bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevention of nitroimidazole resistance in Campylobacter pylori by coadministration of colloidal bismuth subcitrate: clinical and in vitro studies.
Authors: Goodwin C S , Marshall B J , Blincow E D , Wilson D H , Blackbourn S , Phillips M
Published: June 2007

One hundred patients with duodenal ulceration and Campylobacter pylori in their stomach were entered into a double blind placebo controlled prospective study. Treatment schedules were cimetidine and placebo, or cimetidine and tinidazole, or colloidal bismuth subcitrate (CBS) and placebo, or CBS and tinidazole. Seventeen per cent of isolates of C pylori obtained at the first endoscopy were resistant to tinidazole and 70% of the second isolates from patients given cimetidine and tinidazole became tinidazole resistant. Suspensions of nitroimidazole sensitive cultures of C pylori showed that three of 22 isolates had a nitroimidazole resistant subpopulation. In patients who healed and remained free of C pylori after treatment ulcers recurred less often than in patients who healed but retained C pylori (23% v 73% over 12 months, p less than 0.001).
Use of microcomputer for histopathology: system using IBM PC and dBaseIII.
Authors: Suen W M , Chick K W
Published: June 2007

A microcomputer program for use in the storage and retrieval of histopathology records is described. The program was written using dBaseIII, a commercially available data management system. The program provides for efficient storage and rapid retrieval of pathology reports and facilitates clinical research. Downloading of data on to a mainframe computer is possible.
Comparison of immunological detection of 5-hydroxytryptamine by monoclonal antibodies with standard silver stains as an aid to diagnosing carcinoid tumours.
Authors: Shaw P A
Published: June 2007

Immunoreactivity to a monoclonal antibody against 5-hydroxytryptamine (5HT) was compared with Churukian Schenk argyrophilia and Masson Fontana argentaffin staining as an aid to the diagnosis of 53 carcinoid tumours. Thirty four tumours were argentaffin positive, 50 were argyrophil positive, and 43 contained immunologically detectable 5HT. In general, argentaffin staining and immunological detection of 5HT failed to pick up tumours derived from the foregut of type B or type D morphology. Argentaffin negative tumours usually showed only focal immunoreactivity for 5HT. If immunological detection of 5HT is used alone as a marker for carcinoid tumours problems arise in the differentiation of carcinoid tumours from adenocarcinomas which may also contain 5HT. These results were compared with those culled from other reported techniques used as an aid to the diagnosis of carcinoid tumours.
Detection of small cell lung cancer metastases in bone marrow aspirates using monoclonal antibody directed against neuroendocrine differentiation antigen.
Authors: Berendsen H H , de Leij L , Postmus P E , Ter Haar J G , Poppema S , The T H
Published: June 2007

To detect metastases in the bone marrow of patients with small cell lung cancer, immunofluorescence with a monoclonal antibody detecting a membrane antigen (MOC-1) associated with small cell lung cancer was performed on 53 bone marrow aspirates from 30 patients. In 19 (63%) patients MOC-1 reactive cells were detected. Simultaneous histopathological examination of the bone marrow biopsy specimens detected tumour cells in only six (20%). The method is more sensitive than conventional histochemical staining of bone marrow aspirate and may eventually be able to show additional subgroups, such as patients with limited disease who might benefit from adjuvant radiotherapy or surgery.
Nature of mononuclear cells positive for acid phosphatase activity in bone marrow of patients with renal osteodystrophy.
Authors: Kaye M , Henderson J
Published: June 2007

Fifty two of 63 patients with renal osteodystrophy had one or more mononuclear cells positive for acid phosphatase in the marrow. These cells are also tartrate resistant and non-specific esterase negative, and are believed to be precursors to osteoclasts and other acid phosphatase positive cells resorbing bone on the trabecular surface.
Detection of human papillomavirus DNA sequences by in situ DNA-DNA hybridisation in cervical intraepithelial neoplasia and invasive carcinoma: a retrospective study.
Authors: Collins J E , Jenkins D , McCance D J
Published: June 2007

Human papillomavirus (HPV) infection of cervical intraepithelial neoplasia (CIN) and invasive cervical carcinoma was investigated using in situ DNA-DNA hybridisation on histological sections of formalin fixed, paraffin embedded tissue to assess the technique's sensitivity and to assess retrospectively the association between HPV16 and invasive cervical carcinoma. HPV DNA was detected in 16 of 33 biopsy specimens of CIN. Cells containing viral DNA were more numerous than those positive for viral structural proteins. HPV DNA was also present in less differentiated cells deeper in the epithelium. The detection rate in CIN was lower than that reported for other hybridisation techniques such as Southern blotting. In a retrospective study of biopsy specimens of invasive squamous carcinoma of the cervix HPV16 DNA, the virus most commonly associated with cervical malignant disease, was found in 20 of 25 cases, including those dating from as far back as 1932. The level of sensitivity was similar to that reported for other hybridisation techniques. DNA positive cells were focally distributed in the invasive tumours, and most tumour cells were negative for viral DNA, a result consistent with the low copy number found in malignant cells. It is concluded that HPV16 is not a new virus but that its prevalence is a result of changes in sexual behaviour and that in situ hybridisation is useful in the localisation of HPV DNA replication in CIN and invasive carcinoma.
Immunohistological determination of proliferative activity in seminomas.
Authors: Düe W , Dieckmann K P , Loy V
Published: June 2007

