bluuebunny/crossref_metadata_2025 huggingface dataset:
Histological and immunohistochemical study of hepatitis B virus in human immunodeficiency virus infection.
Authors: Goldin R D , Fish D E , Hay A , Waters J A , McGarvey M J , Main J , Thomas H C
Published: June 2007

Because the risk factors for human immunodeficiency virus (HIV) infection and hepatitis B (HBV) are similar and therefore coinfection is not uncommon, a detailed histological and immunohistochemical study of chronic hepatitis B infection in a group of 20 HIV positive Caucasian males (who did not have AIDS) and 30 HIV negative controls were undertaken. Using both the conventional histological classification and the Knodell histological activity index it was shown that HIV negative patients were more likely to have active disease and also more scarring than HIV positive patients. Hepatitis B surface antigen (HBsAg) expression was not significantly different between the two groups but expression of hepatitis Be antigen (HBeAg) and HBV-DNA polymerase was greater in those who were HIV positive. HIV positive patients are therefore more likely to have immunohistochemical markers of active viral replication, although histologically, liver disease is less severe. These findings have important implications for assessing the biopsy specimens in this group of patients and for treatment strategies aimed at improving their immune function.
Immunoreactive alpha interferon in cervical flat koilocytic lesions and intraepithelial neoplasia.
Authors: Stewart C J , Farquharson M A , McNicol A M , Foulis A K
Published: June 2007

Immunocytochemical staining for alpha-interferon was carried out on cervical biopsy specimens showing non-condylomatous koilocytic atypia (n = 12) and cervical intraepithelial neoplasia (n = 18), both of which are associated with human papilloma virus (HPV) infection. Normal cervical tissue obtained from hysterectomy specimens was also assessed. Koilocytes were not immunoreactive for alpha interferon and keratinocyte staining was observed in only four cases of intraepithelial neoplasia. HPV infection alone does not therefore seem to induce the production of alpha interferon in cervical squamous epithelium. There was variable but, in some cases, prominent staining of cells in the stromal inflammatory infiltrate as well as intraepithelial cells which had morphological and immunocytochemical characteristics of Langerhans' cells. Alpha interferon immunoreactivity in Langerhans' cells is in keeping with derivation from the mononuclear phagocyte system and may be important in the host response to HPV infection.
Role of nucleolar organiser regions in differentiating malignant from benign tumours of the colon.
Authors: Yang P , Huang G S , Zhu X S
Published: June 2007

An argyrophilic technique (AgNOR) was applied to paraffin wax sections of 12 tubular adenomas, 17 villous adenomas with moderate and severe atypia, and 21 colonic adenocarcinomas. The range of the mean number of nucleolar organiser regions (NORS) per nucleus was 1.54-3.28 (99% CI 2.29-3.04) for tubular adenomas 3.07-4.36 (2.98-4.43), and 3.60-5.02 (3.74-4.69) for villous adenomas with moderate and severe atypia, respectively, and 5.53-9.33 (6.15-8.54) for highly differentiated adenocarcinomas. The number of AgNORs permitted differentiation among the three groups. The differences observed were significant. Malignant tumour cells were characterised by a large number of AgNORs which were small in size and showed a scattered distribution. Nuclei of tubular adenoma and villous adenoma with moderate atypia had only a small number of large sized AgNORs in a clustered distribution. It is suggested that this method distinguishes malignant epithelial cells from benign cells of colon, even those with severe atypia, and that it is a useful adjunct to diagnostic histopathology.
Histogenesis of ovarian malignant mixed mesodermal tumours.
Authors: Clarke T J
Published: June 2007

The histogenesis of ovarian malignant mixed mesodermal tumours, which includes the concept of metaplastic carcinoma, is controversial. Four such tumours were examined for evidence of metaplastic transition from carcinoma to sarcoma using morphology and reticulin stains. Consecutive sections were stained immunohistochemically using cytokeratin and vimentin to determine whether cells at the interface between carcinoma and sarcoma expressed both cytokeratin and vimentin. There was no evidence of morphological, architectural, or immunohistochemical transitions from carcinoma to sarcoma in the four tumours studied. This suggests that ovarian malignant mixed mesodermal tumours are not metaplastic carcinomas but are composed of histogenetically different elements.
Severe granulomatous arthritis due to spinous injury by a "sea mouse" annelid worm.
Authors: Wilson G E , Curry A , Kennaugh J H , McWilliam L J , Watson J S
Published: June 2007

A case of destructive arthritis and soft tissue granulomatous inflammation occurred in a 25 year old man who had injured his right index finger while snorkelling in the Mediterranean. It was initially thought that he had fallen on a sea-urchin. He removed some spines at the time of injury but the finger became stiff, swollen, and painful, and after eight months with no symptomatic improvement amputation through the proximal phalanx was performed. Examination showed an exuberant granulomatous and foreign body type inflammation in the dermis and subcutaneous tissues and affecting the bone, with erosion of the cartilaginous surfaces of the proximal interphalangeal joint. Spines present in soft tissue sections contained no calcium but did contain chitin as shown by a von Wisseling reaction for chitosan. It is concluded that the chitinous spines almost certainly came from a sea-mouse (Phylum Annelida, family Aphroditidae). Sea mice are inconspicuous creatures which live on the sea floor and which may cause some injuries thought to be attributable to sea-urchins.
Early reconstitution of haematopoiesis after allogeneic bone marrow transplantation: a prospective histopathological study of bone marrow biopsy specimens.
Authors: van den Berg H , Kluin P M , Vossen J M
Published: June 2007

