bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of adhesion molecules in the immunopathogenesis of giant cell arteritis.
Authors: Wawryk S O , Ayberk H , Boyd A W , Rode J
Published: June 2007

To explore the role of adhesion molecules in mediating mononuclear cell localisation, development of the granulomatous reaction, and cell mediated damage to the arterial wall in giant cell arteritis, 17 temporal artery biopsy specimens were examined. Eleven showed the histological features of giant cell arteritis and six showed no evidence of arteritis. All were examined for the expression of LFA-3, ICAM-1 and its receptor LFA-1, and HLA-DR. Temporal arteries with early features of arteritis, as well as histologically unaffected skip areas, showed a regional induction of ICAM-1 expression, but not HLA-DR, on smooth muscle cells of the media. ICAM-1 expression was detected in areas where a clinically important mononuclear cell infiltrate had not yet developed. In more florid cases of giant cell arteritis there was an additional widespread induction of ICAM-1 expression on intimal myofibroblasts. Strong expression of ICAM-1, HLA-DR, and LFA-3 was found on macrophages, epithelioid cells, and giant cells comprising the granulomatous lesion. The pattern of expression of these adhesion molecules suggests that they have a role in leucocyte traffic into the vascular lesion as well as in mediating the intercellular interactions which constitute the granulomatous response.
Value of quantitative nucleolar features in the preoperative cytological diagnosis of follicular neoplasias of the thyroid.
Authors: Montironi R , Braccischi A , Scarpelli M , Matera G , Alberti R
Published: June 2007

Nucleolar prevalence, size, and outline were investigated on cytological material from cold thyroid nodules obtained by fine needle aspiration. The percentage of nucleolated nuclei in follicular adenoma (32 cases) was less than in follicular carcinoma (26 cases). In adenoma most nuclei contained one nucleolus, and nuclei with two or more nucleoli were less common than in carcinoma where most cases showed the highest nucleolar diameter values. There was some overlap between adenomas and carcinomas, however, when the mean of the 10 largest values of the major nucleolar diameter was considered. In follicular carcinoma the percentage of marginated nucleoli--that is, those touching the nuclear membrane--was, in general, greater than 20%; in adenoma the values were equal to or lower than 16%. The overlap index showed that the percentages of marginated nucleoli and nucleolated nuclei are the two best discriminatory features between adenoma and carcinoma.
Cachexia and tumour necrosis factor-alpha in cytomegalovirus infection.
Authors: Tilg H , Vogel W , Herold M , Aulitzky W E , Huber C
Published: June 2007

Although cachexia is a common feature of cytomegalovirus infection, little is known about its cause. To explore any contributory role that tumour necrosis factor-alpha (TNF) might have the serum concentrations of TNF in eight patients who developed CMV disease after liver transplantation were investigated. All patients exhibited pronounced and long lasting increases in TNF serum concentrations. Increased endogenous TNF concentrations were associated with weight loss and anorexia. In contrast, liver transplant recipients without CMV disease showed no weight loss.
Comparison of IgG antibody profiles by immunoblotting in patients with acute and previous Toxoplasma gondii infection.
Authors: Moir I L , Davidson M M , Ho-Yen D O
Published: June 2007

The IgG antibody profile to Toxoplasma gondii proteins of less than 37 kilodaltons in sera from patients with acute and previous infection was studied by immunoblotting. Bands at 28, 29, and 36 kilodaltons were more common in acute infection (10 out of 10, nine out of 10, and nine out of 10, respectively) compared with previous infection (five out of 10, four out of 10, and one out of 10, respectively). The 6 kilodalton band was present in 10 out of 10 sera from patients with acute infection and five out of 10 sera from those with previous infection. A new observation is a doublet of bands of 22-25 kilodaltons present only in sera from patients with acute infection. This doublet may be a more reliable indicator of acute infection than the 6 kilodalton band.
Enterococcal meningitis in an HIV positive haemophilic patient.
Authors: Patton W N , Bienz N , Franklin I M , Hastings J G
Published: June 2007

A 25 year old, human immunodeficiency virus (HIV) seropositive, severe haemophilic patient was treated for suspected Pneumocystis carinii infection with high dose intravenous cotrimoxazole and subsequently with prednisolone. When he improved he was discharged on oral treatment only to return two days later, extremely unwell, with headaches, fever, sweats, tachycardia and hypotension. A lumbar puncture showed modest neutrophil pleocytosis but despite empirical antibiotic treatment with intravenous benzylpenicillin and cefuroxime he continued to deteriorate. Culture of cerebrospinal fluid subsequently grew Enterococcus faecalis that was resistant to trimethoprim and sensitive to ampicillin, rifampicin, and vancomycin. After a change in treatment to intravenous ampicillin and rifampicin he dramatically improved. Enterococcal meningitis is rare in adults but important to recognise and treat appropriately in view of its high mortality and relative resistance to antibiotics. In our case the combination of HIV infection and previous treatment with antibiotics or steroids, or both, were probable predisposing factors.
Haemorrhagic colitis and haemolytic-uraemic syndrome: false positive reaction with a rotavirus latex agglutination test.
Authors: Bendall R P , Gray J J
Published: June 2007

A stool sample from a child with haemorrhagic colitis and haemolytic-uraemic syndrome gave a positive reaction with the RotaScreen latex agglutination test in the absence of other evidence of rotavirus infection. When this test is performed on bloody specimens, positive reactions should be interpreted with caution and confirmed by other means.
Detection of Borrelia burgdorferi in patients with Lyme disease by the polymerase chain reaction.
Authors: Guy E C , Stanek G
Published: June 2007

