bluuebunny/crossref_metadata_2025 huggingface dataset:
Intrapartum hypoxia: the association between neurological assessment of damage and abnormal excretion of ATP metabolites.
Authors: Harkness R A , Whitelaw A G , Simmonds R J
Published: June 2007

A series of 29 newborn infants had been studied after intrapartum hypoxia defined as meconium aspiration, an Apgar score of less than or equal to 6 at 5 min or a peripheral blood pH of 7.2 or less after resuscitation. Two independent sets of techniques were used; one concerned with the critical system in hypoxic damage, the central nervous system, the other assessing the central biochemical events in hypoxia. Both sets of data were assembled, then graded separately and only then combined. In this way detailed neurological assessment has been combined with measurement of urinary excretion of the ATP metabolites, hypoxanthine and xanthine. The essential metabolic consequence of hypoxia is a reduction in the synthesis of the energy currency of cells, ATP. This is associated with an outflow of ATP metabolites from cells. The extent of neurological damage was related to the magnitude of the hypoxanthine and xanthine excretion; neither were closely related to the initial blood pH. Infants who were normal neurologically had normal oxypurine excretion. Infants with neurological abnormalities for less than 48 h had lower excretion than those who were abnormal for more than 48 h. The duration of abnormal oxypurine excretion after an acute episode of hypoxia was studied in two infants with respiratory distress and in two other infants with apnoeic attacks. Severe hypoxia was followed by abnormal oxypurine excretion for at least 40 h after an acute episode. It is justifiable to suggest that abnormalities of oxypurine excretion should indicate intrapartum hypoxia in newborn infants. This excretion should also quantify the metabolic damage.
Coeliac disease, adenocarcinoma of jejunum and in situ squamous carcinoma of oesophagus
Authors: O'Brien CJ , Saverymuttu S , Hodgson HJF , Evans DJ
Published: June 2007

The development of both adenocarcinoma of the jejunum and in situ squamous carcinoma of the oesophagus in an adult coeliac patient is described. Good evidence that adenocarcinoma of jejunum occurs more frequently in patients with coeliac disease has recently become available though this association has been suggested for some time. While oesophageal carcinoma has long been associated with coeliac disease, in situ carcinoma of oesophagus has not been previously described in these circumstances. We feel that the risk of this complication, as calculated from published series, warrants a screening programme for oesophageal malignancy in adult coeliacs.
Intestinal lactase, sucrase and alkaline phosphatase in relation to age, sex and site of intestinal biopsy in 477 Irish subjects
Authors: Keane R , O'Grady J G , Sheil J , Stevens F M , Egan-Mitchell B , McNicholl B , McCarthy C F , Fottrell P F
Published: June 2007

Small intestinal lactase, sucrase and alkaline phosphatase activities were measured in histologically normal peroral intestinal biopsies from 477 individuals. Enzyme activities varied with age, sex, site of biopsy, and were lowest in post-weaning children and highest in young adults. Lactase activity does not decrease with advancing age.
Isolation of Clostridium difficile from patients and the environment of hospital wards.
Authors: Malamou-Ladas H , O'Farrell S , Nash J Q , Tabaqchali S
Published: June 2007

Rectal swabs from 122 patients and 497 environmental swabs from several wards were examined for the presence of Clostridium difficile in order to assess the role of the environment in the spread of this organism. Clostridium difficile was isolated from 6/27 (22.2%) oncology patients and from 8/163 (4.9%) environmental specimens obtained from the oncology unit. Items found positive for C difficile were those subjected to faecal contamination such as commode chairs, bed pans, dust pans, discard bins, the sluice and a disposable bed pan machine. Fourteen of 51 (27.4%) asymptomatic neonates yielded mostly toxigenic C difficile in their stools during their first week of life. Five of 156 (3.2%) specimens taken from inanimate objects in the environment of the neonatal units were positive for C difficile. The organism was also isolated from the hands of a nurse. Similar antibiogram patterns were demonstrated in the strains obtained from the patients and their environment indicating the possible occurrence of cross infection. These results indicate that environmental contamination is important in the spread of C difficile in hospitalised patients and the implementation of isolation procedures may limit that spread.
Biotyping of Haemophilus using API 10S—an epidemiological tool?
Authors: Mehtar S , Afshar S Amini
Published: June 2007

One hundred and ninety-nine strains of Haemophilus isolates were biotyped by Kilian's method1and a modified API 10S strip and the results compared. One hundred percent correlation was found between the two systems. The ONPG test proved of value in differentiating betweenHaemophilus influenzaeandHaemophilus parainfluenzaewhen there was growth factor disc failure.
Trends in the epidemiology of tuberculosis--a physician's view.
Authors: McNicol M
Published: June 2007

It is likely that the incidence of tuberculosis will continue to decline, although there will be problems in areas with large numbers of immigrants from Third World countries. They will present problems only if they come from countries with high incidence of primary drug resistance. In the indigenous population there is one problem group--middle aged and elderly men often with sputum positive disease. Diagnosis tends to be delayed, they may not co-operate with treatment and there is a significant death rate. Despite the very substantial decline in incidence, it is probably premature to abandon BCG vaccination, although this will have to be reconsidered within the next 10 years.
Cytogenetic studies: an essential part of the paediatric necropsy.
Authors: Sutherland G R , Carter R F
Published: June 2007