The proliferative activity and growth pattern of 20 seminomas were determined immunohistologically with the monoclonal antibody Ki-67. A growth fraction of tumour cells between 50 and 80% was found in seminomas with an almost even distribution of proliferating cells in all sections, regardless of tumour size. There was a slight tendency towards a greater growth fraction in tumours at an advanced histopathological stage. No positive correlation could be found between growth fraction and tumour size or lymphocytic infiltration. The results confirm the well known sensitivity of seminomas to radiation and chemotherapy and show that the determination of proliferative activity should be included in the histopathological routine diagnosis of malignant tumours with regard to systemic treatment and prognosis.
Immunoglobulin G (IgG) serological response to Branhamella catarrhalis in patients with acute bronchopulmonary infections.
Authors: Black A J , Wilson T S
Published: June 2007

Over 12 months serum was collected from 45 inpatients, with acute bronchopulmonary infection, in whose sputum Branhamella catarrhalis predominated, or was the sole pathogen. Serum was examined for IgG against B catarrhalis using an immunofluorescence antibody test. Acute and convalescent sera were compared with sera of age and sex matched controls. The convalescent sera had significantly higher titres than the acute sera which in turn had higher titres than the controls. The findings confirm the role of B catarrhalis as a respiratory pathogen and suggest that patients with chronic pulmonary disease are more prone to infection with this organism than the general population.
Monoclonal antibodies to human factor VII: a one step immunoradiometric assay for VII:Ag.
Authors: Takase T , Tuddenham E G , Chand S , Goodall A H
Published: June 2007

Three mouse monoclonal antibodies (RFF-VII/1, RFF-VII/2, and RFF-VII/3) which bind specifically to different epitopes on human factor VII antigen were raised. Two of the antibodies, RFF-VII/1 and RFF-VII/2, bound strongly to factor VII antigen (VII:Ag), but only RFF-VII/1 and RFF-VII/3 were potent inhibitors of factor VII coagulation activity (VII:C). RFF-VII/1 and RFF-VII/2 were used in a one step, double monoclonal immunoradiometric assay for VII:Ag. This was highly reproducible and detected as little as 0.05U/dl VII:Ag. Values for VII:Ag obtained for plasma samples from normal subjects (n = 20), patients with liver disease (n = 20), patients treated with warfarin (n = 20), and those congenitally deficient in factor VII (n = 7) correlated very well (r = 0.96) with data obtained in a radioimmunoassay using polyclonal rabbit antiserum to factor VII. This simple and sensitive monoclonal antibody based assay offers a convenient method for the detection of VII:Ag in various disease states.
Correlation of urine cytology with ABO(H) antigenicity in transitional cell carcinoma of the bladder.
Authors: Das G , Glashan R W
Published: June 2007

Cell surface ABO(H) antigenicity of superficial bladder tumours was assessed by the indirect immunoperoxidase test in 49 patients. Good correlation was obtained between surface antigenicity of tumours and the results of urine cytology. Malignant cells were detected cytologically in 22(56%) of cases with ABO(H) antigen negative tumours which are known to behave more aggressively than ABO(H) antigen positive ones. In contrast, malignant cells were found in the urine cytology of only one (10%) of patients with ABO(H) antigen positive tumours.
Polybrene technique for red cell antibody screening using microplates.
Authors: Lown J A , Ivey J G
Published: June 2007

The manual polybrene technique was adapted as a microplate test for antibody screening to determine its sensitivity and specificity and compared with conventional tube testing using various antibodies and serologically inert sera. Equivalent results were obtained for both techniques and it is concluded that this adaptation of the polybrene technique is useful in pretransfusion testing.
Immunocytochemical detection of tumours of neuroectodermal origin.
Authors: Carey P J , Malcolm A J , Pearson A D , Kemshead J T , Reid M M
Published: June 2007

Immunocytochemical methods were applied to bone marrow aspirate and cerebrospinal fluid specimens to show cellular reactivity with the monoclonal antibody UJ13A, which recognises an antigen expressed by cells of neuroectodermal origin. The antigen remained stable after air drying and appropriate fixation. In five patients with various neuroectodermal tumours the diagnostic advantages of these techniques were clear; they can be performed even when only very small amounts of diagnostic material are available.
Significant intimal abnormalities in muscular pulmonary arteries of patients with early obstructive lung disease.
Authors: Fernie J M , McLean A , Lamb D
Published: June 2007

Substantial intimal changes, unrelated to aging, were found in resected lobes or lungs of 30 smokers with early obstructive lung disease (22 men, eight women: age range 46-74 years: forced expiratory volume in one second (FEV1)% predicted range 47-119%). Intimal area was measured using a digitiser and expressed as a proportion of the area enclosed by the internal elastic lamina (IEL), correcting for constriction (intima index). Arteries were subdivided into four size (length IEL) groups. For the smallest group (less than or equal to 600 micron length IEL) the mean intima index (II600) ranged from 0.09-0.34; half the values were greater than or equal to 0.20. Intimal abnormality was unrelated to the size or site of tumour or to macroscopic emphysema, and correlated weakly with pack years. II600 values were, however, significantly correlated with factors known to be affected by smoking such as alveolar wall surface area per unit lung volume, FEV1% predicted, and FEV1/FVC (forced vital capacity); these last two factors were also significantly associated with intimal abnormality in arteries measuring 601-1200 micron length IEL.
Smooth muscle pseudotumours: a potentially confusing artefact of rectal biopsy.
Authors: Dankwa E K , Davies J D
Published: June 2007

