Some reminiscences of a former medical officer of health and community medicine specialist with an interest in environmental health and communicable disease.
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History, 20th Century↗
Biomedical subjects
T S Wilson
Publications and source records attributed to T S Wilson.
Non-menstrual associated toxic shock syndrome.
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Adult↗
Outbreak of Legionnaires' disease in Glasgow Royal Infirmary: microbiological aspects.
The bacteriological investigation of an outbreak of Legionnaires' disease in Glasgow Royal Infirmary affecting 16 patients is described. Most of the patients had been treated in high-dependency areas on two floors of the hospital supplied by the same two air-conditioned ventilation systems. The source of infection was traced to contamination of a cooling tower from which a plume of spray discharged into the intake vents of the two ventilation systems. Rubber grommets within the cooling tower probably provided a nidus of infection there. The control and management of the outbreak are discussed: a policy of frankness about the course and progress of the investigations was adopted and helped to allay anxiety on the part of both staff and media.
Air Conditioning↗
Dietary copper intake in artificially fed infants.
Plasma concentrations of copper and zinc and leucocyte concentrations of zinc were measured in mothers during later pregnancy, at delivery, and 8-10 weeks after birth, and plasma concentrations of copper and zinc were measured in their infants at delivery and 8-10 weeks after birth. The 145 infants were either breast fed or fed one of two milk formulas supplying copper at different concentrations. None of the infants achieved the minimum copper intakes recommended by the World Health Organisation (WHO). At 2 months of age there were no major differences in growth or health detected in infants fed the different copper intakes. Infant birth weight correlated well with the ratio of maternal venous plasma zinc:maternal leucocyte zinc at delivery. Maternal venous plasma copper and zinc concentrations at birth correlated with umbilical venous plasma copper and zinc concentrations. Infants fed the higher copper content formulas had a low mean plasma zinc concentration without a significant increase in the mean plasma copper concentration. The present WHO recommendations regarding minimum copper intakes for infants fed formulas cannot be achieved with currently available formulas and are probably wrong.
Breast Feeding↗
Sleep disorders in hospital.
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Hospitalization↗
Rubella: immunity and vaccination in schoolgirls.
Of 191 schoolgirls, 128 volunteered to take part in a feasibility study of serotesting before and after rubella vaccination, and all responded to RA 27/3 vaccine. Had the serum samples been taken by a fingerprick method the number of volunteers would probably have increased considerably. A change in policy for rubella vaccination to testing both before and after vaccination would cost no more than the existing policy, would ensure primary response, and would differentiate those women who were protected by the vaccine from those with antibody to wild virus.
Adolescent↗
Histochemical studies of dense-core granulated tumors of the lung. Neuron-specific enolase as a marker for granulated cells.
It is well known that carcinoid tumors and some small-cell carcinomas of the lung contain dense-core granules (DCGs). Moreover, a small number of tumors presenting with epidermoid, large-cell, or adenocarcinoma histologic characteristics (so-called atypical endocrine tumors), also contain DCGs. Herein, we describe certain histochemical features of DCG tumors and compare them with other major lung tumor types that lack DCGs (non-DCG tumors). All DCG tumors contained neuron-specific enolase and many contained serotonin. These markers were not present in any non-DCG tumor. Other histochemical markers (glycogen, mucosubstances, corticotropin, beta-human chorionic gonadotropin, keratin, somatostatin, and calcitonin) were found in a proportion of DCG and non-DCG tumors, but were, in general, more common in non-DCG tumors and atypical endocrine tumors than in carcinoids and small-cell carcinomas. alpha-Fetoprotein was rarely found in non-DCG tumors, and was never observed in DCG tumors. The atypical endocrine group represents a class of tumors with a remarkably mixed and varied phenotype. Their potential significance is discussed and methods to facilitate their diagnosis are suggested.
Adenocarcinoma↗
Immunohistochemical studies of keratin in human bronchus and lung tumors.