To study early haematopoietic reconstitution after bone marrow transplantation bone marrow biopsy specimens taken in the third week after transplantation were evaluated. Cellularity was highly variable; localisation of the various cell lineages and the ratios of myeloid cells to erythroid cells were abnormal. Clustering of cells of the same lineage in the same stage of maturation was prominent. The bone marrow stroma showed many anomalies, including increased fibre content, periodic acid Schiff positivity of fat cells, oedema, sinus ectasia and granulomas. A comparison of biopsy findings with clinical and laboratory data showed a correlation between the amount of erythroid cells and the day of appearance of reticulocytes, as well as the number of reticulocytes. Absence of clustering of haematopoietic cells in four of five patients was associated with either failure of engraftment or early leukaemic relapse. Variables such as infections and administration of possibly myelosuppressive drugs did not influence bone marrow biopsy findings.
Management of cytomegalovirus antibody negative patients undergoing heart transplantation.
Authors: Freeman R , Gould F K , McMaster A
Published: June 2007

In a series of 61 consecutive patients undergoing heart, heart and lung, and lung transplantation, 24 patients were known to be cytomegalovirus (CMV) antibody negative on the day of transplantation. Enzyme linked immunosorbent assays (ELISA) for CMV IgG were performed on donor samples on the day of operation. In 16 of the 24 susceptible patients the test was negative and the only preventive measure taken was the use of blood and blood products from CMV-antibody negative blood donors. None of these patients acquired primary infection with CMV. In another six patients the donor serum was found to contain CMV specific IgG, and in these patients, including one heart and lung transplant recipient, prophylaxis with CMV specific hyperimmune globulin was given. All six patients developed CMV IgM antibodies and in five there was an associated but clinically mild illness. None of these patients required treatment. In the remaining two patients ELISA tests on the donor sera gave equivocal results and hyperimmune globulin was withheld. Both patients developed primary CMV infection of greater severity than those given hyperimmune globulin and one required treatment. Reference tests confirmed that the donor sera contained CMV antibodies. Primary CMV infection in susceptible patients after heart transplantation can be avoided by the use of screened blood and blood products where the organ donor is seronegative to CMV and it can be improved by the use of prophylactic hyperimmune globulin where the donor is CMV antibody positive.
Chromosome 11 allele loss in sporadic insulinoma.
Authors: Patel P , O'Rahilly S , Buckle V , Nakamura Y , Turner R C , Wainscoat J S
Published: June 2007

DNA was extracted from tissue samples of three unrelated cases of insulinoma. Chromosome 11 allele loss was investigated using several chromosome 11 specific probes which detect restriction fragment length polymorphisms. In one case, which proved informative for many of the chromosome 11 markers, allele loss was shown on both 11p and 11q. This finding is of considerable interest as the allele loss closely corresponds to that recently reported in insulinomas occurring in the familial multiple endocrine neoplasia type 1 (MEN-1) syndrome.
Oxygen derived free radicals in patients with chronic pancreatic and other digestive diseases.
Authors: Basso D , Panozzo M P , Fabris C , del Favero G , Meggiato T , Fogar P , Meani A , Faggian D , Plebani M , Burlina A
Published: June 2007

To ascertain modifications in the activation products derived from oxygen free radicals in patients with chronic pancreatic and extra-pancreatic diseases, lipid peroxide activity was measured in the sera of 40 control subjects, 28 patients with pancreatic cancer, 49 with chronic pancreatitis, and 53 with extra-pancreatic diseases. In 142 of the subjects, elastase 1, amylase, and pancreatic isoamylase activities were also determined. Increased lipid peroxide activities were found in some patients with both chronic pancreatic and extra-pancreatic diseases. Patients with chronic pancreatitis studied during relapse had higher activities of lipid peroxides than those without active disease. No difference was found between the values in patients with pancreatic cancer with liver metastases and those without. Correlations were found between lipid peroxides and both amylase and pancreatic isoamylase activities; no correlation was detected between lipid peroxides and elastase 1. In benign biliary tract disease a correlation was detected between lipid peroxides and alanine aminotransferase and alkaline phosphatase activities. In all patients, however, a correlation was found between alkaline phosphatase and lipid peroxide activities. It is concluded that activation of oxygen derived free radicals occurs in chronic pancreatic as well as in extra-pancreatic disease; it seems to reflect the degree of inflammation.
Ploidy of smooth muscle tumours: retrospective image analysis study of formalin fixed, paraffin wax embedded tissue.
Authors: Dorman A , Graham D , Curran B , Henry K , Leader M
Published: June 2007