An artefactual smooth muscle lesion was found in seven of 500 consecutive rectal biopsy specimens. The lesions had the deceptive appearance of a genuine tumour although none of the patients with the lesion had presented with a rectal mucosal swelling. The morphology of the lesion and its poor reproducibility under experimental conditions suggested that it was an artefact of the biopsy procedure: it was easily reproduced in resected specimens of large bowel using punch or basket forceps but not when using flat forceps. The presence of the lesion seems to depend on the type of forceps used rather than on differences in deployment and seems to be caused by avulsion of the superficial part of the muscularis propria and its incorporation into the tissues included in rectal biopsy specimens.
Upper oesophageal gastric heterotopia: a prospective necropsy study in children.
Authors: Variend S , Howat A J
Published: June 2007

Three hundred specimens of oesophagus obtained at necropsy from infants and children aged from 0 to 14 years, dying from a variety of causes, were examined prospectively for evidence of gastric heterotopia. Gastric heterotopia was observed in 63 (21%) of the whole series, representing a much higher incidence than reported previously. Excluding deaths in the perinatal period, the incidence appeared to be inversely related to age. Heterotopia was restricted to the subcricoid level of the oesophagus and often showed a close association with lymphoid tissue. There was no association with congenital malformation, and heterotopia occurred more commonly in those infants whose deaths were unexplained, although the reason for this association was unclear.
CD3+ CD8+ T cell lymphocytosis masking B cell leukaemia.
Authors: Smith J L , Oscier D G , Haegert D G , Jones D B , Howell M , Hodges E , Stevenson F K , Hamblin T J
Published: June 2007

A patient with CD3, CD8 positive lymphocytosis presented with features consistent with T cell chronic lymphocytic leukaemia/proliferations of large granular lymphocytes. The marrow and blood lymphoid populations (19.4 x 10(9)/l) contained more than 80% CD3 and CD8 positive cells with no evidence of a monotypic B cell population. A biopsy specimen of a vasculitic rash showed a diffuse infiltrate of CD3, CD8 positive cells into the upper dermis, consistent with T cell lymphocytic disease. After follow up for two years without treatment the blood lymphocyte count was 53 x 10(9)/l and was composed of cytologically small lymphocytes. A monoclonal SIg M D k lymphoid population (more than 90%) was demonstrable in sample blood and marrow aspirate. Gene rearrangement studies carried out on DNA extracted from peripheral blood lymphocytes at presentation and at two year follow up exhibited JH and Ck immunoglobulin gene rearrangement but no rearrangement of T cell receptor TcR gamma and beta genes. It is thought that this is the first well documented case of an aggressive CD8 positive lymphocytosis preceding, or in response to, an underlying B cell neoplasm.
Monoclonal antibody (Y1/82A) with specificity towards peripheral blood monocytes and tissue macrophages.
Authors: Davey F R , Cordell J L , Erber W N , Pulford K A , Gatter K C , Mason D Y
Published: June 2007

A new monoclonal antibody, Y1/82A, was raised against phytohaemagglutinin activated peripheral blood mononuclear cells. Using an immunohistochemical technique it was shown that Y1/82A reacts against peripheral blood and bone marrow monocytes and resident macrophages from essentially all human tissues. Y1/82A bound to determinants present in leukaemic cells from patients with acute myelomonocytic leukaemia and acute monocytic leukaemia, but not to neoplastic cells from patients with malignant lymphoproliferative disorders or malignant epithelial tumours. Y1/82A failed to react with other cell types, with the exception of osteoclasts and megakaryocytes. Analysis by Western blotting showed that the antigen detected by antibody Y1/82A was associated with intracellular granules in macrophages. Monoclonal antibody Y1/82A may be useful in the diagnosis of monocytic leukaemias and histiocytic neoplasms and in the identification of macrophages in tissues from various inflammatory and neoplastic conditions.
Method to quantitate intestinal metaplasia of stomach by image analysis.
Authors: Rubio C A , Porwit A , Rodensjö M
Published: June 2007

With the aid of an image quantifier, the distribution of histochemically labelled (alcian blue, pH 2.5) mucin-producing goblet cells was recorded from a gastrectomy specimen with a peptic ulcer to determine the degree of metaplasia. Of 254 measurements made, 130 were in the antrum and 124 in the fundic area. The areas occupied by cells positive for alcian blue were 7.5 (SD 9.89)% in the antral region, and 1.8 (1.84)% and 0.92 (1.15)% in the two zones representing the fundic area. The difference between the positive mucosal areas in the antrum was significantly higher (p less than 0.001) than in the fundic area. The positively stained area found along the lesser curvature was 7.76 (12.0)% while along the greater curvature, it was 2.17 (3.02)% (p less than 0.001). This method will be useful for future studies of the extent and topographical distribution of intestinal metaplasia among populations with disparate incidences of gastric carcinoma because it permits comparison of different areas of intestinal metaplasia in mucous gastric zones.
New rapid latex agglutination test for diagnosing Trichomonas vaginalis infection.
Authors: Carney J A , Unadkat P , Yule A , Rajakumar R , Lacey C J , Ackers J P
Published: June 2007

