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Biomedical subjects

B Williams

Publications and source records attributed to B Williams.

At least 37 records · Page 2Linked to original sources
PubMed1978

ABO-incompatible marrow transplants.

Seventeen patients with aplastic anemia or acute leukemia received transplants from donors who had major ABO incompatibilities. Antibody titers were decreased by plasma and whole blood exchanges prior to marrow infusion. All 17 patients were successfully engrafted, and there was one possible rejection in the patient with the highest pretransplant anti-A IgG titer. Nine of 17 patients are currently alive. A review was carried out of transplants performed in Seattle between HLA-matched siblings with aplastic anemia and leukemia. Two hundred forty-six evaluable patients with ABO-compatible donors were compared with 46 with minor ABO-incompatible donors. There was no effect of minor ABO incompatibility on graft rejection, incidence and severity of graft-versus-host disease, or survival.

ABO Blood-Group System↗
PubMed1978

Reduction of enzyme levels by propranolol after acute myocardial infarction.

The effect of propranolol (0.1 mg/kg intravenously followed by 320 mg given over 27 hour orally) on serum levels of creatine kinase enzyme was studied in a randomized trial involving 95 patients seen within 12 hours of onset of symptoms of uncomplicated myocardial infarction. In 15 patients who were treated with propranolol within 4 hours of onset, and who eventually developed pathological Q waves, peak measured enzyme levels were 27% (P less than 0.0125) lower than in 19 control patients who were also seen within 4 hours of the onset but had no specific treatment. Total calculated enzyme appearance was also lower in the treated patients (reduced 25%, P less than 0.05) as was the calculated rate of the appearance (33%, P less than 0.005). No significant difference was found for treated compared with control patients entering the trial more than 4 hours after the onset of chest pain. This evidence suggests that propranolol may reduce the size of uncomplicated infarctions if it is given intravenously within 4 hours of the onset.

Acute Disease↗
PubMed1977

Influence of lipid concentrations and age on transfer of plasma lipoprotein into human arterial intima.

Transfer of low-density lipoprotein (L.D.L.2) from plasma to arterial intima was studied in 16 patients undergoing arterial surgery. Autologous labelled lipoprotein was used to demonstrate that L.D.L.2 enters the intima from plasma. Net flux of L.D.L.2 appeared to increase with age. Within each age-group the net flux of L.D.L.2 showed a pronounced positive correlation with plasma-L.D.L.-cholesterol concentrations. This may account in part for the association between hypercholesterolaemia and the development of atherosclerosis.

Adult↗
PubMed1977

Difficult labour as a cause of communicating syringomyelia.

Although some causes of communicating syringomyelia are known most cases of the disease can only be described as idiopathic. The results of a questionnaire suggest a high incidence of difficult labour in the mothers of syringomyelia patients. A high proportion of patients had forceps deliveries, and a high proportion were the first born in their families. Because the validity of taking a birth history at the age of presentation (mean age 40 y, S.D. 14 for this sample) might be questioned, patients admitted with other disorders (mean age 40 y, S.D. 16) were used as a control group. These patients matched the syringomyelia patients in social class and place of birth. It seems likely that birth trauma may be a cause of tonsillar descent through the foramen magnum (ectopia) and of arachnoiditis; both conditions are often present. Once the tonsils become engaged in the foramen magnum, difference between the cranial and spinal pressure may, over the course of several years, cause the tonsils to descend further, thus leading to communicating syringomyelia. Over half these patients have a history of difficult labour and it is possible that birth injury may be a factor even where birth is regarded as normal.

Adult↗
PubMed1977

Acoustic neuroma causing subarachnoid haemorrhage.

The case reported in this paper appears to be the first example of spontaneous subarachnoid haemorrhage complicating an acoustic tumour. The only comparable case is one of a pontocerebellar angle tumour, but its histological nature is unstated. The excellent response to surgical management has been gratifying, and the patient has remained well over an extended period of surveillance.

Adult↗
PubMed1977

Foramen magnum impaction in a case of acro-osteolysis.

