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Biomedical subjects

T Williams

Publications and source records attributed to T Williams.

At least 145 records · Page 8Linked to original sources
PubMed1996

Acceptability and usefulness of vaginal washes in premenarcheal girls as a diagnostic procedure for sexually transmitted diseases. The Child Protection Centre at the Winnipeg Children's Hospital.

OBJECTIVE: To assess the suitability of vaginal washes as specimens for sexually transmitted disease diagnosis and determine the usefulness of PCR technology for Chlamydia trachomatis diagnosis in prepubertal girls. STUDY DESIGN: Paired sets of vaginal secretions were collected with swabs and by vaginal wash from 138 prepubertal girls for evaluation because of alleged sexual abuse. Detection by culture of Neisseria gonorrhoeae and C. trachomatis was compared between the two sampling techniques. PCR techniques were also used to test 29 vaginal wash specimens for C. trachomatis. RESULTS: In the prepubertal girls N. gonorrhoeae was detected in two wash specimens but in only one swab specimen; C. trachomatis was detected by culture in both paired specimens from two children and by PCR in vaginal washes from both of the two children positive by culture; PCR identified two other infected children. CONCLUSIONS: A vaginal wash technique coupled with newer molecular amplification technology may be useful in the assessment of sexually abused children.

Adolescent↗
PubMed1996

The non-structural proteins of bluetongue virus are a dominant source of cytotoxic T cell peptide determinants.

Virus-specific, CD8+ cytotoxic T lymphocytes (CTLs) were generated in two strains of mice (BALB/c, CBA/Ca) against bluetongue virus serotype 10 (BTV-10). Recombinant vaccinia viruses (VV) expressing the individual structural and non-structural proteins of BTV were used to infect syngeneic target cells. We found that in both BALB/c (H-2d) and CBA/Ca (H-2k) mice, polyclonal CTL populations recognized target cells expressing the non-structural proteins better than those expressing the structural proteins. CTLs generated against other BTV serotypes also predominantly recognized the non-structural proteins. However, the extent of cross-reactivity was dependent on the H-2 background of the animals immunized. No CTLs cross-reactive to the BTV-10 heterotype were demonstrated with the panel of molecularly cloned recombinants in the H-2d haplotype. The outer capsid proteins VP2 and VP5 which vary considerably between serotypes were not recognized by heterotypic CTLs. Using this murine model we have determined which BTV proteins are the major targets of the CTL response. The implications for the design and development of subunit vaccines are discussed.

Animals↗
PubMed1996

The responses of an able bodied person to wheelchair training: a case study.

OBJECTIVE: To examine the responses of a previously untrained, able bodied male to a 10 month training programme in a wheelchair. METHODS: Physiological indices and performance times were measured over the 10 month period during periods of general conditioning, specific conditioning, and competition. RESULTS: Although both peak oxygen uptake and maximum heart rate increased it was found that the main contribution to improvements in performance was from increased pushing economy. The value of peak oxygen uptake for the subject was within the normal range for paraplegics; however, maximum ventilation exceeded the levels normally achieved by paraplegics. At the conclusion of the study the subject successfully completed a wheelchair marathon in a time of 2 h 9 min at an average speed of 5.17 m s1. CONCLUSIONS: It was possible for an able bodied person with no previous experience in a wheelchair to successfully compete in a wheelchair marathon with only 10 months training. The main contribution to the improvement in performance was from increased pushing economy.

Adult↗
PubMed1996

Hematopoietic bone marrow hyperplasia: correlation of spinal MR findings, hematologic parameters, and bone mineral density in endurance athletes.

PURPOSE: To determine the frequency of hematopoietic hyperplasia on spinal magnetic resonance (MR) images in endurance athletes and to correlate MR alterations with clinical parameters. MATERIALS AND METHODS: In 15 endurance athletes, MR images of the lumbar spine were analyzed for hematopoietic hyperplasia; vertebral T1 and T2 were determined. Bone mineral density (BMD) was determined, blood tests were performed, and maximum oxygen consumption (VO2max) was measured. RESULTS: Nine subjects showed evidence of hematopoietic hyperplasia: Eight showed T1 prolongation, and six had patchy or diffuse T1 hypointensity. No definite correlation existed between hematopoietic hyperplasia and duration of training, hematologic results, or VO2max levels. Borderline significance existed between hematopoietic hyperplasia and anemia (P = .103) and intensity of training (P = .09). BMD had no statistically significant effect on T1. CONCLUSION: Changes in BMD do not appear to contribute to MR marrow changes that are consistent with hematopoietic hyperplasia. Depleted iron reserves or increased hematopoiesis probably contribute to hematopoietic hyperplasia in endurance athletes.

Adult↗
PubMed1996

Cell saver efficacy for routine coronary artery bypass surgery.

