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Biomedical subjects

W J Williams

Publications and source records attributed to W J Williams.

At least 37 records · Page 2Linked to original sources
PubMed1995

Isolated peripheral tuberculous lymphadenitis in adults: current clinical and diagnostic issues.

Eight cases of isolated peripheral tuberculous lymphadenitis occurred over a 16-month period at our institution, prompting a literature review to establish the epidemiology, clinical manifestations, and current approaches to diagnosis and treatment of this disorder. It occurs most commonly in young adult women who either are immigrants from areas where tuberculous is endemic or have histories of travel that are suggestive of exposure to Mycobacterium tuberculosis. The disease is indolent and usually presents as a unilateral painless neck mass. Constitutional symptoms are rare, except in individuals infected with the human immunodeficiency virus (HIV). The results of skin testing with purified protein derivative are invariably positive. Excisional biopsy for histopathologic and microbiological evaluations provides the highest diagnostic yield, although fine needle aspiration may be useful for HIV-infected individuals and in areas of the world with a high prevalence of disease. A 6-month course of combination antituberculous therapy is adequate for disease due to susceptible organisms. This infection may be readily diagnosed if suggestive epidemiological and clinical findings lead to expeditious tissue sampling.

Adult↗
PubMed1995

Changes in sympathoadrenal response to standing in humans after spaceflight.

Plasma catecholamine levels and cardiovascular responses to standing were determined in astronauts before and after several Space Shuttle missions. Blood pressure, heart rate, and cardiac output were measured and blood samples for catecholamine analyses were drawn at the end of the supine and standing periods. Supine plasma norepinephrine and epinephrine concentrations increased 34 and 65%, respectively, on landing day compared with before flight. Standing on landing day resulted in a 65 and 91% increase in plasma norepinephrine and epinephrine, respectively. Supine and standing norepinephrine levels remained elevated 3 days after landing while epinephrine levels returned to preflight levels. On landing day, supine heart rate and systolic blood pressure increased 18 and 8.9%, respectively, and standing heart rate and diastolic blood pressure were elevated by 38 and 19%, respectively. On standing, stroke volume was decreased by 26% on landing day compared with before flight. Collectively, these data indicate that the decreased orthostatic function after spaceflight results largely from the decreased stroke volume. Possible mechanisms contributing to this condition are discussed.

Adrenal Glands↗
PubMed1994

Identification of Rickettsia conorii infection by polymerase chain reaction in a soldier returning from Somalia.

A soldier developed characteristic manifestations of boutonneuse fever shortly after leaving Somalia. Rickettsial DNA was detected in a biopsy sample of the tache noire by a polymerase chain reaction (PCR) in which primers derived from the 190-kD antigen gene of Rickettsia rickettsii were used. The source of this DNA was identified as Rickettsia conorii by restriction fragment length polymorphism (RFLP) analysis of the PCR product. R. conorii was also isolated from the skin biopsy specimen. The patient did not develop a significant increase in specific antibodies, as assessed by indirect fluorescent antibody testing, until several weeks after the onset of symptoms. This case demonstrates that the PCR/RFLP technique can be used for the direct identification of rickettsiae from clinical specimens. To our knowledge, this is the first confirmed case of R. conorii infection in Somalia.

Adult↗
PubMed1994

Conscious and nonconscious processes: an ERP index of an anticipatory response in a conditioning paradigm using visually masked stimuli.

This study investigates the nonconscious elicitation of a previously conditioned response by using a differential conditioning paradigm with visually masked affectively valent facial schematics. Electrodermal (skin conductance response [SCR] and brain (event-related potential [ERP]) activity were main dependent measures. Following a preconditioning phase in which subjects viewed energy masked pleasant and unpleasant facial schematics, conditioning with an aversive shock was established to unmasked presentations of an unpleasant face in a partial factorial design. A postconditioning phase of masked presentations, when compared with the preconditioning phase, revealed how the conditional effect within awareness might affect the same stimuli when presented outside awareness. An adaptive staircase technique was used to establish individual threshold levels, which represented a methodological advance over procedures typically used in visual masking research. The results revealed that responses to the CS+ (unpleasant face) changed significantly in predicted directions from preconditioning to postconditioning phase when compared with responses to the CS- (pleasant face). The SCR results systematically replicated recent Ohman, Dimberg, and Esteves (1988) findings, with the pattern of responses resembling a resistance to extinction effect. A new finding emerged for the brain responses. For the CS+, distinct slow wave activity occurred just before the point at which the shock had been delivered in the conditioning phase; no such activity was found for the CS-. This slow wave activity is similar to what has been described by others as an expectancy wave. The results indicate that an anticipatory process, as indexed by different physiological systems, can be elicited entirely outside awareness. Implications are discussed in regard to the nature of conscious and nonconscious processes.

Adult↗
PubMed1994

Convolution: a method for data analysis in perifusion systems.

