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Biomedical subjects

R Williams

Publications and source records attributed to R Williams.

At least 19 recordsLinked to original sources
PubMed1979

De novo acute infection and reactivation of hepatitis B virus in established cirrhosis.

Five patients with cirrhosis proved by biopsy had clinical, biochemical, and serological evidence of an acute hepatitis B infection. In two the illness was fulminant and led to death. Only one patient completely recovered. Serological markers for the hepatitis B virus were absent before the onset of the acute illness in four patients, which suggested that a de novo infection had been acquired as a result of recent transfusions of blood or blood products. The fifth patient, who had Goodpasture's syndrome, had antibody to the core of hepatitis B virus, indicating previous exposure to the virus; his acute hepatitis may have been related to immunosuppressive drug treatment, which may have reactivated a dormant virus infection. Thus an acute type B viral hepatitis due to either a de novo or a reactivated infection may be superimposed on cirrhosis.

Acute Disease↗
PubMed1979

Use of partial cardiopulmonary bypass during the anhepatic phase of orthotopic liver grafting.

Femoro-femoral partial cardiopulmonary bypass has been used in two patients under going orthotopic liver allografting who had severe cardiovascular disturbances on trial clamping of their venae cavae. Flows of 2-3 litres/min resulted in satisfactory cardiovascular control during the anhepatic phase in each ase. A third patient who tolerated caval clamping withstood the grafting without bypass. Having bypass available for use in critical cases could increase the safety of orthotopic liver transplantation.

Adult↗
PubMed1979

Non-operative arterial embolisation in primary liver tumours.

Three patients with primary hepatic tumours were treated by selective arterial embolisation with gelatin-foam fragments to induce necrosis. In the two with histologically proved hepatocellular carcinoma ultrasonography suggested that necrosis had been induced, as did the rapid initial falls in serum alpha-fetoprotein concentration by 95 and 81% of the original values respectively. Treatment was continued with a course of adriamycin, and both patients remained well and symptom free at 10 and 12 months. In the third patient, who had an expanding and highly vascular benign hepatic adenoma associated with use of a contraceptive pill, embolisation obliterated the tumour mass. Tumour embolisation should be regarded as only the first step in managing hepatocellular carcinoma and as a means of reducing appreciably the viable tumour mass before chemotherapy. It may be used as the primary and definitive treatment in patients with benign liver tumours.

Adenoma↗
PubMed1979

Increased hepatic copper concentration in Indian childhood cirrhosis.

19 Indian children with liver disease were studied. 5 in whom a clinical and histological diagnosis of Indian Childhood Cirrhosis was made had massive orcein-staining deposits in liver cells. The hepatic copper content in these 5 cases was strikingly high (1389 microgram/g dry tissue, range 1045--2303) the normal range being 15--55 microgram/g. Of the other 14 cases, only 2 had hepatic copper levels above normal (170 and 262 microgram/g.) This high hepatic copper concentration may be caused by excessive copper ingestion or an abnormality of copper metabolism.

Coloring Agents↗
PubMed1979

Non-A non-B hepatitis associated with chronic liver disease in a haemodialysis unit.

To clarify the aetiology of an outbreak of HBsAg-negative acute hepatitis in the renal unit at Fulham Hospital in 1968--70, serological tests for antibody to hepatitis-A virus (anti-H.A.V.) were done retrospectively on serum samples obtained at the time of the outbreak. 7 patients had had two previous episodes of clinical HBsAg-negative hepatitis. Serum samples were available from 24 of the 29 infected patients, and these were paired in 12 instances. There was a slight increase in the titre of anti-H.A.V. in 1 patient, and a further 2 patients who subsequently developed chronic hepatitis showed a decrease in titre, but no changes in titre were detected in the remaining 21 cases. These findings do not provide evidence for the involvement of hepatitis-A virus in the outbreak of hepatitis and effectively exclude a role for this virus in the chrnoic liver disease which developed subsequently in 8 (28%) of the patients. This outbreak is therefore probably non-A non-B hepatitis, which has not been reported previously in Great Britain in a haemodialysis unit. The results confirm that this form of hepatitis may be related to a high frequency of persistent hepatic dysfunction.

Antibodies, Viral↗
PubMed1979

Transmission of non-A non-B hepatitis to chimpanzees by factor-IX concentrates after fatal complications in patients with chronic liver disease.

6 cases of non-A non-B hepatitis which followed administration of four different batches of concentrates of coagulation factor IX from commercial and non-commercial sources are described. Of 17 patients who received the concentrate on account of chronic liver disease, 4 developed hepatitis, and in 3 of these the illness proved fatal. The incubation periods ranged from 42 to 103 days (mean 65 days). 3 chimpanzees were inoculated with concentrate from the same batch used on the above patients, a further commercial batch upon which no adverse reactions had been reported, and plasma from a known non-A non-B carrier. All developed hepatitis after 10 weeks' incubation. Liver biopsy when serum-aminotransferase was at its highest level showed features consistent with acute hepatitis. As in the patients, viral markers for hepatitis A and B, cytomegalovirus, and Epstein-Barr virus were unchanged.