The feasibility of using an image analyser, the CAS 100, to assess the ploidy of smooth muscle tumours on formalin fixed paraffin wax embedded tissue was assessed. Various different methods of assessment were compared. A paraffin wax block of 15 leiomyomata and 13 leiomyosarcomata yielded serial sections of 3 microns, 5 microns, and 7 microns and a cytospin preparation (from a 50 micron section). Sections and cytospin preparations were stained with Feulgen and quantified using the CAS 100. The suitability of lymphocytes, previously suggested to be unsuitable as control cells in tissue sections due to the compact nature of their DNA, was assessed in sections and cytospin preparations and compared with endothelial cells, the standard alternative, on the same slide. Despite having a mean nuclear area of only 18.5 microns 2 in sections lymphocytes had a similar diploid peak--that is, 4.1 pg--to endothelial cells (mean nuclear area 39 microns 2). A comparison of 3 microns, 5 microns, and 7 microns sections showed 5 microns to be the optimal thickness. Cytospin preparations yielded histograms of superior quality than those from tissue sections. All 15 leiomyomata had a 5C exceeding rate of less than 0.3%. Ten of 11 histologically malignant tumours had a 5C exceeding rate of more than 5% (mean 14%) in sections and cytospins. Two leiomyosarcomata that had arisen in the lower gastrointestinal tract had a mitotic rate of less than or equal to 1/10 per high power fields and yielded histograms similar to those of the leiomyomata. It is concluded that formalin fixed, paraffin wax embedded tissue can be used for DNA quantification by image analysis; that tissue sections yield poorer results than cytospin preparations; that lymphocytes are reliable control cells in cytospin preparations; and that a population of cell greater than 5C is seen in 90% of leiomyosarcomata.
Fibrinolysis and the bleeding tendency in patients with hepatosplenic schistosomiasis.
Authors: Omran S A , Hussein N A , Mohamed A A , el-Kaliouby A H , Hussein A T
Published: June 2007

Fifty seven patients with schistosomiasis of the liver and spleen in both the compensated and decompensated states and 15 non-bilharzial subjects were studied. Fibrinogen, plasminogen, fibrinogen/fibrin degradation products, alpha 2-macroglobulin, antithrombin III and Cl-activator concentrations were evaluated in an attempt to assess abnormalities at various stages of the disease. The results showed a progressive decrease in fibrinogen and plasminogen concentrations; fibrin degradation products showed a progressive increase as the disease progressed. Together with a falling platelet count, these data indicate the possible occurrence of disseminated intravascular coagulation with enhanced fibrinolysis which was most pronounced in those who vomited blood. Antithrombin III concentration showed a progressive decrease in parallel with the progress of the disease, possibly due to decreased synthesis or increased consumption, or both. Cl-activator concentration showed no significant change from that in normal controls at any stage of the disease. These findings provide further evidence that disseminated intravascular coagulation and enhanced fibrinolysis in the late stages of schistosomiasis may contribute to the haemorrhagic diathesis seen in the liver and spleen.
Microbiological investigations into an outbreak of Pontiac fever due to Legionella micdadei associated with use of a whirlpool.
Authors: Fallon R J , Rowbotham T J
Published: June 2007

In the investigation of a large outbreak of non-pneumonic legionellosis at a leisure complex in Lochgoilhead, Scotland all direct cultures of environmental samples were initially negative for legionellae. Legionellae readily infect appropriate protozoa under suitable conditions, and following immunofluorescence to select specimens for special study, Legionella micdadei was isolated from whirlpool water via co-cultivation with Acanthamoeba polyphaga. L micdadei was also isolated, along with host amoebae, from the whirlpool filter. The use of amoebae in the isolation of legionellae from environmental (and other) sources can be of great value, especially if specimens shown by indirect immunofluorescence to contain legionellae fail to yield legionellae on routine culture.
Primary adenocarcinoma of the jejunum and ileum: clinicopathological review of 25 cases.
Authors: Lioe T F , Biggart J D
Published: June 2007

Between 1954 and 1988 only a total of twenty five cases of primary adenocarcinoma of the small bowel (excluding periampillary tumours) were recorded at the Department of Histopathology, Belfast City Hospital. Of these, 14 tumours were located in the jejunum: the remainder arose in the ileum. The average age at presentation was 61.3 years and a slight female to male preponderance of 1:7:1 was noted. The adenocarcinoma arose from a preexisting villous adenoma in six cases. The overall prognosis was poor, with a five year survival of 15.7%. All the survivors had tumours located in the jejunum. The single most important prognostic indicator was the depth of tumour invasion or stage at the time of diagnosis. Tumour size and grade did not seem to correlate well with survival. It is concluded that the rarity of these tumours and their inaccessibility hinder detection and treatment and that surgical resection is more effective than chemotherapy.
Cerebral lymphomas: review of 70 cases.
Authors: Adams J H , Howatson A G
Published: June 2007

Seventy cerebral lymphomas from 37 men and 33 women were reviewed and reclassified using the modified Kiel classification. Fifty two of the patients were over the age of 50 years (age range 23-85 years). Only two patients were known to be immune deficient--one case of AIDS and one renal transplant recipient. Necropsies only were performed on 31 cases, biopsies only in 23 cases, and both biopsies and necropsies in 16 cases. Systemic tumour was found in 16 of 47 necropsy cases. All the tumours available for review were classic diffuse non-Hodgkin's lymphomas. Where immunocytological studies were positive, the tumour cells were of B cell origin. None was of T cell origin, although reactive T cells in the tumours were frequently identified. It is concluded from this and other studies that the incidence of intrinsic cerebral lymphomas is increasing.
Clonality of T cell and phenotypically undefined lymphoid neoplasms: the value of genotypic analyses.
Authors: Hodges E , Stacey G N , Howell W M , Jones D B , Smith J L
Published: June 2007