Considerable interest has developed in defining how imposed stimuli effect dynamic changes in cellular metabolism. We have developed a miniature perifusion system that can reveal alterations in extracellular protons within seconds after application of metabolic perturbants. This perifusion system contains two pH sensors: one before the cells records changes between medium and test solutions, and one, located just past the cells, records these alterations plus cellular modifications. Because distortion occurs as chemicals pass through perifusion systems, the shape of pH changes induced by switching from medium to test solutions is different at each electrode. This study describes and validates convolution to correct this distortion. Data from HeLa cells exposed to the metabolic uncoupler of oxidative phosphorylation carbonyl cyanide m-chlorophenyl hydrazone have been analyzed with convolution. Cellular response to oxidative phosphorylation removal is comprised of multiple components, is consistent with a rapid uncoupling, and is followed by cellular adaptation. Therefore convolutional analysis can provide an important adjunct to the analysis of data acquired by perifusion and can provide new insights into cellular responsiveness and metabolism.

Carbonyl Cyanide m-Chlorophenyl Hydrazone↗
PubMed1994

Human cardiovascular response to sympathomimetic agents during head-down bed rest: the effect of dietary sodium.

Changes in sympathoadrenal function and cardiovascular deconditioning have long been recognized as a feature of the physiological adaptation to microgravity. The deconditioning process, coupled with altered hydration status, is thought to significantly contribute to orthostatic intolerance upon return to Earth gravity. The cardiovascular response to stimulation by sympathomimetic agents before, during, and after exposure to simulated microgravity was determined in healthy volunteers equilibrated on normal or high sodium diets in order to further the understanding of the deconditioning process.

Adult↗
PubMed1993

Pulmonary Langerhans' cell granulomatosis (LCG).

Pulmonary Langerhans' granulomatosis (LCG) is characterised by infiltration of peripheral airways by dendritic cell precursors and Langerhans' cells (LC) together with eosinophils and mixed chronic inflammatory cells. Consequent airways destruction commonly leads to cystic changes and frequent pneumothorax. LC's are best identified by the electron microscope finding of Birbeck granules. Immunocytochemical markers are also of value. They are frequent in the early stages though absent in end stage disease. LCG is distinguished from sarcoidosis by the absence of epithelioid cell granulomas, association with heavy cigarette smoking in young males and frequency of pneumothorax. Both diseases show lymphocytosis in bronchoalveolar lavage but differ in that LCG shows a predominance of T-suppressor cells and sarcoidosis an excess of T-helper cells.

Diagnosis, Differential↗
PubMed1992

Isolation and purification of a vascular hyperreactivity factor from rabbit kidney cortex.

A compound capable of amplifying the threshold pressor response to norepinephrine (NE) was obtained from rabbit kidney cortex. This compound was purified and characterized using a series of techniques including gel filtration, ion exchange chromatography, preparative electrofocusing, HPLC, FAB mass spectrometry (FAB-MS), and Fourier transform infrared spectrometry. From this, an acid/heat stable (6N HC1, 160 degrees C, 24 hours), low molecular weight (ca 147) compound with a strong (+) charge density (Pi greater than 10) was identified. When injected into assay rats (i.v.), this compound amplified the pressor response to fixed doses of NE. Taken together, this compound exhibits nearly identical characteristics (i.e. acid/heat stability, structure, charge and biologic activity to the naturally occurring polyamine spermidine (SPD-145.6 daltons). Moreover, bolus injections of SPD (10 micrograms, i.v.) amplified the pressor response to NE over a range of doses from 5-25 ng.

Animals↗
PubMed1992

CD4 lymphocyte decline and survival in human immunodeficiency virus infection. The Military Medical Consortium for Applied Retroviral Research.

The loss of the CD4 lymphocyte is the central pathophysiologic event in the progression of human immunodeficiency virus (HIV) infection. This retrospective study, based on review of data from deceased HIV patients followed in a single HIV clinic, was conducted to determine if the rate of CD4 lymphocyte decline was predictive of survival. Forty of 172 patients met defined criteria for inclusion in this study. For each patient, CD4-cell counts showed approximate exponential decline over time. A Cox regression analysis was used to assess the association of CD4 cell decline (half-life), race, age, gender, initial CD4-cell count, and treatment (anti-Pneumocystis carinii pneumonia prophylaxis and/or zidovudine vs. no therapy) on total survival (from initial CD4 cell count) and on remaining survival time after reaching a CD4 cell count of 100 (estimated). For all patients, the rate of CD4 cell decline was predictive of total survival (p = .009) but not for survival after reaching a count of 100 (p = .6). For patients who had never received therapy (6 patients), however, the CD4 half-life remained associated with survival time from 100 CD4 cells (p < .05) as opposed to the treated patients. Therapy was the single variable most predictive of both survival endpoints, resulting in an increase in median total survival of 27.2 mo (p < .00001) and of 15.4 mo from a CD4 cell count of 100 (p < .00004). Nonwhites had a slight survival disadvantage compared to whites (p = .08 overall; p = .02 from CD4 cell count of 100).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

An information flow technique for category related evoked potentials.