A newly developed latex agglutination test for Trichomonas vaginalis infection was compared for sensitivity, specificity, efficiency, and positive and negative predictive values with microscopy, culture, and an enzyme linked immunosorbent assay (ELISA) in the diagnosis of 395 women attending a genitourinary medicine clinic. T vaginalis infection was diagnosed in 42 (11%) women. The sensitivities of both the latex agglutination test and the ELISA were 95% compared with 74% for microscopy and 76% for culture. The latex test was specific and showed no cross reaction with a wide range of other genital tract infections. The latex agglutination test can detect antigen in both soluble and insoluble forms, and as it is simple to perform, can be undertaken during routine examination without recourse to special equipment or training. Further evaluation is required.
Representative sample of rheumatoid synovium: a morphometric study.
Authors: Kennedy T D , Plater-Zyberk C , Partridge T A , Woodrow D F , Maini R N
Published: June 2007

The synovium from 11 patients with rheumatoid arthritis, who were undergoing joint surgery, was assessed using histological and morphometric techniques. Histological examination confirmed previous reports that the intensity of the cellular reaction varied throughout the synovium, and the morphometric method reflected this variability sensitively. The method was shown to be reproducible and allowed areas of similar cellular density to be defined. From these defined areas a total of 2.5 mm2 of synovium equivalent to 12 fields at x250 required analysis to reflect the variation in the cellular reaction. It would be feasible to collect this amount of material using an arthroscope.
Morphometric comparison of synovium from patients with osteoarthritis and rheumatoid arthritis.
Authors: Kennedy T D , Plater-Zyberk C , Partridge T A , Woodrow D F , Maini R N
Published: June 2007

Synovium was collected from 15 patients who were undergoing joint surgery. Two groups were defined by clinical diagnosis: patients with primary osteoarthritis (n = 4); and those with rheumatoid arthritis (n = 11). The synovium was studied using histological and morphometric techniques. In agreement with previous studies, no histological features specific for either diagnosis were found. A previously validated morphometric method was used to estimate the cellular density of randomly picked fields within defined areas of synovium. The mean nuclear density of cellularity of comparable areas of synovium was significantly different between these two disease states, but the mean nuclear density between individual representative samples within each clinical group was homogeneous. The morphometric analysis of lymphocyte subsets showed that within the upper synovial region and cellular aggregates in osteoarthritis, the distribution of T cells expressing the CD4 and CD8 antigen was the same. In rheumatoid arthritis CD8 cells predominated in the upper synovial region and CD4 cells in the cellular aggregates. Plasma cells were rarely found in osteoarthritic synovia, but were common in rheumatoid arthritis, with IgG-producing plasma cells predominating. Morphometric studies of representative synovial samples may help to improve histological diagnosis and our understanding of pathological mechanisms.
Use of monoclonal antibody against human neutrophil elastase in normal and leukaemic myeloid cells.
Authors: Pulford K A , Erber W N , Crick J A , Olsson I , Micklem K J , Gatter K C , Mason D Y
Published: June 2007

A monoclonal antibody, NP57, was produced and used against the neutrophil granule protein elastase, which selectively stain neutrophils in cryostat and paraffin wax sections. The antibody stains neutrophils and a subpopulation of monocytes in blood smears and neutrophil precursors in bone marrow smears, and gives positive reactions with the cell lines HL60 and U-937. It labelled the blast cells in 68% of cases of acute myeloid leukaemia (M1-M5) but was unreactive with all cases of lymphoid leukaemias. Most of the elastase negative myeloid leukaemias were labelled by monoclonal anti-myeloperoxidase (antibody MPO-7) as were cells from the promyelocytic line HL60. No cases of myeloid leukaemia showed the opposite pattern--that is elastase positive, myeloperoxidase negative, suggesting that the production of myeloperoxidase precedes the onset of elastase synthesis during myeloid maturation. The anti-elastase antibody NP57 is a useful addition to the range of monoclonal antibodies available for the differential diagnosis of acute leukaemia by alkaline phosphatase-antialkaline phosphatase (APAAP) labelling of cell smears; it may also be of value for the histopathological diagnosis of tumour deposits in myeloid leukaemia and for the detection of neutrophils in paraffin sections.
Papillomavirus and c-myc antigen expression in normal and neoplastic cervical epithelium.
Authors: Hughes R G , Neill W A , Norval M
Published: June 2007

Cervical punch biopsy specimens or brushings were collected from 33 patients with cervical human papilloma virus (HPV) infection, cervical intraepithelial neoplasia (CIN), or invasive cervical carcinoma, and from eight control patients with recent normal cervical cytology. Prostatic chippings obtained from six men with benign prostatic hypertrophy were used as further controls. Biopsy specimens and brushings were assayed by flow cytometry for c-myc oncogene antigen and papillomavirus antigen expression and rate of cell division (by measuring DNA content). Results obtained from analysis of specimens and brushings were similar in terms of c-myc antigen and total DNA content, but when the percentages of nuclei from biopsy and brush specimens staining positively with antibody to papilloma viral antigens were compared, brush specimens gave consistently higher percentages than biopsy specimens. More specimens from normal epithelium were c-myc antigen positive (five of eight, (63%) than specimens from CIN II or III (two of 10, 20%), or invasive carcinoma (0%). No association was found between c-myc antigen expression and cell division. HPV antigen positive specimens were found to contain more dividing cells than negative specimens.
Acute phase response in cerebral infarction.
Authors: Syrjänen J , Teppo A M , Valtonen V V , Iivanainen M , Maury C P
Published: June 2007

