University of Washington School of Medicine Seattle, Washington.
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Isolation and characterization of epizootic hemorrhagic disease virus from white-tailed deer (Odocoileus virginianus) in eastern Washington.
A virus was isolated from the spleen of a white-tailed deer (Odocoileus virginianus) that had died during an epizootic in Washington state in 1967. Inoculation of a 10% spleen suspension from the deer caused hemorrhagic disease in normal white-tailed deer. Studies were conducted on the biological, physicochemical, and serologic properties of the Washington isolate. An in vitro assay system, utilizing a cultured primary of white-tailed deer fetal cells from an entire fetus, was employed for isolation and propagation of the virus. Cytopathic effect was characterized by focal development of rounded and clumped cells. Propagation was unsuccessful in suckling mice, BHK-21, and Vero cell cultures. The virus was resistant to treatment with ether, sodium deoxycholate, trypsin, oxytetracycline hydrochloride, and was sensitive to chloroform. Virus yield was not affected when infected cultures were treated with 5-iodo-2'-deoxyuridine, but dactinomycin (actinomycin D) treatment of infected cultures reduced virus yield. The virus was inactivated when heated at 70 C for 5 minutes or when exposed to pH 5 for 18 hours at 4 C. The virus was completely excluded from the filtrate by a 0.10- micronm (APD) membrane filter. Staining of infected cells with acridine orange indicated the presence of double-standard nucleic acid in the cytoplasm. Serum-neutralization tests with antiserums against the homologous virus and the New Jersey and Alberta strains of epizootic hemorrhagic disease virus resulted in neutralization of the Washington isolate. The Washington virus was not neutralized by bluetongue virus antiserum. Cells infected with the Washington isolate exhibited intracytoplasmic fluorescence by the indirect fluorescent antibody method with New Jersey and Alberta epizootic hemorrhagic disease antiserums but not with bluetongue antiserum.
Animals↗
Factors influencing the location of rural general practitioners. A study in Washington state.
Data on (1) personal background, (2) place of medical education and training, (3) reasons for selecting the present place of practice and (4) previous practice location were gathered and analyzed from 41 general practitioners in rural Washington state. The analysis was done to isolate factors influencing the choice of location by physicians. Results show that most of the physicians had spent at least some of their preadulthood years in small communities and that most had some exposure to the state of Washington before establishing their practices in the state. In addition to the apparent importance of previous exposure to small communities and Washington state, the physicians were also influenced in their locational choice by (1) the professional advantages or appeal of the community, (2) recruitment efforts by persons within the community and (3) economic reasons. The physicians were rather immobile. Most had never practiced in another community and only two of the 41 physicians planned to move to another community.
Economics↗
Neoplasms of the central nervous system. incidence and population selectivity in the Washington DC, metropolitan area.
During the period 1960 through 1969, 990 primary neoplasms of the central nervous system were diagnosed in hospitals in the Washington, DC, Standard Metropolitan Statistical Area (SMSA). All cases were identified according to age, race, sex, histologic type, and date of diagnosis. A West African composite of 253 cases was used for comparison. In the Washington SMSA, the age-adjusted incidence rates were: for Caucasians 5.5 in males and 3.6 in females and for Negroes 4.8 in males and 3.4 in females per 100,000 annual population. Caucasians in the Washington SMSA had a higher relative proportion of gliomas than Negroes in the same area and in Africa (p less than 0.005). The relative proportion of pituitary adenomas was higher in American Negroes (p less than 0.005) and in Africans than in Caucasians. The comparable pattern of CNS tumors in American and African Negroes, relative to Caucasians, suggests that in the development of neoplasms of the central nervous system racial factors may be of importance.
Africa, Western↗
General Washington and the patriot soldiers. They won a war with little food. A Bicentennial study.
