bluuebunny/crossref_metadata_2025 huggingface dataset:
HLA antigens in Hungarian patients with idiopathic haemochromatosis.
Authors: Czìnk E , Gyódi E K , Német K , Hollán S
Published: June 2007

Thirteen unrelated patients with idiopathic haemochromatosis (eight men, five women) were studied. The diagnosis was based on clinical, biological, and histochemical findings. HLA typing was performed in all 13 and in all of their available first degree relatives (n = 31). HLA A3 was present in nine of 13 probands (69.2% compared with 18.8% in the group of 53 healthy blood donors and 22.4% in a selected Hungarian population (n = 1910). HLA B7 was present in five of 13 probands (38.4% compared with 11.3% and 14.6%). An A3B7 antigen association was found in five of 13 patients. The A3B7 haplotype was found in three, A2B12 and A2B38 haplotypes were found twice in 10 genotyped probands. Pedigree studies showed that there was one unaffected homozygote, 24 heterozygotes, and six non-carriers. Extended family and population studies are necessary to establish the prevalence of the gene in Hungary and an association with haplotypes other than A3B7.
Cytogenetic analysis of a granulocytic sarcoma in a patient without systemic leukaemia.
Authors: Adam L R , Angus B , Carey P , Davison E V
Published: June 2007

Granulocytic sarcoma is a rare complication of leukaemia. Occasionally it presents before the development of systemic leukaemia when diagnosis may be difficult. A case of granulocytic sarcoma occurring in a patient with no overt evidence of leukaemia, but in whom cytogenetic analysis of the bone marrow showed a clonal t(12;13) translocation, is reported. Cytogenetic analysis of tissues in this disease may indicate evidence of systemic disease before overt morphological changes.
Comparison of two commercial kits for identifying and biotyping Haemophilus parainfluenzae.
Authors: Warren M , Ahmet Z , Houang E
Published: June 2007

The Minitek system and the more recently introduced Micro Scan HNID panels for the identification and biotyping of 98 V dependent Haemophilus isolates were compared. Identical results were obtained for 77 isolates. The discrepancy in the results of ornithine and urease was accounted for mainly by the mismatching of the identification by the two kits. When 13 isolates of H parainfluenzae with mismatched biotypes were re-examined, the results from Micro Scan correlated with 92% of those obtained by Christensen's urea broth and 100% by the ornithine test (Lab M); the corresponding figures for Minitek were 61% and 30%, respectively. Micro Scan was easy to handle on the bench and results were ready on the same day. These results suggest that further work is required to assess these two systems for the biotyping of H parainfluenzae.
Intestinal origin alkaline phosphatase activity in plasma for differential diagnosis of jaundice.
Authors: Kuwana T , Rosalki S B
Published: June 2007

Intestinal origin alkaline phosphatase activity (ALP) in plasma was measured by a sensitive immunocapture assay in 104 jaundiced patients--84 with intrahepatic and 20 with post-hepatic jaundice. Increased enzyme activities were observed in those with intrahepatic disease and subnormal values in those with post-hepatic disease. At a discriminant level intestinal origin ALP showed a diagnostic sensitivity of 77% for intrahepatic cholestasis, with a diagnostic accuracy of 75% for its differentiation from post-hepatic jaundice. This diagnostic accuracy is not as good as that derived with other techniques--for example, imaging--and the technique is therefore not recommended as a supplement or replacement.
Model system for optimising mRNA non-isotopic in situ hybridisation: riboprobe detection of lysozyme mRNA in archival gut biopsy specimens.
Authors: Martinez-Montero J C , Herrington C S , Stickland J , Sawyer H , Evans M , Flannery D M , McGee J O
Published: June 2007

The aim of this study was to optimise conditions for mRNA detection by nonisotopic in situ hybridisation (NISH) using biotinylated and digoxigenin labelled riboprobes. Because lysozyme gene transcripts are present at high concentrations in Paneth and other alimentary cells, archival gut biopsy specimens were chosen as a model system for these experiments. Most of the variables in NISH, from unmasking of mRNA, to its ultimate detection by peroxidase or alkaline phosphatase based detection systems, were examined in detail. The most important findings were that simultaneous heating of tissue targets and riboprobes at 95 degrees C for 15 minutes before hybridisation at 50 degrees C for two hours gave the most intense signal for lysozyme mRNA in Paneth cells, Brunner's glands, and lamina propria macrophages; digoxigenin labelled riboprobes gave a higher signal to noise ratio than their biotinylated counterparts, and probes 600 base pairs long were superior to shorter probes. It is concluded that the mRNA NISH method may be generally useful for detecting gene transcription in archival clinical biopsy specimens.
Oestrogen receptors in conjunctival malignant melanoma: immunocytochemical study using formalin fixed paraffin wax sections.
Authors: Paridaens D A , Alexander R A , Hungerford J L , McCartney A C
Published: June 2007

In a group of 15 women with conjunctival malignant melanoma six cases (40%) were shown to have oestrogen receptor positivity using a monoclonal antibody to oestrogen receptor related antigen (ER-D5, Amersham RPN.710) on formalin fixed, paraffin wax sections. Receptors were also present in the epithelium of these six cases but not in controls and cases without ER-D5 positivity in their tumours. A subset of these aggressive, intractable unilateral tumours may therefore be amenable to hormone treatment.
Alpha 1-antitrypsin deficiency, complement activation, and chronic liver disease.
Authors: Littleton E T , Bevis L , Hansen L J , Peakman M , Mowat A P , Mieli-Vergani G , Vergani D
Published: June 2007

