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Biomedical subjects

S D Wilson

Publications and source records attributed to S D Wilson.

At least 73 records · Page 4Linked to original sources
PubMed1982

Identification of physical therapist shortage areas: a study of thirteen states.

Establishing the adequacy or inadequacy of the supply of physical therapists, nationally and across geographic areas, has important policy implications for federal support of education and training of physical therapists. This article summarizes research that was undertaken to determine 1) whether physical therapists are in short supply nationally, or are geographically maldistributed in the United States, and 2) if there is an uneven distribution, whether it is possible to identify areas lacking physical therapists. The supply of physical therapists at the county level is examined in relation to factors presumed to indicate need for physical therapy services. Next, the distribution of physical therapists is examined in selected groups of counties to determine why some areas are relatively better supplied than others and whether any obvious set of criteria accurately and consistently identifies those areas appearing underserved. The major conclusion is there may be a maldistribution of physical therapist. Criteria for identifying shortages are recommended.

Health Services Accessibility↗
PubMed1982

Use of glycerol-cryoprotected Lactobacillus casei for microbiological assay of folic acid.

A simple procedure for preparing glycerol-cryoprotected Lactobacillus casei cultures has been developed. L. casei grown in medium supplemented with low concentrations of folic acid (0.3 micrograms/L) is diluted with an equal volume of glycerol (800 mL/L) and stored at -20 degrees C. Growth response of the glycerol-cryoprotected L. casei to low concentrations of folic acid exceeded that of cultures maintained by monthly agar stab transfer. Also, growth for the zero-folate blanks was considerably less for the cryoprotected cultures. Assay of folate in several rat tissues correlated well (r = 0.999) with the standard microbiological assay. The growth rate of the culture depends on the inoculum size, and a heavy inoculum of cryoprotected L. casei may be used to complete the assay after only an overnight incubation.

Animals↗
PubMed1982

The role of surgery in children with the Zollinger-Ellison syndrome.

Long-term follow-up of children with the Zollinger-Ellison syndrome (gastrinomas) suggests that surgical management is still advantageous. Twenty-eight children with the Zollinger-Ellison syndrome have been followed up to 21 years after their initial surgical procedure. Six of seven children with less than total gastrectomy, all of whom underwent operation before the introduction of histamine H2-receptor antagonists, are known dead from complications of continued gastric hypersecretion and tumor growth. Sixteen children had a total gastrectomy, with no operative deaths, and only one died of progressive tumor growth, even though 14 had evidence of metastatic islet-cell carcinoma. Follow-up serum gastrin measurements have been obtained for 13 patients with total gastrectomy, and 5 patients now have a normal serum gastrin levels. Malignant gastrinomas in children have been slow growing, indolent, and compatible with long life. The biologic behavior of malignant gastrinomas appears to be more favorable in the young patient. Total gastrectomy can be done safely in children with the Zollinger-Ellison syndrome and effectively controls gastric hypersecretion when all gastrin-producing tumor cannot be excised. Surgical exploration and an attempt at "curative" tumor excision, even when tumor is extrapancreatic and in lymph nodes, appear worthwhile in selected patients.

Adolescent↗
PubMed1981

A human parathyroid carcinoma that produces parathyroid hormone: long term maintenance in tissue culture.

Parathyroid carcinoma cells from a pulmonary metastasis of a patient with a serum Ca of 17 mg/dl and an immunoreactive parathyroid hormone (PTH) of 6.4 ng eq bovine (b) PTH/ml (normal 40--400 pg/ml) have been maintained in tissue culture for more than 2 1/2 years. The cells secrete PTH into the culture media that 1) during immunoassay dilutes in parallel to human hyperparathyroid serum, 2) has a molecular weight similar to intact highly purified bPTH, and 3) stimulates bone resorption in a manner that is equivalent and additive to synthetic bPTH-(1--34).

Adult↗
PubMed1981

Geographic distribution of occupational therapists.