Chromosome studies were attempted on 97% of necropsies carried out in the Department of Histopathology of the Adelaide Children's Hospital over the four-year period ending May 1981. Results were obtained from 89% of necropsies of which 7.5% had major chromosome abnormalities. The chromosome results are analysed according to the category of the necropsy and to primary cause of death. It is recommended that cytogenetic studies be performed on all stillbirths and infants dying at less than 28 days of age except in cases of isolated CNS malformation, sudden infant death syndrome (SIDS), trauma, or known single gene defects.
Studies of intestinal lymphoid tissue. VI--Proliferative response of small intestinal epithelial lymphocytes distinguishes gluten- from non-gluten-induced enteropathy.
Authors: Marsh M N , Haeney M R
Published: June 2007

Several diseases of the small intestine, including gluten-sensitivity, present with malabsorption and a "flat" mucosa. Determination of the mitotic index of epithelial lymphocytes provides a simple, objective method of assessing, and thus of predicting, whether a flat mucosa is due to gluten-sensitivity (index greater than 0.2%), or not (index less than 0.2%). The use of this index in circumstances especially likely to cause diagnostic confusion--for example, intestinal lymphoma; Crohn's jejunitis of immunodeficiency--is illustrated in this paper. Of seven cases, five (two primary lymphoma, three immunodeficiency) had been treated with a gluten-free diet without benefit; a mitotic index performed on the initial biopsy in each of these patients could have predicted from the outset that none was gluten-sensitive. Of the remaining two cases, determination of the mitotic index on the biopsy initially obtained from a man with severe hypogammaglobulinaemia would have indicated that he was also gluten-sensitive. Empirical use of a gluten-free diet was avoided in the other patient (with flat small intestinal mucosa and low mitotic index) in whom the diagnosis was ultimately shown to be due to Crohn's disease of jejunum.
Early time course of the acute phase protein response in man.
Authors: Colley C M , Fleck A , Goode A W , Muller B R , Myers M A
Published: June 2007

The rate at which the acute phase protein response occurred after both major and minor surgery was explored. Increases in the plasma concentration of C-reactive protein (CRP), alpha-1-acid glycoprotein (alpha 1 AG) and fibrinogen were not detected until 6-8 h after the initial incision. The peak concentration of CRP occurred at 48 h and that of fibrinogen at 96 h; alpha 1 AG concentrations rose rapidly until 48 h followed by little change until about 120 h. Although there was widespread variation in the concentrations of individual proteins in patients, severity of injury did not seem to have a significant effect on the time course of the change. Plasma cortisol concentration and the total white blood cell count (WBC) reached their peaks before the acute phase proteins, cortisol at 6 h and WBC at 12 h.
Comparison of enzyme-linked immunosorbent assay (ELISA) and complement fixation test for detection of Mycoplasma pneumoniae antibodies.
Authors: Dussaix E , Slim A , Tournier P
Published: June 2007

An enzyme-linked immunosorbent assay (ELISA) for the detection of IgG and IgM antibodies against Mycoplasma pneumoniae, performed with commercial antigen and reagents, is compared with the complement fixation test (CF) in a serological study of 209 human sera. Concordant results were usually obtained by CF test and by IgG ELISA in sera from patients with recent M pneumoniae infection. In contrast, when used for an immunological survey of a general population, approximately 27% of the sera negative in the CF test were positive for IgG by the ELISA, and sera with low CF titres were found to have a broad range of IgG titre by the ELISA. This may be due to the greater sensitivity of the ELISA technique and/or to different types of antibody measured by both tests. IgM was detected by ELISA in sera from all patients with recent M pneumoniae infection diagnosed on the basis of clinical findings and by CF assay. Occasionally false-positive IgM antibodies were due to rheumatoid factor (RF); this potential interference necessitates routine testing of IgM antibody positive sera for RF.
Blood group antigens in the normal and neoplastic bladder epithelium.
Authors: Thorpe S J , Abel P , Slavin G , Feizi T
Published: June 2007

The indirect immunofluorescence technique was used to study the expression of the blood group A and H antigens in fresh-frozen and formalin-fixed paraffin-embedded sections of the bladder mucosa of 21 patients with non-neoplastic diseases of the bladder. Reliable assessment of these antigens could only be made using cryostat sections of fresh-frozen tissues. Also included in this study were tumour tissues of 5 patients with bladder cancer. The blood group A antigen was totally deleted in cryostat sections of the tumour of one patient with aggressive carcinoma and the appropriate antigens were diminished or focally deleted in the four patients with tumours that were non-invasive during one to three years of follow-up. It is concluded that sections of fresh-frozen tissues or sections processed in the absence of glycolipid-extracting solvents should be used for visualising the expression of blood group antigens in bladder tissues and assessing their value as prognosticators of the malignant potential of bladder tumours.
Increased transfer of iron to the fetus after total dose infusion of iron dextran during pregnancy.
Authors: Bingham D , Khalaf M M , Walters G , Whicher J T
Published: June 2007

After total dose infusion of iron dextran to 14 pregnant women the saturation of transferrin and the concentration of ferritin were increased in the cord blood at birth, compared with untreated cases. These changes suggest that the fetal iron stores may be increased by such treatment.
Faecal carriage rate of Aeromonas hydrophila.
Authors: Millership S E , Curnow S R , Chattopadhyay B
Published: June 2007