Borrelia burgdorferi, the causative agent of Lyme disease, was detected in patients' serum by DNA amplification using the polymerase chain reaction (PCR). B burgdorferi was pelleted from serum samples by centrifugation (10,000 x g for 10 minutes) and lysed by treatment with ammonium hydroxide (100 degrees C for 15 minutes). Two pairs of "nested" PCR primers complementary to the gene encoding a major outer surface protein (OSP A) of B burgdorferi were used in DNA amplification under standard PCR conditions (Perkin-Elmer Cetus). Two out of five patients with erythema migrans, the characteristic primary skin lesion associated with early Lyme disease, were positive by the PCR. This method could form the basis of a useful routine laboratory test in those cases of early Lyme disease where conventional serological testing commonly yields equivocal or false negative results.
Heterogeneity of T cell lymphoblastic leukaemias.
Authors: Gómez E , San Miguel J F , González M , Orfao A , López-Berges C , Ríos A , López Borrasca A
Published: June 2007

Twenty eight out of 170 consecutive cases of acute lymphoblastic leukaemia (ALL) were examined. They were of T cell origin, with the following distribution: seven (28%) cases had pre-T or prothymic features; nine (36%) cases showed early thymocytic features, six (24%) had cortical features; and three (12%) had a "mature" phenotype. The remaining three cases could not be sub-classified. A striking finding was that pre-T ALL differed from intrathymic ALL not only in the absence of both E rosettes and intrathymic differentiation antigens, but also in the expression of two non-lineage specific antigens HLA-DR and CD10. Both antigens appear in the bone marrow from the very first stages of lymphoid differentiation, implying that the origin for pre-T ALL is bone marrow. A comparison of the clinical features of pre-T and thymic ALL showed that pre-T ALL disease showed a pattern more similar to non-T ALL disease: a lower incidence of mediastinal mass, absence of extrahaematopoietic disease, lower white cell counts and haemoglobin concentrations, and a higher incidence of bone pain. No obvious difference in response to treatment was apparent. The results show that T-ALL is not only a heterogeneous immunological group but also suggest that it may have different origins: bone marrow for pre-T ALL and the thymus for thymic ALL.
Ber-ACT8: new monoclonal antibody to the mucosa lymphocyte antigen.
Authors: Kruschwitz M , Fritzsche G , Schwarting R , Micklem K , Mason D Y , Falini B , Stein H
Published: June 2007

Using a newly established HTLV-1 positive T cell line as an immunogen, a new monoclonal antibody, Ber-ACT8, was produced. It reacts with in vitro activated T cells and a small subset of normal resting T cells, but not with resting B cells or any of the 29 established human permanent cell lines tested. Immunohistological analysis of a wide spectrum of human tissues showed that Ber-ACT8 reactivity is restricted to a few T cells in the peripheral blood, the extrafollicular areas of lymph nodes and tonsils, and splenic red pulp. In the gut Ber-ACT8 labelled most intraepithelial T cells and up to 50% of lamina propria T cells. The antibody also immunostained T cells present in the oral and bronchial mucosa. Double labelling on splenic cells, fresh blood lymphocytes, and in vitro activated T cells showed that most Ber-ACT8 positive cells coexpressed CD8. Ber-ACT8 did not react with any of the 14 Hodgkin's lymphomas nor any of the 172 non-Hodgkin's lymphomas tested, with the exception of 10 cases of T cell lymphomas, five of which were located in the jejunum and associated with coeliac disease, and one B cell lymphoma, and most cases of hairy cell leukaemia tested. Parallel immunostainings with Ber-ACT8, anti-TCR-beta (beta F1), and anti-TCR-delta showed that most Ber-ACT8 positive T cells carry the TCR of alpha beta type. Comparison of Ber-ACT8 with HML-1, B-ly7, and LF61 showed essentially the same reactivity and an identical molecular target. The molecular structure recognised seems to be a trimeric molecule with components of 150, 125 and 105 kilodaltons, with the Ber-ACT8 epitope localised on the 150 kilodalton chain. The 150 kilodalton molecule contains an 0-linked carbohydrate moiety of about 10 kilodaltons. Because of its very selective distribution, the trimeric antigen is a powerful reagent for the diagnosis of gut T cell-derived T cell lymphomas and other extranodal T cell lymphomas, as well as hairy cell leukaemia.
Detection of Epstein-Barr virus genomes in AIDS related lymphomas: sensitivity and specificity of in situ hybridisation compared with Southern blotting.
Authors: Hamilton-Dutoit S J , Delecluse H J , Raphael M , Lenoir G , Pallesen G
Published: June 2007

Eighteen cases of AIDS related, non-Hodgkin's lymphomas were examined for the presence of Epstein-Barr virus (EBV) genomes using in situ hybridisation with a 35S-labelled probe. The results were compared with those obtained independently by Southern blot analysis with a 32P-labelled probe of frozen tissue from the same tumours. Technically satisfactory results were obtained with both methods in 15 lymphomas. EBV DNA was detected in seven of 15 (47%) cases by in situ hybridisation and in eight of 15 (53%) cases by Southern blotting (including all the cases positive by in situ hybridisation). The results of EBV DNA detection by the two techniques were identical in 14 of 15 (93%) cases. In situ hybridisation gave no false positive results. This study shows that the sensitivity and specificity of in situ hybridisation for the detection of EBV genomes in AIDS related lymphomas approaches that of Southern blotting, even when using routinely processed archival, paraffin wax embedded material.
New sternal puncture needle.
Authors: Islam A
Published: June 2007

