinous lesions could be documented on gross post mortem and histological examination at three, 10, or 35 days post operatively. There was mild paratendinous proliferation in all instances. In one horse, four intratendinous ligatures were placed within the medial and lateral borders of the contralateral tendon to isolate further from its blood supply a 10 cm segment. Gross lesions at 35 days post operatively included a marked paratendinous response involving the entire 10 cm segment, and a darkened, soft focus within the core of the tendon. Histopathology and electron microscopy demonstrated focal degeneration. It was concluded that the blood supply of the normal equine superficial digital flexor tendon is primarily intratendinous, rather than paratendinous as previously thought. The lesions in one horse similar to those in naturally occurring tendinitis supported a vascular aetiology of the disease, and set the groundwork for studies aimed at the development of a clinically relevant tendinitis model.

Angiography↗
PubMed1992

New outpatient treatment of recurrent patellar dislocations.

From December 1987 through February 1991, outpatient arthroscopic procedures were done on patients experiencing recurrent dislocations of the patella. A modified Emslie-Trillat procedure was used. Twenty-four patients (27 knees) were available for follow-up. Using the criteria of Cox, excellent results were found in 78% (21 knees), whereas 18% (5 knees) were rated as good. Only 4% (1 knee) was considered fair, and none were rated poor. Most patients (96%) showed improvement. No patient suffered a postoperative dislocation. Based upon the findings of this study, it is concluded that this procedure is an effective method of treatment for patients having recurrent dislocations of the patella.

Adolescent↗
PubMed1992

Public policy and quality assurance.

The definition of quality varies widely among different key players in the American health care system. It is important for physicians and other providers to have an understanding of the public policy approach to quality assessment and assurance. Policy analysts use a number of techniques and methods in an attempt to define and balance the interests of individual patients with that of society as a whole. Benefit-cost, cost-effectiveness, and evaluation synthesis methods are used by public policy makers to arrive at rational consideration of the implications of allocation of scarce health care resources. Emergency medicine is on the forefront of many key policy decisions relative to the health care system. As the nation's health safety net, emergency medicine plays an integral and pivotal role in the definition, structure, and function of the health care system. In this regard, it is essential that emergency physicians and emergency medicine organizations play an active and formative role in the rapidly changing health care environment. Understanding conceptual approaches to the public policy approach to the health care system is an important endeavor for leadership in emergency medicine.

Cost-Benefit Analysis↗
PubMed1991

Does anxiety lead to selective processing of threat-related information?

Four experiments investigating the detailed nature of the attentional bias in anxiety are reported. Previous research using the Stroop task has shown that, when compared with non-patient controls, anxious patients are relatively slower at colour naming threat-related words than non-threat words. Experiments One and Two investigated whether this apparent attentional bias is a function of anxiety per se and/or is related to patient/non-patient status. Experiment One compared colour-naming times for threat and non-threat words in low, medium and high trait anxiety normal subjects. High anxiety was not associated with slower colour-naming times for threat words. Experiment Two compared generalized anxiety disorder patients with equally anxious non-patients and found that the patients were significantly slower at colour-naming threat words. Read aloud and dwell tasks were also included in these experiments in order to identify the mechanism of Stroop interference. Experiments Three and Four investigated whether anxious patients' attentional bias is specific to threat-related material or also extends to certain positive, emotional material. In Experiment Three words used in previous Stroop studies were rated for emotionality. Threat words were more emotional, as well as more threatening, than control words, indicating that previous studies have confounded threat and emotionality. Experiment Four compared colour-naming times for threat words, equally emotional positive words, and neutral words. Consistent with the emotionality hypothesis, generalized anxiety disorder patients were slower than non-anxious controls at colour naming both threat words and positive words. The theoretical, methodological and clinical implications of these results are discussed.

Adult↗
PubMed1991

Determination of the capacity of ram epididymal and ejaculated sperm to undergo the acrosome reaction and penetrate ova.