Over a four and a half month period, 1004 unselected routine faecal specimens from 815 patients were cultured for Aeromonas hydrophila. Forty-two specimens (4.2%) representing 38 patients were culture-positive. The study specimens also yielded Salmonella on 116 occasions, Shigella on seven, Campylobacter species on six and other bacterial pathogens on 17 occasions, respectively. Seven specimens had A hydrophila together with another bacterial pathogen. In only 19 of 38 patients (50%) was A hydrophila possibly associated with gastrointestinal symptoms. All the Aeromonas isolates were resistant to ampicillin but sensitive to gentamicin, piperacillin, mecillinam, chloramphenicol, ceftazidime and colistin.
The value of screening blood donors for antibody to hepatitis B core antigen.
Authors: Archer A C , Cohen B J , Mortimer P P
Published: June 2007

Rapid counter-immunoelectrophoresis (CIE) and radioimmunoassay (RIA) methods for detecting antibody to hepatitis B core antigen (anti-HBc) were used to screen nearly 8000 blood donors, including 919 prisoners. The prevalence of anti-HBc in prisoner donors (3.4%) was significantly higher than that in other donors (0.7%). The three HBsAg positive donors in the series were all anti-HBc positive and, of the other 73 anti-HBc positive donors, 62 had antibody to HBsAg (anti-HBs). Two panels of control sera, including 155 HBsAg positive samples, were tested by CIE for anti-HBc: 149 of the 155 were anti-HBc positive. Of the six negative samples, four were HBsAg positive only by RIA. One of the panels, containing 16 weakly HBsAg positive samples, was available for anti-HBc testing by RIA. Fifteen of the samples were positive and the other was slightly reactive. Donor sera that gave unconfirmable reactions in initial CIE tests were invariably negative when tested by RIA. The RIA was a more sensitive and specific test for anti-HBc than CIE. The ways in which anti-HBc screening could meet the needs of blood transfusion centres are discussed. We suggest that, in areas of low prevalence, it has a role as a rapid confirmatory test of HBV infection and as a means of identifying those potentially infectious donations in which HBsAg cannot be detected.
Colonic bicarbonate output as a test of disease activity in ulcerative colitis.
Authors: Roediger W E , Lawson M J , Kwok V , Grant A K , Pannall P R
Published: June 2007

No available test objectively measures impairment of function of the inflamed colonic mucosa in ulcerative colitis. To study function we assessed rectal bicarbonate output by rectal dialysis in the presence of water and bacterial fatty acid (n-butyrate) in 21 controls, 18 patients with acute ulcerative colitis, 12 patients with ulcerative colitis in remission, and 12 patients with other forms of colitis. In acute ulcerative colitis, compared with controls, bicarbonate output and pH was reduced (p less than 0.001); stimulated bicarbonate output with bacterial fatty acid (incremental bicarbonate output) was reduced by 80% in acute ulcerative colitis (p less than 0.01). Results indicate that bicarbonate output is a useful and selective test of mucosal function in acute ulcerative colitis. A diminished incremental bicarbonate output with n-butyrate supports the view of inadequate oxidation of bacterial fatty acids in vivo by the mucosa in ulcerative colitis. Whether the test will prove to be an index of prognosis or will aid choice between medical or surgical therapy requires further study.
Acquired cystic disease of kidney with multiple renal and urothelial neoplasms.
Authors: Banerjee S S , Harris M , Lupton E W , Ackrill P
Published: June 2007

Acquired polycystic disease with concurrent development of renal cell tumours is a well documented complication of long term haemodialysis. We present a case of acquired polycystic disease with renal cell tumours and multifocal urothelial tumours. Only two similar cases have been recorded.
Clear cell carcinoma of the lung.
Authors: Edwards C , Carlile A
Published: June 2007

Six tumours of the lung initially classified as clear cell carcinoma, were studied. Examination of further material by light and electron microscopy showed adenocarcinomatous differentiation in three cases and squamous differentiation in two. One case showed the features of a large cell anaplastic carcinoma. The clear appearance of the cytoplasm in paraffin sections was due to accumulations of glycogen that were partially removed during processing. It is concluded that clear cell carcinoma is not a single and separate entity.
IgA deposition in alcoholic liver disease.
Authors: Goldin R D , Cattle S , Boylston A W
Published: June 2007

Immunoglobulin deposition in alcoholic and non-alcoholic liver disease was studied using an indirect immunoperoxidase technique. A continuous pattern of IgA deposition, with IgA outlining the sinusoids, was shown to be a specific and sensitive marker for liver disease caused by alcohol in both cirrhotic and non-cirrhotic livers. The sensitivity was lowest in cases of alcoholic disease showing fatty change alone. In one case it was possible to show the absence of IgA in liver disease caused by a drug, which was histologically indistinguishable from alcoholic hepatitis.
Antineuron specific enolase staining reactions in sarcomas and carcinomas: its lack of neuroendocrine specificity.
Authors: Leader M , Collins M , Patel J , Henry K
Published: June 2007

