Screening, ethics and the law.
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Biomedical subjects
Publications and source records attributed to E S Williams.
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Explore the source record for details and available documents.
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Two patients developed cardiac tamponade from delayed hemorrhage into the pericardial sac following open heart surgery. The initial clinical manifestations of tamponade included nausea and dramatic elevations of serum aminotransferases, simulating acute hepatitis. To our knowledge, this presentation of cardiac tamponade has not been previously reported.
Vaginal cytology and vulva size were used to characterize the reproductive cycle of female black-footed ferrets (Mustela nigripes), Siberian polecats (M. eversmanni), and domestic ferrets (M. putorius furo). Emphasis was on black-footed ferrets because of the need to breed these critically endangered animals and on Siberian polecats because of the close taxonomic relationship to black-footed ferrets. Vaginal cytology of the 3 species of ferret is similar. Proestrus was characterized by an increasing percentage of superficial epithelial cells and enlargement of the vulva. During estrus, superficial cells were usually greater than or equal to 90% of epithelial cells in the vaginal lavage and after several days were fully keratinized. Neutrophils were more common during all stages of the estrous cycle in domestic ferrets than they were in the other species. Following copulation, percentage of superficial calls in the vagina declined and vulva swelling subsided. Large cells, probably of uterine symplasma origin, were observed in vaginal lavages following whelping or pseudopregnancy. Vaginal cytology is extremely useful in the reproductive management of black-footed ferrets and Siberian polecats. Knowledge of normal vaginal cytology could be applied to the diagnosis of female reproductive abnormalities in all 3 species.
A Mycobacterium bovis-infected herd of captive wapiti (Cervus elaphus nelsoni) in Colorado was depopulated after lesions of bovine tuberculosis were confirmed in 8 of 10 tuberculin skin test reactors. Of the 43 animals > 1 year of age, 26 had gross lesions suggestive of tuberculosis, 24 had microscopic lesions of tuberculosis, and 23 had acid-fast bacilli associated with the lesions. Lungs and retropharyngeal lymph nodes were the most frequently affected sites. Most lesions grossly and microscopically resembled tuberculosis in cattle; however, some lesions resembled abscesses or ovine caseous lymphadenitis lesions. Special stains and immunohistochemical techniques labeled few to numerous mycobacteria associated with the lesions.
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The known host range of naturally-occurring transmissible spongiform encephalopathies has expanded in recent years to include wild ruminants. Chronic wasting disease (CWD) occurs in mule deer (Odocoileus hemionus hemionus) and Rocky Mountain elk (Cervus elaphus nelsoni) in Colorado and Wyoming, United States of America. These species belong to the family Cervidae. Cases have occurred primarily in captive animals but a few affected free-ranging animals have been identified. Clinical disease in both species is characterised by progressive weight loss, behavioural alterations and excessive salivation. In deer polydipsia and polyuria also commonly occur. Significant lesions are confined to the central nervous system and consist of spongiform change in grey matter, intraneuronal vacuolation, astrocytosis and amyloid plaques. Inflammatory reaction is absent. The origin of this disease is not known. In contrast to the cases of spongiform encephalopathy recognised in five species of antelope (family Bovidae) in British zoological parks, which are an extension of the current bovine spongiform encephalopathy epizootic, CWD is not the result of food-borne exposure to the infectious agent. CWD appears to be maintained within captive populations by lateral and, possibly, maternal transmission. Spongiform encephalopathies in wild ruminants are currently geographically isolated and involve relatively small numbers of animals. However, these potentially transmissible diseases could be of greater importance in the future and should be viewed with concern in the light of international movements of wild ruminants and the current expansion of the game farming and ranching industry in many parts of the world.
Scrapie amyloid-immunoreactive plaques are present in brain tissues of captive mule deer with chronic wasting disease (CWD), a progressive neurological disorder characterized neuropathologically by widespread spongiform change of the neuropil, intracytoplasmic vacuolation in neuronal perikarya and astrocytic hypertrophy and hyperplasia. We report here the immunolocalization of scrapie amyloid (PrP27-30) in plaques observed in brain tissues of Rocky Mountain elk (Cervus elaphus nelsoni) and hybrids of mule deer and white-tailed deer (Odocoileus virginianus) naturally affected with CWD. Similar findings have been shown in kuru, Creutzfeldt-Jakob disease, and Gerstmann-Sträussler syndrome in humans. Our data corroborate that CWD in Rocky Mountain elk and hybrids of mule deer and white-tailed deer belongs to the subacute spongiform virus encephalopathies (transmissible cerebral amyloidoses).