This paper reports the findings of a recent study conducted to determine whether there is an appropriate distribution of occupational therapists in the United States. A method for an analysis of requirements for occupational therapists was developed to assess whether, given requirements indicators in each county, the current distribution is appropriate. As a final stage of the analysis, three groups of counties were singled out for special attention: 1. those with no occupational therapists; 2. those with low levels of relative supply of occupational therapists; and 3. those with high levels of relative supply of occupational therapists. These groups were compared in order to determine whether differences exist in demographic characteristics and health status indicators that might be associated with differences in the supply of occupational therapists in each group of countries. Conclusions and discussion of potential policy implications were drawn from the descriptive and analytic findings.

Health Services Needs and Demand↗
PubMed1981

Histopathologic responses of the jird, Meriones unguiculatus, to the bile duct and pancreatic trematode, Brachylaime microti.

Biliary tract histopathologic responses of the Mongolian jird, Meriones unguiculatus, were monitored during infection with Brachylaime microti. At 15 days postinoculation (PI), an inflammatory cell (polymorphonuclear and band neutrophil) response occurred in periductal tissue of the common bile duct at the site of oral sucker attachment; basophils and eosinophils were not observed. Capillary prominence and fibroblasts also were noted in this region. Histologic evidence suggested an immunologic response had begun by 15 days PI; massive periductal lymphocytic infiltration occurred and enlarged mesenteric lymph nodes adjacent to the pancreas contained proliferating lymphocytes. Hepatocyte vacuolation was noted at this time. By 30 days PI, the bile duct epithelium had invaginated and lymph nodes were enlarged further. At 65 days PI, worms were encapsulated in small intrahepatic ducts by fibrous tissue of host origin. Gastric peritoneal mesothelial cysts containing ova were seen in one host. Pancreatitis was not observed in response to infection with B. microti.

Animals↗
PubMed1980

Choledochoduodenostomy: importance of common duct size and occurrence of cholangitis.

Choledochoduodenostomy was performed in 68 patients. In these cases, we attempted to determine any correlation between the size of the common duct and subsequent cholangitis. Follow-up information was available in 64 (94%) of the cases, with a mean follow-up of three years. The most common indication for choledochoduodenostomy was choledocholiothiasis. Prior biliary surgery was used in 33 (48%) patients. Benign disease was present in 51 patients, and 17 patients had malignant neoplasms. The mean size of the common duct was 2.1 cm and the range was 1.0 to 4.0 cm. Only two patients (2.8%) experienced episodes of cholangitis after choledochoduodenostomy and both of these patients had a common duct that measured less than 1.6 cm at the time of anastomosis. Other procedures than choledochoduodenostomy should be considered when common duct size is less than 1.6 cm.

Adult↗
PubMed1979

Effective surgical therapy of esophagitis. Experience with Belsey, Hill, and Nissen operations.

During the years 1971 to 1978, 252 patients needed surgical treatment of primary or secondary esophagitis. Major operations performed were 73 Belsey Mark IV repairs, 55 Hill repairs, and 129 Nissen repairs. In the group with primary reflux, barium swallow tests and endoscopy were useful in confirming the diagnosis in patients with typical symptoms; routine biopsy, lower esophageal sphincter, manometry or an acid infusion test did not add to diagnostic certitude. If symptoms were atypical, a biopsy was helpful but manometry and acid infusion were not. Mean symptom scores in this group of patients were improved by each of the "valve-building" operations. Intraoperative dilation after mobilization of the esophagus coupled with a valve-building operation was successful in managing 26 of 29 strictures. Reoperation after an operation failed carried appreciable morbidity and mortality but resulted in good control of symptoms. Addition of a Belsey or Nissen procedure to myotomy for management of primary esophageal motility disorders diminished symptoms and did not cause disabling obstruction.

Collagen Diseases↗
PubMed1979

The MEA-I syndrome: an all or none phenomenon?