The serum concentrations of the acute phase proteins, C-reactive protein, serum amyloid A protein, and alpha-1-antichymotrypsin were determined in 50 young and middle aged patients with cerebral infarction and in sex and age matched community controls. Of 46 case control pairs, 11 cases but only one control had raised acute phase protein concentrations simultaneously (p less than 0.01); four case control pairs were excluded because of an infectious complication following infarction and an acute phase response. Seven of the 11 patients (64%) with raised acute phase protein concentrations had a history of bacterial infection in the preceding month but of the remaining 35 patients without raised concentrations only four (11%) had such a history (p less than 0.01). In general, the acute phase response was less pronounced and occurred less often than has been reported in patients after acute myocardial infarction. The results suggest that a positive acute phase response is associated with a preceding bacterial infection or with an infectious complication after cerebral infarction. Measurement of acute phase proteins, therefore, could be used to evaluate the possible role of preceding bacterial infection in the development of cerebral infarction and also in the management of these patients as an early indicator of possible infectious complications.
Class specific antibody response to gonococcal infection.
Authors: Miettinen A , Hakkarainen K , Grönroos P , Heinonen P , Teisala K , Aine R , Sillantaka I , Saarenmaa K , Lehtinen M , Punnonen R
Published: June 2007

An enzyme immunoassay was used to determine IgM, IgG, and IgA antibodies to gonococcal pili in 68 patients with uncomplicated gonorrhoea, 35 women with pelvic inflammatory disease, and in 115 normal controls. A clear difference in response rate in all three antibody classes between patients with gonorrhoea and healthy controls was evident. Among women with gonorrhoea, the magnitude of antibody response was higher than among men with gonorrhoea, especially in the IgM class. No major differences were found in the overall distribution of serological findings between women with uncomplicated gonorrhoea and those with gonococcal pelvic inflammatory disease. Among this last group, however, high IgM antibody levels in acute phase sera were significantly associated with the isolation of Neisseria gonorrhoeae in the upper genital tract.
Lack of association between cytomegalovirus infection of heart and rejection-like inflammation.
Authors: Stovin P G , Wreghitt T G , English T A , Wallwork J
Published: June 2007

Serial myocardial biopsy specimens, taken up to the time of serological evidence of primary cytomegalovirus (CMV) infection in 22 heart transplant patients, were examined and compared with those taken over similar times after transplantation in 21 patients who did not develop CMV infection. None of these 43 patients had serological evidence of CMV infection before their heart transplantation. There was no evidence of an increased cellular infiltrate in the myocardium at the time of the active CMV infection, even though the donor heart is the likeliest source of infection, nor was there any change in myocyte, interstitial cell, or vascular endothelial cell nuclei to identify active CMV infection.
Is there any justification for the routine examination of bowel resection margins in colorectal adenocarcinoma?
Authors: Cross S S , Bull A D , Smith J H
Published: June 2007

The proximal and distal bowel resection margins of 339 specimens of colorectal adenocarcinoma were examined for the presence of tumour. In only five cases was tumour found in a resection margin. In four of these cases macroscopic examination showed that the tumour extended to the resection margin. In the fifth case the tumour was present in the pericolic fat. These results and reported data on the intramural spread of colorectal cancer suggest that examination of bowel resection margins is unnecessary unless the tumour extends to within 2 cm of the resection margin. Examination of the deep radial margins of the tumour and slides to show other prognostic indicators would be a more effective use of histopathological resources.
Findings in lymph nodes of patients with germ cell tumours after chemotherapy and their relation to prognosis.
Authors: Zuk R J , Jenkins B J , Martin J E , Oliver R T , Baithun S I
Published: June 2007

One hundred and forty six patients with advanced germ cell testicular tumours (38 seminomas and 108 malignant teratomas) treated by combination chemotherapy were studied over 10 years. Most of the improvement seen was in patients with malignant teratoma undifferentiated. In the most recently treated patients (1984-1987) 75% of drug resistant cases were malignant teratoma intermediate compared with 26% in the series treated between 1978-1983. The microscopic features of 52 primary testicular tumours were compared with features seen in excised retroperitoneal lymph nodes after completion of chemotherapy. Primary malignant teratoma intermediate had a higher incidence of viable malignancy in the excised tissue than malignant teratoma undifferentiated. Mature teratoma or fibronecrotic tissue within resected tissue was associated with a good prognosis. If resection was complete patients with drug resistant malignant teratoma intermediate had a more favourable prognosis than drug resistant malignant teratoma undifferentiated. It is advised that retroperitoneal node dissection should be considered in the management of patients with advanced germ cell testicular tumours, and that as complete a resection as possible be attempted to avoid the danger of missing residual disease.
Antibodies to cytomegalovirus in renal allograft recipients: correlation with isolation of virus.
Authors: Dolan J , Briggs J D , Clements G B
Published: June 2007