The troops in the first action of the American Revolution in Massachusetts were well provisioned through the efforts of Joseph Trumbull of Connecticut, whom the Second Continental Congress appointed Commissary General, at General Washingtion's request. The ration, as ordered, would have provided-by today's standards-more calories, twice as much protein, and adequate minerals and vitamins, except possible vitamin A and ascorbic acid. Unfortunately, all items in the ration were seldom available to the soldiers. Each man was issued his ration and was responsible for cooking it. Trumbull held his post for two years, with little support from the Congress and no departmental organization. When the Army moved to New York, difficulties in provisioning the troops on the march began-and continued until 1781. Following the retreat to Morristown, New Jersey, in 1776, flour and beef, but little else, were available during the winter and into the following summer. Washington pleaded with the Congress for help with food supplies, but to no avail. Finally, Trumbull resigned. Thereafter, followed a series of four reorganizations of the commissariat by the Congress-each disastrously conceived-which brought no relief to the ill-fed soldiers, whose physical condition progressively worsened. Finally, a fifth reorganization in 1781 put into operation a contract plan of procuring food; no longer was it necessary for Washington to order impressment of food from farmers or for the troops to live off the land. The Continental Army "starved, not because the country could not furnish the food, but becasue the people were unwilling to endure taxation and Congress did not understand the importance of administrative centralization; ...the greater part of the hardships" were avoidable. Yes, General Washington and the patriot soldiers won the war with little food.
Cooking↗
Education and integration of midlevel health-care practitioners in obstetrics and gynecology: experience of a training program in Washington state.
The impetus for the development of the Gynecorps Training Program was the identification of medically underserved populations of women in Washington State and their need for preventive health care, the maldistribution of physicians, and the success of a pilot program for training midlevel personnel conducted in 1972 by the Department of Obstetrics and Gynecology, University of Washington School of Medicine. The program trains community-based and -sponsored Registered Nurses and Physician's Assistants as women's health-care specialists, with the goal of delivering preventive care in obstetrics and gynecology to populations of high-risk, low-income, and/or underserved women. A summary of the training program, its curriculum, and the integration of its graduates into community health teams is presented and discussed.
Certification↗
Family physician pathway and medical student career choice. Ten years after curriculum change at the University of Washington.
In 1968 the University of Washington School of Medicine initiated a new curriculum that included a family physician pathway. Six of these classes have now graduated. Two thirds of the planned strategies for the pathway were actually implemented. Approximately half of the students in each second-year class now choose this pathway. Ninety percent of those graduating have done so in the traditional four years. Seventy-three percent of those in the pathway actually pursued family practice training on graduation. Approximately one third of all University of Washington graduates now enter training for family practice, one third enter internal medicine, 10% enter surgical fields, and 8% enter pediatrics. These rates represent significant increases in the proportion of students entering directly into family practice, internal medicine, and pediatrics training.
Career Choice↗
Oxygen equilibrium analyses of isolated hemoglobins A2, Lepore-Washington and P-nilotic.
Oxygen equilibrium studies have been carried out on hemoglobins A2 (alpha2delta2), Lepore-Washington (alpha2(deltabeta)2) and P-Nilotic (alpha2(beta2delta)2) using the beta chain containing hemoglobins A and S as controls. This investigation was initiated mainly because of controversial data that have been published on the oxygen affinity of hemoglobin (Hb) A2 and because samples containing the rare Hb P-Nilotic became available. Each hemoglobin was isolated in pure form by anion exchange chromatography; the samples used in the equilibrium analyses contained 100 mg Hb/dl with less than 5% ferrihemoglobin and no 2,3--diphosphoglycerate. Oxygen equilibrium analyses were made at 37 degrees C with the method of Benesch et al. (1965) Anal. Biochem. 11, 81--87; Anal. Biochem. 55, 245--248 (1973). A slight, but definite increase in oxygen affinity was observed for Hb A2 as well as for Hb P-Nilotic while the increase for the Hb Lepore-Washington was somewhat greater. The values for n, the Hill coefficient, and the Bohr effects were the same for all hemoglobin types. The differences in oxygen affinity of these hemoglobins apparently result from the differences in primary structure that are characteristic for those proteins.
