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Biomedical subjects

W C Winn

Publications and source records attributed to W C Winn.

At least 55 records · Page 3Linked to original sources
PubMed1981

Extrathoracic localization of Legionella pneumophila in Legionnaires' pneumonia.

Extrathoracic organs of 12 fatal cases of Legionnaires' disease from the 1977 Vermont epidemic were reviewed for the presence of Legionella pneumophila. The bacteria were identified by direct immunofluorescence microscopy of paraffin-embedded spleen, liver, lymph node, and kidney tissue. Extrathoracic bacteria were demonstrated in six of the 12 cases (3/7 spleens, 2/9 livers, and 2/10 kidneys). In the liver and spleen, the legionellae were associated with cells of the reticuloendothelial system. In the kidney, the bacteria were restricted to the interstitium and renal tubules. There were no acute inflammatory lesions in any of these organs. The distribution of bacteria in the extrathoracic viscera is compatible with dissemination through the blood stream.

Fluorescent Antibody Technique↗
PubMed1981

Legionnaires' disease in Vermont. 1972-1976.

One hundred four autopsy cases with previously diagnosed pneumonitis were examined for evidence of Legionnaires' disease. The peak epidemic months of July, August, and September in the five years before the 1977 Vermont epidemic were chosen for study. The bacterium, Legionella pneumophila (serogroup 1) was demonstrated in lung tissue by direct immunofluorescence and the Dieterle silver impregnation stain. There was no clustering of Legionnaires' disease in any one year., The clinical presentation and pulmonary pathology were similar to that of Legionnaires' disease previously reported in Vermont. Seven out of 104 cases were identified as previously undiagnosed Legionnaire's disease. In this time frame, it can be concluded that the disease has been endemic in Vermont.

Adult↗
PubMed1981

Exflagellation of malarial parasites in human peripheral blood.

Exflagellation of microgametocytes in malarial parasites is associated with the life cycle in the mosquito. However, it is not found with the usual developmental phases in humans. This report describes two case reports where exflagellation of microgametocytes was observed in vitro in patients documented to have Plasmodium vivax malaria.

Adult↗
PubMed1980

Evaluation of Uricult dip slide in two hospital populations.

The Uricult dip slide was compared to traditional methods of bacterial isolation and quantitation in two different hospital wards. In a chronic care ward for patients with spinal cord injuries, the correlation of the dip slide and pour plate results was 96 per cent; there were very few specimens which had colony counts between 10(4) and 10(5) per ml. In a busy emergency room, the correlation between the dip slide and quantitative loop techniques was 75 per cent. In this population 18 per cent of the dip slide and 2l per cent of the calibrated loop cultures yielded colony counts between 10(4) and 10(5) per ml., and most of these cultures contained a mixture of bacteria. The results show that the Uricult dip slide performs well under ideal conditions. The dip slide can alleviate, but not eliminate, the problem of mixed bacterial growth at 10(4) to 10(5) colones per ml. The usefulness of the slide must be assessed in relation to the patient population and clinical situation in which it is to be employed.

Bacteriological Techniques↗
PubMed1980

Direct immunofluorescent detection of Legionella pneumophila in respiratory specimens.

Respiratory secretions from patients with clinically suspected Legionnaires pneumonia were examined by direc immunofluorescent tests at the Medical Center Hospital of Vermont and at the Center for Disease Control. No fluorescent bacteria were found by either laboratory in eight specimens from eight patients who were seronegative. Twenty specimens were obtained from seven patients who had serologically confirmed Legionnaires disease. Four of the seven cases were identified at the Medical Center Hospital of Vermont, and six of the seven were identified at the Center for Disease Control. Of 20 specimens, 8 were positive at the Center for Disease Control (six or more bacilli per slide), and 7 specimens were suspicious (one to five bacilli per slide); at the Medical Center Hospital of Vermont, 4 of 20 specimens were positive, and 2 were suspicious. The inclusion of a rhodamine-conjugated counterstain at the Center for Disease Control facilitated the examination and may have improved the sensitivity. Smears from transtracheal aspirates, bronchoscopic aspirates, transcutaneous lung aspirates, pleural fluids, and tracheal aspirate-expectorated sputum produced positive results. Several specimens contained fluorescing bacilli when stained for serogroup 2 as well as serogroup 1, perhaps reflecting the presence of cross-reacting antigens in vivo.

