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Biomedical subjects

W Williams

Publications and source records attributed to W Williams.

At least 145 records · Page 8Linked to original sources
PubMed1984

Scintigraphic variations of normal biliary physiology.

We studied 115 healthy adult volunteers, fasting overnight, to establish the normal scintigraphic variability. Five Tc-99m IDA agents with liver excretion half-times ranging from 18 to 108 min were used. The time of appearance of the common bile duct correlated directly with the liver's excretion half-time. The appearance of the gallbladder and the small intestine were independent of the excretion half-time and showed a reciprocal relationship suggesting a major role for the sphincter of Oddi. In 22% of the subjects, the sphincter tonus was tight enough to divert all of the hepatic bile into the gallbladder, allowing none into the intestine. All of such subjects showed normal dynamic response to intravenous cholecystokinin. The pattern of the bile drainage from the two lobes differed, resulting in asymmetry of the right and left hepatic ducts. It is concluded that the selection of a Tc-99m IDA agent should be based on the clinical problem at hand and that a clinician's understanding of the scintigraphic variability in normal subjects is critical before attempting diagnosis.

Adult↗
PubMed1984

Proteinuria and glomerular disease in Jamaica.

Clinical, laboratory and renal biopsy data on 50 adult patients investigated in Jamaica because of proteinuria of more than 1 g/day were reviewed. Primary glomerular disease was present in 23 cases and the most common histological pattern was mesangial proliferation. Proteinuria was part of a systemic disease in 27 patients of whom 19 had systemic lupus erythematosus (SLE). Urinary protein excretion was less in patients with systemic diseases than in those with primary glomerulonephritis, but hypoalbuminemia, renal function and presence of edema were not helpful in distinguishing types and causes of renal disease. By comparison with other countries SLE and mesangial proliferative glomerulonephritis are common causes of proteinuria and nephrotic syndrome in Jamaica whereas idiopathic membranous glomerulonephropathy appears to be rare.

Adolescent↗
PubMed1983

Chronic plasma exchange in systemic lupus erythematosus nephritis.

Thirty-nine patients with systemic lupus erythematosus (SLE) and diffuse proliferative glomerulonephritis have been enrolled in a multi-centre randomised controlled prospective study of chronic 4L plasma exchange therapy performed every three to four weeks. In the patients randomised to the pheresis (P) group and who received either albumin or plasma as replacement, there was a difference of 33 per cent better renal function at this time in the study. This difference did not achieve a significance with a p value of less than 0.05. However, the 30 patients randomised into the P group to receive albumin replacement did demonstrate a 50 per cent difference from the C group which was significant at a p value of less than 0.045. This also correlated with a statistically significant reduction in immune complex titres in the P versus the C groups. Chronic 4L plasma exchange with albumin replacement may be a useful therapeutic adjunct in patients with SLE and diffuse proliferative glomerulonephritis.

Adult↗
PubMed1982

Moxalactam in the therapy of serious infections.

Sixty-seven patients were treated with moxalactam in a noncomparative trial of hospitalized patients; 32 had endometritis or chorioamnionitis, 12 had skin and soft tissue infections, 5 had osteomyelitis, 5 had pneumonia, 5 had urinary tract infections, 4 had arthritis, 2 had sepsis from an unknown source, 1 had endocarditis, and 1 had peritonitis. Bacteremia was present in 12 of these patients. Patients were given 3 to 12 g of moxalactam per day (mean, 6.24 g/day) in divided doses every 6 to 8 h. Seven patients were given intramuscular treatment for 3 to 20 days for part or all of their therapy. The rest were given intravenous treatment exclusively. Treatment was continued for 2 to 42 days (mean, 10 days). The dose and the duration of therapy were determined by the type of infection and the response of each patient. There were four treatment failures and one enterococcal-clostridial superinfection. Moxalactam was well tolerated. Allergic reactions led to the discontinuation of the antibiotic in three patients. Prolonged prothrombin and partial thromboplastin times were observed in 2 of 11 patients tested; in both instances in patients had severe underlying diseases, including malnutrition and alcoholism. Pain on intramuscular injection was noted in two patients receiving 1,500 mg, but not in five receiving a lower dose; in one case the pain forced the use of intravenous therapy after one dose, and in the other case the pain was mild and the patient was treated for 20 days. We concluded that moxalactam was effective in the treatment of the types of infections included in this study and produced few adverse reactions.

Bacterial Infections↗
PubMed1982

A comparison of two techniques for the detection of the vasculogenic component of impotence.

Eighty-six patients have been evaluated in the vascular laboratory with regard to vasculogenic impotence. Doppler ultrasound and a new method, photoplethysmography, have been used alone and in combination, compared and correlated with the results of psychiatric therapy. Doppler ultrasound and the photoplethysmographic techniques give almost identical results apart from the zero reading on the Doppler recordings which correlates poorly with the results of psychotherapy and photoplethysmographic findings. The photoplethysmographic technique is quicker, more esthetically acceptable and is, therefore, the method of choice for the assessment of the vasculogenic component of impotence.

Blood Pressure↗
PubMed1980

The practical management of the otherwise fully sexually responsive woman who complains of inability to climax during intercourse.

Many women who can climax easily with their partner to direct clitoral stimulation are unable to reach orgasm during intercourse unless they receive supplementary manual clitoral stimulation. Such women frequently consult their physician for advice. This two-part article aims to provide clear practical guidelines to the management of this situation.

Clitoris↗
PubMed1979

Subclavian arterioplasty for the ipsilateral subclavian-to-pulmonary artery shunt.

A new technique is described to avoid kinking and improve flow in the ipsilateral subclavian-to-pulmonary artery shunt. Experience with this procedure is reviewed in 35 infants and children with a variety of cyanotic congenital heart disease, including 10 with tricuspid atresia. Of these, 17 had had previous shunts: a Waterston shunt in six, a Glenn shunt in six, and a contralateral Blalock-Taussig shunt in five. The mean age was 5.6 years (range, 1 day to 16 years), and the mean follow-up was 24 months (range, 11 months to 4.5 years). There were no early deaths (less than 30 days), but there were two late deaths. There were three shunt failures at 2 weeks, 1 month, and 10 months; two of the failures were in infants aged 1 day and 4 days at operation. There were no late shunt failures. The patency by the life table method was 91.4% at 6 months, 88.5% at 1 year, with no further drop-off. It is concluded that subclavian arterioplasty can be performed safely and offers improved shunt patency in comparing to the ipsilateral Blalock-Taussig shunt.

Adolescent↗