Activation of the complement system, the main humoral mediator of inflammation, is restrained by the action of enzyme inhibitors including alpha 1-antitrypsin. Deficiency leads to chronic liver disease in about one in five children with this genetic defect. Complement activation was investigated in 34 children with alpha 1 AT deficiency (12 with minimal, 10 with moderate, and 12 with severe liver disease) and in 38 sex and age matched normal children by measuring the complement parent molecules C3, C4, the C3d fragment and by calculating the C3d:C3 ratio. C3 and C4 were lower in children with severe liver disease compared with controls, indicating impairment of hepatic protein synthesis or complement consumption. The C3d activation fragment was higher in all the patient groups when compared with controls while the C3d:C3 ratio, a measure of activation independent of the concentrations of the parent molecule, was higher in patients than in controls and increased with the degree of disease severity. These results suggest that complement may have a role in the pathogenesis of the chronic liver disease associated with alpha 1AT deficiency.
Intestinal graft versus host disease.
Authors: Bryan R L , Antonakopoulos G N , Newman J , Milligan D W
Published: June 2007

An ileocolectomy specimen was examined from a patient with graft versus host disease (GvHD). In addition to the characteristic histological features of this condition, both the small and the large intestine showed extensive destruction of mucosal tissue with survival of clusters of enterochromaffin cells. This appearance has previously been described only in the large bowel. Endocrine cells seem to be less vulnerable to the effects of GvHD than epithelial cells, resulting in their being spared, which is not seen in other types of crypt destruction.
Malignant glioma in laboratory workers.
Authors: Rutty G N , Honavar M , Doshi B
Published: June 2007

In 1989 an increased risk of cancer, with a higher than expected incidence of brain tumours, was reported in laboratory workers at the Pasteur Institute, Paris. Three cases of primary brain tumours occurring in three laboratory workers from one laboratory in a district general hospital also came to light. Although this may have been due to coincidence or geographic clustering, the need for stringent safety standards in all laboratories is reiterated, and it is proposed that a national register should be established to record the causes of death in laboratory workers.
Removal of inhibitor(s) of the polymerase chain reaction from formalin fixed, paraffin wax embedded tissues.
Authors: An S F , Fleming K A
Published: June 2007

A problem associated with use of the polymerase chain reaction to amplify specific DNA fragments from formalin fixed, paraffin wax embedded tissues is the not infrequent failure of amplification. One possible reason for this could be the presence of inhibitor(s), which interfere with the activity of the reaction. It has been shown that such inhibitor(s) exist when amplifying the human beta globin gene (which exists in human genomic DNA as a single copy gene) from routine clinical samples. A variety of methods to remove such inhibitor(s) were investigated. The results indicate that inhibitor(s) are removed by proteinase K digestion, followed by purification with phenol/chloroform, and centrifugation through a Centricon-30 membrane (30,000 molecular weight cut off). Other factors, including the length and concentration of the DNA sequence to be amplified, can also affect amplification.
Squamous cell carcinoma arising in endometriosis of the ovary.
Authors: Naresh K N , Ahuja V K , Rao C R , Mukherjee G , Bhargava M K
Published: June 2007

Squamous cell carcinoma arising in ovarian endometriosis is extremely rare, but a case is reported in a 62 year old woman. If such an ovarian tumour is discovered evidence of teratoma, Brenner tumour, or endometriosis should be sought. Extensive sampling is mandatory as the developing tumour often overgrows the foci of endometriosis, thus obliterating evidence of its origin.
Lack of c-erbB-2 oncoprotein expression in male breast carcinoma.
Authors: Fox S B , Day C A , Rogers S
Published: June 2007

A series of 21 male breast carcinomas were immunostained using NCL-CB11, an antibody directed against the internal domain of the c-erbB-2 transmembrane oncoprotein. In contrast to female breast cancer, where up to 35% of cases show positivity, all of these cases were negative. This suggests that no prognostic information regarding patient survival can be made in these patients and that male breast carcinomas may be under different growth control mechanisms from female breast carcinomas.
Distinction between antinuclear antibody and P-ANCA.
Authors: Lee S S , Lawton J W , Chak W
Published: June 2007

To differentiate between perinuclear immunofluorescence staining of antinuclear antibody (ANA) and the perinuclear form of anti-neutrophil cytoplasmic antibody (P-ANCA), the pattern after formaldehyde vapour fixation of normal human neutrophils was compared with that of standard ethanol fixation. Fifteen out of 17 myeloperoxidase antibody positive sera showed cytoplasmic staining on formaldehyde vapour fixed cells; 30 of the 32 ANA positive samples became negative or gave weak nuclear staining on the same substrate. Formaldehyde vapour fixation is a simple, useful technique for differentiating between ANA and P-ANCA.
Lung mast cells in plexogenic pulmonary arteriopathy.
Authors: Heath D , Yacoub M
Published: June 2007