The value of genotypic analysis for routine assessment of leukaemia and lymphoma was shown by the findings in a selected series of 30 cases. T cell receptor (TcR) gene rearrangements were observed in six out of nine cases of CD3+ CD8+ lymphocytoses and provided clear evidence for clonality in this group. The T cell proliferations in two of the remaining cases masked B cell lymphocytic leukaemia and hairy cell leukaemia, while in the third case no cause was found for the polyclonal proliferation. Heterogeneity of phenotype and genotype were observed in peripheral T cell lymphomas: one out of six cases showed TcR gene rearrangement, one case retained its germline configuration, a further case masked B cell lymphoma and the remainder were polyclonal. Genotypic analysis was helpful in the analysis of a tumour of mixed T cell and myeloid phenotype which was shown to be germline for TcR and immunoglobulin genes, consistent with a myeloid origin. Two histiocytic tumours were found to have clonal rearrangement of TcR genes. Nine out of 11 B cell tumours showed immunoglobulin gene rearrangement. It is concluded that genetic analyses are useful in the analysis of T cell, histiocytic, and B cell tumours in which an immunoglobulin phenotype cannot be defined.
Plasma fibronectin concentrations in patients with human immunodeficiency virus infection.
Authors: Torre D , Issi M , Sampietro C , Fiori G P , Chelazzi G , Ferraro G
Published: June 2007

Plasma fibronectin (PFN) concentrations were assessed in 21 patients with AIDS, in seven with AIDS-related complex (ARC), in 17 asymptomatic seropositive patients, and in 36 age and sex matched healthy control subjects. A single radial immunodiffusion technique was used to determine PFN concentration. A significant decrease in PFN concentrations was observed in patients with ARC and AIDS (especially in those patients with Pneumocystis carinii pneumonitis). On the other hand, normal PFN concentrations were observed in asymptomatic seropositive patients. The determination of PFN concentration in patients with AIDS and ARC may contribute to the diagnosis of such patients.
Cholesterol absorption by the gall bladder.
Authors: Ross P E , Butt A N , Gallacher C
Published: June 2007

Model and real biles were used to investigate factors influencing cholesterol and dextran (70,000 molecular weight) absorption by the gall bladder. Cholesterol absorption was proportional to cholesterol concentration when real bile was used, but model biles showed maximal absorption at cholesterol saturation. Reduction of temperature reduced cholesterol absorption and serosal secretion, but had little effect on dextran absorption. This indicates differences in uptake where cholesterol undergoes passive diffusion but dextran is taken up by fluid-phase endocytosis. Model bile prepared with a single bile salt showed lowest cholesterol uptake from cholate bile, but there was no difference in serosal secretion. Dextran uptake was also lowest from cholate bile, although serosal secretion was highest. These results show that an increase in the biliary content of dihydroxy bile salts increases gall bladder permeability to both hydrophobic and hydrophilic molecules and may lead to the accumulation of lipids in the mucosa, as seen in cholesterolosis.
Automated immunochemistry.
Authors: MaWhinney W H , Warford A , Rae M J , Lauder I
Published: June 2007

A prototype immunostainer, featuring totally enclosed slide chambers, a reagent carousel and a microcomputer controlled fluid transfer system, was developed. The machine offers total flexibility in choice of primary and detection reagents for each slide and has been successfully used for the immunochemical demonstration of a variety of antigens in paraffin wax and blood smear preparations. It is considerably cheaper to use than manual immunochemistry and will be even cheaper in a production version currently under development.
Monocytoid B cell lymphoma: clinical and prognostic features of 21 patients.
Authors: Cogliatti S B , Lennert K , Hansmann M L , Zwingers T L
Published: June 2007

Twenty one patients between 34 and 83 years of age with monocytoid B cell lymphoma (MBCL) of the lymph node were studied. The histological picture characteristically showed broad strands of medium sized cells with irregularly shaped nuclei and a fairly broad rim of slightly basophilic cytoplasm. One case developed into a centroblastic polymorphic lymphoma. Bone marrow infiltration was documented in three cases and leukaemic conversion in one case of MBCL. Seven patients had enlarged spleens. Eight patients were in stage I, five in stage II/IIE, two in stage IIIs and six in stage IV at the time of diagnosis. Of 18 patients subsequently followed up, eight were in complete remission, two in partial remission, and three were undergoing treatment at completion of the study; five patients had died. Relapse occurred in nine patients and was a common feature of MBCL. The prognosis of MBCL was comparable with that of other low grade malignant lymphomas. Fourteen patients presented with primary nodal lymphoma. In seven patients with nodal MBCL, however, a concomitant low grade B cell lymphoma of the mucosa-associated lymphoid tissue (MALT) was also found in the stomach (n = 4), nasopharynx (n = 1), salivary glands (n = 1) and thyroid gland (n = 1). Two of these cases developed into high grade lymphoma. These extra-nodal manifestations were found simultaneously with MBCL in five patients. In another two patients, however, these symptoms occurred in a later phase of the disease. It is emphasised that adequate staging procedures must be carried out in any case of nodal MBCL to exclude underlying low grade B cell lymphoma of the MALT.
JC70: a new monoclonal antibody that detects vascular endothelium associated antigen on routinely processed tissue sections.
Authors: Parums D V , Cordell J L , Micklem K , Heryet A R , Gatter K C , Mason D Y
Published: June 2007