We report a technique for studying interactions among many subsystems of a biological system. A general mathematical technique is developed for information flow among various subsystems of a system when two or more classes of stimuli are presented to the system. The technique is validated by various simulation studies and then applied to a brain system. The usefulness of the technique is demonstrated for visual event related potentials (ERP's) obtained from human subjects suffering from phobias. The stimuli are briefly flashed words and phrases. The word classes are pleasant, unpleasant, conscious, and unconscious. The conscious class consists of words known by the patient to relate to the problem, whereas the unconscious class of words consists of words related to deep conflicts which are not recognized by the patient. It is demonstrated that information flow is suppressed under supraliminal presentation of the unconscious class, but is strong under subliminal presentation. The technique has the potential of being an objective indicator of conflictual relationships in these patients. The principle of the technique can be applied to any system in which interactions among subsystems are to be analyzed.

Awareness↗
PubMed1992

Time-frequency representation of electrocorticograms in temporal lobe epilepsy.

Three time-frequency distributions are evaluated in terms of their efficacy in representing nonstationary electrocorticograms (ECoG's) in human temporal lobe epilepsy. The results of a new method, the exponential distribution, are compared with those of the spectrogram and the Wigner distribution. It is shown that the exponential distribution represents a considerable improvement over the spectrogram in terms of resolution and markedly reduces cross-terms present in the Wigner distribution. Exponential distribution representations of ECoG's from different stages of an epileptic record are developed as contour maps. These high-resolution representations offer a lucid display of temporal-spectral features of the rapidly varying signals that constitute ECoG's recorded in temporal lobe epilepsy.

Adult↗
PubMed1991

Time frequency distributions of TMJ sounds.

For analysis of time-varying signals such as the TMJ sounds, it is often desirable to know how the frequency components change with time, using methods of time-frequency analysis. The aim of this study was to compare two of the most familiar methods for energy density representation with a newly developed technique. The sounds were recorded with a microphone fastened to the subject's forehead, transformed to the time-frequency domain and displayed as 3D- and contour plots using spectrogram, Wigner distribution (WD), and the reduced interference distribution (RID) to display their time-frequency energy distributions. The spectrogram resolved only the low-frequency components. The WD provided higher resolution but also exhibited strong interference between components. The RID gave a detailed representation of the TMJ signals' relative energy distribution in the time and frequency domains, with a great reduction in the interference or cross terms. The RID therefore appears to be most useful in the application of time-frequency distributions in classification of TMJ sounds.

Analog-Digital Conversion↗
PubMed1991

Kveim-Siltzbach test revisited.

The Kveim-Siltzbach (KS) skin test has been in use worldwide for fifty years. It is a safe, simple and specific out-patient technique to confirm the diagnosis of sarcoidosis and to provide evidence of activity of the disease. It is most helpful in delineating sarcoidosis as a cause of erythema nodosum, uveitis, liver granulomas, hypercalciuria and meningitis. It is the patient's preference when he is confronted with the choice between a skin test or alternatively bronchoscopy, lung biopsy or aspiration liver biopsy. It also creates considerable academic interest for it reflects granuloma formation vividly when viewed by modern immunopathology techniques. Its disadvantage is that it takes a month to provide a result; a critical month in which systemic steroids are avoided for this would suppress the test. The immunopathology of the KS test is similar to spontaneous sarcoid granuloma formation, and evolution of the KS granuloma may provide clues to the cause of sarcoidosis and other granulomatous disorders.

Humans↗
PubMed1991

Caplan's syndrome.

Explore the source record for details and available documents.

Caplan Syndrome↗
PubMed1990

Phase space topography and the Lyapunov exponent of electrocorticograms in partial seizures.

Electrocorticograms (ECoG's) from 16 of 68 chronically implanted subdural electrodes, placed over the right temporal cortex in a patient with a right medial temporal focus, were analyzed using methods from nonlinear dynamics. A time series provides information about a large number of pertinent variables, which may be used to explore and characterize the system's dynamics. These variables and their evolution in time produce the phase portrait of the system. The phase spaces for each of 16 electrodes were constructed and from these the largest average Lyapunov exponents (L's), measures of chaoticity of the system (the larger the L, the more chaotic the system is), were estimated over time for every electrode before, in and after the epileptic seizure for three seizures of the same patient. The start of the seizure corresponds to a simultaneous drop in L values obtained at the electrodes nearest the focus. L values for the rest of the electrodes follow. The mean values of L for all electrodes in the postictal state are larger than the ones in the preictal state, denoting a more chaotic state postictally. The lowest values of L occur during the seizure but they are still positive denoting the presence of a chaotic attractor. Based on the procedure for the estimation of L we were able to develop a methodology for detecting prominent spikes in the ECoG. These measures (L*) calculated over a period of time (10 minutes before to 10 minutes after the seizure outburst) revealed a remarkable coherence of the abrupt transient drops of L* for the electrodes that showed the initial ictal onset. The L* values for the electrodes away from the focus exhibited less abrupt transient drops. These results indicate that the largest average Lyapunov exponent L can be useful in seizure detection as well as a discriminatory factor for focus localization in multielectrode analysis.

Brain Mapping↗
PubMed1990

Silent sarcoidosis and clubbing.

We report a case of sarcoidosis which was not diagnosed in life for a variety of reasons. In particular the chest was silent despite extensive pulmonary damage, and florid finger clubbing developed within a very short time.

Female↗