Amino Acid Sequence↗
Incidence of prostatic calcification in blacks in Washington, D.C., and selected African cities. Correlation of specimen roentgenographs and pathologic findings. Cooperative Prostatic Research Group.
The incidence of calcification in the prostate gland of black men from Washington, D.C., and from Ibadan, Nigeria, and Accra, Ghana, West Africa, was assessed in a total of 874 consecutive, unselected prostate specimens removed at autopsy during a five-year period (1973--1978). In the combined series there was a significant positive association between prostatic calcification and age (p less than 0.001). The frequency of calcification was significantly higher in the Washington, D.C. series than in the West African series at all age levels (p less than 0.001). This difference most likely reflects the different dietary patterns of the two population groups.
Aged↗
Peer review of group therapy: Washington, D.C., 1972-1977.
The author discusses the evolution of psychiatric peer review in Washington, D.C. In its first six years (1972-1977) the Washington Psychiatric Society Peer Review Committee evaluated 146 cases, 23 (16%) of which focused on group therapy. Eight of these cases (35%) were partially or fully denied. Most of the cases involved outpatients with neuroses or character disorders who were treated in combined group and individual therapy. The author presents specific cases illustrating group therapy issues and peer review decisions. He discusses the benefits and liabilities of peer review and emphasizes its importance as a flexible, clinically sensitive, confidential, and meaningful process.
District of Columbia↗
The natural history of Meckel's Diverticulum and its relation to incidental removal. A study of 202 cases of diseased Meckel's Diverticulum found in King County, Washington, over a fifteen year period.
To determine the natural history of Meckel's diverticulum, 202 case records of proved disease of Meckel's diverticulum were retrieved, covering a fifteen year period, from all the hospitals of King County, Washington (population, 1,143,800). Using the figure of 2 per cent incidence of Meckel's diverticulum, we calculated that a Meckel's diverticulum has a 4.2 per cent likelihood of causing disease during a lifetime, decreasing to zero with old age. Using previously published mortality and morbidity figures, we calculated that to save one patient's life from the complications of Meckel's diverticulum, it would be necessary to remove approximately 800 asymptomatic Meckel's diverticula. This would be likely to incur a significant amount of postoperative morbidity from postoperative intestinal obstruction and infection. We suggest that the prophylactic removal of Meckel's diverticulum is rarely, if ever, justified.
Adolescent↗
Incidence of endometrial carcinoma in King County, Washington: a standardized histologic review.
Previously diagnosed tumor specimens from 35- to 74-year-old female patients with endometrial cancer who were residents of King County, Washington, during the first 6 months of 1975 were reviewed by a single pathologist using uniform criteria for the assessment of cancer. Routinely reported incidence of this tumor in this population was judged to be inflated, the annual incidence rate (excluding carcinoma in situ) falling from 108.2 to 88.5 per 100,000 women after the exclusion of cases found not to be unequivocally malignant. This rate nonetheless represented a large increase over the rate of 47.3 per 100,000 observed in the U.S. Third National Cancer Survey just 5 years earlier. We concluded that U.S. pathologists in the 1970's may have been using more liberal criteria by which to diagnose endometrial cancer, but that such a change could only account for a small part of the rising incidence of the disease.
Adenocarcinoma↗
Pathology of hepatomas and other liver abnormalities in English sole (Parophrys vetulus) from the Duwamish River estuary, Seattle, Washington.