Lung tumors of various types, fixed in 4% formaldehyde-1% glutaraldehyde, were stained for keratin proteins. The results were compared with previous ultrastructural evidence of intermediate filament bundles (IFBs), presumed to be keratin. Electron and light microscopic methods were largely complimentary and the results were in agreement in 79% of cases. Light microscopy was superior for demonstrating keratinizing foci containing numerous well-developed IFBs, whereas electron microscopy was superior when keratin filaments were sparsely distributed in cells throughout a tumor. Fetal and adult bronchial specimens were also studied. Normal adult bronchus, fixed in aldehydes, was unreactive but keratin was observed in similarly fixed bronchi that showed epidermoid metaplasia and/or intraepithelial carcinoma. Keratin was demonstrated in normal adult bronchi fixed in ethanol. Keratin was not observed in fetal lung until the 14th week of gestation, when it appeared in basal cells and a few columnar cells of the larger bronchi. Thereafter, keratin progressively appeared in the more distal branches. As specimens from gestations of less than 14 weeks were fixed in aldehydes, the apparent lack of immunoreactivity may have been artifactual. Nevertheless, keratin was demonstrable in aldehyde-fixed fetal bronchi at 16 and 23 weeks' gestation.
Adult↗
Preneoplasia and neoplasia of the bronchus, esophagus, and colon: the use of markers in determining phenotypes and classification.
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Amines↗
Reduction in exposure to lead from drinking water and its effect on blood lead concentrations.
The water supply in Ayr (Scotland, UK) was plumbosolvent and many dwellings in Ayr contained lead pipes. In 1981 treatment of the water supply to reduce its plumbosolvency was initiated. Measurements of water and blood lead concentrations were made before and subsequent to the treatment. Most of the measurements made before and after water treatment began were made on water samples from the same dwellings and blood samples from the same women. Water treatment produced a sharp fall in water lead concentrations and a decrease in the median blood lead concentration from 21 to 13 micrograms/100 ml. Two women had higher than expected blood lead concentrations, both these women had been removing old paint. Women who had lead pipes removed from their dwellings all showed substantial decreases in their blood lead concentrations. The curvilinearity of the relation between blood lead and water lead concentrations is confirmed. Even relatively low (less than 40 micrograms/l) water lead concentrations may make a substantial contribution to blood lead concentrations.
Adult↗
Keratin proteins in human lung carcinomas. Combined use of morphology, keratin immunocytochemistry, and keratin immunoprecipitation.
Light-microscopic immunocytochemistry and electron microscopy demonstrated that adenocarcinomas (AC) and squamous cell (epidermoid) carcinomas (SCCs) of human lung contained keratin proteins in the form of tonofilament bundles. However, moderately differentiated (md) SCCs contained abundant keratin, whereas poorly differentiated (pd) SCCs and all ACs contained lesser amounts. Lung tumors with the diagnosis of AC or SCC, as defined by WHO criteria, were also analyzed by immunoprecipitation techniques for the presence of keratin proteins. Regardless of the degree of tumor differentiation, SCCs contained a 44 kd keratin which was lacking in ACs. Interestingly, normal bronchial epithelium also contained the same 44 kd keratin. In addition, as SCCs became more differentiated, they exhibited even greater differences in the profile of synthesized keratins. Specifically, the relative abundance of the intermediate-sized keratins (57 and 59 kd) was increased in the md SCCs. Although keratin protein patterns appear to be a valuable adjunct in distinguishing AC from SCC, their usefulness as a diagnostic tool will require survey of a larger number of poorly differentiated tumors.
Adenocarcinoma, Bronchiolo-Alveolar↗
Regeneration of hamster tracheal epithelium after mechanical injury. IV. Histochemical, immunocytochemical and ultrastructural studies.