Bacteria↗
PubMed1980

Pyelonephritis associated with Legionella pneumophila, serogroup 4.

A patient with bladder carcinoma metastatic to lung and brain died of pneumonia. Autopsy examination showed a confluent bronchopneumonia with several small abscesses and acute pyelonephritis with abscess formation. Legionella pneumophila, serogroup 4, was isolated in pure culture from lung tissue postmortem and was also shown by direct immunofluorescence in the kidney and spleen. In the kidney, the organism was noted in areas of acute pyelonephritis. This represents the first case of an extrathoracic inflammatory lesion associated with L. pneumophila.

Humans↗
PubMed1979

Rapid diagnosis of Legionnaires' disease by direct immunofluorescent staining.

A blind reading of direct immunofluorescent staining of sputum smears was positive in five of 21 patients with Legionnaires' disease and none of 47 control patients. Positive slides showed from eight organisms per smear (one slide) to 20 to 100 organisms per oil-immersion (magnification, 100) field (three slides). Two of the positive specimens were obtained through an endotracheal tube, one at bronchoscopy, and the other positive slides were from expectorated specimens. In addition, two open-lung biopsies and a bronchial lavage sediment from three confirmed cases of Legionnaires' disease were positive by direct immunofluorescent staining for Legionnaires' disease bacterium.

Fluorescent Antibody Technique↗
PubMed1979

Legionnaires' disease in patients with associated serious disease.

Of nine patients with Legionnaires' disease, seven were receiving corticosteroids, and all nine had serious underlying diseases. Direct immunofluorescent examination of respiratory secretions, including sputum and transtracheal aspirates, showed the Legionnaires' disease (LD) bacterium in five of seven patients who seroconverted and in a sixth patient with a single elevated titer to the LD bacterium. All nine patients received erythromycin therapy, and five survived. Two patients showed persistence of their infection after receiving 2 weeks of erythromycin therapy, and two patients developed pulmonary abscesses. These cases of Legionnaires' disease show the occurrence of pulmonary abscesses, the possibility of relapse after giving only 2 weeks of erythromycin therapy, and the utility of direct immunofluorescence for early diagnosis.

Adrenal Cortex Hormones↗
PubMed1979

Macroscopic pathology of the lungs in Legionnaires' disease.

We used the whole lung section technique to review the macroscopic pathology in 12 patients who died with Legionnaires' disease. None of these patients had been treated with erythromycin. Consolidation was evenly distributed throughout all lobes without a consistent segmental distribution. The smallest lesions were around bronchioles or bounded by lobular septa. In most cases there was confluent involvement of multiple lobules. Extensive consolidation made distinction between a lobar and confluent lobular distribution difficult. Abscesses were present in two cases and nodular infiltrates in two others. In five additional patients, Legionnaires' disease had been treated with erythromycin. Four had a clinical response to treatment, and the fifth had diffuse staphylococcal pneumonia as the predominant lesion. Because the lungs of all five patients contained bacteria other than the Legionnaires' disease bacterium at the time of autopsy, it was difficult to ascertain the role of Legionnaires' disease bacterium in the pathology.

Bacteria↗
PubMed1979

Ultrastructure of lung in Legionnaires' disease. Observations of three biopsies done during the Vermont epidemic.

Open lung biopsies from three patients with Legionnaires' disease were examined by light and transmission electron microscopy. The patients had serious underlying disease. All developed a rapidly progressive pneumonia unresponsive to penicillin, oxacillin, and gentamicin. One patient, who received erythromycin, survived. Light microscopy in all three showed severe acute bronchopneumonia. The Legionnaires' disease bacterium was seen in tissue sections and confirmed by direct immunofluorescence. Transmission electron microscopy showed numerous rod-shaped intracellular organisms that were morphologically similar to other gram-negative bacteria and the Rickettsieae. They were within phagolysosomes, free in the cytoplasm, and rarely within structures resembling dilated rough endoplasmic reticulum. Lung tissue changes included marked detachment and necrosis of alveolar pneumocytes, septal and alveolar exudate with lysis, and prominent endothelial cell swelling and degeneration. Capillary and epithelial basement membranes were consistently intact, suggesting that the tissue changes are potentially capable of reverting to normal structure and function.

Adult↗
PubMed1978

Campylobacteriosis in man: pathogenic mechanisms and review of 91 bloodstream infections.