The numbers of mast cells/mm2 of lung parenchyma were counted in four controls, 15 cases of primary plexogenic pulmonary arteriopathy (PPA), and 17 cases in which the arteriopathy was secondary to congenital heart disease, to determine if increased numbers occur in PPA and with what stage of disease they might be associated. Considerable accumulations of lung mast cells may occur in this disease, but these are not closely related to any particular histological stage in the development of the arteriopathy. It is postulated that while mast cells could conceivably exert a vasodilatory effect on constricted small pulmonary arteries, it seems more likely that they are part of the parenchymal changes that commonly develop in this disease.
Molecular specificity of two commercial enzyme linked immunosorbent assays for human immunodeficiency virus antigens.
Authors: Brown K E , Shanson D C , Mascagni P , Coates A R
Published: June 2007

Only "fair" agreement has been shown between the Abbott and DuPont enzyme linked immunosorbent assays when used for the detection of human immunodeficiency virus (HIV) antigen in serum samples from asymptomatic HIV antibody positive homosexual men. To investigate the discrepancies between the two ELISA results, further experiments were performed. The rabbit detector antibody solutions of both tests were western blotted and showed that the DuPont test was specific for p24; the Abbott detector antibody had bands for p18, p41-43, gp120 as well as p24. By using dilutions of a known amount of HIV antigen, the Abbott test could detect 20 pg/ml p24; the DuPont test could detect 30 pg/ml p24. The DuPont test was also more sensitive than the Abbott test at detecting a synthetic 104mer peptide of p24. Within the 104mer sequence two regions (294-318, 334-348 amino acids) inhibited the binding of the DuPont detector antibody, but no blocking was observed with the Abbott antibody. Although the Abbott test was slightly more sensitive at detecting HIV protein than the DuPont test, the major difference between the tests was in the molecular specificity, in that the Abbott test detected proteins other than p24. This may not be important for detecting antigen in cell culture, but it may affect the detection of antigenaemia in patients' sera.
Evaluation of a screening test for detecting urinary tract infection in newborns and infants.
Authors: Lejeune B , Baron R , Guillois B , Mayeux D
Published: June 2007

The results of a study of a screening test for urinary tract infection (UTI) in infants under 18 months is reported. Two hundred and forty three urine specimens were tested in the laboratory using AMES Multistix 8SG reagent strips read by photometer. The strips included three potential markers for urinary tract infection: leucocyte esterase, nitrite, and protein. The predictive value of a positive result (PPV) was low. The predictive value of negative test (NPV) when combining the screen of leucocyte esterase, nitrite, and protein was 99.4% with no difference between boys and girls. The test for leucocyte esterase had a 97.6% negative predictive value. An examination of the results by age confirms the good NPV in all age groups. Paediatricians should find Multistix 8SG strips a useful aid in the diagnosis of urinary tract infection in infants, and that costly culture of samples with negative strip tests can be avoided.
Oncocytic metaplasia of the nasopharynx or extra-parotid Warthin's tumour?
Authors: Griffiths A P , Dekker P
Published: June 2007

A case of oncocytic metaplasia obstructing the Eustachian tube in an elderly patient is described. Histologically, it was similar to Warthin's tumour of the parotid gland. The lymphocytes were predominantly T cell, unlike those of Warthin's tumour which are predominantly B cell. It is proposed that oncocytic metaplasia represents an early stage in the evolution of Warthin's tumour.
Atypical Ph negative chronic myeloid leukaemia presenting as sudden profound deafness.
Authors: Smith N , Bain B , Michaels L , Craven E
Published: June 2007

A patient with atypical Ph negative chronic myeloid leukaemia presented with the sudden onset of profound deafness. He survived only eight months. Detailed histological investigation performed at necropsy showed loss of ganglion cells and afferent nerve fibres in the cochlea and vestibule associated with extensive fibrosis and new bone formation in the labyrinthine spaces. Both leucophoresis and high dose chemotherapy capable of rapid cytoreduction are recommended in patients with chronic myeloid leukaemia with profound hearing loss, as conventional chemotherapy is rarely followed by recovery.
Cytological features of non-small cell carcinomas of the lung in fine needle aspirates.
Authors: Zusman-Harach S B , Harach H R , Gibbs A R
Published: June 2007

Fifty eight lung tumours were typed according to the second World Health Organization histological classification and compared with the cytological appearances obtained by fine needle aspiration in a total of 47 primary non-small cell carcinomas. The presence of glands, cell balls, branching or papillary structures, cylindrical cells and nuclear grooving were major diagnostic indicators for adenocarcinoma. Cytoplasmic macrovacuoles were more common in adenocarcinomas (69%) than in squamous (37%) and large cell (50%) carcinomas. Two or more of these features were combined in all well and moderately differentiated adenocarcinomas and in 67% of poorly differentiated adenocarcinoma. The major cytological indicators for squamous carcinomas were the presence of keratin and eosinophilic spindle cells with glassy or laminated cytoplasm. Granular cytoplasm was not specific for any histological type. A combination of the major features for both adeno- and squamous carcinoma was present in 58% of adeno-squamous carcinomas, including some poorly differentiated types. Correct typing could be obtained in almost all the well and moderately differentiated carcinomas and in about two thirds of the poorly differentiated tumours using FNA, provided that combinations and not individual variables are considered.
Class I and class II major histocompatibility complex antigens on hepatocytes: importance of the method of detection and expression in histologically normal and diseased livers.
Authors: Senaldi G , Lobo-Yeo A , Mowat A P , Mieli-Vergani G , Vergani D
Published: June 2007