A commercially available polyclonal antiserum (Dakopatts) raised against bovine neuron specific enolase (NSE) was reacted with 197 sarcomas, 32 carcinomas, 11 carcinoid tumours and 20 malignant melanomas to assess its specificity for neuroendocrine tumours. All the tumours had been fixed in formalin and embedded in paraffin. Positive tumour cells were found in two of 11 squamous cell carcinomas, one of 11 adenocarcinomas, 10 of 10 oat cell carcinomas, 11 of 11 carcinoid tumours, 16 of 20 malignant melanomas, four of seven clear cell sarcomas, nine of 25 leiomyosarcomas, four of 22 rhabdomyosarcomas, one of seven angiosarcomas and one of 20 synovial sarcomas.
Necropsy study of mountaineering accidents in Scotland.
Authors: Reid W A , Doyle D , Richmond H G , Galbraith S L
Published: June 2007

One hundred and twenty one people died in mountaineering accidents in Scotland between July 1978 and December 1983. Necropsies were carried out on 42, which form the basis of this report. In 21 cases head injury was major fatality factor, but in 11 of these there were also serious chest injuries. Focal brain damage (haematomas, contusions, or lacerations) was more common (n = 21) than diffuse brain damage (n = 18). Over half of the victims with severe head injury had few other injuries and would probably have survived had the head injury been prevented. Spinal injuries usually occurred with other major injuries. Chest injuries were common, being serious in 18 cases, but abdominal injuries were uncommon. Four climbers with only minor injuries died of hypothermia.
Novel method for detecting micro-organisms in blood cultures.
Authors: Sawhney D , Hinder S , Swaine D , Bridson E Y
Published: June 2007

A method for detecting the growth of micro-organisms in blood culture by a visual signal is described. The system utilises a single blood culture medium that has been specifically formulated to support growth of aerobic, anaerobic, and microaerophilic micro-organisms. The system is based on the principle that when micro-organisms grow in the medium in a sealed bottle their metabolic products create positive pressure. This positive pressure displaces the infected blood and broth into an upper chamber, which acts as a visual signal of microbial activity. All the test micro-organisms, when inoculated at less than 20 colony forming units into simulated human blood cultures, gave a positive signal.
Immunohistochemical analysis of mononuclear cell subsets in inflammatory and non-inflammatory myopathies.
Authors: Lemoine N R , Ryan J F , Cox E L , Mayston V , Revell P A , Swash M
Published: June 2007

Immunohistochemical procedures were used to analyse the subpopulations of mononuclear cells in muscle biopsies from 24 patients with polymyositis. The character of the cellular infiltrate was similar at the perivascular, perimysial, and endomysial sites, with cytotoxic-suppressor T lymphocytes (T8+) and macrophages being the dominant elements. Helper T lymphocytes (T4+) and B lymphocytes were present in smaller numbers. A control series of 17 muscle biopsies from normal subjects and patients with non-inflammatory myopathies and neurogenic conditions was also studied: the numbers of mononuclear cells present were much smaller than in polymyositis, but the ratio of T4:T8 lymphocytes was similar to that found in biopsies affected by polymyositis. We conclude that both cytotoxic-suppressor T lymphocytes and macrophages are important in the pathogenesis of inflammatory myopathy.
Metastatic thymoma: a case report and immunohistological analysis.
Authors: Salter D M , Krajewski A S
Published: June 2007

A patient with metastatic lymphocyte predominant thymoma was studied and an immunohistological analysis of frozen and paraffin sections was performed. The immunophenotype of the lymphoid cells was similar to that of primary thymomas and T cell lymphoblastic lymphomas. The epithelial cells reacted with an anticytokeratin monoclonal antibody. The results have diagnostic implications for the histopathologist using immunohistochemistry as a diagnostic aid and it is concluded that a panel of monoclonal antibodies against both lymphoid and epithelial markers should be used for immunohistological typing of tumours of uncertain histogenesis.
Nature of "basal" and "reserve" cells in oviductal and cervical epithelium in man.
Authors: Peters W M
Published: June 2007

The epithelium of the human fallopian tube (oviduct) and cervix were studied by histological, immunohistological, and ultrastructural methods with a view to establishing the nature of the so called "basal" and "reserve" cells. The results indicated that the "basal" cells of the oviductal epithelia were T lymphocytes, with a predominance of T cytotoxic and suppressor cells. A more heterogeneous inflammatory cell population was present in cervical epithelium, although once again T cytotoxic and suppressor cells were the most numerous subtype. The intraepithelial inflammatory cells were quite distinct from the cells commonly referred to as "reserve" cells (reserve cell hyperplasia), which have epithelial characteristics. The origin of the "reserve" cells is unclear, but they seem to arise within the epithelium. They probably represent an early sign of squamous metaplasia. The lymphoid tissue of fallopian tube and endocervix shows similarities with that of the endometrium and mucosal associated lymphoid tissue in general.
Septicaemia and meningitis caused by dysgonic fermenter-2 (DF-2).
Authors: Chan P C , Fonseca K
Published: June 2007

A patient developed dysgonic fermenter-2 (DF-2) septicaemia and meningitis after having been bitten by a dog. The pathogenic organism was isolated from the oral cavity of the dog, which, it is believed, is the first time that this has been done. The growth characteristics of the organism and the immunological response of the patient were studied. The isolation of the infecting agent from the dog confirms that the oropharyngeal flora of dogs is a reservoir of the organism: the fastidiousness and slow growth of this Gram negative bacillus may account for the small number of reported cases of infection caused by this organism.
Quantitative method for determining serum alkaline phosphatase isoenzyme activity II. Development and clinical application of method for measuring four serum alkaline phosphatase isoenzymes.
Authors: Shephard M D , Peake M J , Walmsley R N
Published: June 2007

