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Biomedical subjects

D H Wilson

Publications and source records attributed to D H Wilson.

At least 19 recordsLinked to original sources
PubMed1992

South Australian hypertension survey. General practitioner experiences with drug treatment.

OBJECTIVE: To investigate prescribing habits, educational approaches and perceived needs of general practitioners in the drug treatment of hypertension. DESIGN, SETTING AND PARTICIPANTS: Of 156 randomly selected South Australian general practitioners 132 responded to a questionnaire survey. MAIN FINDINGS: Diuretics are the most commonly chosen drug for the initial management of uncomplicated moderate hypertension. Equivalent patients aged 45, 60 and 75 years would be prescribed a diuretic as drug of first choice in 41%, 55% and 68% of cases respectively. Despite this, there are wide differences in the choice of initial therapy between individual practitioners. These differences can have a substantial cost impact, given that in Australia the cost of diuretic therapy for one month can be as low as $1.97 compared with $34.08 for standard angiotensin converting enzyme inhibitor therapy for one month. There was also a perceived need, and demand, for patient education materials to assist practitioners in the drug treatment of hypertension.

Adult↗
PubMed1992

South Australian hypertension survey. General practitioner knowledge and reported management practices--a cause for concern?

OBJECTIVE: To survey South Australian general practitioners to investigate their knowledge and reported management of patients with hypertension. DESIGN, SETTING AND PARTICIPANTS: Of 156 randomly selected SA general practitioners 132 responded to a questionnaire survey. RESULTS: This survey showed substantial differences between general practitioners in their knowledge about hypertension and in their reported practices for diagnostic levels, investigations to be undertaken once diagnosis had been made, levels at which pharmaceutical treatment should be initiated, at which level treatment was regarded as having attained satisfactory control, and length of time for routine review. There was also a demand for materials to be provided to assist in the management of this important condition. CONCLUSIONS: There is a perceived need for better and more appropriate educational materials and a need for a different approach to try and reduce the reported variability in management of patients with hypertension by general practitioners.

Aged↗
PubMed1991

Generation of T cells with lytic specificity for atypical antigens. I. A mitochondrial antigen in the rat.

F1 rats primed with normal parental strain lymphocyte populations and restimulated in culture with parental lymphoblasts generate potent cytotoxic T cell responses to unusual antigen systems. Here we describe in the Lewis (L)/DA anti-DA combination an antigen system most likely of mitochondrial origin with the following properties: it is transmitted maternally from DA strain females, inherited in an extra-chromosomal manner, restricted by class I RT1Aa major histocompatibility complex gene products, extinguished on target cells treated with chloramphenicol, and its pattern of expression in different rat strains correlates with restriction fragment-length polymorphisms of mitochondrial DNA. Sequence analysis of the rat ND1 gene indicates that the maternally transferred factor in the rat is not a homologue of the maternally transmitted factor responsible for the mitochondrial antigen in mice. In keeping with its inheritance from DA females, this antigen is present on target cells from (DA female x L male)F1 donors and all other F1 combinations derived from DA female parents, but absent from target cells from some F1 combinations (L/DA and Wistar-Furth [WF]/DA) derived from DA strain males. The presence of this antigen in other F1 combinations (Brown Norway [BN]/DA, August 2880 [AUG]/DA, and PVG/DA) indicates that this mitochondrial antigen system is shared by the DA, BN, and PVG strains, but not by the L and WF strains.

Amino Acid Sequence↗
PubMed1979

AID for lesbians.

Explore the source record for details and available documents.

Ethics, Medical↗
PubMed1979

SSW and dichotic digit results pre- and post-commissurotomy: a case report.

A 19-year-old right-handed male with normal peripheral hearing bilaterally, was tested on the SSW and dichotic digits before and after commissurotomy. SSW results showed a definite deficit for words presented to the left ear in both the competing and noncompeting conditions. Dichotic digit results showed complete inability on the part of the subject to report the digits presented to the left ear. These findings are similar to other dichotic test results previously reported on split-brain patients.

Adult↗
PubMed1979

Plasticity in speech organization following commissurotomy.

For three-and-a-half years we have been studying the cognitive and conscious mechanisms in a remarkable 18-year-old man: Case P.S. This unique individual had his corpus callosum divided in order to control intractable epilepsy. Although for some time after the operation he appeared like other split-brain patients, unable to describe verbally stimuli directed to his mute right hemisphere, he behaved as if he was capable of comprehending a wide range of language-related stimuli directed to that hemisphere. Spelling by choosing the appropriate letters with his left hand, he could process nouns, verbs, rhymes, antonyms, and superordinate concepts. When asked about tachistoscopic presentations delivered to his left visual field, he either said he had seen nothing, or only a flash of light. He was also unable to identify verbally tactile 'sterognostic' inputs to his left hand. In the last year P.S. has begun to speak about stimuli directed to his right hemisphere. This series of experiments suggests that this speech is not interhemispheric transfer within the visual modality. Further, plotting the relative increased proficiency of verbal description of inputs directed to the right hemisphere, this speech system seems to be in a process of continuing development.

Cerebral Cortex↗
PubMed1979

Microsurgical lumbar discectomy: preliminary report of 83 consecutive cases.