Methodological differences in major histocompatibility complex (MHC) antigen detection were investigated on isolated, viable hepatocytes and cryostat hepatic sections from 27 children with liver disorders, six of whom had normal histology. Class I antigens were constantly found on sections using a three step immunoperoxidase technique after acetone/chloroform fixation, other techniques being less sensitive, or on isolated hepatocytes by indirect immunofluorescence alone. With mechanical isolation the percentage of positivity ranged from 85 to 100%, while with collagenase isolation it ranged from 22 to 49% on immediate testing, and from 53 to 80% after 24 hour incubation. Class II antigens were only detected in one patient with autoimmune chronic active hepatitis and two with primary sclerosing cholangitis. Flow cytofluorimetric analysis in 11 cases confirmed class II or class I positivity, or both, on isolated hepatocytes, allowing MHC antigen expression on hepatocytes to be measured. Class I and II antigen detection on hepatocytes is influenced by the technique used. Although class I antigens are invariably expressed on hepatocytes, class II antigens are only found on hepatocytes from patients with immune mediated liver disorders.
Simplified procedures for applying the polymerase chain reaction to routinely fixed paraffin wax sections.
Authors: Coates P J , d'Ardenne A J , Khan G , Kangro H O , Slavin G
Published: June 2007

The polymerase chain reaction was applied to the analysis of DNA contained in archival paraffin wax embedded material. DNA suitable for the reaction was obtained from these tissues by simple extraction methods, without previous dewaxing of tissue sections. When compared with unfixed material, the reaction efficiency was compromised, so that an increased number of amplification cycles were required to produce equivalent amounts of amplified product. This in turn led to an increase in amplification artefacts, which can be minimised by a simple modification of the standard reaction. Amplification of relatively large DNA fragments was not always successful, and it seems prudent to bear this in mind when designing oligonucleotide primers which are to be used for the amplification of archival material. The efficiency of the procedure can be improved by dividing the amplification cycles into two parts: this reduces the amount of reagent needed, is relatively simple and inexpensive, and can be performed in one working day.
Twelve cases of Ki-1 positive anaplastic large cell lymphoma of skin.
Authors: Banerjee S S , Heald J , Harris M
Published: June 2007

In seven of 12 cases of Ber-H2 (Ki-1) positive anaplastic large cell non-Hodgkin's lymphoma (Ki-1 ALCL) disease remained localised to skin, and in five there was extracutaneous spread. Four patients had histological evidence of pre-existing or coexisting mycosis fungoides, and three patients had a long standing history of eczema or ichthyosis. In two cases the presence of a T phenotype was shown in frozen sections, and in a further six cases a T phenotype was firmly established in paraffin wax sections. Four patients died less than one year after presentation (two with disseminated lymphoma; two from other causes); one died at five years with widespread lymphoma and the remaining seven cases were alive one to 14 1/2 years after presentation. Three of the four patients with associated mycosis fungoides had prolonged survival, contrary to the findings of previous reports which suggest secondary Ki-1 ALCL behaves aggressively. The recognition of these tumours is important because of their relatively good prognosis. The diagnosis can be readily substantiated immunohistochemically, using a simple panel of antibodies.
Globin chain synthesis in myelodysplastic syndromes.
Authors: Chalevelakis G , Karaoulis S , Yalouris A G , Economopoulos T , Tountas N , Raptis S
Published: June 2007

Globin chain synthesis was studied in the reticulocytes of 30 patients with various myelodysplastic syndromes (MDS) to determine the alpha:beta globin chain synthetic ratio and its probable prognostic value. The mean (SD) value of the total alpha:beta ratio was 0.82 (0.45) ranging from 0.05 to 1.73. The same ratio in 10 normal controls was 1.01 (0.04). This difference was significant. Furthermore, the alpha:beta ratios were lower than normal in 14 patients (alpha-thalassaemia-like) (group I), almost within normal limits in 11 (group II), and higher than normal in five (beta-thalassaemia-like) (group III). In each group almost all the FAB subtypes were represented. The addition of exogenous haem in several of the test samples resulted in a slight to pronounced increase in the alpha:beta ratios, particularly in group I. In 92% of the high risk cases (refractory anaemia with excess blasts (RAEB), chronic myelomonocytic leukaemia (CMML] or 87.5% of patients who finally developed acute non-lyphoid leukaemia (ANLL) low or normal alpha:beta ratios were found. No significant correlation was noticed between alpha:beta ratios and various haematological variables or survival. It is concluded that in MDS the alpha:beta ratio varied enormously across the entire population of patients, as well as within each FAB subtype, thereby restricting its prognostic value. Although haem deficiency may be implicated in some cases of MDS, why this should be remains unclear.
Immunoblotting and culture positive endocarditis.
Authors: Clark I , Burnie J P
Published: June 2007

Serum samples from patients with endocarditis due to Streptococcus mutans, Streptococcus pneumoniae, Streptococcus agalactiae, Streptococcus lactis and a "nutritionally" variant streptococcus were immunoblotted against antigenic extracts from all five species. In S mutans endocarditis there was an endocarditis specific pattern of IgM against bands of 220, 200, and 190 kilodaltons. In S pneumoniae IgM against antibody of a molecular weight greater than 150 kilodaltons was specific to endocarditis. In S agalactiae IgM against bands at 82, 71, and 66-67 kilodaltons was endocarditis specific. In S lactis endocarditis specific IgM was present against antigenic bands at 105, 66, 61 and 58 kilodaltons. With the "nutritionally" variant streptococcus it was impossible to distinguish between cases of endocarditis and controls.
What's in a burger?
Authors: Carr N J , Machin L G
Published: June 2007