A new monoclonal antibody, JC70, raised against a membrane preparation from a spleen affected by hairy cell leukaemia, recognises a membrane bound glycoprotein identical with that of the CD31 group of monoclonal antibodies. The antibody stains a fixation resistant epitope on endothelial cells in benign and malignant conditions in a wide variety of paraffin wax embedded tissue. JC70 stained malignant endothelial cells in 10 angiosarcomas with more consistency than monoclonal or polyclonal antibodies to factor VIII related antigen (FVIII-Rag). In four cases of Kaposi's sarcoma the antibody stained malignant endothelial cells but not spindle cells. It is concluded that antibody JC70 is of value for studying benign and malignant human vascular disorders in routinely processed tissue.
Use of urea filter paper disc to detect urease activity in Enterobacteriaceae by multipoint replication techniques.
Authors: Winter D B , McDermott S N
Published: June 2007

A new method of detecting urease activity in Enterobacteriaceae was developed. An 8.5 cm filter paper disc impregnated with 20% urea and 0.5% bromocresol purple was placed on the surface of a glucose fermentation plate after inoculation with a multipoint replicator and overnight incubation. This method was compared with the commercially prepared Mast urea agar (Multipoint) and Fuscoe's Urea Plate Medium. A total of 240 routine isolates of Enterobacteriaceae were tested for urease activity using the three methods. Sixty five isolates were positive by the three methods while 33 isolates gave differing results. The urea disc method was more sensitive for detecting urease activity in isolates of Klebsiella species, Morganella morganii, and Yersinia enterocolitica. It also overcame the problem associated with the other two media of diffusion of alkali end products through the medium.
Effect of sample volume on yield of positive blood cultures from adult patients with haematological malignancy.
Authors: Brown D F , Warren R E
Published: June 2007

Six hundred and sixteen blood samples from patients with haematological malignancy were each distributed equally among three identical cells in a Malthus Microbiological Growth Analyser. The mean (SD) volumes inoculated into sets in which one, two, or three of the three bottles were positive were 37.7 (10.1) ml, 37.4 (12.9) ml, and 37.7 (10.5) ml, respectively. Overall, clinically important organisms were isolated from one bottle only with 18 cultures, from two bottles only with 19 cultures, and from all three bottles in a set with 104 cultures. If the yield from a single bottle inoculated with a mean volume of 12.6 ml blood is taken as 100%, the yield from 25.2 ml in two bottles was 110.7% and the yield from 37.7 ml in three bottles was 115.6%. The increased yield from increased volume was considerably lower than that reported from unselected groups of patients, which suggests that the magnitude of bacteriaemia is greater in patients with neutropenia. The isolation of infecting organisms from the blood of patients with neutropenia is, however, particularly important in directing chemotherapy and consequently 45 ml blood samples from these patients continue to be requested.
Endothelial markers in malignant vascular tumours of the liver: superiority of QB-END/10 over von Willebrand factor and Ulex europaeus agglutinin 1.
Authors: Anthony P P , Ramani P
Published: June 2007

A new monoclonal antibody, QB-END/10, raised against the CD34 antigen in human endothelial cell membranes and haemopoietic progenitor cells, was studied for its usefulness as a marker of neoplastic vascular cells in 21 angiosarcomas and seven malignant haemangioendotheliomas of the liver. QB-END/10 was both more sensitive and more specific than Von Willebrand factor (VWF) and Ulex europaeus 1 agglutinin (UEA-1) in labelling endothelial cells and it did not cross react with epithelia as UEA-1 often does. Staining was uniformly strong and clear in all histological variants of these two tumours. QB-END/10 should prove particularly useful in the differential diagnosis of malignant vascular tumours of the liver.
Increased serum beta 2-microglobulin concentrations in hyperthyroid states.
Authors: Roiter I , Da Rin G , De Menis E , Foscolo G C , Legovini P , Conte N
Published: June 2007

Serum beta 2-microglobulin concentrations were determined in 21 untreated hyperthyroid patients (12 with Graves' disease, and nine with toxic nodular adenoma) and in 20 healthy controls. All subjects had normal serum creatinine concentrations and urine analysis. Both total and free thyroid hormones were significantly higher in the hyperthyroid groups than in controls. Beta 2-microglobulin concentrations were significantly increased in both groups of hyperthyroid patients compared with controls. No difference was found in the thyroid hormone and beta 2-microglobulin concentrations between both sets of patients. The beta 2-microglobulin and thyroid hormone concentrations were not correlated. These data show that hyperthyroidism is another cause of increased beta 2-microglobulin production along with viral infections, immunologically mediated diseases, and malignant neoplasms. The increased serum beta 2-microglobulin concentration in thyroid hyperfunction is probably related to metabolic rate, even if autoimmunity might contribute to its overproduction.
Detection of chloramphenicol resistance in Haemophilus influenzae.
Authors: Snell J J , Perry S F , Brown D F
Published: June 2007