The needles most commonly used for obtaining bone marrow aspirates from the sternum are the Salah and Klima needles. They were designed in the 1930s, and except for the introduction of different kinds of stops and guards there has been no change in their basic structure and design. These instruments are small, do not fit properly in the operator's hand, and the lack of a T-bar handle often makes them difficult to manoeuvre; their introduction into the sternum by twisting or rotary movement of the hand can be cumbersome. To overcome all of these disadvantages an instrument was designed which is larger, provides better grip, and offers improved maneuverability. The stilette of this aspiration needle has a domed handle which rests snugly in the operator's hand and affords operator comfort, while the specially shaped large T-bar handle at the proximal end of the needle provides adequate and firm grip and also ensures precise control during the sternal puncture procedure.
HTLV-1 associated T cell lymphoma in South East Asia: case report and family study.
Authors: Wang T L , Liu T C , Chan L , Kueh Y K , Wong S Y
Published: June 2007

Geographic clustering of human T cell lymphoma/leukaemia virus type 1 (HTLV-1) infection is well recognised, particularly in south western Japan, parts of West and Central Africa, the south eastern United States and the Caribbean islands. Sporadic cases have been reported in many other parts of the world. The first case of HTLV-1 associated leukaemia/lymphoma (ATLL) in South East Asia is reported. Contact tracing showed a high incidence of carriers among the relatives.
Detection of Helicobacter pylori carriers by discriminant analysis of urea and pH levels in gastric juices.
Authors: Ameglio F , Abbolito M R , Giannarelli D , Citarda F , Grassi A , Gandolfo G M , Casale V
Published: June 2007

An alternative approach to the problems inherent in current methods for detecting Helicobacter pylori carriers--that of being generally time-consuming, expensive, and not sufficiently sensitive--was devised by using the urea concentration and pH levels of gastric juices. A linear discriminant analysis of these variables, measured in 54 patients submitted to digestive endoscopy for gastritis, provided a mathematical formula for assigning the subjects (previously classified by other standard methods) to groups of either positive or negative H pylori carriers. The results obtained showed a correct classification in 52 out of 54 cases with only one false negative and one false positive case.
Pathological mimics of chronic inflammatory bowel disease.
Authors: Shepherd N A
Published: June 2007

When all of the macroscopic and microscopic features of Crohn's disease and ulcerative colitis are present, the correct diagnosis is usually made without difficulty. When some of the changes are absent, the accuracy of diagnosis is reduced. This review has outlined those diseases which feature some of these pathological changes and may masquerade as idiopathic chronic inflammatory bowel disease. Some of the pathological mimics are iatrogenic while other common diseases, such as bacterial infection, ischaemia, and diverticulosis may produce confusing histological appearances. The picture is complicated by the fact that many of these pathological imitators may themselves cause or predispose to chronic inflammatory bowel disease, or may complicate chronic inflammatory bowel disease. For example, drugs and infectious agents are recognisable causes of relapse in ulcerative colitis; Crohn's disease may cause diverticulitis in patients with diverticulosis; and lymphoma may complicate ulcerative colitis. It behooves all practising histopathologists to recognise these mimics of ulcerative colitis and Crohn's disease to ensure appropriate management for patients with inflammatory pathology of the intestines.
Colour perception in pathologists: the Farnsworth-Munsell 100-hue test.
Authors: Rigby H S , Warren B F , Diamond J , Carter C , Bradfield J W
Published: June 2007

The value of many histological stains depends on the ability of the observer to differentiate colour. This ability was assessed in 30 histopathologists and cytopathologists of varying experience using the Farnsworth-Munsell 100-hue test. As a group, the pathologists performed better than a reference population. Twenty eight subjects showed a wide ranging ability to differentiate colour: none was colour blind. Three of the 30 pathologists, however, fell below the twentieth centile for normal subjects and only one was aware of this deficiency! They may unknowingly misinterpret subtle stains. Two of these three had specific and major defects which could affect their ability to interpret a wide range of less subtle stains. Those with the poorest colour discrimination were not those with the least experience of microscopy. Pathologists should be apprised of the importance of their ability to discriminate colour, and that formal colour vision testing of prospective histopathologists may be appropriate.
Problems of thermonuclease detection for identifying Staphylococcus aureus in blood culture broths.
Authors: Megson G M , Law D , Ganguli L A
Published: June 2007

The detection of thermonuclease by the Oxford strain and eight clinical isolates of Staphylococcus aureus in a variety of bacteriological broths with and without added blood was examined using a toluidine blue-DNA-agar plate method. In Isosensitest, brain-heart infusion, tryptic soy, nutrient and gas-liquid chromatography broths (all of which do not contain liquoid) thermonuclease detection was uncomplicated. In Bactec broths (containing liquoid) detectable thermonuclease activity was greatly reduced in the absence of blood. The addition of 10% blood to the Bactec broths restored the activity. Liquoid was shown to be responsible for the inhibition of thermonuclease activity, and its effect could be neutralised by the addition of blood, albumin, or haemoglobin. In specimens containing no blood, or insufficient blood to neutralise the liquoid in culture broths, more has to be added to prevent false negative reporting of S aureus. This can be done after growth at the time of thermonuclease testing. Clinical consequences of delayed identification of S aureus in routine blood cultures may be serious. The application of the thermonuclease test to blood culture broths is both fast and specific.
Evaluation of the Microring YT system for identifying clinical yeast isolates.
Authors: Ridgway E J , Allen K D
Published: June 2007