In an attempt to confirm the presence or absence of central nervous tissue in commercially prepared beefburgers, four burgers were processed and stained using routine histological laboratory techniques. Constituent parts of the burgers could be identified readily. In this small sample no central nervous tissue was found. There is currently considerable general interest in the contents of foodstuffs, particularly now that certain specified bovine offals as well as central nervous tissue have been banned from human consumption. Conventional histological techniques may be of value in analysing the ingredients of beef products.
Ki-67 staining in histological subtypes of breast carcinoma and fine needle aspiration smears.
Authors: Kuenen-Boumeester V , Van Der Kwast T H , Van Laarhoven H A , Henzen-Logmans S C
Published: June 2007

Thirty four cases of invasive breast carcinoma were analysed for heterogeneity of Ki-67 reactivity in a tumour, and proliferative activity in various histological subtypes was compared. The growth factions determined in areas of central and peripheral tumour were the same. Mucinous and lobular carcinoma showed lower Ki-67 activity than ductal carcinomas. When ductal carcinomas were subdivided according to their dominant growth pattern, the carcinomas with a solid or comedo growth pattern showed the highest proliferative activity. These results largely confirm data from previous cell kinetic studies on the incorporation of radioactively labelled thymidine. A correlation between the growth fraction determined by Ki-67 in fine needle aspiration smears and cryostat sections of corresponding tumours was shown, implying that the immunostaining of cytological smears gives a reliable impression of the growth fraction of a tumour and may therefore be used in prospective studies.
Monocyte counting: discrepancies in results obtained with different automated instruments.
Authors: Goossens W , Van Hove L , Verwilghen R L
Published: June 2007

To determine the accuracy of several methods for measuring the monocyte count, the results obtained by a number of different automated cell counters were analysed. Considerable discrepancies occurred for monocyte counts obtained in normal blood among the counters. The results of a visual monocyte count on a total of 800 leucocytes were used as the reference method. The technique of measuring the monocyte count by using dual staining with monoclonal antibodies CD45 and CD14 provided the closest agreement with the reference method. Six other automated counting systems were assessed. Two of these systems (Coulter VCS and Technicon H1) gave results, which, although under-estimating monocytosis, correlated well with the results obtained by the reference technique. A third system (Toa Sysmex NE-8000) gave unreliable results. Three of the automated systems evaluated measured a "third population"--that is, monocytes together with other leucocytes. One of these systems (Ortho ELT 1500), overestimated the count, as expected, but correlated well with the reference method. The second of these "third population counters" (Coulter S Plus IV) correlated moderately well with the reference monocytosis, while the Toa Sysmex E-5000 correlated poorly. It is clear that problems exist in the evaluation of different instruments for counting monocytes. An accurate and reliable reference method is a pre-requisite to evaluate this aspect of cell counters. As the visual method is too cumbersome a different reference method would be useful. Based on the results of this study, it is suggested that the technique using fluorescence labelled monoclonal antibodies should be regarded as an acceptable alternative.
Measurement of acute phase proteins for assessing severity of Plasmodium falciparum malaria.
Authors: Gillespie S H , Dow C , Raynes J G , Behrens R H , Chiodini P L , McAdam K P
Published: June 2007

Seventeen adult patients with acute Plasmodium falciparum malaria, admitted to the Hospital for Tropical Diseases, were studied. Serial measurements of the serum concentration of C-reactive protein, serum amyloid A protein, and percentage parasitaemia were determined, together with initial measurement of serum electrolytes, liver function, haemoglobin, white cell and platelet counts. Initial C-reactive protein and serum amyloid A concentrations were increased (C-reactive protein mean 49.0 mg/l serum amyloid A 28 mg/l) falling towards the normal range by the seventh day of treatment. There was a significant correlation between the pretreatment parasite count and clinical and laboratory markers of inflammation. C-reactive protein and serum amyloid A concentrations correlated inversely with the serum sodium. These results indicate that measurement of acute phase reactants such as C-reactive protein and serum amyloid A may prove valuable in assessing the severity of P falciparum malaria, and in following the response to antimalarial treatment.
Plasma histamine in patients with chronic renal failure and nephrotic syndrome.
Authors: Gill D S , Fonseca V A , Barradas M A , Balliod R , Moorhead J F , Dandona P
Published: June 2007

Plasma histamine concentrations were measured using a commercially available monoclonal antibody radioimmunoassay in 38 patients with nephrotic syndrome, end stage renal failure, those receiving haemodialysis, and those receiving continuous ambulatory peritoneal dialysis to determine whether histamine may mediate damage to glomerular capillaries and arterial endothelium. Plasma histamine concentrations were significantly increased in all four patient groups when compared with those of controls and were the highest in two patients with pruritus. Raised plasma histamine concentrations in such patients are consistent with the hypothesis that histamine may contribute to the damage to glomerular capillaries and to arterial endothelium. These effects may be relevant to the pathogenesis of glomerular disease and atherosclerosis. Histamine may also contribute to the pathogenesis of pruritus in patients with chronic renal failure.
Primary squamous cell carcinoma of the terminal ileum.
Authors: Platt C C , Haboubi N Y , Schofield P F
Published: June 2007