An average of 358 (13%) of United Kingdom laboratories failed to detect resistance to chloramphenicol in strains of Haemophilus influenzae distributed by the United Kingdom National External Quality Assessment Scheme for Microbiology. Clear associations between methods used and results obtained show that error rates are minimised by the use of low content (10 micrograms) disc and a sensitive control strain of H influenzae.
Retrospective application of prognostic indices to pancreatitis discovered at necropsy.
Authors: Heatley M K
Published: June 2007

Six prognostic indices, which were developed to assess inpatients with acute pancreatitis, were evaluated for possible retrospective application. When applied to a series of 14 cases in whom pancreatitis was first diagnosed at necropsy, the index devised by Jacobs et al was found to be the most useful, because in nine of these cases eight or more of the variables required were available for assessment from the case records. In the other indices evaluated fewer than eight of the required variables were available for retrospective assessment in most cases. Although undiagnosed pancreatitis is probably uncommon as a sole cause of death, the retrospective use of one or more of these indices may help assess the severity of the patient's condition on admission to hospital.
Evaluation of commercial enzyme linked immunosorbent assay for detection of B19 parvovirus IgM and IgG.
Authors: Patou G , Ayliffe U
Published: June 2007

An indirect enzyme linked immunosorbent assay (ELISA) (Parvoscan-B19; Sweden) was compared with an in-house MACRIA for the detection of B19 specific IgM. A Parvoscan-B19 IgG test was also evaluated for its ability to detect a recent B19 infection in paired sera. Two hundred and twenty sera submitted to the laboratory for B19 serology and four MACRIA positive control sera were assayed for B19 IgM. Confirmation of the response of sera giving discordant results in the two assays was sought by the use of a "nested" polymerase chain reaction (PCR) for the detection of B19 DNA. The Parvoscan-B19 IgM test was 79% sensitive and 96% specific. Parvoscan-B19 was poor at detecting parvovirus infection in sera collected two to three months after the onset of symptoms. When sera collected more than seven weeks after the onset of symptoms were excluded from the analysis, Parvoscan-B19 IgM was 84% sensitive and 96% specific. Rubella specific IgM positive sera, rheumatoid factor positive sera, and heterophil antibody positive sera were also assayed for B19 IgM. No false positive results were encountered with these problematic sera. By using the cut off criteria for the Parvoscan-IgM test previously advocated by the manufacturers, 90% sensitivity and 87% specificity could be achieved. False positive results, however, occurred with six of the 17 rubella IgM positive sera, four of the 10 rheumatoid factor positive sera, and two of the 11 heterophil antibody positive sera tested. It is concluded that the Parvoscan-B19 was specific but insensitive when compared with in-house assays.
Audit of necropsies in a British district general hospital.
Authors: Harris M D , Blundell J W
Published: June 2007

A comprehensive study was made of the value of necropsies carried out over a six month period in Peterborough Health Authority, using a modification of the format proposed by Schned et al in Vermont, United States of America. Cause of death, clinical correlation, clinical factors contributing to death and clinical evaluation of the necropsy were recorded. The principal diseases were cardiac (33%), and neoplastic (29%). The pathologist disagreed with the clinical cause of death in 13% of cases and major unsuspected diagnoses were found in 30%. Seventy nine per cent of necropsies provided additional information, including feedback on clinical investigations. Clinicians' questions were answered fully in 87%. Necropsies were rated as "very valuable" in 44% of cases, "valuable" in 54%, and "of no value" in only 2%. In 14% of cases the clinical consultant stated that the results of the necropsy would affect future clinical practice. These findings underline the essential place of necropsies in both audit and postgraduate education. The format described could conveniently be used by other pathology departments as part of an audit program.
Familial antithrombin III deficiency and Mycoplasma pneumoniae pneumonia.
Authors: Creagh M D , Roberts I F , Clark D J , Preston F E
Published: June 2007

A 10 year old girl presented with a massive femoral vein thrombosis associated with Mycoplasma pneumoniae pneumonia. Subsequently type I familial antithrombin III deficiency was diagnosed. It is suggested that prophylactic measures aimed at preventing thrombosis should be considered in acutely ill subjects with infection and familial thrombophilia.
T cell receptor V beta expression by mucosal T cells.
Authors: Spencer J , Choy M Y , MacDonald T T
Published: June 2007

Immunohistochemistry with monoclonal antibodies to the T cell receptor V beta regions 5, 6, 8 and 12 was used to determine whether normal intestinal lymphocytes that are potentially exposed to many bacterially derived superantigens show any preferential expression of particular V beta regions compared with the blood. No difference between V beta expression in the mucosa and the blood was observed, suggesting that they share a common pool of alpha beta T cells and that there is no expansion of alpha beta T cells in response to bacterial "superantigens" in the gut. The T cell receptor V beta expressed by the activated T cells in the lamina propria of bowel from patients with Crohn's disease was also studied. There was no increase in V beta 8 expression in these cells, suggesting that the increase in V beta 8 observed in the blood and mesenteric nodes of patients with Crohn's disease is not of primary importance in the aetiology of the disease. Finally, V beta expression by mucosal T cells in coeliac disease was studied. There was no difference in V beta use by T cells in coeliac disease and those in the blood and normal jejunum.
Prospective study of quantitative aspects of audit in a large general histopathology laboratory.
Authors: Thomas J S , Lessells A M , McIntyre M A , Klys H S , Webb J N
Published: June 2007