All stages of regeneration in hamster tracheal epithelium were studied following a denuding mechanical injury. At 1 h all the cells had sloughed from the wound site leaving a bare and sometimes disrupted basal lamina. Viable cells at the wound margins rapidly changed shape, flattened and migrated to cover the denuded lesion by 12 h. In addition, epithelial cells that remained viable demonstrated sublethal changes that included the rapid discharge of mucous granules from secretory cells, internalization of cilia by ciliated cells and evidence of heterophagy in both cell types. By 24 h a wave of epithelial cell divisions occurred, primarily by secretory cells. This produced a multilayered epidermoid metaplasia that was best developed at 48 h. The metaplastic epithelium was largely composed of cells with both secretory (mucous granules) and epidermoid (tonofilament bundles and numerous desmosomes) characteristics. The peroxidase-antiperoxidase (PAP) method demonstrated a few keratin-positive cells in the wound as early as 12 h post-wounding and keratin was demonstrated in more cells by 24 h. All cells in the metaplastic wound epithelium were keratin-positive by 48 h. Following 48 h some of the most superficial keratinized cells sloughed from the epithelium and the keratin content of the remaining cells began to decline. At 72 h pre-ciliated and pre-secretory cells were seen in the wound. Pre-ciliated cells were characterized by an abundant electron-lucent cytoplasm, large pale nucleus, filiform apical microvilli and evidence of ciliogenesis, similar to that seen during fetal development. Pre-ciliated cells often contained apical mucous granules, apparently carried over from the parent secretory cells. With the appearance of these columnar cells the normal mucociliary morphology was restored in small wounds by 120 h, but some persistent epidermoid metaplasia remained in the large wounds through 168 h post-wounding. These data provide further evidence for the important role of secretory cells in the histogenesis of epidermoid metaplasia and the regeneration of normal morphology following injury. The implications of these findings in understanding the histogenesis of other lesions in the tracheo-bronchial epithelium are discussed.
Animals↗
An Alcian blue (pH 2.5)-PAS-keratin immunoperoxidase method for the simultaneous demonstration of keratin and neutral and acidic mucosubstances.
A method is proposed for the simultaneous staining of neutral and acidic, periodate reactive and nonperiodate reactive mucosubstances, glycogen and keratin in paraffin sections. Briefly, sections are stained by the Alcian blue (pH 2.5)-PAS method, followed by a peroxidase-antiperoxidase immunohistochemical stain for keratin. The proposed method modifies an existing method, and expands the range of polysaccharides and mucosubstances which may be demonstrated. The proposed method is easily performed within a single working day and promises to be of value in surgical pathology as well as in studies of bronchial carcinogenesis.
Alcian Blue↗
Assessment of lead intakes and dose-response for a population in Ayr exposed to a plumbosolvent water supply.
1 Dietary lead intakes, blood lead concentrations and water lead concentrations were measured and their relationships investigated for 31 adults and 11 infants living in dwellings in Ayr with lead plumbing. 2 For adults, some lead intakes were found to be higher than the provisional tolerable weekly intake for lead, and for infants most of the intakes were high. 3 A cube root relationship fitted the data on blood lead versus water lead better than a linear relationship. Similarly, blood lead varied with the cube root of weekly dietary lead intake. 4 These cube root equations provided a means of estimating the impact on blood lead concentrations of exposure to lead from food and water. If cube root relationships correctly describe the association between these parameters, then the curve fitted to the results for adults indicates that the contribution to the blood lead concentrations from sources other than the diet and water was relatively small.
Adult↗
Atypical endocrine tumors of the lung.
Seven malignant peripheral lung tumors that were diagnosed using light microscopy as large-cell carcinomas or as epidermoid or adenocarcinomas were studied by light and electron microscopic histochemistry. All tumors contained numerous dense-core granules. The cells were joined by desmosomes and contained well-developed tonofilament bundles. Serotonin was demonstrated in six of seven tumors and argyrophilic granules were demonstrated in five of six tumors tested. Four tumors produced mucus. All tumors extended to the visceral pleura and two invaded the chest wall. The existence of lung tumors that contain serotonin and bear argyrophilic putative endocrine granules, but that do not have a light-microscopic histology characteristic of either carcinoid or oat-cell carcinomas, is confirmed. The presumptive endocrine nature of such tumors usually passes unrecognized because they lack criteria to allow diagnosis by routine methods.
Adenocarcinoma↗
Elaboration of human chorionic gonadotropin by lung tumors: an immunocytochemical study.
The highly sensitive peroxidase-antiperoxidase immunocytochemical method was used to demonstrate the presence of the beta-subunit of human chorionic gonadotropin (HCG) within paraffin sections of human lung tumors of diverse histologic patterns. Of the 61 tumors studied, 51 (84%) displayed HCG-like immunoreactivity. This is a much higher incidence than was expected considering studies by other investigators in which serum samples from patients with lung cancer were assayed for HCG. Our results are, however, consistent with data from studies by other investigators in which tumor extracts were assayed for HCG. In addition, it was found that HCG production was often linked with glycogen storage within tumor cells. This may explain the association of HCG production with large-cell carcinomas of the lung, because these tumors often contain copious quantities of glycogen.
Carcinoma, Bronchogenic↗