A case of squamous cell carcinoma of the terminal ileum with no underlying duplication or inflammatory disorder is described. The neoplasm seemed to have originated from the surface epithelium, invading the wall and metastasising to the regional lymph nodes. The 65 year old patient was free of disease three years after having had the tumour removed. Previous reports of squamous carcinoma of the small intestine have been associated with intestinal duplication or metastatic disease from distant sites.
Audit of turn-around times in a microbiology laboratory.
Authors: Rogers S , Bywater M J , Reeves D S
Published: June 2007

To determine the turn-around time in a microbiology laboratory a survey form was designed to collect data on the origin and type of specimen and the dates and times when (i) the sample was taken; (ii) the specimen was received in the laboratory; (iii) the report was signed by the microbiologist; (iv) the report was sorted by the laboratory clerical staff; and (v) the final report was received on the ward. The cumulative time from sampling to a result arriving on the ward was 51.5 (SD 28.6) hours. The survey is a simple method of determining turn-around time and high-lighted minor deficiencies in the service which were easily rectified.
Ophthalmomyiasis caused by the reindeer warble fly larva.
Authors: Kearney M S , Nilssen A C , Lyslo A , Syrdalen P , Dannevig L
Published: June 2007

Two boys with ophthalmomyiasis caused by the first instar larva of the reindeer warble fly Hypoderma tarandi are reported. Both were 9 years old and came from the coast of northern Norway. One had ophthalmomyiasis interna posterior and one eye had been removed because of progressive pain and blindness. Histological examination showed the remains of a fly larva. The second boy had ophthalmomyiasis externa with a tumour in the upper eyelid, and histological examination showed a warble with a well preserved larva. Identification of the parasite in the histological material was based on the finding of cuticular spines and parts of the cephalopharyngeal skeleton identical with those of the first instar larva of H tarandi.
Human cervical epithelial cells that express HLA-DR associated with viral infection and activated mononuclear cell infiltrate.
Authors: Fais S , Delle Fratte F , Mancini F , Cioni V , Guadagno M , Vetrano G , Pallone F
Published: June 2007

The association between the expression of HLA-DR antigens on cervical epithelium and the local immune state of activation in colposcopically obtained biopsy specimens from patients with histologically documented wart virus infection was investigated. In normal cervical epithelium no HLA-DR staining was detected. No or few IL-2R positive cells were found in the contiguous sections. HLA-DR was expressed by epithelial cells in six out of the 14 samples of wart virus infection. The pattern of fluorescence was focal, but strong and diffuse, to the whole epithelial layer. In the six samples with HLA-DR positive epithelium the numbers of IL-2R positive cells in the lamina propria were strongly increased, ranging between 75 and 90%. HLA-DR expression by cervical epithelium was observed in only two of 12 samples from patients with mixed epithelial non-virus related abnormalities. No increase in the numbers of IL-2R positive cells was observed in this group of patients. Additionally, no significant differences in terms of T lymphocyte infiltrate were found among the three groups. The results indicate that wart virus infection is associated with enhanced HLA-DR epithelial expression and they lend support to the concept that in the human cervix the epithelium actively participates in the local immune response.
Production of plasma selectively depleted in fibrinogen by affinity chromatography.
Authors: Hirst C F , Stevenson K J
Published: June 2007

An affinity chromatography column was prepared using a polyclonal anti-fibrinogen antibody bound to Sephacryl S 1000. Normal human plasma was depleted of fibrinogen by passage through this column. The fibrinogen free plasma corrected the prolonged clotting times of plasmas deficient in factors V, VII, VIII and IX. Clottable fibrinogen was recovered from the column. An immunodepleted fibrinogen free plasma could fulfil a useful role in internal and external quality control alone, or in combination with other test materials; it could also be used in research.
Immunohistochemical demonstration of neurone specific enolase in bone marrow infiltrated by neuroblastoma.
Authors: Caillaud J M , Martinez-Madrigal F , Hartmann O , Carlu C
Published: June 2007

One hundred and two bone marrow samples were analysed by histological and immunohistochemical methods for neurone specific enolase (NSE). The biopsies were performed to determine the extent of bone marrow disease in 84 neuroblastomas, nine embryonal rhabdomyosarcomas, five Ewing's sarcomas, two cases of Hodgkin's disease and two lymphoblastic lymphomas. Twenty seven (32%) of neuroblastoma bone marrows showed metastases by conventional histological techniques and 33 (39%) after immunohistochemical staining with NSE. Five embryonal rhabdomyosarcomas, five Ewing's sarcomas, and two lymphoblastic lymphomas showed bone marrow metastases. Only one of these cases was reactive for NSE. NSE represents a very sensitive immunomarker for the follow up of neuroblastoma and improves detection of bone marrow invasion by neuroblastoma.
Detection of Chlamydia trachomatis by the polymerase chain reaction in swabs and urine from men with non-gonococcal urethritis.
Authors: Palmer H M , Gilroy C B , Thomas B J , Hay P E , Gilchrist C , Taylor-Robinson D
Published: June 2007