A non-computerised method of accurate prospective analysis of the quantitative aspects of the work of a general histopathology laboratory was devised. The method entails monitoring the progress of all biopsy and cytology specimens through the laboratory during selected monthly periods of study. The data collected include details of specimen type, block/section/stain details for each specimen, and information about the timed progress through technical, medical, and secretarial stages of specimen/report handling. The results give a detailed breakdown of the biopsy and cytology workload of this department. They give information about the rate of passage of specimens through the system and identify reasons for delay in the reporting of some cases. The method is easy to operate and will allow for the analysis of specific effects--for example, staff changes--on the efficiency of the department. The data will also provide some of the information required for the costing of histopathology laboratory services, and the type of information obtained will probably become a necessary requirement for laboratory accreditation.
Ber-MAC3: new monoclonal antibody that defines human monocyte/macrophage differentiation antigen.
Authors: Backé E , Schwarting R , Gerdes J , Ernst M , Stein H
Published: June 2007

A new monoclonal antibody Ber-MAC3 is reported. It recognises a formol sensitive epitope of a not yet clustered monocyte/macrophage specific 140 kilodalton glycoprotein that is expressed on the cell surface and in the cytoplasm. In 30 cases of acute and chronic leukaemia, Ber-MAC3 staining was restricted to 15 myeloid leukaemias of M4 and M5 types. The tumour cells of two cases of true histiocytic malignancies were Ber-MAC3 positive, whereas those of all 280 malignancies of lymphocytic origin were negative. The latter included 52 cases of Hodgkin's disease and 41 cases of Ki-1 positive anaplastic large cell lymphomas which had previously been classified as true histiocytic lymphomas. Ber-MAC3 therefore seems to be of considerable value for selective identification of monocytes and macrophages at a certain stage of differentiation and seems to be suitable for diagnosing myelomonocytic or monocytic leukaemia and neoplasms of true histiocytic origin.
Mnemonic coding system for clinical data entry into laboratory computers: its effect on quality and efficiency.
Authors: Bailey I R , Page K B , Jones R G , Payne R B , Little A J
Published: June 2007

A simplified coding method for entering the clinical details found on pathology request cards was developed. The method uses a basic four letter code, derived from the initial character of the first four words in a clinical detail, being expanded to four characters with letters from the final word if the number of words is less than four. Rules were devised to cope with common medical terminology. In excess of 90% of clinical details on request cards are readily input by clerical staff using our coding system, and 8% of clinical details are used intelligently by the computer in scheduling further tests or automatically commenting on results. A carefully designed coding system such as the one outlined above could greatly facilitate input of clinical detail without the penalty of reduced throughput.
Demonstration of Chlamydia trachomatis in colposcopic cervical biopsy specimens by an immunoperoxidase method.
Authors: Edwards J M , Campbell A R , Tait A , Lusher M
Published: June 2007

A total of 31 cervical biopsy specimens were taken from 29 women attending a genitourinary medicine clinic, nine women (11 biopsy specimens) were known to have Chlamydia trachomatis cervicitis and 20 women were known to be free of chlamydial infection. The specimens were routinely processed to paraffin wax and stained by an anti-Chlamydia immunoperoxidase technique to localise the organisms. Of the 11 positive biopsy specimens three showed positive staining of elementary/reticulate bodies. In one case the surface endocervical cells showed large inclusions which were packed with chlamydial bodies. The diagnosis of chlamydial infection is difficult to make clinically and in routine cytological and histological specimens but immunoperoxidase staining can clearly identify C trachomatis inclusions in cervical biopsy specimens provided infection is severe.
Comparison of a modified thiazole orange technique with a fully automated analyser for reticulocyte counting.
Authors: Bowen D , Bentley N , Hoy T , Cavill I
Published: June 2007

Two independent methods for quantitating reticulocyte counts were compared. One used a modified thiazole orange technique and a flow cytometer (Becton Dickinson FACS); the other was a fully automated whole blood analyser (Sysmex R1000). Both methods gave comparable results with a coefficient of variation of less than 5%. Samples measured using the R1000 showed a negligible decrease in the reticulocyte count over five days at room temperature, although there was evidence of continuing intracellular maturation: with thiazole orange there was an apparent increase. A practical reference range of 20-70 x 10(9)/l was established from 89 normal subjects. The close correlation between the two independent estimates indicates the validity of the quantitation of the reticulocyte count and shows that automation allows significant changes within and below the normal range to be detected with a degree of reliability which was not previously possible.
Comparison of image analysis and flow cytometric determination of cellular DNA content.
Authors: Cope C , Rowe D , Delbridge L , Philips J , Friedlander M
Published: June 2007