A cohort of 47 renal transplant recipients was studied prospectively for up to one year after transplantation. Cytomegalovirus (CMV) was isolated from 21 of the patients. The first time the virus was isolated seven patients were IgM positive, nine showed a significant rise in IgG titres, and 12 had a four-fold or greater rise in complement fixation titre. There was no significant difference in the time at which virus was first detected following transplantation between patients with primary CMV infection and those with reinfection or recurrent infection. In general, patients with primary infection shed virus consistently over long periods. Those with reinfection or recurrent infection shed virus intermittently or not at all. There were considerable differences between individual patients in the timing and pattern of the immune response. Taken overall, a four-fold rise detected by the complement fixation test correlated best with the onset of CMV shedding in primary infection. There was more variation in the pattern of antibody response in cases of reinfection or recurrent infection, with no single serological test correlating better than the others. It is concluded that serology is of limited value in the detection of active CMV infection after renal transplantation.
Monitoring the acute phase response: comparison of tumour necrosis factor (cachectin) and C-reactive protein responses in inflammatory and infectious diseases.
Authors: Maury C P
Published: June 2007

The relation between the inflammatory cytokine tumour necrosis factor-alpha (TNF or cachectin), which induces acute phase responses, and an established acute phase protein, C-reactive protein, was studied in various infectious and inflammatory diseases in man. All cases with very high serum concentrations of C-reactive protein (150 to 400 mg/l; normal reference value less than 10 mg/l) also had raised serum concentrations of TNF (53 to 705 ng/l; normal reference value less than 40 ng/l). In 19 out of 91 (21%) of the cases, however, a raised TNF concentration without correspondingly raised C-reactive protein concentration was also noted. Conversely, in 23 out of 106 (22%) cases raised C-reactive protein was observed in the absence of a raised TNF concentration. The ratios were high in allograft rejection and low in myocardial infarction and Kawasaki's disease. The highest mean concentration of circulating TNF was found in bacterial infections, graft rejection, and myocardial infarction. It is concluded that although high C-reactive protein concentrations are usually accompanied by raised TNF concentrations, there are pronounced relative variations in the serum concentrations of these proteins in various disease states, suggesting that there may be independent, disease specific regulatory pathways for TNF and C-reactive protein.
Evaluation of commercial latex slide test for identifying Escherichia coli O157.
Authors: Chapman P A
Published: June 2007

A commercial latex slide test (Oxoid DR 620) for the identification of Escherichia coli O157 was compared with a standard tube agglutination method using E coli O157 antiserum (Difco). Thirty isolates previously confirmed as E coli O157 were positive by both methods: 30 isolates of E coli of serogroups other than O157, 30 isolates of non-sorbitol fermenting organisms from various genera, and one isolate of E hermanii were all negative by both methods. It is concluded that the latex slide test offers a rapid and economical alternative to tube agglutination for the identification of E coli O157.
N-myc amplification in neuroblastomas: histopathological, DNA ploidy, and clinical variables.
Authors: Oppedal B R , Oien O , Jahnsen T , Brandtzaeg P
Published: June 2007

The association between tumour N-myc amplification, DNA ploidy, and various prognostic factors (patient age, tumour stage at diagnosis, primary site and histopathological differentiation) was studied in 18 children who had neuroblastoma, ganglioneuroblastoma, or ganglioneuroma. Amplification of genomic N-myc was observed in six patients who had been treated with chemotherapy before surgery (one with stage III and five with stage IV). All these tumours were located in the adrenal or upper retroperitoneum; five were neuroblastomas and one was a ganglioneuroblastoma. Three of them were aneuploid and three diploid. The degree of N-myc patients with tumour N-amplification varied from 20 to 1500 copies without relation to ploidy. All patients with tumour N-myc amplification died of their tumour. Amplification was always associated with poor prognosis, independent of tumour cell ploidy. Four patients without such amplification also died: three had diploid tumours, the fourth was aneuploid. It is suggested that genomic N-myc amplification takes place mainly in adrenal and retroperitoneal neuroblastomas and can be a feature of tumours with and without histological signs of differentiation. The precise role of N-myc in the pathogenesis of neuroblastoma remains unclear.
Umbilical cord sclerosis as an indicator of congenital syphilis.
Authors: Knowles S , Frost T
Published: June 2007

In two cases of congenital syphilis examination of the umbilical cord showed a distinctive picture of perivascular sclerosis and inflammation. Large numbers of spirochaetes were shown in the sclerotic zone in both cases. No organisms were demonstrable in the placental disc and there were no morphological changes suggestive of syphilis. It is concluded that the finding of sclerosing funisitis, together with the clinical circumstances, should raise the possibility of congenital syphilis.
Evaluation of impact of immunocytochemical techniques in cytological diagnosis of neoplastic effusions.
Authors: Linari A , Bussolati G
Published: June 2007

A prospective study (1984-87) on the immunocytochemical identification of cancer cells in effusions using HMFG2 monoclonal antibody, and in addition, monoclonal anti-CEA and B72.3 antibodies in cases of suspected mesothelioma, was undertaken. On the basis of cytology alone, of a total of 2362 pleural, peritoneal, and pericardial effusions, 525 cases were diagnosed as positive and 1485 as negative for neoplastic cells, while in 352 (15%) specimens from 307 patients the diagnosis was doubtful. Sections of the embedded sediment of doubtful cases were tested with HMFG2 antibody and proved positive in 215 cases, negative in 108, and inconclusive in 29. The results were checked by following the clinical outcome of the cases. The method was specific in identifying cancer cells in cases at best diagnosed as suspicious on the basis of cytology alone; this represents a clear diagnostic gain. Sensitivity of the test, however, was relatively low (41%). Combined cytological and immunocytochemical characteristics (CEA negative and only some of the neoplastic cells positive with HMFG2 and B72.3 monoclonal antibodies) permitted diagnosis on the effusions of most cases of mesothelioma. The impact of the diagnosis on the progress of the disease was not appreciable as no difference in outcome was noted, irrespective of whether cancer cells had been recognised. The occurrence of an effusion remains an ominous sign in most patients treated for cancer.
Detection of erythroid hypoplasia in myelofibrosis using erythrokinetic studies.
Authors: Howarth J E , Waters H M , Hyde K , Geary C G
Published: June 2007