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Chronic wasting disease (CWD), a progressive neurological disorder of captive mule deer, black-tailed deer, hybrids of mule deer and white-tailed deer and Rocky Mountain elk, is characterized neuropathologically by widespread spongiform change of the neuropil, intracytoplasmic vacuolation in neuronal perikarya and astrocytic hypertrophy and hyperplasia. We report the topographic distribution of amyloid plaques reactive to antibodies prepared against scrapie amyloid in CWD-affected captive mule deer (Odocoileus hemionus hemionus). Scrapie amyloid-immunoreactive plaques were found in the cerebral gray and white matter, in deep subcortical nuclei, in isolation or in clusters in areas of vacuolation, and perivascularly, in subpial and subependymal regions. In the cerebellum, immunoreactive amyloid plaques were observed in the molecular, pyramidal and granular layers. Scrapie amyloid-immunoreactive deposits were also seen in neuronal perikarya. Furthermore, amyloid plaques in CWD-affected captive mule deer were alcianophilic at 0.3 M magnesium chloride indicating the presence of weakly to moderately sulfated glycosaminoglycans. Our data corroborate that CWD in captive mule deer belongs to the subacute virus spongiform encephalopathies.
A review of the United Kingdom (UK) multiple sclerosis (MS) literature suggests that over the last three decades prevalence and estimated incidence rates have increased, while mortality rates have been declining. UK mortality data over a 30 year period have been studied to examine temporal and geographical variations, to estimate changes in survival, and to examine the relationship between mortality and morbidity trends. The study has shown an overall decline in mortality throughout the UK of approximately 25% over the 30 year period ending in 1983, and a reduction in the mortality differential between Scotland, and England and Wales, but no positive correlation has been found between mortality and morbidity. The overall decline in death rate in females was 23% and in males 30% over the 30 years of the survey. The total number of deaths declined by 39% between the five year periods 1954-58 and 1979-83 in Scotland compared with a 10% decline for England and Wales. Estimated median age of death increased from 52 to 59 years and the improvement in survival over the period of study was similar for both countries and is unlikely to have contributed to the reduction in mortality differential. Within England and Wales regional mortality rates did not show a clear north-south gradient. The decline in the mortality differential between Scotland and England (if not artefactual) may provide an important aetiological clue in the search for the cause of multiple sclerosis, and the rate of decline suggests an environmental rather than a genetic aetiology.
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Eight domestic ferrets (Mustela putorius furo) and two Siberian polecats (M. eversmanni) were inoculated subcutaneously with 12 to 1.2 x 10(7) Yersinia pestis originally isolated during an epizootic of plague in white-tailed prairie dogs (Cynomys leucurus) near Meeteetse, Park County, Wyoming (USA) in 1985. None of the ferrets or polecats developed clinical signs of disease which suggested that black-footed ferrets (M. nigripes), a congener, also would be resistant to plague. All animals receiving greater than or equal to 1.2 X 10(3) organisms produced serum antibodies detected by the passive hemagglutination test with titers peaking at 1:1,024 and remaining positive until at least 219 days postinoculation. Sera collected from 12 free-ranging black-footed ferrets near Meeteetse in 1984 and 1985 were negative for antibodies against Y. pestis. Prevalence of antibodies against Y. pestis was high in other carnivores collected from the same area in 1986.
We observed clinical signs, compared adrenal responses, and performed diagnostic tests on 12 captive Rocky Mountain bighorn sheep (Ovis canadensis canadensis) during a spontaneous outbreak of pasteurellosis. Cortisol in urine and feces was measured for bighorns sampled three times between 20 October and 1 November 1986. By 6 November, four of these had developed pneumonia, four showed only mild rhinitis, and four remained clinically normal. Bighorns that ultimately developed pneumonia showed elevated mean urinary (P = 0.003) and fecal (P = 0.046) cortisol excretion over the 12-day sampling period. Twenty-four hour mean urine cortisol: creatinine ratios ranged from 10 to 57 ng/mg dry matter for affected and 5 to 22 ng/mg for healthy individuals; 24 hr mean fecal cortisol concentrations ranged from 7.2 to 20 ng/g dry matter for affected and 3.6 to 9.1 ng/g dry matter for healthy individuals. Elevated cortisol excretion preceded clinical pneumonia in affected bighorns by less than or equal to 16 days. Beta-hemolytic Pasteurella haemolytica biotype T, serotype 3 or 4, was isolated from nasal and pharyngeal swabs from all eight bighorns with pneumonia or mild rhinitis. We detected no evidence of parainfluenza 3, bovine respiratory syncytial virus, or Chlamydia psittaci using fluorescent antibody and/or serologic tests. Although elevated cortisol excretion was associated with pneumonia, we also believe age, reproductive physiology, and/or prior recovery from clinical pasteurellosis may have influenced individual susceptibility to pneumonia during this epizootic.