The Microring YT is a commercial system for identifying clinical yeast isolates. The system uses a series of discs impregnated with inhibitory agents mounted on a ring. The pattern of growth and inhibition produced provides a six digit code which can be compared with a table provided by the manufacturer. The performance of this system was compared with the API 32C in the identification of 606 yeast isolates (355 clinical and 251 environmental strains). The Microring YT system was in 72.6% agreement with the API 32C system. The sensitivity of identification of different species varied from 38% to 100%. The API 32C system has a more extensive database than the Microring YT and is thus more reliable for use, but it is considerably more expensive. It is concluded that although the Microring YT is cheap, easy, and convenient to use, it is inadequate for many common Candida species.
Assessment of the Glycotronic C blood glucose meter.
Authors: Forrest A R , Pitt E J
Published: June 2007

The performance of the Glycotronic C blood glucose meter, a pocket sized glucose strip meter, was assessed on the ward and in the laboratory. Theoretically there is a relation between blood glucose concentration, plasma glucose concentration and haematocrit when glucose is measured using conventional methods. The Glycotronic C meter would yield results about 20% greater than those of a conventional instrument when used to measure plasma glucose and about 15% less than a conventional instrument when used to measure the blood glucose concentration of a neonate. The Glycotronic C is easy to use and gives an acceptable performance for near patient use; it compares well with its current British competitors.
Sudden postoperative death caused by unheralded Mallory Weiss tears.
Authors: Humphrey G M , Benbow E W , Tait W F
Published: June 2007

Mallory Weiss tears are a common cause of upper gastrointestinal bleeding, typically reported as following repeated vomiting after an alcoholic binge. This association may have been overemphasised, and these lesions could be caused by a wide range of spontaneous and iatrogenic events. A case of sudden postoperative death caused by massive haematemesis, unheralded by any evidence of vomiting or retching, as a result of Mallory Weiss tears is reported.
In situ hybridisation of albumin mRNA in normal liver and hepatocellular carcinoma with a digoxigenin labelled oligonucleotide probe.
Authors: Murray G I , Paterson P J , Ewen S W , Melvin W T
Published: June 2007

AIMS: To study the localisation and distribution of albumin mRNA in normal liver and hepatocellular carcinoma by in situ hybridisation with an oligonucleotide probe. METHODS: A 51 base oligonucleotide was synthesised from a sequence at the 5' end of the human albumin gene and the probe was labelled at its 3' end with digoxigenin 11-dUTP. Formalin fixed, wax embedded sections of liver biopsy specimens were used to study the localisation and distribution of albumin mRNA. After in situ hybridisation the bound probe was visualised using a digoxigenin antibody conjugated with alkaline phosphatase. RESULTS: In normal liver albumin mRNA was detected in hepatocytes and no positive signal was observed in biliary epithelium, vascular endothelium, or Kupffer cells. In 75% (9/12) of the hepatocellular carcinomas studied a positive hybridisation signal was observed in tumour cells. CONCLUSIONS: Albumin mRNA can be detected in sections of formalin fixed, wax embedded liver, a digoxigenin labelled probe is ideally suited for in situ hybridisation of liver because there is no background from the detection system. The identification of albumin mRNA may be a useful marker of hepatocellular carcinoma, and the demonstration of albumin mRNA by in situ hybridisation overcomes the potential background problem associated with albumin immunohistochemistry.
Experience of a quality assessment scheme for non-laboratory glucose meters.
Authors: Trinick T R , Duly E
Published: June 2007

In late 1989 a quality assessment scheme was introduced for glucose meters at 12 non-laboratory sites in a unit of management. The overall monthly imprecision of the meters varied from 3.4% to 17.1%, the highest coefficients of variation being recorded for glucose concentrations outside the range 3-20 mmol/l. In the same period 37% of results fell outside +/- 10% of laboratory set target limits; 13% fell outside +/- 20% of these limits. Participants have been advised of the unreliability of results outside the range 3-20 mmol/l. The main benefit of the scheme has been the improved confidence of users in the results obtained.
Distribution of type IV collagen immunoreactivity to assess questionable early stromal invasion.
Authors: Stewart C J , McNicol A M
Published: June 2007

AIMS: To determine if the immunocytochemical delineation of subepithelial basement membrane can be used in the assessment of questionable early invasive cervical carcinoma. METHODS: The distribution of immunoreactive type IV collagen was examined in 15 cervical biopsy specimens in which the reporting pathologist had specifically described difficulty in assessing or excluding early invasion of subepithelial stroma associated with cervical intraepithelial neoplasia (CIN). The results were compared with those from biopsy specimens showing CIN III (N = 8), carcinoma with definite early stromal infiltration (FIGO stage 1a1) (n = 6), and more advanced invasive squamous tumours (FIGO stages 1a2 to 3) (n = 8). In all cases the immunocytochemical findings were assessed in relation to serial sections stained with haematoxylin and eosin. RESULTS: Six of the 15 diagnostically problematic biopsy specimens were considered, on review, to show early infiltration of subepithelial tissue and putative invasive foci were consistently absent in basement membrane. A similar pattern was observed in the "definite" early invasive cases. Eight problematic biopsy specimens were considered to show only in situ neoplasia; five of these had intact though occasionally attenuated basement membrane, three showed focal type IV collagen defects. In the remaining case biopsy trauma precluded further assessment. Basement membrane defects were identified in five of eight cases of CIN III, while three of eight squamous carcinomas showed partial retention of type IV collagen immunoreactivity around invasive tumour cell nests. CONCLUSIONS: Defects in subepithelial basement membrane occur in in situ and invasive neoplasia in the uterine cervix. Immunocytochemical staining for type IV collagen is of limited diagnostic value in the assessment of biopsy specimens with questionable early stromal invasion.
Comparative analysis of human papillomavirus detection by dot blot hybridisation and non-isotopic in situ hybridisation.
Authors: Troncone G , Anderson S M , Herrington C S , de Angelis M L , Noell H , Chimera J A , O'D McGee J
Published: June 2007