A polymerase chain reaction (PCR) was developed for Chlamydia trachomatis in which a 380 base pair DNA fragment was amplified. Amplification occurred with the DNA from the 15 serovars but not with that from other Chlamydia spp or with DNA from a variety of other organisms. Chlamydial DNA (10(-16) g) could be detected and the PCR seemed to be able to detect single organisms. Urethral swabs were obtained from 37 men with acute non-gonococcal urethritis (NGU), 18 (49%) of whom were positive for C trachomatis by MicroTrak. As a result of clinical re-examinations 65 urethral swabs were available for analysis by the PCR. In comparison with MicroTrak, PCR had a sensitivity of 95%, a specificity of 94%, a positive predictive value of 86% and a negative predictive value of 98%. The PCR was apparently less sensitive (82%) in tests on urine samples. Overall, however, values of sensitivity and specificity of the PCR compared favourably with those of MicroTrak. The PCR for C trachomatis is likely to be a valuable technique for research, but problems of DNA contamination suggest that it should not be recommended for routine diagnosis.
Absence of human papilloma virus in cervical adenocarcinoma determined by in situ hybridisation.
Authors: Young F I , Ward L M , Brown L J
Published: June 2007

A few studies using DNA technology have suggested that human papillomavirus (HPV) may be an aetiological factor for adenocarcinoma of the uterine cervix. Twenty one cases of cervical adenocarcinoma were studied by in situ hybridisation using biotinylated DNA probes for HPV types 6, 11, 16 and 18 and a streptavidin, biotinylated alkaline phosphatase detection system. Intranuclear HPV DNA was detected in none of the adenocarcinomas, while positive controls gave a clear intranuclear signal. Adjacent areas of normal, koilocytic, and dysplastic squamous epithelium also gave positive results. It may be that squamous epithelium contaminates adenocarcinomas reported as positive by Southern blotting. Our results showing absence of detectable HPV DNA within adenocarcinomas suggest that HPV infection may not have a major role in the aetiology of adenocarcinoma of the uterine cervix.
Cytomegalovirus infection in Gambian mothers and their babies.
Authors: Bello C , Whittle H
Published: June 2007

A 15 month longitudinal study of cytomegalovirus (CMV) infection in 178 Gambian mothers and their babies was undertaken. Twenty five (14%) of the babies were congenitally infected despite the fact that 87% of their mothers were antibody positive to the virus. Two of the 25 congenitally infected infants had evidence of severe neurological damage; skin sepsis was also a prominent feature in congenitally infected infants. The other children soon became infected. At 6 months of age, 53% of the infants were shedding virus either in urine or saliva. By the age of 12 months 86% of the infants had serological evidence of CMV infection. Preliminary evidence suggests that sibling to sibling infection in crowded compounds might be a major route of transmission.
Serological diagnosis of HIV infection: practice and performance in western Europe.
Authors: Glynn A A
Published: June 2007

Current laboratory practice in testing for HIV antibodies in western Europe was investigated by means of a questionnaire addressed to the 12 EC countries and Finland, Norway, Sweden and Switzerland. Despite inevitable regional differences there was a fair degree of homogeneity in broad laboratory organisation and in the types of tests and confirmatory strategies used. The primary test is always some form of enzyme linked immunosorbent assay (ELISA), though a number of laboratories also use agglutination tests. Confirmation is by an ELISA of a different type, or by Western blot, or both. The size and workload of laboratories covered a wide range. It is suggested that laboratories doing only a small number of tests at infrequent intervals should take extra care in validating their results and should be closely monitored. Twelve of the 16 countries studied have a quality assurance scheme for monitoring laboratory performance. Participation is voluntary but is invaluable even for the largest laboratories. The results suggest that the standard of laboratory diagnosis is reasonably uniform throughout the region, which is not only important for the individual patient but means that epidemiological comparisons of data from different areas have at least a sound technical base.
Neutropenia associated with X-linked agammaglobulinaemia.
Authors: Kozlowski C , Evans D I
Published: June 2007

In a series of six cases of sex-linked agammaglobulinaemia neutropenia occurred as a presenting feature in four and during the presenting illness in the other two. The six patients all had low antibody titres and absent or low immunoglobulin concentrations with normal concentrations of T cells and absent B cells. The patients were all first seen with severe, acute infection, including septic abscesses and meningitis; neutropenia resolved as the infection and immunoglobulin deficiency were treated. Haematologists should be aware that neutropenia is a common association of infection in patients with immunoglobulin deficiency.
In situ human papillomavirus (HPV) genotyping of cervical intraepithelial neoplasia in South African and British patients: evidence for putative HPV integration in vivo.
Authors: Cooper K , Herrington C S , Graham A K , Evans M F , McGee J O
Published: June 2007