A retrospective study was conducted to determine the effect of intraoperative Haemonetics Cell Saver (HCS) usage on postoperative homologous blood product requirements in CABG patients. From 1 January to 31 December 1993, 516 patients without renal disease or postoperative surgical or gastrointestinal haemorrhage had elective, first-time CABG surgery. The HCS was utilized in 435 of these patients (Group CS) and in 81 patients the HCS was excluded (Group NCS). Preoperative patient variables were similar in the group. We evaluated the HCS effect on blood product transfusion by comparing -x units of red blood cells (RBC), fresh frozen plasma (FFP) and platelets (PLTS) transfused per patient between groups CS and NCS. There were no differences in the -x units of RBC (1.9 +/- 2.7 CS vs. 1.8 +/- 1.5 NCS) or in the RBC transfusion rate (48% CS vs 50% NCS). There were also no significant differences between the groups in -x units of FFP (0.9 +/- 0.8 CS vs 0.4 +/- 0.9 NCS) or PLTS (0.7 +/- 3.1 CS vs 0.4 +/- 2.5 NCS), or in the percentage of patients receiving these products (12% CS vs 8% NCS). These data provide no evidence that the use of the HCS decreases the amount of homologous blood bank products required postoperatively in patients having routine first-time CABG surgery. The current era of aggressive blood conservation may have limited the role of the HCS in routine CABG surgery.

Aged↗
PubMed1996

Contraceptive and sexually transmitted diseases protection among adult and adolescent women infected with human immunodeficiency virus.

The goal of this study was to describe contraceptive and sexually transmitted disease (STD) prevention practices in human immunodeficiency virus (HIV) infected adult and adolescent women, and to determine if hormonal contraception has unique adverse effects in this population. A retrospective review of 241 HIV-infected women age 15-45 years was performed. The associations between contraceptive methods and selected characteristics were determined by chi-square methods and logistic regression modelling. African American race (RR 8.6, 95% CI 3.3, 22.5), injection drug use history (RR 5.0, 95% CI 2.2, 11.2), age < 25 years (RR 1.9, 95% CI 1.1, 3.5) and progestin only contraceptive use (RR 3.0, 95% CI 1.4, 6.6) were significantly associated with incident STDs. The only potential adverse effect of hormonal contraception noted in this retrospective study was the significant association between STDs and progestin-only contraception. Prospective studies to better delineate the true association between STDs and progestin-only agents after adjustment for behaviour patterns are warranted.

Adolescent↗
PubMed1996

Pulmonary allograft ischemic time: an important predictor of survival after lung transplantation.

BACKGROUND: Traditionally organ availability in human lung transplantation has been limited by aiming to keep the graft ischemic time under 6 hours. To maximize organ supply in a country with a widely spread population, we have routinely procured organs beyond this time. Our experience outlines the clinical consequences of a prolonged allograft ischemic time. METHODS: Between 1990 and 1994 we performed 106 lung or heart-lung transplantations. The average graft ischemic time was 323 +/- 93 minutes. Lung preservation included a prostacyclin infusion (40 to 80 ng/kg/min for 10 minutes) and cold modified Euro-Collins solution flush. Organs were stored and transported on ice at 6 degrees to 10 degrees C. Graft ischemic time, transplant type, age, gender, cytomegalovirus status, and anesthetic time were subject to multivariate Cox regression analysis. RESULTS: Survival and graft ischemic times for heart-lung (n = 38), single lung (n = 33), and bilateral lung transplantation (n = 35) were not significantly different. Graft ischemic time was an independent predictor of survival (p < 0.01). Subgroup analysis notes the effect to be most pronounced beyond 5 hours (p = 0.02, hazard ratio 3.44, confidence interval 1.12 to 9.8). CONCLUSIONS: Pulmonary allograft ischemic time beyond 5 hours does not result in acceptable outcomes although survival is reduced. Attempts should be made to minimize graft ischemic times with careful coordination of transport and personnel.

Adult↗
PubMed1996

Reverse telescope anastomotic technique reduces the incidence of bronchial stricture.

BACKGROUND: Bronchial stricture remains a major problem after lung transplantation. We hypothesized that a "reverse" telescope anastomosis, where the donor bronchus is sleeved external to the recipient bronchus, would be associated with a lower incidence of anastomotic stricture. METHODS: Over a 12-month period our Unit performed 35 consecutive single and bilateral sequential lung transplantations. The 56 bronchial anastomoses were constructed as a conventional (n = 27) or as a reverse (n = 29) telescope. RESULTS: Bronchial strictures developed in 48% of the conventional anastomoses but in only 7% of the reverse anastomoses (p < or = 0.05). Furthermore, the reverse telescope anastomosis eliminated the need for stenting. CONCLUSIONS: This technique greatly reduced the need for dilatation, debridement, and stent placement and may reduce the morbidity and mortality associated with anastomotic complications.

Adult↗
PubMed1996

Characteristics of children and adolescents with mental retardation and frequent outwardly directed aggressive behavior.