The iron kinetic model described by Ricketts et al was used to study haemopoiesis in chronic myelofibrosis. The clearance of 59Fe-labelled transferrin from the plasma was analysed to quantify total, effective, and ineffective erythropoiesis, denoted by the terms marrow iron turnover (MIT), red cell iron turnover (RCIT), and per cent ineffective iron turnover (IIT%), respectively, in 12 cases of this disease. The patterns obtained were variable: values for MIT ranged from 24.4 to 510 mumol/l blood/day; those for RCIT from 0.4 to 119 mumol/l blood/day; and those for IIT% from 67 to 98%. One noteworthy feature was the presence in two cases of functional erythroid hypoplasia; these were characterised by severely reduced values for MIT (24.4 and 28 mumol/l blood/day) and RCIT (0.4 and 8 mumol/l blood/day.) A systematic study of the erythrokinetic features of myelofibrosis may indicate that erythroid hypoplasia is a more common cause of anaemia in this disease than has been previously recognised.
Nucleolar organiser regions in adenocarcinoma in situ of the endocervix.
Authors: Cullimore J E , Rollason T P , Marshall T
Published: June 2007

The AgNOR technique was used to analyse 11 cases of adenocarcinoma in situ of the endocervix and five examples of healthy cervices to assess whether areas of "increased nuclear activity" could be located adjacent to the malignant tissue. Areas of adenocarcinoma in situ had significantly more AgNOR staining dots than apparently normal bordering areas ("transitional areas") and areas of endocervical epithelium remote from adenocarcinoma in situ. There were no significant differences between AgNOR counts in transitional areas and areas remote from adenocarcinoma in situ, and between these areas and histologically normal cervices. These observations provide no support for the hypothesis that areas of glandular atypia of lesser severity or zones of "increased nuclear activity" exist adjacent to adenocarcinoma in situ.
Serological screening tests for syphilis in pregnancy: results of a five year study (1983-87) in the Oxford region.
Authors: Bowell P , Mayne K , Puckett A , Entwistle C , Selkon J
Published: June 2007

Between 1983 and 1987, 62 out of 76519 pregnancies in 51 mothers had a positive miniaturised Treponema pallidum haemagglutination assay (TPHA) test--1 in 1234, or 0.81 per 1000 births. About two thirds of these mothers had syphilis and the remainder non-venereal treponematoses such as yaws or pinta. Antenatal screening identified 13 patients with previously unknown acquired syphilis, 11 of whom were given antibiotics during pregnancy. There were six fetal losses among the 62 TPHA positive pregnancies, but none had evidence of congenital syphilis. No live born child in this study group showed stigmata of congenital syphilis. It is concluded that despite the current low incidence of syphilis in the United Kingdom it is imperative to continue antenatal serological screening and to emphasise the importance of early adequate treatment of the infection.
Assessment of immunoglobulin-M immunosorbent agglutination assay (ISAGA) for detecting toxoplasma specific IgM.
Authors: Duffy K T , Wharton P J , Johnson J D , New L , Holliman R E
Published: June 2007

An immunoglobulin-M immunosorbent agglutination assay (ISAGA) was introduced to detect toxoplasma specific IgM. This assay incorporates mu chain capture and use of entire toxoplasma trophozoites as an antigen source. The performance of the ISAGA was compared with that of a double sandwich enzyme linked immunosorbent assay (DS-ELISA) currently used in the Public Health Laboratory Service Toxoplasma Reference Laboratories. The ISAGA was found to be more sensitive than DS-ELISA but there was no demonstrable difference in the specificity or reproducibility between the two assays. The ISAGA is suitable for the diagnosis of acute toxoplasmosis in immunocompetent patients and as a screening test for recent infection in pregnant women. The persistence of ISAGA reactivity, however, is such that additional serological assessment is required to define the risk of congenital infection.
Differentiation between Bernard-Soulier syndrome and immune thrombocytopenia by immunostaining of peripheral blood.
Authors: Poulsen L O , Johansen P , Jensen M K , Freund L
Published: June 2007

Peripheral blood smears from seven patients with Bernard-Soulier syndrome were examined by an immunocytochemical staining procedure using a monoclonal antibody specific for platelet glycoprotein Ib. No platelet staining was observed except for very slight staining of the large sized platelets from one of the patients. Application of the assay to blood smears from 12 patients with immune thrombocytopenia showed that their peripheral platelets stained normally, so the assay can be used to differentiate between immune thrombocytopenia and Bernard-Soulier syndrome and to confirm a diagnosis of the syndrome.
Implausibility of an aetiological association between cytomegalovirus and Kaposi's sarcoma shown by four techniques.
Authors: Van den Berg F , Schipper M , Jiwa M , Rook R , Van de Rijke F , Tigges B
Published: June 2007