A method for quantitating the liver, bone, intestinal and placental alkaline phosphatase activity of serum, using an algorithm for converting selective inactivation by guanidine hydrochloride, L-phenylalanine, and heat into equivalent isoenzyme activity is described. The method can individually quantify mixtures of isoenzymes to within a margin of 3%; it has acceptable reproducibility and has been used to develop both age and sex related reference ranges. Analysis time is about 30 minutes. The clinical reliability of this method has been shown in a study of 101 patients, in 79% of whom isoenzyme results were compatible with the final clinical diagnosis; in 10% a clinical diagnosis resulted from isoenzyme analysis, and in a further 11% the source of the increased alkaline phosphatase activity was identified and supported by electrophoresis, with a definite clinical diagnosis yet to be made.
New marker for mesothelioma: an immunoperoxidase study.
Authors: Donna A , Betta P G , Bellingeri D , Marchesini A
Published: June 2007

An antibody was raised against a protein isolated from the cytoplasm of mesothelioma cells. It was subsequently used in an immunoperoxidase procedure on formalin fixed, paraffin embedded tissue sections. A representative sample of benign and malignant tumours from all the systems of the human body was examined. All the tumours derived from coelomic surfaces (mesotheliomas of pleura, peritoneum, and ovary, and adenomatoid tumour of epididymis) reacted with the antibody. No other tumour tested in this study expressed the protein. These findings indicate that the antibody may be useful in the identification of mesothelioma cells in both histological and cytological diagnostic routine practice when morphological interpretation is in doubt.
Biopsy pathology of acquired immune deficiency syndrome (AIDS).
Authors: Boylston A W , Cook H T , Francis N D , Goldin R D
Published: June 2007

Between January 1982 and May 1986 279 biopsy specimens from 82 patients with acquired immune deficiency syndrome (AIDS) were examined. A wide variety of infectious conditions were diagnosed, the commonest being Pneumocystis pneumonia (n = 36), cytomegalovirus (n = 21), a variety of fungi (n = 8), mycobacteria (n = 7). Kaposi's sarcoma was the commonest tumour (n = 40), and there were two cases of extranodal lymphoma. Striking features were the unusual sites of disease and the occasional paucity of organisms.
Clinical value of ELISA assays for IgM and IgG rheumatoid factors.
Authors: Stone R , Coppock J S , Dawes P T , Bacon P A , Scott D L
Published: June 2007

The clinical value of enzyme linked immunosorbent assays (ELISA) assays for IgM and IgG rheumatoid factors was assessed in a series of studies using rabbit IgG as antigen. The tests were reproducible with intra-assay coefficients of variation of 6% and could be simply and rapidly performed. Normal ranges were established using 106 sera from healthy controls. In a cross sectional study of 208 rheumatoid patients these assays were compared with the Rose-Waaler and laser nephelometric assessments of rheumatoid factor. In some patients there were discrepancies between rheumatoid factor positivity determined by one method or another. IgM ELISA and Rose-Waaler titres showed a significant correlation (r = +0.58; p less than 0.001), but there was a low correlation between IgM and IgG ELISA (r = +0.27; p less than 0.001). There was no evidence to show that the measurement of IgM or IgG rheumatoid factor gave significantly more clinical information than traditional tests such as the Rose-Waaler or latex agglutination tests.
Glycol methacrylate embedding for light microscopy. I. enzyme histochemistry on semithin sections of undecalcified marrow cores.
Authors: Islam A , Henderson E S
Published: June 2007

A simple, routine procedure for water miscible glycol methacrylate (GMA) embedding of undecalcified bone marrow cores, which preserves the activity of enzymes useful in diagnosing various haematopoietic disorders, is described. The GMA used in this study has a low acid content that eliminates background staining, and the modified May-Grünwald-Giemsa stain provides good definition and excellent colour differentiation of various haematopoietic cells in the bone marrow, thereby providing optimal conditions for the study of the morphology and enzyme activity of bone marrow cells in the same preparation. The method is simple, reproducible, requires no expensive equipment, and is suitable for routine processing of small bone marrow cores in any histopathology or haematology laboratory.
Activation of the alternative complement pathway: clinical application of a new technique to measure fragment Ba.
Authors: Senaldi G , Peakman M , Alhaq A , Makinde V A , Tee D E , Vergani D
Published: June 2007

A new laser nephelometric technique for the measurement of the alternative complement pathway fragment Ba has been developed. Activation of the alternative complement pathway was assessed in 16 patients with Gram negative bacteraemia, six with Gram positive bacteraemia, 20 with rheumatoid arthritis, and 18 healthy subjects. Patients with Gram negative bacteraemia had significantly higher values of Ba (median 14.8%) than controls (9.3%) (p less than 0.01), while patients with Gram positive bacteraemia and rheumatoid arthritis had values similar to those of controls (10.1% and 9.5%). The technique proved sensitive and precise, and is suitable for the routine laboratory evaluation of complement activation through the alternative pathway.
Adaptation of methods for glutamate dehydrogenase and alcohol dehydrogenase activities to a centrifugal analyser: assessment of their clinical use in anoxic states of the liver.
Authors: Shephard M D , Penberthy L A , Berry M N
Published: June 2007