Studies of two kindreds with the MEA-I syndrome prompted us to challenge the long-standing concept that endocrine involvement in this syndrome may be limited to one or two endocrine glands. Evaluation of medical histories, autopsies, or biochemical screening of 72 family members from five generations suggests that individuals inheriting the trait will develop endocrinopathy in all three endocrine systems characteristically involved in this syndrome, i.e., parathyroids, islets of Langerhans, and pituitary. Thirty-six surgical procedures have been performed on 21 family members. Gastrointestinal bleeding was the cause of death in 10 of 11 affected individuals. Only two individuals who inherited the trait have lived beyond 54 years, one with a total gastrectomy and one taking Cimetidine. In each instance, when tissue from one of the three endocrine systems was obtained (surgery or autopsy), abnormalities were documented. A search of the English-language literature (1953 to 1978) for reports of complete autopsies of MEA-I-affected individuals indicated pathology in all three endocrine systems in 29 of 32 cases. Medical and surgical management of this inherited disorder should be based on the concept that pathological changes will develop in the parathyroids, pancreatic islets, and the pituitary.

Adrenal Gland Neoplasms↗
PubMed1977

Operative choledochoscopy. Results of a prospective study in several institutions.

A prospective study from six surgical units utilizing choledochoscopy in conjunction with primary choledocholithotomyand cholangiography resulted in an incidence of less than 2 per cent unsuspected residual biliary calculi. Total reliance on choledochoscopy without associated operative cholangiography is not justified and fraught with error. When there are no calculi in the common duct, the choledochoscope allows the surgeon to shorten exploration time with confidence that the postexploratory cholangiogram will confirm his negative findings. The choledoschoscope is of additional value in the extraction of calculi. Certain considerations in the management of biliary tract tumors also can be helped by the addition of choledochoscopy. The simultaneous presence of calculous disease and biliary tract neoplasm can coexist can be brought to light by the use of the choledochoscope. The incorporation of choledochoscopy, using a rigid Berci-Shore choledochoscope, as part of routine common duct exploration, appears to be warranted.

Adolescent↗
PubMed1976

Plasma alpha-cell glucagon in primary hyperparathyroidism.

Plasma glucose, insulin, and alpha-cell glucagon profiles were examined in ten adults with uncomplicated primary hyperparathyroidism before and 8-12 week after surgical removal of a single parathyroid adenoma. Treatment restored abnormal serum calcium and phosphorus concentrations to a normal range and reduced serum parathyroid hormone levels from 47 +/- 4 to 16 +/- 4 mu 1 Eq/ml (normal = 0-40). Plasma glucose curves during 100-g oral glucose tolerance, 30 min intravenous glucose (1.5 g/min), or arginine infusions (1.0 g/min) did not differ before and after surgery. However, basal and peak insulin concentrations were higher before treatment during these tests (p less than 0.05). Basal glucagon levels were unaffected by hyperparathyroidism (72 +/- 7 versus 77 +/- 7 pg/ml). Peak 30 min values after arginine provocation were also similar before and after treatment as was maximal suppression of basal glucagon during glucose infusions. Four patients also received 400 g lean beef meals. Glucose and glucagon responses over 240-min periods were nearly identical before and after surgery despite higher insulin levels before treatment. It is concluded that elevated serum parathyroid hormone and plasma insulin concentrations in primary hyperparathyroidism do not relate to abnormalities of plasma alpha-cell glucagon in the basal state or after glucose, arginine, or protein administration.

Adult↗
PubMed1976

Does hyperparathyroidism cause hypergastrinemia?

To define the relationship between hyperparathyroidism (HPT) and gastric function, 31 patients with HPT were prospectively studied before and 2 to 25 months after parathyroidectomy. The gastrin response to a standard test meal (STM), the basal acid output (BAO), and the peak acid output (PAO) were determined. Parathormone and calcium were elevated in all patients and returned to normal following parathyroidectomy. The mean fasting gastrin concentration, mean integrated gastrin response (IGR) to feeding, mean basal acid output (BAO), and mean peak acid output (PAO) were not changed by successful parathyroidectomy. There was no significant correlation between gastrin concentration or gastrin response to feeding and gastric acid secretion. Eight of 31 HPT patients had fasting gastrin concentrations above normal preoperatively and remained so postoperatively. Hypergastrinemia in six of these eight patients could be explained by the Zollinger-Ellison (Z-E) syndrome or chronic atrophic gastritis. The hypothesis that peptic ulcer disease seen in some HPT patients is the result of calcium-induced hypergastrinemia causing gastric hypersecretion is not supported by this study.

Adolescent↗