In South Africa asymptomatic wart virus infection diagnosed by morphological criteria occurs in 16-20% of all ethnic groups; the incidence in black women is 66%. To identify human papillomavirus (HPV) types the prevalence of HPV in cervical intraepithelial neoplasia (CIN) in South African women (n = 72) with age matched British women (n = 73) was compared by non-isotopic in situ hybridisation (NISH) using digoxigenin labelled probes for HPV 6, 11, 16, 18, 31, 33 and 35 on archival biopsy specimens. A higher proportion of British biopsy specimens (68%) contained HPV than those from South Africa (50%) in CIN 2 and 3; this difference was due to HPV 16. Thirty six per cent of the positive biopsy specimens from South African women also contained HPV 33/35 compared with 16% in the United Kingdom. There was no difference in HPV detection with age in either group. These data indicate that HPV types vary geographically, with "minor" HPV types being more common in South Africa. Three qualitatively distinct NISH signals were observed; a diffuse (type 1) signal in superficial cells, mainly koilocytes; a punctate signal (type 2) in basal/"undifferentiated" cells in CIN 3; and combined type 1 and 2 signals in CIN with wart virus infection (type 3). The punctate signal may represent HPV integration.
Seminal polyamines as agents of cervical carcinoma: production of aneuploidy in squamous epithelium.
Authors: Fletcher S , Neill W A , Norval M
Published: June 2007

The effects of several polyamines found in seminal fluid on the cell cycle and ploidy of three cervical cell lines and of primary epithelial cells cultured from cervical biopsy specimens were monitored by fluorescent flow cytometry. The rate of cell growth did not change but there were indications of either hypodiploidy or hyperdiploidy in some cultures at certain concentrations of spermine and spermidine. An interaction of exogenous polyamines with the DNA of cervical cells was shown to occur, leading to changes in ploidy with, perhaps, the potential to induce or promote dysplasia.
Prognostic value of proliferative activity in lymph node metastases of patients with breast cancer.
Authors: van Diest P J , Matze-Cok E , Baak J P
Published: June 2007

Whether the proliferative activity of distant metastases could be predicted by the proliferation in axillary lymph node metastases was investigated in 304 lymph nodes metastases of 52 patients with breast cancer who had not received adjuvant treatment. The standard deviation of the mean mitotic index (MI)--the average number of mitoses per field in 10 high power fields--was of the best prognostic valve in univariate survival analysis. None of the classic (volume % epithelium and stroma) or morphometric features (nuclear area, nuclear axis ratio. shape factors) provided significant results. In Cox regression analysis a multivariate combination of the mean MI, the SD of the mean MI, and the maximum MI emerged, which provided a satisfying means of differentiating patients with a good (68% survival) and a poor (28% survival) prognosis. Proliferation variables derived from axillary lymph node metastases of patients with breast cancer can predict the clinical course of distant metastases.
Screening for heparin binding variants of antithrombin.
Authors: Harper P L , Daly M , Price J , Edgar P F , Carrell R W
Published: June 2007

A chromogenic assay for use as a screening test for the identification of antithrombin deficiency is described. The heparin concentration and the incubation time in the assay were optimised specifically to permit the detection of heparin binding defects of antithrombin. The sensitivity of antithrombin assays for the detection of this type of variant was significantly impaired when an incubation time of more than 30 seconds was used. Several commercially available assays recommend a longer incubation time than 30 seconds and therefore some patients with heparin binding defects of antithrombin may not be identified. The assay described here allows heparin binding variants of antithrombin to be identified and distinguished from other types of antithrombin deficiency in a simple two stage procedure.
Routine histological compared with immunohistological examination of bone marrow trephine biopsy specimens in disseminated neuroblastoma.
Authors: Reid M M , Wallis J P , McGuckin A G , Pearson A D , Malcolm A J
Published: June 2007

The ability to detect infiltration in bone marrow biopsy specimens from patients with disseminated neuroblastoma was assessed by immunohistological and routine histological methods. Frozen cores from 33 staging procedures were tested with UJ13A and UJ127.11. Immunopositive tumour cells were found in 10 of 17 staging procedures in which tumour was detectable by routine histological methods. Positive cells or stromal material were also found in eight of 12 staging procedures in which distorted architecture and fibrosis, but no obvious tumour, had been noted. Paraffin wax embedded cores from 29 of the same staging procedures were tested with antibodies against neurone specific enolase and neurofilament. Only a single core reacted with anti-neurofilament antibody. Neurone specific enolase positive cells or stromal material were found in nine of 15 staging procedures in which obvious tumour was detectable. Although these immunohistochemical techniques proved inferior to routine histology in their ability to detect obvious tumour, the demonstration of immunopositive stromal tissue which was not frankly malignant supports the view that distorted, fibrotic marrow may reflect persistence of neuroectodermal tissue and justifies its distinction from normal marrow when reporting the response to treatment.
Method for auditing turnround time in histopathology related to user requirements.
Authors: Chow J W , Dilly S A
Published: June 2007

Histopathology audit schemes have concentrated on the accuracy of diagnosis or the standard of technical work. The most appropriate measure of specimen report time for histopathology was assessed. The simplest method is to calculate the mean or median number of days from receipt of specimens to issue of report, but this takes no account of clinical practice. An alternative approach is to compare the laboratory's performance with the clinicians' requirements. Clinicians were invited to complete a questionnaire specifying the reporting times they required subdivided by tissue type, clinical suspicion of malignancy, and bed occupancy of the patient. The questionnaire showed that there were distinct differences in clinicians' requirements. The turnround time for each category of specimen was calculated and expressed in three ways. The traditional method of quoting a median value showed very few differences among the categories. A comparison of the department's performance with the clinicians' requirements, using an arbitrary cut-off point of satisfying at least 80% of the clinicians' most stringent requirements or an achievement index, however, provided useful information for refining laboratory priorities.