Sensitive, precise, and rapid methods for the measurement of alcohol dehydrogenase (ADH) and glutamate dehydrogenase (GDH) were developed on the Cobas Bio centrifugal analyser. The optimal pH for ADH in caucasians was 9.8. Non-linearity of ADH enzyme activity was observed when samples were diluted in saline; linearity was restored when inactivated serum was used as diluent. ADH was shown to be a sensitive index of liver anoxia due to cardiorespiratory disturbance (clinical sensitivity 90%) and generalised anoxia. GDH exhibited sensitivity equal to that of alanine aminotransferase (ALT) but was inferior to gamma-glutamyltransferase (GGT) in the detection of specific liver disease. Both ADH and GDH were sensitive indicators of alcoholic liver disease.
Plasma intestinal alkaline phosphatase and intermediate molecular mass gamma glutamyltransferase activities in the differential diagnosis of jaundice.
Authors: Collins D , Goold M F , Rosalki S B , Mayne P D , Foo A Y
Published: June 2007

An assessment was made of the value of: (i) the demonstration of intestinal alkaline phosphatase in plasma for the differentiation of intrahepatic from post-hepatic jaundice in 122 jaundiced patients; and (ii) the demonstration of an intermediate molecular mass gamma glutamyltransferase in plasma for the identification of post-hepatic cholestasis in 74 jaundiced patients. The first test had a diagnostic sensitivity of only 32% with a specificity of 86%; the second test had a sensitivity of 50% and specificity of 75%. It is concluded that neither procedure is worth while.
Diagnosis of lung disease in acquired immune deficiency syndrome: biopsy or cytology and implications for management.
Authors: Francis N D , Goldin R D , Forster S M , Cook H T , Coleman D V , Shaw R , Pinching A J , Boylston A W
Published: June 2007

One hundred and twenty consecutive bronchoscopic examinations were carried out on 80 patients with acquired immune deficiency syndrome (AIDS) between January 1982 and December 1986. Ninety one paired biopsy and cytology specimens from 72 of these patients were analysed. There was no significant difference between biopsy and cytology in diagnosing Pneumocystis carinii pneumonia (0.95 greater than p greater than 0.1). In 10 cases P carinii pneumonia was diagnosed by biopsy but not cytology and in seven cases by cytology but not biopsy. Nineteen patients had multiple infections or Kaposi's sarcoma. Biopsy was more useful than cytology in the diagnosis of other infections (n = 20) and Kaposi's sarcoma (n = 2) with positive cytological correlation in only three of the infections. Biopsy and cytology together have a diagnostic yield of 78.3%. We conclude that all patients presenting with respiratory disease who have, or are in a high risk group for, AIDS should be examined by bronchoscopy at an early stage with both cytology and biopsy.
Cytogenic investigations in the assessment of response to treatment in neuroblastoma.
Authors: Bown N , Reid M M , Pearson A D , Davison E V , Malcolm A J , Craft A W
Published: June 2007

In a patient with stage IV disseminated neuroblastoma treated by chemotherapy extensive cytogenetic investigations were performed on the residual primary tumour and bone marrow immediately before myeloablative treatment and autologous marrow rescue. Two abnormal clones both showing lp+, a characteristic abnormality of neuroblastoma, were detected in cells from the residual primary tumour, providing direct evidence of persisting viable tumour. Such investigations should be a routine part of the assessment of response to treatment in patients with neuroblastoma, and could be extended to others in whom "second look" surgery is performed.
Syphilis screening in the Blood Transfusion Service: a report of four years' experience with the Treponema pallidum haemagglutination assay and the subsequent development of a rapid "spin" method.
Authors: Puckett A , Pratt G
Published: June 2007

A comparison of cardiolipin and a modified Treponema pallidum haemagglutination assay (TPHA) method over a four year period confirmed the superior sensitivity and specificity of TPHA. In 86,495 new donor sera 19 (0.02%) confirmed positive results were detected by TPHA, 10 of which did not react by the cardiolipin test. In 150,789 antenatal samples 49 confirmed positive results were found by TPHA, 30 of which did not react by cardiolipin. No cardiolipin positive, TPHA negative samples were confirmed as positive by the absorbed fluorescence treponemal antibody test, and overall 78% of cardiolipin reactions gave false biological positive results. Cardiolipin tests were continued only because of their speed. A further modification ("spin") of the TPHA has now been developed which is rapid, sensitive, and inexpensive, and in testing 21,807 sera, gave results equivalent to those of the previous "settle" method. Serious consideration should be given to dispensing with cardiolipin tests.
Maternal serum alpha fetoprotein concentrations in mid trimester in hepatitis B surface antigen positive and negative subjects.
Authors: Kitau M J , Grint P , Heath R , Chard T
Published: June 2007

Maternal serum alpha fetoprotein (AFP) was measured as part of a routine antenatal screening programme in 48 patients positive for hepatitis B surface antigen (HBsAg). After exclusion of two cases with obvious obstetric abnormalities there was no difference in AFP concentrations between subjects who were positive or negative for HBsAg.
Unusual immunophenotype displayed by histiocytes in haemophagocytic lymphohistiocystosis.
Authors: Herlin T , Pallesen G , Kristensen T , Clausen N
Published: June 2007