AIMS: To determine the relative diagnostic performance of non-isotopic in situ hybridisation (NISH) and a dot-blot assay for detecting human papillomavirus (HPV) on exfoliated cervical cells; and to correlate the results with cytopathological assessment. METHODS: Cervical smears and cytological samples were obtained from 122 patients during the same clinical examination and the presence of HPV sequences determined by NISH and dot-blot analysis, respectively. RESULTS: Dot-blot analysis gave an autoradiographic signal in 15 of 121 (12.4%) cases, while NISH detected viral genomes in 38 of 114 (33.3%) cases. Even in the presence of koilocytosis, where vegetative replication of the virus occurs, NISH was positive in over twice as many cases as dot-blot analysis (NISH 90%, dot-blot 40%), while in smears within normal cytological limits, where the viral copy number is likely to be considerably lower, the differences were more striking (NISH 31%, dot-blot 5%). CONCLUSIONS: These data show that NISH on cytological smears is more sensitive than a standardised dot-blot hybridisation assay for detecting HPV infection in cytological material and is therefore a more appropriate screening tool.
Cell sizing in chronic lymphoproliferative disorders: an aid to differential diagnosis.
Authors: Alexander H D , Markey G M , Nolan R L , Morris T C
Published: June 2007

AIMS: To determine if leucocyte volume distribution analysis (LVDA), obtained using a Coulter Counter Model S Plus IV, can be used to aid differentiation of chronic lymphoproliferative disorder (CLPD) subtypes. METHODS: Mean lymphocyte volume and lymphocyte distribution width were measured on each patient (n = 90) using a hard copy of an amplified LVDA histogram. The mean lymphocyte volume was taken as the mean of the values on either side of the peak at half maximum height. The lymphocyte distribution width was taken as the range of cell values between the two values used to calibrate the mean lymphocyte volume. A template showing typical histograms from commonly occurring CLPD was also produced on an acetate sheet. This was used to examine the histogram from each new patient to evaluate its usefulness as an alternative to the calculation of mean lymphocyte volume and lymphocyte distribution width. RESULTS: Mean lymphocyte volume and lymphocyte distribution width were significantly higher in B cell lymphocytic leukaemia of mixed cell type (B CLL/PL), B cell non-Hodgkin's lymphoma with peripheral blood spill, hairy cell leukaemia and T cell prolymphocytic leukaemia than in B cell chronic lymphocytic leukaemia (B CLL). The mean lymphocyte volume, but not the lymphocyte distribution width, was also significantly higher in T cell chronic lymphocytic leukaemia than in B CLL. The template gave an immediate preliminary indication of possible subtype(s) of disorder and could be used as an alternative to measurement of mean lymphocyte volume and lymphocyte distribution width. CONCLUSIONS: Electronic haematology analysers producing an LVDA provide a useful, cost effective cell sizing analysis which can aid the differentiation of subtypes of CLPD.
ICAM-1 expression in renal disease.
Authors: Chow J , Hartley R B , Jagger C , Dilly S A
Published: June 2007

AIM: To determine the role of intercellular adhesion molecule-1 (ICAM-1) in immune mediated damage in glomerulonephritis, and whether its expression correlates with disease activity. METHODS: Fifty three renal biopsy specimens from a range of non-immune renal disease and low grade and high grade glomerulonephritides were stained with ICAM-1. Positivity was assessed in the tubules. Tubular damage and accompanying interstitial inflammation were also noted. The ICAM-1 positivity in damaged and undamaged tubules was correlated with the three groups of renal disease. RESULTS: ICAM-1 positivity in undamaged tubules was observed in glomerulonephritis, and this showed a strong correlation with disease activity. In contrast, ICAM-1 positivity on damaged tubules correlated with evidence of chronic tubular damage, and was seen in a large proportion of cases, regardless of the underlying disease. There was no correlation between ICAM-1 positivity and a local lymphocytic infiltrate. CONCLUSION: ICAM-1 probably has an important role in the pathogenesis of glomerulonephritis. Its expression may be secondary to cytokines released by cells participating in the glomerular damage. As these cytokines also influence tubule function, tubular ICAM-1 expression may be a marker of the extent of tubular disturbance in glomerulonephritis.
Amyloid in prostatic corpora amylacea.
Authors: Cross P A , Bartley C J , McClure J
Published: June 2007

AIM: To determine the presence and nature of amyloid in prostatic corpora amylacea using immunohistological studies. METHODS: Prostatic tissue from 18 transurethral and two open resection specimens was studied. Paraffin wax embedded tissue sections were stained with haematoxylin and eosin and the alkaline Congo red method with and without previous treatment with potassium permanganate. Sections were also stained with antibodies to amyloid A, beta 2 microglobulin, lambda and kappa light chains, prealbumin IgA, G, M, S100 protein, prostatic specific antigen, amyloid P component and CAM 5.2 (control and blocking studies were performed). RESULTS: The prostatic corpora amylacea universally showed the presence of amyloid. In all instances this contained beta 2 microglobulin. CONCLUSION: Prostatic corpora amylacea represents a localised amyloidosis of beta 2 microglobulin origin that is unrelated to chronic renal failure and haemodialysis.
Antithrombin III deficiency and cerebrovascular accidents in young adults.
Authors: Graham J A , Daly H M , Carson P J
Published: June 2007