Two interrelated cross-sectional studies were conducted to expand earlier findings about correlates of outwardly directed aggressive behavior in children with mental retardation. In Study 1 we compared children with mental retardation, 27 with and 23 without aggression. Aggression was best predicted by concurrent self-injurious behavior (SIB). In Study 2 we examined the likelihood that aggression was predicted by concurrent SIB and other nondestructive maladaptive behaviors in an archival cohort of 701 children younger than 21 with IQs below 70. Self-injurious behavior significantly predicted outwardly directed aggression for all children regardless of age. Additional predictors besides SIB showed only minimal improvements in model R2 values. Results were discussed in light of recent research proposing a common basis for aggression and SIB.

Adolescent↗
PubMed1995

The developmentally regulated transcription factor AP-2 is involved in c-erbB-2 overexpression in human mammary carcinoma.

Overexpression of the c-erbB-2/HER2 protooncogene in breast carcinoma is controlled not only by the degree of amplification of the gene but also at the level of gene transcription. Thus, whether or not the gene is amplified, the activity of the c-erbB-2 promoter is enhanced in overexpressing cells through the binding of an additional transcription factor, OB2-1, whose activity is increased in these lines. Here we describe further characterization of OB2-1 and show that it is identical to the developmentally regulated transcription factor AP-2. Functional assays confirm that AP-2 is able to regulate c-erbB-2 expression in mammary-derived cell lines. Furthermore, although AP-2 is barely detectable in cells with the low c-erbB-2 expression phenotype, protein levels are clearly elevated in a panel of c-erbB-2-overexpressing lines. These findings demonstrate an important role for this transcription factor in human cancer.

Base Sequence↗
PubMed1995

Critical limb ischaemia in patients over 80 years of age: options in a district general hospital.

A total of 114 reconstructions were performed in 82 octogenarian patients and the results compared with those of 33 patients who had primary amputation. The operative mortality rate was higher after amputation (45 versus 11 per cent) and the mean survival less (25 versus 34 months). Quality of life assessment using a Rosser scale suggested that, although there was no improvement in the 38 per cent with a failed reconstruction, there was a significant improvement in the 62 per cent whose reconstruction remained patent. There was minimal improvement in quality of life after primary amputation and this was due to relief of pain. Costs (including the costs of revisions and community costs) were assessed in detail. Although the mean total operative costs of reconstruction were higher than those of amputation (10,222 pounds versus 6475 pounds) this was more than offset by the high community costs of amputation. The total cost of reconstruction was 13,546 pounds, compared with 33,095 pounds for amputation. Following reconstruction 66 per cent of those patients independent before critical limb ischaemia occurred were able to return to their own home; only 33 per cent of amputees were able to do so.

Aged↗
PubMed1995

Intraperitoneal sodium carboxymethylcellulose administration prevents reformation of peritoneal adhesions following surgical lysis.

Although intraperitoneal administration of sodium carboxymethylcellulose (SCMC) prevents the formation of adhesions following laparotomy in rats, it remains unknown whether SCMC treatment prevents the recurrence of preformed peritoneal adhesions following surgical lysis. Additionally, the optimal amount of SCMC required for adhesion prevention, as well as the effects of SCMC upon the healing of bowel anastomoses, has yet to be determined. To study this, 114 male rats underwent laparotomy and adhesion induction via peeling of the cecal serosa with a gauze sponge. Two weeks later, all animals again underwent laparotomy, the adhesions were graded, and surgical lysis of adhesions was performed. Following this, 3 to 12 ml of either normal saline or 1% SCMC solution was instilled into the peritoneal cavity prior to closure. A segment of small bowel was transected and reanastomosed prior to administration of SCMC or saline in another group of 70 rats. After an additional 2 weeks, the animals were sacrificed, the adhesions graded, and all the abdominal contents removed for fixation. The results show that treatment with high volume (i.e., 12 ml) intraperitoneal SCMC prevents reformation of adhesions following surgical lysis. This effect is demonstrated by a proportionate and significant decrease in the incidence of intraabdominal adhesions associated with administration of increasing amounts of SCMC (P < 0.05). While high volume SCMC did prevent adhesion of peritoneal structures to newly formed small bowel anastomoses, SCMC did not impair anastomotic healing.

Animals↗
PubMed1995

Fatty acid profiles of invertebrate iridescent viruses.

Eight invertebrate iridescent viruses (IVs) from diverse host taxa were grown in a common lepidopteran host, Galleria mellonella. The lipid composition of purified virus was assessed by fatty acid methyl esterase (FAME) analysis using a gas-liquid chromatograph. IV fatty acid profiles were markedly different from those of the host tissues. The interrelationships among the IVs did not follow previous serological and genetic findings. We conclude that FAME analysis is not a useful technique for revealing phylogenetic relationships among these viruses.

Fatty Acids↗
PubMed1995

Pediatric gonococcal infection: case report demonstrating diagnostic problems in remote populations.

The inability of Neisseria gonorrhoeae to survive prolonged transit times and hostile ambient temperatures has made its detection at referral laboratories by cultural methods untenable. In this situation, reliance upon antigen detection systems is attractive but when these tests are performed on vaginal specimens from children, false positive results are a significant concern. Some of the difficulties associated with the investigation of a gonococcal infection resulting from sexual abuse of a child in an isolated community are illustrated in this report.

Antigens, Bacterial↗