A case of a rare, non-familial, generalized, congenital, osseous dysplasia is described with features which have previously been described under the name 'acro-osteolysis'. Basilar invagination followed defective bone formation in the skull and this produced occipital headache and progressive neurological deterioration with involvement of the lower cranial nerves and cerebellar function. Hydrocephalus and valvular impaction of the cerebellum in the foramen magnum were demonstrated. Partial relief was obtained by foramen magnum decompression; death supervened from infection and respiratory inadequacy at the age of 20.

Adolescent↗
PubMed1977

Cranial isotopic section scanning.

Some results of isotopic cranial section scanning are presented from a busy neurosurgical practice. Isotopes have been used for parenchymal lesions and also CSF pathway imaging. Comparisons with information yielded by other neuroradiological techniques have indicated that tomographic sections are a worthwhile addition to rectilinear isotope scans. In particular comparison with X-ray transmission (EMI) scans has confirmed the anatomical accuracy of the method and the two techniques have proved complementary in patient management.

Brain↗
PubMed1977

Cervical vertebrae measurements in syringomyelia.

Lateral X-rays of the cervical spine taken under standard conditions in 69 cases of syringomyelia have been measured to assess the relative sizes of the canals and bodies. One hundred and five cases without cervical spine abnormality provided controls. The expected expansion has been observed in males from C5 to C7 and in females from C3 to C7. The oddity that the expansive process seemed to come higher in females than in males has been noted by other workers. In both sexes it has been found that diminution of vertebral body size is a more consistent finding than enlargement of the canals and correlation coefficients have confirmed that enlargement of the canal appears to take place at least in part at the expense of the body. Possible factors in the enlargement are discussed. Oblique measurements taken in 57 syrinx cases and 89 controls showed the expected change caused by the view of the lower cervical vertebrae being closer to AP and pictures of the upper vertebrae being progressively closer to lateral views. There was a tendency for the bigger oblique diameters to occur in these cases with the biggest sagittal diameters and an insignificant tendency for the biggest canals to have a diminished difference between the two oblique measurements. There was no evidence that oblique measurements could be used to detect slight degrees of enlargement in cases of syringomyelia.

Adult↗
PubMed1977

The influence of the time of etching and washing on the bond strength of fissure sealants applied to enamel.

Variation of the etching and washing times of enamel surfaces prior to the application of fissure sealants affect the bond strength in differing ways. Depending on the length of the etch time, the effect of washing may increase or decrease the bond strength of the sealant. Clinically, the most satisfactory combination of etch and wash time was found to be different to that suggested by the manufacturers.

Acid Etching, Dental↗
PubMed1977

Three cases of communication syringomyelia secondary to midbrain gliomas.

Three cases of midbrain gliomas are descrbied clinically and pathologically. In each case high pressure symptoms were followed by visual disturbance and the onset of syringomyelia symptoms before death. All the patients had hydrocephalus. In one case with concomitant syringobulbia, the syrinx appeared to due to CSF communicating with the cord cavity through the tissues of the brain stem. In the other cases the communication between the CSF pathways and the syrinx was at the usual site, through the central canal at the obex.

Adolescent↗
PubMed1977

Aqueduct stenosis. Case review and discussion.

Twenty-seven cases of hydrocephalus associated with aqueduct stenosis are reviewed, and a further nine cases discussed in which hydrocephalus was present and the aqueduct was stenosed but some additional feature was present. This was either a meningocoele or an encephalocoele, or else the aqueduct was not completely obstructed radiologically at the initial examination. The ratio of the peripheral measurement from the inion to the nasion to the distance between the inion and the posterior lip of the foramen magnum is presented for each case with an outline of the ventricles. The cases behave as would be expected if the aqueduct was being blocked by the lateral compression of the mid-brain between the enlarged lateral ventricles. On reviewing these cases and other evidence it is suggested that non-tumourous aqueduct stenosis is more likely to be the result of hydrocephalus than the initial cause. The response to treatment is reviewed and a high relapse rate noted. It is suggested that assessment of the extracerebral pathways may be advisable before undertaking third ventriculostomy or ventriculo-cisternostomy.

Adolescent↗