Acute Disease↗
PubMed1979

Benign inflammatory tumour of the common bile duct.

A rare cause of obstructive jaundice in childhood is presented. Ultrasound and subsequent percutaneous cholangiography demonstrated the site of obstruction. Histological examination of the resected tumour showed features consistent with a diagnosis of benign inflammatory tumour of the common bile duct.

Adolescent↗
PubMed1979

Adsorption of human serum albumin to Amberlite XAD-7 resin.

In the present study the conditions leading to tight binding of human serum albumin to the Amberlite XAD-7 resin without the use of chemical coupling agents have been defined. Optimal binding (10.97 mm/kg dry XAD-7) was achieved at pH 5.0 and adsorption conformed to a Langmuir isotherm. Theoretical analysis of the data suggest adsorption of a monolayer of albumin which is supported by the absence of visual surface coating on scanning electron micrographs. Binding of human serum albumin was reduced when two chemical coupling agents, glutaraldehyde and carbodiimide were included in the human serum albumin solution, the elution of adsorbed HSA from the resins under severe flow conditions was reduced, and the amount eluted was minimal in all instances.

Acrylic Resins↗
PubMed1979

Budd Chiari syndrome from myosarcoma of right atrium.

A 50-year-old man presented with abdominal pain followed by marked liver and renal dysfunction. Although liver scan appearances were not diagnostic, at laparotomy a tense, enlarged liver was found with thrombosis of the inferior vena cava. Despite full supportive measures the patient died within a month of laparotomy. Subsequent necropsy confirmed the diagnosis of Budd Chiari syndrome and revealed the primary cause to be a myosarcoma of the right atrium, an occurrence hitherto unreported.

Budd-Chiari Syndrome↗
PubMed1979

Platelet function in chronic liver disease: relationship to disease severity.

Abnormalities of platelet aggregation in response to adenosine diphosphate in 56 patients with chronic liver disease correlated with impairment of hepatocellular function but not with the etiology of the liver disease. Platelet-poor plasma from some patients appeared to contain an inhibitor since, in cross-over studies, it reduced the degree of aggregation of control subjects. However, platelet-poor plasma from some other patients enhanced aggregation in controls, and this was thought to be due to the presence of fibrin monomer. In the majority of patients with severe liver disease, platelet function still appeared defective, even after exclusion of the effects of plasma, and was independent of the platelet count in peripheral venous blood. Since patient platelet volumes were smaller than those of controls, these findings might be explained by deficiency of the larger hemostatically active type of platelet as a consequence of either bone marrow failure or splenic sequestration.

Adenosine Diphosphate↗
PubMed1979

Single arch extraction--upper first molars or what to do when nonextraction treatment fails.

The logical goal of treatment must be to correct a malocclusion to the nearest possible approach in all respects to a normal condition as we understand it. When extraction within the upper arch only is the desired treatment plan, removal of two upper first molars will produce the closest approach to normalcy in terms of the dentition's function, its health, its influence on facial features, and its appearance. With the removal of upper first molars for treatment purposes, the result will be a dentition that has all the magnificent appearance of a dentition that never had any extractions at all. It will be a dentition that can have good functional movements at the end of treatment and on into the posttreatment period.

Adolescent↗
PubMed1979

Minute eye movement during sleep.

The minute eye movements of 4 sleeping subjects were studied with a piezo-electric strain-gauge transducer. The frequency and amplitude of ocular microtremor activity diminished during sleep. Activity increased after auditory stimulation and with the appearance of a K complex in the EEG. The ocular microtremor activity also increased with the onset of rapid eye movement (REM). Low amplitude 'micronystagmoid' movements were observed at intervals throughout sleep. In contrast to the changes observed during sleep, ocular microtremor activity did not diminish during hypnosis. The transducer was far more sensitive than the conventional EOG recording system.

Acoustic Stimulation↗
PubMed1979

Renal sodium retention in cirrhosis: relation to aldosterone and nephron site.

1. In a group of patients with cirrhosis who showed a wide range of values for the rate of renal sodium excretion, the latter was found to be inversely related to both the plasma concentration and rate of renal excretion of aldosterone. However, for a given sodium excretion the values for aldosterone were significantly lower in the patients than for a group of healthy control subjects. These findings suggest either an increased renal tubular sensitivity to aldosterone or the participation of other factors in the pathogenesis of the sodium retention. 2. Based on measurements of the rate of urine flow and the clearances of free water and inulin during a maximal water diuresis, the fractional reabsorption of sodium by the 'proximal', 'diluting segment' and 'distal' segments of the nephron was estimated. For patients retaining sodium the enhanced reabsorption occurred at both proximal and distal sites, the latter being quantitatively more important. There was no significantly enhanced sodium reabsorption in the diluting segment.

Aldosterone↗