Extensive immunophenotypic studies in a 2 1/2 month old girl with haemophagocytic lymphohistiocytosis were performed to characterise the proliferating histiocytes of the disease. The cells strongly expressed conventional macrophage antigens, but unexpectedly, there was a dissociated expression of the CD1a antigen (reacting with the monoclonal antibody NA1/34 but not with OKT6) and intracellular S-100 protein by the haemophagocytic lymphohistiocytosis histiocytes. These findings indicate that there is a "hybrid" phenotype between the two main arms of the mononuclear phagocyte system--namely, Langerhans' cells and phagocytic macrophages.
Scintigraphy of the salivary glands in Sjögen's syndrome.
Authors: Arrago J P , Rain J D , Brocheriou C , Rocher F
Published: June 2007

Scintigraphy of the salivary glands with technetium-sodium pertechnetate (99mTc) was undertaken on 320 patients with oral dryness or connective tissue disease using a computer assisted method that gave quantitative results about the major salivary gland function. Compared with clinical and histological data, scintigraphy provides a sensitive method, even though it is not specific, for detecting minimal injuries to salivary glands in patients suspected of having Sjögen's syndrome. Moreover, it might differentiate between the Sjögen-like syndrome and the sequelae of radiotherapy in patients with bone marrow graft. Scintigraphy of the major salivary glands could therefore form part of the routine investigation of patients with Sjögen's syndrome.
Diffuse axonal injury in early infancy.
Authors: Vowles G H , Scholtz C L , Cameron J M
Published: June 2007

Diffuse axonal injury typified by retraction balls and axonal swellings was identified in the brains of a series of infants, 5 months old and younger, who had suffered closed head injuries. These axonal discontinuities were shown by using Nauomenko and Feigin's silver method, which is particularly useful for showing fine axons such as those found in the developing brain. Diffuse axonal injury in early infancy may occur in the same way as that described in adults. The low incidence of intracerebral haematomata suggests that recurrent trauma to the head from a combination of direct contact and shaking results in axonal damage to the poorly myelinated axons and that blood vessels are rarely damaged.
Serum alpha-thiol protease inhibitor concentrations in health and disease.
Authors: Webb J R , Cooper E H , Forbes M A
Published: June 2007

Serum alpha-thiol protease inhibitor (alpha-TPI) concentration was assayed by radial immunodiffusion in normal subjects, pregnant women, and in a wide variety of diseases. The normal concentration (448 (SD 75) mg/l) increased significantly (p less than 0.001) in pregnancy to 575 (89) mg/l, and in prostatic cancer treated by oestrogens to 666 (87) mg/l. Inconsistent changes were observed in inflammatory and malignant disease and in liver disease. A temporary pronounced fall of alpha-TPI was seen after burn injury, and a sustained fall after bone marrow transplantation. Crossed immunoelectrophoresis showed that the serum alpha-TPI occurred in two forms, with alpha 2 and alpha 1 electrophoretic mobilities. A heavy demand on this antiprotease may result in suppression of the alpha 1 form.
Incidence and clinical importance of bone marrow eosinophilia in Hodgkin's disease (BNLI Report No 29). British National Lymphoma Investigation.
Authors: Macintyre E A , Vaughan Hudson B , Vaughan Hudson G , Jelliffe A M , Linch D C
Published: June 2007

A retrospective study of 136 bone marrow aspirates was undertaken before treatment to evaluate the importance of bone marrow eosinophilia in Hodgkin's disease. This occurred in 28 patients (21%) but did not correlate with age, sex, B symptoms, histopathological type or peripheral blood count. It also had no effect on survival. Bone marrow eosinophilia, therefore, seems to represent a common but non-specific reaction to Hodgkin's disease.
Wise Anaerobic Work Station: an evaluation.
Authors: Sisson P R , Ingham H R , Byrne P O
Published: June 2007

The Wise Anaerobic Work Station permitted the growth of type cultures of a range of fastidious obligate anaerobes. In the isolation of anaerobic bacteria from clinical specimens the performance equalled that of a standard anaerobic jar incubated for 48 hours, and gave results superior to those obtained when incubation of jar cultures was interrupted at 24 hours. The Wise Anaerobic Work Station was easy to use and provided comfortable working conditions; running largely on industrial nitrogen, it was more economic than anaerobic cabinets or jars using conventional gas mixtures.
Prostatic infiltration in chronic lymphatic leukaemia.
Authors: Cachia P G , McIntyre M A , Dewar A E , Stockdill G
Published: June 2007

Forty six men with chronic lymphatic leukaemia (CLL) were studied for up to seven years. Six patients required surgery for prostatic outlet obstruction. Histological examination of the prostatic chippings showed variable degrees of infiltration with small mature lymphocytes in all six patients, suggestive of a leukaemic origin for the cells. Patients with chronic lymphatic leukaemia who undergo prostatectomy may have a higher incidence of leukaemic infiltration than has been previously recognised.
Laboratory diagnosis of megaloblastic anaemia: current methods assessed by external quality assurance trials.
Authors: Dawson D W , Fish D I , Frew I D , Roome T , Tilston I
Published: June 2007

The results of an Interregional quality assurance scheme for tests in the diagnosis of megaloblastic anaemia were reviewed to assess the methods used. Serum folate assays showed great variation between methods, partly due to limitations in assessment by external quality assurance. Red cell folate assays yielded widely different results and much imprecision due both to the differences in preparation of the haemolysate and to the problems inherent in radioassay of a mixture of folate compounds. Intrinsic factor antibody tests showed appreciable variation in sensitivity. There was considerable inconsistency in the detection of polymorph nuclear hypersegmentation.
Xanthogranulomatous cholecystitis: clinicopathological study of 13 cases.
Authors: Roberts K M , Parsons M A
Published: June 2007