The application of microsurgical technique to lumbar discectomy may be of dual value: minimal disruption of the integrity of normal anatomy and meticulous hemostasis may help to speed the process of convalescence, and the retention of epidural fat around the nerve root may help to prevent adhesions, a common cause of the late, "failed disc" syndrome. The authors report their experience with 83 consecutive microdiscectomies for lumbar disc protrusions. The results must be considered as tentative because the follow-up period has been short and the authors found it difficult to quantify the quality of health during the convalescent phase, although this seemed to be excellent. Their short term results are similar to those of the larger series reported by Williams, whose experience with microsurgical lumbar discectomies began 6 years ago. No other series have been reported. The authors describe their technique and compare it to that of Williams.

Adult↗
PubMed1978

Block design performance following callosal sectioning. Observations on functional recovery.

A patient with complete surgical section of the corpus callosum was tested on a constructional task 17 months post-operatively. The left and right hands were separately tested under conditions of free visual exposure and lateralized visual field exposure. The results suggest that the typically observed improved performance of the right hand with increasing postoperative time is attributable to the acquisition of homolateral control over the right hand by the right hemisphere. The implications for left-right brain organization and the syndrome of constructional apraxia are considered.

Adolescent↗
PubMed1978

Division of the corpus callosum for uncontrollable epilepsy.

Cerebral commissurotomy, the "split-brain" procedure, has been employed for the control of intractable seizures, in conjunction with moderate doses of anticonvulsant drugs. The results have been encouraging in several small series. The use of microsurgical techniques and the restriction of surgery to one commissure, the corpus callosum, has reduced morbidity without apparent change in result. The eight patients in our first series who underwent the prescribed division of several forebrain commissures are compared to the four patients in our second series who underwent division of the corpus callosum alone. The technique of callosotomy is described.

Adult↗
PubMed1978

Surgery of the carpal tunnel. Technical note.

The authors describe a modified technique for surgery of the carpal tunnel. The primary cause of the carpal tunnel syndrome is the same as other entrapment neuropathies: an enlarged nerve within a tight tunnel. Electrical studies have shown that the area of compression is in the middle of the tunnel. Treatment is surgical: a palmar incision, which begins at the wrist medial to the palmaris longus, to avoid damage to the sensory branch of the median nerve; and selection of the retinaculum from the exit of the tunnel toward the entrance.

Carpal Tunnel Syndrome↗
PubMed1977

The generation of killer cells to trinitrophenyl-modified allogeneic targets by lymphocyte populations negatively selected to strong alloantigens.

Negatively selected mouse and rat lymphocyte populations, specifically deprived of alloreactivity to a particular major histocompatibility complex (MHC) haplotype, are nevertheless fully capable of responding to trinitrophenyl (TNP)-modified allogeneic stimulator cells and developing cytotoxic T-lymphocyte activity to TNP-altered allogeneic target cells. As for syngeneic systems, lytic expression of those responder killer cells also requires MHC identity between the target and stimulator cell populations. Such a finding argues strongly against two variations of the dual recognition hypothesis: like-like interactions and adaptive differentiation. Instead, these data favor either the altered self model or a third variation of the dual receptor model, where one of the relevent receptors is specific for the modifying antigen and the second is a low affinity receptor unable to be triggered in the absence of a modifying antigen.

Animals↗
PubMed1977

A divided mind: observations on the conscious properties of the separated hemispheres.

Each cerebral hemisphere in Patient O.S., a callosum-sectioned patient, appears to possess mental properties deserving of conscious status. The observations seem to answer many questions concerning the issue of whether the mechanisms of consciousness can be split and doubled by split-brain surgery. As P.S. is the first split-brain patient clearly to possess double conscious processes as well as the first with extensive bilateral linguistic skills, the observations suggest that the special nature of human conscious experience is closely tied to linguistic processes.

Child↗
PubMed1977

Diagnosis of acute abdominal pain in the accident and emergency department.

This paper reports the findings in a study involving 1537 patients with 'acute abdominal pain' presenting over a 13-month period to the Accident and Emergency Department of the General Infirmary at Leeds. Of these, 341 patients who proved to have pain of greater duration than a week, pain incidental to some other identifiable condition or no pain at the time of their attendance were excluded. The remaining 1196 were diagnosed clinically (using a structured case sheet) and subsequently by a Bayesian computer system. Feedback of the results of clinical and computer systems was given to clinicians at regular intervals. Clinical diagnostic accuracy in patients with surgical disorders rose from 40 per cent before the study to 61 per cent. Computer accuracy in these patients was 69-9 per cent. The proportion of patients sent home without ill effects rose from 20 per cent to 39 per cent. In other areas (e.g. gynaecology) the effects were less marked. It is suggested that the introduction of a simple postgraduate educational service, aided by a small computer, might prove of practical benefit in this clinical situation.

Abdomen, Acute↗
PubMed1977

Computer-aided diagnosis of lower abdominal pain in women.

This paper describes the use of a system of computer aided diagnosis in an unselected, prospective survey of 393 women suffering from lower abdominal pain of less than 1 week's duration. An accurate diagnosis was made by clinicians at first patient contact in 68-5 per cent of the group of patients. The computer's diagnostic prediction (based on the same data) matched the final diagnosis in 81-6 per cent of the patients. During this survey a marked improvement in diagnostic accuracy was observed amongst the junior clinicians. It is suggested that this is because of the discipline of data collection imposed and the intermittent feedback received, and also that this educational aspect of computer usage may be of wider benefit.

Abdomen↗