An understanding of epididymal maturation of sperm requires descriptions of changes in membrane properties and their relation to changes in cell function. While sperm membranes have been studied in some detail in rams, few reports address associated functional changes. This report provides such data by evaluating (a) the time course of sperm acrosome reaction (AR) induction for cells from each epididymal region; (b) the capacity of epididymal sperm to penetrate ova; (c) differences in physiological AR and general sperm degeneration; and (d) acrosin release of epididymal sperm. Ram epididymal (caput, corpus, and proximal and distal cauda) and ejaculated (EJ) sperm were incubated in vitro to assess their capacity to undergo an AR. Light microscopy revealed that in sperm populations which had traversed the proximal cauda epididymidis, greater than or equal to 50% exhibited an endogenous AR in less time (less than 17 h) than did sperm isolated from more proximal regions of the epididymis (22-greater than 50 h). Heparin added to sperm did not stimulate the AR in epididymal or EJ sperm, whereas addition of a calcium ionophore (A23187) increased AR rates for cauda and EJ sperm, but not caput or corpus sperm. A second experiment evaluating percent AR, percent motile cells, and percent hamster ova penetrated revealed that sperm isolated from regions proximal to the cauda epididymidis failed to penetrate ova. When cauda or EJ sperm exhibited motility greater than 5% and AR greater than 24%, penetration of hamster eggs occurred. Comparisons of acrosomal integrity by electron or light microscopy were not different for sperm at any stage of epididymal maturation, suggesting that minimal nonspecific membrane changes occur and that light microscopy is valid for evaluating the acrosomal status of ram spermatozoa. Acrosin activity (sperm bound and dissociated) also was measured. Both total activity and release of acrosin from sperm to the medium during an 8-h incubation was greater for mature than for immature sperm. Results from these experiments are discussed in relation to the changes that must occur in sperm as they acquire the capacity to undergo an AR and penetrate hamster ova.

Acrosin↗
PubMed1991

Giardia lamblia and Cryptosporidium infections in child day-care centers in Fulton County, Georgia.

Risk factors for the introduction, spread and persistence of Cryptosporidium and Giardia lamblia infections in child day-care centers are not well understood. In 1989 and 1990 stool specimens were obtained from 292 diapered children attending 17 randomly selected day-care centers in Fulton County, GA; 8 (2.7%) children in 2 centers were infected with Cryptosporidium and 21 (7.2%) children in 7 centers were infected with Giardia. In 1986 the prevalence of Cryptosporidium and Giardia in these same centers had been 0.4 and 11.0%, respectively; the prevalence of Cryptosporidium, but not Giardia, increased significantly (P = 0.04) between 1986 and 1989 to 1990. Risk factors for Giardia infection included day-care attendance for greater than 3 months, the presence of toddlers in the classroom and the presence of other children in the household. Day-care centers with a Giardia-positive child in 1986 were not more likely to have an infected child in 1989 to 1990. Cryptosporidium, like Giardia, may be endemic in day-care centers in Fulton County.

Child Day Care Centers↗
PubMed1991

Radiation-induced augmentation of host resistance to histocompatible tumor in mice. Detection of a graft antitumor effect of syngeneic bone marrow transplantation.

Lethally irradiated and syngeneic bone marrow-reconstituted (C57BL/6JxDBA/2J) F1 female mice demonstrated prolonged survival following challenge with the DBA/2 mastocytoma P815-X2 compared with non-irradiated littermate controls. This radiation-induced augmentation of host resistance to P815-X2 was not abolished by the adoptive transfer of normal syngeneic spleen cells. In addition, this phenomenon was not detectable in adult thymectomized recipients, suggesting the requirement for an intact host thymus. This effect was also absent in syngeneic F1 male recipients. We suggest that lethal irradiation and marrow reconstitution may result in activation of a nonspecific immune effector mechanism against tumor cells--and, as such, may serve as a model to explore the graft-antitumor effect of bone marrow transplantation.

Animals↗
PubMed1991

Evaluation of a commercially available enzyme-linked immunosorbent assay for Giardia lamblia antigen in stool.

The lack of a quick, simple, and inexpensive diagnostic test has limited the ability of public health officials to rapidly assess and control outbreaks of Giardia lamblia in child day-care centers. We evaluated the performance of a commercially available enzyme-linked immunosorbent assay (ELISA) for the detection of a G. lamblia-associated antigen in stool. Stool specimens were collected from the diapers of 426 children attending 20 day-care centers, fixed in 10% Formalin and polyvinyl alcohol, and examined by microscopy by Formalin concentration and trichrome staining techniques. Specimens were also tested visually and spectrophotometrically by ELISA. Of 99 tests positive by microscopy, 93 were visually positive by ELISA (sensitivity, 93.9%). Of 534 tests negative for G. lamblia by microscopy, 32 (6.0%) were ELISA positive. However, on the basis of examination of multiple specimens from the same child, none of these could be considered false-positive ELISAs; the specificity of the ELISA was therefore 100%. The sensitivity of both microscopy and ELISA improved as the number of specimens per child increased. An optical density value of greater than 0.040 was 98.0% sensitive and 100% specific for G. lamblia. This ELISA, which appeared to be more sensitive for G. lamblia than did microscopic examination of stool, should be useful as an epidemiologic tool, particularly in day-care settings, and may also have a role in confirming clinical diagnoses of giardiasis.