In a retrospective three year study 13 cases of xanthogranulomatous cholecystitis (XGC) (seven female, six male) were found in 724 gallbladders (1.8%), an estimated incidence of 1.7 cases per 100,000 population per annum. Symptoms often began with an episode of acute cholecystitis and persisted for up to five years. There was extension of xanthogranulomatous tissue into adjacent organs in nine cases. Three patients had fistulae from the gallbladder, one to skin, and two to the duodenum; this is the first report of this complication in XGC. In two patients XGC sufficiently resembled carcinoma for the surgeon to request intraoperative frozen section diagnosis. There was a high rate of postoperative infective complication, with one subphrenic abscess and three wound infections (one fatal), two in patients with fistulae.
Cell surface expression of beta 2-microglobulin (beta 2m) correlates with stages of differentiation in B cell tumours.
Authors: Jones R A , Scott C S , Norfolk D R , Stark A N , Child J A
Published: June 2007

Cell surface beta 2-microglobulin (beta 2m) densities of malignant B cells were determined by enzyme immunoassay in 97 cases of immunologically defined lymphoproliferative disease. Absolute beta 2m densities were found to depend on disease category with the lowest levels found on cells from chronic lymphocytic leukaemia (mean = 5.6 ng/10(6) cells, n = 27); atypical chronic lymphocytic leukaemia (mean = 5.9 ng/10(6) cells, n = 8); and prolymphocytoid chronic lymphocytic leukaemia variant (mean = 6.0 ng/10(6) cells, n = 16). beta 2m densities for B non-Hodgkin's lymphoma (n = 14) and B prolymphocytic leukaemia (n = 17) cases were 8.1 and 10.0 ng/10(6) cells, respectively, and the highest densities were found on cells from "late-B cell" tumours (mean = 14.3 ng/10(6) cells). Plasma cells from cases of Ig secreting tumours expressed unexpectedly low beta 2m densities (mean = 9.3 ng/10(6) cells; n = 6).
Control of oral anticoagulant treatment by chromogenic prothrombin assay.
Authors: O'Donnell J R , Walker I D , Davidson J F
Published: June 2007

Doses of oral anticoagulants in 50 patients on long term treatment were easily and satisfactorily monitored over six months by an automated chromogenic assay of prothrombin (CPA). It is suggested that chromogenic assay of one or more of the vitamin K dependent coagulation factors would provide a readily standardised alternative to those conventional tests which depend on human brain derived reagents, now regarded as a biohazard.
Granulomatous lobular mastitis.
Authors: Going J J , Anderson T J , Wilkinson S , Chetty U
Published: June 2007

The clinical and pathological features of nine cases of granulomatous mastitis were compared with those of 10 cases of duct ectasia/periductal mastitis (DE/PM), all of which were associated with active granulomatous inflammation. Granulomatous mastitis affects a younger age group, and although there is some overlap with DE/PM, it has distinctive pathological features, particularly a lobule centred distribution, for which the term "granulomatous lobular mastitis" is recommended. There is a strong tendency for persistence or recurrence. Our cases of granulomatous mastitis all occurred in parous women, five of them within three years of pregnancy. Awareness of this condition is important, because surgery does not offer the best treatment of recurrent disease, and trials of adequate drug treatment, including corticosteroids, are required.
Carcinoid tumour of stomach and primary hyperparathyroidism: a new association.
Authors: Rode J , Dhillon A P , Cotton P B , Woolf A , O'Riordan J L
Published: June 2007

Three cases of carcinoid tumour of the stomach associated with primary hyperparathyroidism had the clinical and pathological features of a pluriglandular syndrome. Two of the patients showed multiple small polypoid carcinoids in the non-antral stomach, in conjunction with a parathyroid adenoma in one and parathyroid hyperplasia in the other case. One of these patients was also suffering from pernicious anaemia. A third patient had a large metastasising carcinoid arising in the gastric body and a parathyroid adenoma. Immunohistochemical stains for PGP 9.5 were positive in the carcinoids of all three cases. In all cases the carcinoids showed immunoreactivity for gastrin. A positive family history of endocrine hyperplasia and neoplasia was established in one case. It is suggested that patients with gastrointestinal carcinoids and their families should be evaluated for hyperparathyroidism, and patients with hyperparathyroidism presenting with upper gastrointestinal symptoms should undergo endoscopy to rule out gastric carcinoid tumours.
Detection of Trichomonas vaginalis antigen in women by enzyme immunoassay.
Authors: Yule A , Gellan M C , Oriel J D , Ackers J P
Published: June 2007

An enzyme immunoassay (EIA) was developed for the detection of Trichomonas vaginalis antigen in vaginal swabs. Four hundred and eighty two women attending a sexually transmitted disease (STD) clinic were tested; 44 (9.1%) were positive by culture, 32 (6.6%) were positive by wet film examination, and 54 (11.2%) were considered to be positive for trichomonal antigen by EIA. Taking culture as the reference method, the EIA had a sensitivity of 93.2% and a specificity of 97.5%. The predictive value of a positive test was 82% and that of a negative test was 99.3%.