A young man with antithrombin III (AT-III) deficiency sustained a cerebellar venous infarct and recovered following treatment with AT-III concentrate. A family study showed that other members were affected. AT-III deficiency in this family was found to be due to a new variant AT-III TRURO 1. Young patients with strokes should be screened for thrombophilia.
Tissue artefacts caused by sponges.
Authors: Farrell D J , Thompson P J , Morley A R
Published: June 2007

Artefacts which occur during the processing of small biopsy specimens can cause sufficient tissue distortion to impair interpretation and can be a considerable source of nuisance. Triangular artefacts were noted in renal and liver biopsy specimens which were caused by foam sponges in embedding cassettes. Scanning electron microscopic examination of the sponges showed they comprised a mesh of scimitar-shaped rigid spikes which closely match the artefacts seen in the tissues.
Tubulovillous adenoma arising 30 years after ileocystoplasty.
Authors: King P H , Osborn D E , Mackay E H
Published: June 2007

The possibility of recurrent colonic metaplasia occurring as a complication of pelvic ileal pouches after ileo-rectal anastomosis has been raised. Several reports have documented malignant bladder tumours developing in patients many years after an ileocystoplasty. The case of a 50 year old man, who developed a tubulovillous adenoma in the ileal patch 30 years after an ileocystoplasty had been performed to enlarge a tuberculous shrunken bladder, is reported. The adjacent small intestinal mucosa showed features suggestive of colonic metaplasia.
Abnormal haemoglobin electrophoresis caused by BW 12C.
Authors: van Rhee F , Ware I , Littlewood T
Published: June 2007

BW 12C, a substituted benzaldehyde, stabilises haemoglobin in the oxy-conformation and has attracted interest as an anti-sickling agent. The drug causes a left shift in the oxygen saturation curve and may induce tumour anoxia and enhance the effect of cytotoxic drugs. During clinical trials in patients with cancer abnormal bands on haemoglobin electrophoretic strips were observed. This made correct diagnosis of abnormal haemoglobins impossible. Solubility tests for sickling disorders (Itano) also proved unreliable.
Renal AA amyloidosis in a patient with Bence Jones proteinuria and ankylosing spondylitis.
Authors: Quinton R , Siersema P D , Michiels J J , ten Kate F J
Published: June 2007

A patient with a 10 year history of monoclonal gammopathy of undetermined significance and Bence Jones proteinuria, and a 44 year history of ankylosing spondylitis, developed a nephrotic syndrome secondary to renal amyloidosis. Clinically the amyloidosis was ascribed to Bence Jones proteinuria rather than to the burnt out ankylosing spondylitis. However, histochemical and immunofluorescence staining techniques used to type the amyloid fibrils showed AA amyloidosis, implicating ankylosing spondylitis rather than monoclonal gammopathy as the underlying cause of the patient's systemic amyloidosis and consequent nephrotic syndrome. It is recommended that immunostaining of amyloid become a routine procedure to detect occult or apparently inactive disease.
Factors affecting the precision of warfarin treatment.
Authors: Britt R P , James A H , Raskino C L , Thompson S G
Published: June 2007

AIM: To determine what factors influence the precision of anticoagulant control using warfarin by examining the computerised records of 2207 patients. METHODS: Records from seven district general hospitals were combined and analysed. The precision of anticoagulant control was taken as the absolute deviation of International Normalised Ratio (INR) from target at the most recent determination. This quantity was examined using univariate and multiple regression analyses. RESULTS: Deviation of INR from target was continuously distributed, almost symmetrically about a mean of zero. The patients' age and sex had little bearing on control. Patients with a high target INR were more likely to be undertreated, and patients taking higher doses of warfarin were more likely to be overtreated. Previous over- or undertreatment were strongly related to poorer current control. The control of treatment varied substantially among the seven hospitals. One possible cause of this variation was the dose adjustment coefficient: the greater the dose adjustment for a given deviation from target INR, the better was the control achieved. CONCLUSION: Several groups of patients were identified whose control was less satisfactory and in whom anticoagulant treatment needs particular scrutiny: these include patients with a record of previous over- or undertreatment, but not elderly patients in general. The variation in control among hospitals is a source of concern that merits further attention to achieve better uniformity of anticoagulant treatment.
p53 protein in odontogenic cysts: increased expression in some odontogenic keratocysts.
Authors: Ogden G R , Chisholm D M , Kiddie R A , Lane D P
Published: June 2007

AIMS: To assess p53 protein expression in a range of odontogenic cysts arising in the mouth, including those of developmental and inflammatory origin. METHODS: p53 protein was identified using the polyclonal antibody CM-1, together with a standard immunoperoxidase technique. A total of 36 cystic lesions were examined, all of which were histologically benign. RESULTS: Expression of p53 protein was identified within the lining of five of 12 odontogenic keratocysts but was not detected in the other cystic lesions in the series. CONCLUSIONS: This is believed to be the first report that identifies increased expression of p53 protein in benign cystic epithelium. The increased expression of p53 protein in the nucleus is usually associated with malignant disease. These findings are relevant to the management of odontogenic keratocysts which have a tendency to recur, and also to Gorlin Goltz syndrome in which keratocysts and multiple basal cell carcinomas are features.
p53 expression in lymphatic malignancies.
Authors: Soini Y , Pääkkö P , Alavaikko M , Vähäkangas K
Published: June 2007

