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Biomedical subjects

G W Ward

Publications and source records attributed to G W Ward.

At least 19 recordsLinked to original sources
PubMed1992

Aspergillus epidural abscess and cord compression in a patient with aspergilloma and empyema. Survival and response to high dose systemic amphotericin therapy.

A 57-yr-old man with a chronic lung cavity presumed to be related to ankylosing spondylitis and/or old cavitary tuberculosis presented with hemoptysis and rapidly developed lower extremity paresis and hypoesthesia. On chest radiograph he had a left upper lobe lesion suggestive of aspergilloma combined with a large left empyema with bronchopleural fistula. Serologic analysis demonstrated precipitins and very high titer IgG antibodies to Aspergillus fumigatus antigens. Decompressive laminectomy from T1 to T5 was performed, with drainage of A. fumigatus culture-positive material from an epidural abscess compressing the spinal cord. Chest drainage was required for control of the empyema. With a total course of 3 g of intravenously administered amphotericin B, rehabilitative therapy, and chronic empyema drainage, he is now at home and ambulatory with assistance. He is also being followed by regular serum assays of IgG antibodies to Aspergillus proteins. We report the case of an apparent long-term survivor of a formerly lethal and/or nonreversible paraplegic condition. The critical factors compared with previous cases with a poor outcome would appear to be prompt neurosurgical intervention, restoration of a normal number of T-cells, effective long-term chest drainage, and high dose amphotericin treatment.

Abscess↗
PubMed1977

Hypertension.

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Antihypertensive Agents↗
PubMed1976

Extrinsic allergic alveolitis after Aspergillus fumigatus inhalation. Evidence of a type IV immunologic pathogenesis.

Three weeks after a massive inhalation of mold present on infected oats, a farmer's wife had extrinsic allergic alveolitis. Aspergillus fumigatus was cultured from the moldy oats and from deep bronchial washings obtained at fiberoptic bronchoscopy. Spores and hyphae characteristic of Aspergillus species were demonstrated within granulomas in the pulmonary tissue obtained by transbrochial biopsy. Serum precipitins, delayed (48 hour) cutaneous hypersensitivity and in vitro lymphocyte transformation to A. fumigatus were demonstrated. The findings in this case suggest that a type IV immunologic response and subsequent (lymphocyte-mediated) tissue inflammation may underlie the pathogenesis of this and other forms of hypersensitivity pneumonitis.

Adolescent↗
PubMed1976

Immunologic studies in a case of baker's asthma.

A 28-year-old baker with 13 years of occupational experience has developed, over the past several years, sinusitis, rhinitis, contact dermatitis, and asthma. Clinically, all of his symptoms were felt to be related to occupational exposure. Immunologic evaluation consisted of the following tests: intradermal skin testing, leukocyte histamine release, total serum IgE, PK transfer with immunoadsorption, and specific antigen bronchial challenge. Analysis of results would tend to implicate a type I, IgE-mediated immunologic reaction.

Adult↗
PubMed1976

The effect of atropine and albuterol aerosols on the human bronchial response to histamine.

This study was designed to determine whether histamine-induced bronchoconstriction in human asthmatics is mediated by the parasympathetic nervous system and involves cholinergic pathways. Inhalation challenges were performed on 14 adult asthmatic patients using the standardized procedure for inhalation challenge recently recommended by the Asthma and Allergic Disease Centers panel. The effect of pretreatment with either aerosolized atropine sulfate or aerosolized albuterol, a specific beta-2 adrenergic agonist, was studied. The comulative units of histamine required for induction of a positive bronchial response (20% or greater drop in FEV1 from baseline) was used as the basis of comparison of the effects of these drugs. This value was expressed as the PD20-FEV1 to histamine. Analysis of the data showed that aerosolization of sufficient atropie to effect a cholinergic blockade, as shown by inhibition of the bronchial response to inhaled methacholine, only minimally affected the bronchial response to histamine (p less than 0.05). However, the administration of albuterol markedly shifted the response to histamine (p less than 0.005). Although there was a statistically significant change in the mean PD20-FEV1 to histamine following atropine blockade, this effect was small in comparison to that which could be demonstrated with a beta agonist. It would thus appear that the major influence of histamine is not through cholinergic pathways.

Administration, Intranasal↗
PubMed1976

Quantitative levels of immunoglobulin E in advanced tuberculosis.

Quantitative levels of immunoglobulin E (IgE) were determined in samples of sera obtained from 29 patients with proven moderate to far-advanced tuberculosis. The sensitive radioimmunoassay test for IgE was used. Statistical analysis of the results revealed no difference in IgE values as compared to a control group of normal sera. In contrast to other chronic pulmonary infections, such as bronchopulmonary aspergillosis, the IgE level in pulmonary tuberculous infection is of no diagnostic significance. Simultaneous determination of levels of immunoglobulins G, A, M, and D (IgG, IgA, IgM, IgD) in these same sera by radial immunodiffusion showed elevated IgG and lowered IgM levels in the tuberculous patients, confirming previous studies. The significance of these alterations in immunoglobulin levels is unclear and may represent a secondary phenomenon rather than a primary host response.

Adult↗
PubMed1975

C1-bypass complement-activation pathway in patients with chronic urticaria and angio-oedema.

During the routine screening of 152 patients with urticaria or angio-oedema for hypocomplementaemia, 4 patients were found to have low serum levels of the third component of complement (C). These patients were noteworthy and differed from previous reports of patients with urticaria-like skin lesions and hypocomplementaemia because of the absence of immune-complex disease. In addition to the low C3, 2 of these patients were unique on the basis of low serum levels of haemolytic C1, C1q, C1s, and properdin factor B, but normal concentrations of C4 and C2. These C abnormalities may reflect a new clinical entity, and these cases form the first description in man of the C1-bypass complement-activation pathway.

Adult↗
PubMed1975

The insertion of re-entrant cannulae in young calves and their maintenance for long periods.

Re-entrant duodenal cannulae were established in 8 calves 2 to 7 days of age and 1 calf at 11 weeks of age. They have been maintained for up to 12 months and collections of digesta from the calves are still in progress. Most difficulty in the maintenance of the cannulae in the calves was encountered when the calves were weaned from milk, due to repeated blockages of digesta in the elbows connecting the re-entrant system. It was found essential that calves were checked at 12 hour intervals or less so that blockages could be cleared and the fluid balance restored by the infusion of Ringer's solution into the connecting tubes of the cannulae.

Animals↗