Five patients with Campylobacter fetus(previously called "Vibrio fetus") bacteremia are presented with enteric symptoms in four patients, a self-limited course in three, and with possible nosocomial infection in one patient who had disseminated malignancy. The clinical syndromes of 91 bacteremic patients with campylobacteriosis and C. fetus taxonomy and pathogenicity are reviewed. Studies of potential pathogenic mechanisms in enteric infections failed to reveal the production of either heat-stable or heat-labile, cholera-like enterotoxin, cytotoxicity or invasiveness. In comparison with different species of vibrio infections, C. fetus appears to produce disease by a different mechanism, one which involves a bloodstream infection, perhaps following penetration through the intestinal mucosa as has been demonstrated experimentally with salmonellae and yersinia. Such a pattern is consistent with the clinical pattern of C. fetus infections and the experimental studies reported herein.

Adult↗
PubMed1978

Absent tricuspid valve with aortic atresia in mixed levocardia (atria situs solitus, L-loop). A hitherto undescribed entity.

Clinical, angiographic and pathologic features are described in a 36-hour-old male infant with mixed (discordant) levocardia, aortic valve atresia, absent tricuspid (left atrioventricular) valve and resultant massive cardiomegaly. This is the first reported case of this type of complex in a heart with discordant chambers. A possible embryologic explanation is offered for the concomitant presence of semilunar valve atresia and absence of the tricuspid valve.

Aortic Valve↗
PubMed1978

The pathology of Legionnaires' disease. Fourteen fatal cases from the 1977 outbreak in Vermont.

Fourteen fatal cases from the 1977 Vermont outbreak of Legionnaires' disease have been analyzed. Serious underlying diseases were present in all patients. The only consistent lesions were in the lungs. Bronchopneumonia was present in all cases and was confluent in most. No lobe of the lung was preferentially involved and consolidation was usually bilateral. Abscesses were evident macroscopically in only two cases. Microscopically, there was an extensive alveolar infiltrate of polymorphonuclear neutrophils and macrophages. Lysis of the inflammatory cells was frequently present and was associated with an increased number of bacteria. Coagulative necrosis of lung was present in a few cases, and the possibility of a bacterial toxin must be considered. Bacteria were well stained by the Dieterle stain and appeared Gram-negative in tissue imprints from the unfixed lung.

Adolescent↗
PubMed1977

Acute silicosis in tombstone sandblasters.

Four men developed silicosis after sandblasting tombstones for an average of 35 months; 3 of them died an average of 59 months after their first exposure to sandblasting. Lung tissue demonstrated noncaseating granulomas and silicotic nodules involving small arteries and veins in 3 patients and alveolar proteinosis in 2. X-ray energy spectrometry showed primarily elemental silicon in the lung parenchyma. One patient developed lupus erythematosus and another focal glomerulonephritis. Two developed pneumothorax. None had cultural or morphologic evidence of tuberculosis. Pulmonary function studies in all 4 patients revealed a restrictive pattern. Industrial investigations revealed that the patients wore inadequate personal protection equipment and were exposed to 5 times the threshold limit value for respirable silica.

Acute Disease↗
PubMed1976

Early lymphoreticular viral tropism and antigen persistence. Tamiami virus infection in the cotton rat.

Tamiami virus was inoculated into its natural reservoir host, the cotton rat (Sigmodon hispidus), and the course of infection was followed by sequential organ titrations, frozen-section immunofluorescence, and light and electron microscopy. In animals infected at 2 days of age, there was an early lymphoreticular tropism with peak concentrations of virus and viral antigen in lymph nodes, splenic white pulp, thymus, and bone marrow at 16 days postinoculation. Megakaryocyte infection was early and pronounced. Viral antigen concentration peaked in liver and salivary glands at day 30 and in kidney, adrenal cortex, respiratory tract, and bladder epithelium at day 60-long after viral infectivity in these organs had disappeared. Central nervous system infection was only modestly productive of infectious virus, but viral antigen continued to increase in the brain until day 90 and then did not decline throughout the 360-day study. Reticuloendothelial hyperplastic foci were found late in some target organs, but there was never any histologic or ultrastructural evidence of cytonecrosis. Older animals were virtually uninfectable; therefore, this susceptibility of newborns and their slow termination of infection represent the key to virus transmission and perpetuation in nature. These aspects of viral natural history contribute to an understanding of human exposure to the pathogenic arenaviruses which exist in similar rodent niches.

Age Factors↗