Liver abnormalities were found, by gross and histopathologic examination, in 92% of the English sole (Parophrys vetulus) from the Duwamish River Estuary, Seattle, Washington. Hepatomas were found in 32% (20 of 62) of the English sole. Other observed liver aberrations included increased fatty vacuolation, congestion, structure disarray, increased size and number of melanin-macrophage centers, centrolobular fatty degeneration and necrosis, increased amounts of perivascular connective tissue, intercellular melanin deposits, and hepatocellular hypertrophy often associated with the presence of bizarre nuclei and/or multiple nucleoli. Livers evidencing microscopic lesions were usually discolored. Livers containing hepatomas were often mottled yellow or tan and brown; occasionally, hepatomas were visible as tan or white nodules. Although the cause(s) of the liver abnormalities has not been conclusively identified, chemical analyses of Duwamish River English sole have detected polychlorinated biphenyl (PCB) levels of about 1.5 ppm (dry wt) in total body tissue. Many of the above-mentioned abnormalities, with the exception of hepatomas, have been observed in fish exposed to PCB's.
Animals↗
Characteristics of menopausal women: a survey of King and Pierce counties in Washington, 1973-2974.
Age-specific menopause rates, frequency and duration of menopausal estrogen use, and characteristics of users and non-users of menopausal estrogen therapy are presented for the population of King and Pierce counties in the state of Washington from 1973-1974 survey data. Age-specific menopause rates do not differ substantially from rates derived from data from the 1960-1962 US Health Examination Survey, although women over 50 years of age were more likely to report operative menopause in the present study than in the Health Examination Survey. The estimated frequency of menopausal estrogen use of over 3 months' duration in the population was 51%; this is in contrast to an estimated 26% rate of severe menopausal symptoms. Median use of menopausal estrogen therapy was over 10 years. Estrogen users were younger than non-users and reported more formal education. More users had had difficulty with severe menopausal symptoms and more had had a hysterectomy.
Adult↗
A cluster analysis of some bacteria in the water column of Green Lake, Washington.
Mass inoculation and computer clustering techniques were used in an abbreviated procedure to group similar bacteria isolated from four depths in the water column of Green Lake, Washington. Four groups of bacteria were differentiable and were catagorized as orange-yellow Flavobacterium-Cytophaga, yellow Flavobacterium-Cytophaga, Vibrio-Aeromonas-, and Pseudomonas-like. Some of the groups were most prevalent in certain sample depths in the water column.
Aeromonas↗
Male urethritis in King County, Washington, 1974-75: I. Incidence.
In a population-based study in King County, Washington an attempt was made to enumerate all cases of male urethritis receiving primary care from all sources over a defined period of time. The incidence of gonococcal (GCU) and non-gonococcal urethritis (NGU) was estimated to be 1,143 and 2,541 cases per year per 100,000 men age 15 and over, respectively, during 1974-1975. Private practitioners treat 62 per cent of GCU and 64 per cent of NGU estimated to occur in the county. They report only 3 per cent GCU which they see to the Health Department. Only 60 per cent of the general practitioners, 33 per cent of the internists and 65 per cent of the urologists had treated males with GCU in the three months prior to being questioned but these three groups of specialists see 95 per cent of all male urethritis treated by private practioners. The proportion of all male urethritis cases which were GCU ranged from .16 in a university student health clinic to .35 in private practices and Health Department clinics.
Adolescent↗
Male urethritis in King County, Washington, 1974-75: II. Diagnosis and treatment.
Methods of diagnosing and treating male urethritis in King County. Washington in 1974-1975 were examined by a retrospective postal survey, records review, and prospective surveillance. A Gram-stained smear of urethral discharge was used by 86 per cent of private physicians and urethral culture by 56 per cent. Only 5 per cent made a diagnosis without laboratory aid. U.S. Public thealth Service gonorrhea treatment regimens were used by 54-81 per cent of private physicians. Over 90 per cent of physicians not in private practice (emergency room and housestaff) used smear, cultures, and recommended treatment regimens. The Gram-stained smear appeared to be under-utilized and the urethral culture overutilized. There is a significant need for physician education regarding recommended treatment for male gonorrhea.
Drug Administration Schedule↗
Wyominia tetoni (Cestoda: Thysanosomatinae) from bighorn sheep in Washington.
In washington, eitht California bighorn sheep, Ovis canadensis californiana, were necropsied to ascertain age and general physical condition. Four were found to harbor Wyominia tetoni.
Animals↗