AIMS: To investigate the expression of p53 protein in malignant and benign lymphoid tissues. METHODS: Tissue from 42 non-Hodgkin's lymphomas, 10 Hodgkin's lymphomas, three atypical hyperplasias and five benign reactive hyperplasias was studied immunohistochemically for the expression of p53 protein. RESULTS: Of the 42 non-Hodgkin's lymphomas, 13 (31%) were positive for p53 in some of the tumour cells. In two cases the proportion of positive cells was more than 10% and in four cases it was between 1-5%. These six cases consisted of three Burkitt's lymphomas, one immunoblastic lymphoma, one centroblastic diffuse lymphoma and one angioimmunoblastic lymphoma. In seven cases the proportion of p53 positive tumour cells was less than 1%. These cases comprised three centroblastic diffuse, three centroblastic polymorphic diffuse, and one angioimmunoblastic type lymphoma. In three out of 10 (30%) Hodgkin's lymphomas, a proportion of the Reed-Sternberg cells were p53 positive. One of these was a mixed cellular subtype and two nodular sclerosing subtypes. p53 protein was not expressed in the three atypical hyperplasias or the five benign reactive hyperplasias of the lymph nodes. CONCLUSIONS: The presence of p53 positivity in non-Hodgkin's and Hodgkin's lymphomas indicates that mutations of the p53 gene may play a part in the development of these tumours. The concentration of p53 positivity in high grade lymphomas suggests that p53 is involved in the transformation of low grade lymphomas to more aggressive types. Because no p53 positivity was observed in benign lesions of the lymph nodes, positive p53 immunohistochemical staining in a lymphoid lesion suggests malignancy.
Combined immunohistochemical and immunofluorescence method to determine the phenotype of proliferating cell populations.
Authors: Ramshaw A L , Parums D V
Published: June 2007

AIMS: To determine the phenotype of proliferating cell populations. METHODS: The double immunostaining technique combines the autofluorescent properties of alkaline phosphatase substrate naphthol/Fast Red with immunofluorescence using fluorescein. Fresh human tonsil and fresh atherosclerotic aortic aneurysm wall tissue were studied using a panel of monoclonal antibodies including Ki-67, CD4, CD8, CD19, CD22, HLA-DR alpha, CD68 and CD31. RESULTS: This double immunostaining method permitted simultaneous colocalisation of different markers on the same cell and could be used to identify HLA-DR positive cells as well as proliferation associated Ki-67 positive cells in human tonsil tissue and in chronic periaortitis associated with advanced atherosclerosis. CONCLUSION: This technique is simple and the results may be viewed using a single fluorescence filter. The Fast Red reaction product is stable and does not fade under storage. The staining works particularly well with markers for nuclear antigens in combination with markers for cytoplasmic or surface antigens.
CD43 expression in B cell lymphoma.
Authors: Treasure J , Lane A , Jones D B , Wright D H
Published: June 2007

AIMS: To determine the expression of CD43 in frozen sections in a range of B cell lymphomas. METHODS: The monoclonal antibody WR14, clustered provisionally in the Fourth Leucocyte Typing Workshop as a CD43 reagent, was investigated by epitope blocking studies on formalin fixed reactive lymph node tissue, using the established CD43 antibody MT1, to validate its use as a CD43 reagent. CD43 expression was studied in 131 immunophenotypically defined B cell lymphomas, including lymphocytic lymphoma (Lc, n = 13), centrocytic lymphoma (Cc, n = 14), and a range of follicle centre cell lymphomas (FCC) including centroblastic/centrocytic follicular (CbCcF, n = 48), centroblastic diffuse (CbD, n = 39), centroblastic/centrocytic diffuse (CbCcD, n = 4), centroblastic follicular and diffuse (Cb FD, n = 3) and centroblastic/centrocytic follicular and diffuse (CbCc FD, n = 1). Nine lymphomas of mucosa associated lymphoid tissue (MALT) were also examined. RESULTS: Epitope blocking studies showed that WR14 is a CD43 reagent that binds to an epitope identical with or close to that recognised by MT1. Eleven of 13 (84%) cases of Lc and 11 of 14 (78%) cases of Cc expressed CD43; 87 of 95 (91%) cases of FCC did not. All eight low grade lymphomas of MALT were negative. One high grade lymphoma, transformed from a low grade MALT lymphoma, was positive for CD43. The expression of CD43 by tumours of B cell lineage was associated with the expression of CD5 (p < 0.001) although either antigen could occasionally be found in the absence of the other. CONCLUSION: CD43 reagents can be used in conjunction with CD5 antibodies for the immunophenotypic discrimination of follicle centre cell lymphomas from non-follicle centre cell lymphomas.
Intramammary lymph nodes.
Authors: Jadusingh I H
Published: June 2007