A good correlation (r = 0.94) was obtained between the DNA indices (DI) using flow cytometry and image analysis of nuclei cytospins extracted from paraffin wax embedded tumour sections. Some of the limitations and problems associated with image analysis which came to light included an unacceptably high coefficient of variation (CV) and a "left-shift" in the DI in most DNA histograms obtained when using image analysis of 5 microns sections. In contrast, the DNA histograms generated using image analysis of cytospun nuclei from paraffin wax blocks were of good quality and similar to those obtained using flow cytometry. Variability in Feulgen staining was common and an important source of error despite rigorous control of the staining technique. This could be overcome by using internal controls such as fibroblasts rather than external controls (rat hepatocytes) to determine the diploid DI with image analysis. A thorough understanding and appreciation of the methodological problems associated with image analysis and flow cytometric determination of DNA content is required before these methods find widespread clinical application.
Simultaneous in situ genotyping and phenotyping of human papillomavirus cervical lesions: comparative sensitivity and specificity.
Authors: Graham A K , Herrington C S , McGee J O
Published: June 2007

The sensitivity and specificity of immunocytochemistry were compared with those of non-isotopic in situ hybridisation (NISH) for the direct detection of human papillomaviruses in biopsy specimens. Four monoclonal antibodies raised to the capsid protein of HPV16 were less specific than NISH: all four reacted with lesions containing HPV33, and HPV18. Absolute discrimination of HPV types, therefore, was not possible with the monoclonal antibodies used in this study. The relative sensitivities of these antibodies were also lower than NISH. Sequential immunocytochemistry and NISH on the same section showed that 2.9-13.0 times as many cells were positive by NISH than by immunocytochemistry using the most sensitive monoclonal antibody. These data indicate that NISH has higher diagnostic specificity and sensitivity than immunocytochemistry using monoclonal antibodies to the HPV16 capsid protein.
Immunohistological characterisation of amyloid deposits in renal biopsy specimens.
Authors: Fitzmaurice R J , Bartley C , McClure J , Ackrill P
Published: June 2007

The amyloid deposits in 21 renal biopsy specimens were subjected to a detailed immunohistochemical analysis using a panel of antibodies against recognised constituents of tissue amyloid. This was a retrospective study of material originally submitted during the investigation of various renal abnormalities and studied by a routine protocol including histochemistry, electron microscopy, and immunofluorescence. The presence of an amyloid was confirmed in all 21 cases. Seventeen cases contained P component and either amyloid A (AA) (11 cases) or an immunoglobulin light chain associated amyloid (six cases). Four cases contained amyloid material with unusual immunohistochemical findings; one case had AA and P-component (PC) in the interstitium, one case had lambda light chain and beta-2 microglobulin, one case had kappa light chain and Clq, and one case had lambda light chains only. It was possible, therefore, to identify precisely the amyloid constituents and thereby "type" the amyloid by immunohistochemical means. The availability of the antibodies used and their application using these techniques could simplify the confirmation of clinically suspected amyloidosis.
c-erbB-2 expression in different histological types of invasive breast carcinoma.
Authors: Soomro S , Shousha S , Taylor P , Shepard H M , Feldmann M
Published: June 2007

Sections of 149 breast carcinomas were examined for the over-expression of c-erbB-2 oncoprotein using the avidin-biotin immunoperoxidase technique and two different specific antibodies. These included the polyclonal antibody 21N and the monoclonal antibody 4D5. The tumours were divided into two main groups. The first included 75 cases of invasive ductal and classic invasive lobular carcinomas. The second group consisted of 74 cases with histological types known to have a good prognosis, including mucinous, alveolar variant of invasive lobular, medullary, tubular, cribriform and papillary carcinomas. Fifteen (20%) tumours of the first group were positive with the two antibodies. Fourteen of these were of the ductal type and one was a mixed invasive ductal and lobular carcinoma. Ten of the pure ductal cases had areas of comedo carcinoma. The intraductal elements in a further tumour were positively stained with 21N antibody only. None of the second group of tumours, which included histological types known to have good prognosis, stained with 4D5, although one mucinous carcinoma was positively stained with 21N. These findings suggest that in invasive breast carcinoma immunostaining for c-erbB-2 is mainly seen in a subgroup of ductal tumours, and that almost all other histological types, especially those associated with good prognosis, lack this expression.
Histometric studies on cellular infiltrates of tuberculin tests in patients with sarcoidosis.
Authors: Lowe J G , Gibbs J H , Potts R C , Stanford J L , Swanson Beck J
Published: June 2007

The density and microanatomical location of CD4 and CD8 lymphocytes and of monocytes/macrophages at the site of a tuberculin test were measured in 13 patients with sarcoidosis, and the results were compared with those seen in a group of healthy controls. The cellular infiltrate was significantly reduced in the sarcoid subjects compared with the controls for all cell phenotypes studied; the ratio of CD4 positive:CD8 positive lymphocytes was significantly increased in the sarcoid group. Clinically negative reactions showed substantial numbers of infiltrating mononuclear cells, although not as great as in clinically apparent reactions. A clinically negative tuberculin reaction does not necessarily imply anergy to the test substance and should not be termed "negative".