The presence of cytomegalovirus (CMV) was analysed in either lymph node or skin and lung tissue necropsy specimens affected by Kaposi's sarcoma, from 10 patients who had died of AIDS. The different detection techniques used were: (i) immunohistochemical demonstration of CMV immediate early antigen (IEA); (ii) in situ hybridisation with a biotinylated CMV DNA probe; (iii) Southern blot hybridisation of DNA extracted from sequential tissue sections; and (iv) polymerase chain reaction (PCR) with CMV specific primers on the DNA samples. The results of these analyses were compared with the postmortem data on CMV obtained by infectious particle assays and histological examination, especially of adrenal glands of the same patients. The results of the various detection methods correlated very well, yielding a combined score of six of 10 patients positive for CMV; there did not seem to be any association between the presence of CMV and the occurrence of Kaposi's sarcoma in our patients.
Pseudohyponatraemia, hypercholesterolaemia, and primary biliary cirrhosis.
Authors: Hickman P E , Dwyer K P , Masarei J R
Published: June 2007

A 62 year old woman with primary biliary cirrhosis was found to have a plasma sodium concentration of 115 mmol/l. Follow up showed this to be a "pseudohyponatraemia" due to a massively raised serum cholesterol concentration of 78 mmol/l. Electrophoresis of serum lipoproteins and of the lipoproteins and apolipoproteins in fractions isolated on density-gradient ultracentrifugation showed that the major portion of the serum cholesterol was being transported with lipoprotein-X. Low density lipoprotein-cholesterol concentration was also raised. Lipoprotein-X contained, in addition to albumin and apolipoprotein C, apolipoprotein E. This case is of interest because of the degree of hypercholesterolaemia, its association with pseudohyponatraemia, and the unequivocal demonstration of apolipoprotein E associated with lipoprotein-X.
Quantitation of lactoferrin in odontogenic cyst fluids.
Authors: Douglas C W , Craig G T
Published: June 2007

A competitive enzyme linked immunosorbent assay (ELISA) method was used to measure the concentration of lactoferrin in fluids from 36 odontogenic keratocysts, 15 dentigerous cysts, and 30 radicular/residual cysts. Keratocyst fluids contained significantly higher concentrations of lactoferrin than fluids from the other two types of cyst (p less than 0.001); but the range of values obtained within each group was large. Although lactoferrin represents a larger proportion of the total protein in keratocyst fluids than in dentigerous or radicular cyst fluids, lactoferrin concentration is not an absolute diagnostic marker for keratocysts. Lactoferrin concentration correlated strongly with the numbers of neutrophils present in keratocyst fluids (p less than 0.001), less so for dentigerous cyst fluids (p less than 0.05, and not at all in the case of radicular cyst fluids. It is suggested that neutrophils are the source of lactoferrin in the three categories of cyst studied but that the relatively impermeable nature of the keratocyst lining probably accounts for the particularly high concentrations of lactoferrin found in their fluids. Given that most keratocysts were asymptomatic, acute inflammation itself does not explain the reason for the high numbers of neutrophils in many of the fluids.
Histometric studies on cellular infiltrates of tuberculin tests in patients with haemophilia.
Authors: Lowe J G , Beck J S , Madhok R , Gracie A , Gibbs J H , Potts R C , Lowe G D , Forbes C D
Published: June 2007

The number of microanatomical location of CD4 and CD8 lymphocytes, of cells bearing receptors for I12 and transferrin, and of monocyte/macrophages in the dermis at the site of a tuberculin test were measured in 13 patients with haemophilia (10 seronegative and three seropositive for human immunodeficiency virus (HIV]. The overall density of lymphocytes in the perivascular and diffuse parts of the infiltrate was similar to that reported in other groups of subjects without evidence of immunosuppression. The CD4:CD8 ratio of the infiltrating lymphocytes throughout the section showed an inverse relation with clotting factor consumption. There was no significant change in the CD4:CD8 ratio in the diffuse infiltrate at various levels into the dermis in tuberculin reactions in patients with haemophilia, unlike healthy controls and other groups with no evidence of immunosuppression, who have previously been shown to have increasing CD4:CD8 ratio with increasing depth into the dermis. The number of cells bearing receptors for I12 and transferrin and of monocyte/macrophages was related to total lymphocyte density in the infiltrate. There was no evidence of serious impairment of the cell mediated response to a long term recall antigen, but the relatively low preponderance of CD4 lymphocytes in the diffuse infiltrate, particularly in the deeper dermis, may be the earliest indicator of impending immunosuppression.
Comparison of two bone trephine instruments used for quantitative histomorphometry.
Authors: Moore R J , Durbridge T C , Woods A E , Vernon-Roberts B
Published: June 2007

Transilial bone samples were obtained at necropsy using trephine instruments with internal diameters of 2 mm and 7 mm. Undecalcified histological sections were prepared and two structural histomorphometric variables (percentage of trabecular bone volume and surface density of bone) were estimated by a Quantimet 720 image analyser. The differences between the variables measured from the two adjacent cores were due to differences in biopsy site rather than the size of the sample. The smaller diameter needle is therefore recommended for use as the biopsy procedure is simpler and tissue sections can be prepared sooner than is the case with the larger needle.