AIMS: To determine the prevalence and pathology of intramammary lymph nodes in breast specimens. METHODS: All breast specimens examined by a single pathologist over 70 months in a large teaching hospital were studied retrospectively. All the surgical pathology reports were reviewed. Relevant glass slides from cases in which intramammary lymph nodes were identified were also reexamined. RESULTS: Breast specimens (n = 682) were examined. Seven lymph nodes were found in five patients. The specimens comprised 533 biopsy specimens, 29 segmental resections, 22 reduction mammoplasties, 77 modified radical mastectomies and 20 gynecomastia mastectomies. No clinically relevant microscopical abnormalities were found in four lymph nodes and slight sinus histiocytosis was seen in two nodes. One node contained metastatic adenocarcinoma and benign glandular epithelial inclusions. CONCLUSION: Although rare, intramammary lymph nodes may be detected by careful gross examination of breast specimens even in the absence of clinical identification. They can occur in any quadrant of the breast and can display a variety of pathological conditions. Pathologists should be alert to the existence and potential importance of these lymph nodes.
Intradural bronchogenic cysts.
Authors: Wilkinson N , Reid H , Hughes D
Published: June 2007

The pathological findings of an intradural and extramedullary cyst in the mid cervical spinal canal are described in a 55 year old woman who presented with a short history of pain and paraesthesia of the right arm. Intradural well defined solitary cystic lesions in the spinal canal are uncommon, their pathogenesis is poorly understood, and their nomenclature is confusing. In this case the cyst was a bronchogenic cyst; these are a rare form of such cysts and they are thought to be a malformation arising from a split notochordal syndrome and not a teratoma.
Screening for Corynebacterium diphtheriae.
Authors: Wilson A P , Matthews S , Bahl M , Efstratiou A , Cookson B D
Published: June 2007

A throat swab from a 9 year old girl with pharyngitis yielded a non-toxigenic strain of Corynebacterium diphtheriae var mitis and Streptococcus group G. C pseudodiphtheriticum was isolated from the throats of two of her four brothers. In each case the isolate was sent to the reference laboratory before full identification. The growth was found to be mixed for one brother; the other isolate being a toxin producing C diphtheriae var gravis. The child was asymptomatic and the case proves that all colonial types on the Hoyles plate should be identified.
Severe thrombocytopenia secondary to asymptomatic cytomegalovirus infection in an immunocompetent host.
Authors: Wright J G
Published: June 2007

A healthy 33 year old man presented with a short history of purpura and easy bruising. Investigations showed profound thrombocytopenia with atypical lymphocytes in the peripheral blood. Marrow appearances were consistent with platelet consumption. Biochemical hepatitis was also noted. An infection screen showed the underlying diagnosis to be cytomegalovirus (CMV) infection. He was treated successfully with oral prednisolone. This subsequently tailed off without relapse. Careful examination of a stained blood film is needed in all cases of apparent idiopathic immune thrombocytopenic purpura.
Chronic giardiasis of the stomach.
Authors: Quincey C , James P D , Steele R J
Published: June 2007

Two cases of chronic giardiasis of the stomach diagnosed from gastric mucosal biopsy specimens are reported. The first case was associated with an acute-on-chronic gastritis and Helicobacter-like organisms, and the second with an adenocarcinoma of the stomach. In both cases the trophozoites had been missed in earlier biopsy specimens. As far as is known this is the first report of giardiasis of the stomach.
Restrictive endocardial fibroelastosis in a neonate without other cardiac pathology
Authors: Farrell D J , Skinner J R
Published: June 2007

A case is presented of constrictive endocardial fibroelastosis without other cardiac abnormality in a newborn infant who was treated successfully by orthotopic heart transplantation.
New rapid identification test for Clostridium difficile.
Authors: Aspinall S T , Dealler S F
Published: June 2007

AIMS: A set of five tests were developed and tested for their ability to confirm the identity of C difficile colonies within 30 minutes. METHODS: The relevant substrates were incorporated into four filter paper squares attached to a plastic carrier (Diffstrip), five enzymes/products (prolyl aminopeptidase, galactosidase, leucine aminopeptidase, acid phosphatase and indole). The strips were inoculated, incubated for 20 minutes, and reagents added. RESULTS: 96.4% (212 of 220) strains of C difficile were immediately differentiated from 51 other Clostridium spp tested. The remaining 3.6% (eight of 220) of C difficile isolates produced a reaction pattern similar to some of the Clostridium sporogenes tested and required additional tests. None of the other Clostridium spp tested produced reaction patterns similar to C difficile. CONCLUSION: The Diffstrip allowed colonies of C difficile to be confirmed within 30 minutes for 96.4% of isolates, with less than 4% requiring any additional tests. No strains of C difficile were misidentified and no strains of other Clostridium spp tested were misidentified as C difficile.
Parasitology: United Kingdom National Quality Assessment Scheme.
Authors: Hawthorne M , Chiodini P L , Snell J J , Moody A H , Ramsay A
Published: June 2007

AIMS: To assess the results from parasitology laboratories taking part in a quality assessment scheme between 1986 and 1991; and to compare performance with repeat specimens. METHODS: Quality assessment of blood parasitology, including tissue parasites (n = 444; 358 UK, 86 overseas), and faecal parasitology, including extra-intestinal parasites (n = 205; 141 UK, 64 overseas), was performed. RESULTS: Overall, the standard of performance was poor. A questionnaire distributed to participants showed that a wide range of methods was used, some of which were considered inadequate to achieve reliable results. Teaching material was distributed to participants from time to time in an attempt to improve standards. CONCLUSIONS: Since the closure of the IMLS fellowship course in 1972, fewer opportunities for specialised training in parasitology are available: more training is needed. Poor performance in the detection of malarial parasites is mainly attributable to incorrect speciation, misidentification, and lack of equipment such as an eyepiece graticule.