Animals↗
PubMed1991

Use of pooled formalin-preserved fecal specimens to detect Giardia lamblia.

Three formalin-preserved fecal specimens from the same child attending a child-care center were pooled and compared with the three separate individual specimens by a single microscopic examination of concentration sediment for Giardia lamblia. The sensitivity of the pooled system was 100% when two or more individual specimens were positive and 88% when only one individual specimen was positive. The organism density in a single specimen was not a factor of whether the pool of specimens was positive or negative. Nearly half of the pools that contained positive specimens had only one of three specimens with positive results, reinforcing the need for multiple stool examinations when diagnosing G. lamblia infections.

Animals↗
PubMed1991

Phase I clinical trial with floxuridine and high-dose continuous infusion of leucovorin calcium.

Sixty-two patients with metastatic disease were treated with continuous infusion folinic acid (leucovorin calcium; Lv) and 2-deoxy-5-fluorouridine (floxuridine; FUDR). Lv was given by constant intravenous (IV) infusion at 500 mg/m2/d, days 1 to 6, while FUDR was given by IV push, days 2 to 6, at 3:00 PM daily with doses ranging from 294 to 1,214 mg/m2/d. This program was well tolerated with dose-limiting toxicities of diarrhea and stomatitis, while hematologic toxicity was minimal. Eighty-two percent of the assessable patients (46 of 56) had failed at least one chemotherapy regimen. One complete remission lasting 9 months and 10 partial remissions ranging from 5 to 10 months were observed in this heavily pretreated patient population for an overall response rate of 20%. These data suggest that the combination therapy with Lv and FUDR may have clinical use. Because of differing patient sensitivity to this drug combination, the recommended dose of FUDR for the initial therapy cycle is 500 mg/m2/d, days 2 to 6, with subsequent escalation to 900 mg/m2/d in those patients without extreme sensitivity. Phase II studies are now in progress with these doses.

Adult↗
PubMed1990

Identification of a novel structural class of positive modulators of the N-methyl-D-aspartate receptor, with actions mediated through the glycine recognition site.

This study describes a new structural class of compounds which interact at the N-methyl-D-aspartate (NMDA) receptor-associated glycine recognition site. These E-gamma-substituted vinylglycine derivatives were active in displacing [3H]glycine binding from the NMDA receptor-associated recognition site in rat forebrain synaptic plasma membranes, with Ki values in the range of 0.24-8.7 microM. Functional analyses of these compounds indicate that they positively modulate basal [3H](+)-5-methyl-10,11-dihydro-5H- [a,d]cyclohepaten-5,10-imine ([3H]MK-801) binding, consistent with their having agonist characteristics. Little stereospecificity is observed with the gamma-substituted methyl and propyl derivatives while the L-isomer of the hexyl analog is significantly more potent than the D-isomer. The D- and L-hydroxyethyl gamma-substituted vinylglycines were the most potent inhibitors of [3H]glycine binding with Ki values of 0.75 +/- 0.06 microM and 0.24 +/- 0.02 microM, respectively. The 3,4-double bond was necessary for activity in that the saturated hexyl derivative (2-aminodecanoate) was inactive. Based on the results reported herein, the hypothesis that there is a distinct size restriction for functional agonists which interact with the glycine recognition site, should be altered to include these larger extensions of vinylglycine.

Amino Acids↗
PubMed1990

Specific binding of sulphated polymers to ram sperm proacrosin.

Sulphated polysaccharides and zona pellucida glycoproteins have been shown to bind non-enzymatically to proacrosin, the protein found within the acrosomal vesicle of mammalian spermatozoa. The mechanism of this interaction has been investigated using 125I-fucoidan to probe purified ram sperm proacrosin. Results show that (a) binding of 125I-fucoidan to proacrosin is inhibited only by sulphated polymers and (b) recognition is mediated by poly(sulphate) groups and is largely independent of the composition of the polymer chain. It is suggested that a similar mechanism is responsible for the interaction between proacrosin and zona pellucida glycoproteins during the early stages of fertilization in mammals and this process mediates firm binding of spermatozoa to the egg.

Acrosin↗