bluuebunny/crossref_metadata_2025 huggingface dataset:
Screening for lupus anticoagulant and anticardiolipin antibodies in women with fetal loss.
Authors: Creagh M D , Malia R G , Cooper S M , Smith A R , Duncan S L , Greaves M
Published: June 2007

Sixty six women with first or second trimester fetal loss were investigated for the presence of lupus anticoagulant by routine coagulation tests and the dilute Russell's viper venom time with a platelet neutralisation procedure, and for raised anticardiolipin antibodies by an enzyme linked immunosorbent assay. Of 35 women with recurrent fetal loss, seven were positive for lupus anticoagulant and six had increased IgG anticardiolipin antibodies, while of 31 women with only one or two episodes of fetal loss, one had lupus anticoagulant and none increased IgG anticardiolipin antibodies. These findings were significantly different. There was no difference in the incidence of increased IgM anticardiolipin antibodies between the two groups (three and two cases, respectively). A further 11 women with intrauterine death in the third trimester were studied and lupus anticoagulant and raised IgM anticardiolipin antibodies were found in one case. No woman was known to have systemic lupus erythematosus. It is concluded that lupus anticoagulant and increased IgG anticardiolipin antibodies are independently associated with recurrent first and second trimester fetal loss and that such cases should be investigated, even in the presence of otherwise good health, by a comprehensive methodological approach.
Chromosomes in childhood acute lymphoblastic leukaemia: karyotypic patterns in disease subtypes.
Authors: Wodzinski M A , Watmore A E , Lilleyman J S , Potter A M
Published: June 2007

To define further the clinical importance of cytogenetic analysis in acute lymphoblastic leukaemia (ALL) a prospective study was performed on 139 unselected children. Analyses were considered adequate in 104, of whom 35 were normal and 69 had clonal abnormalities. Abnormalities were categorised according to banded chromosome analysis as well as chromosome count. Karyotypes were correlated with clinical and laboratory features at diagnosis and with survival. Of the successful analyses, thirty five (34%) children had no abnormalities; this group contained an excess of T cell disease. Twenty five (24%) had a "characteristic" hyperdiploid karyotype and as a group had lower presenting white counts, a tendency to CD10, and periodic acid schiff positivity of the blast cells and smaller spleens. None was an infant and only one was over 10 years old. Seven (7%) children with t(9; 22), t(8; 14), or t(4; 11) translocations were grouped together as "specific" translocations. Collectively they had a significantly worse prognosis than the remainder. Nine children developed central nervous system relapse, six of whom had either t(4; 11) or abnormalities of 9p or 19p. A descriptive classification taking into account chromosome bonding pattern is cytogenetically more appropriate and may be more clinically useful than grouping children simply by chromosome number. As knowledge and techniques improve, the classification of cytogenetic abnormalities in ALL will need to be kept under frequent review.
Breakdown of gastric mucus in presence of Helicobacter pylori.
Authors: Sidebotham R L , Batten J J , Karim Q N , Spencer J , Baron J H
Published: June 2007

The potential of Helicobacter pylori to degrade gastric mucus was examined. Colonies of H pylori cultured from antral mucosal biopsy specimens of patients with non-autoimmune gastritis were washed with sterile saline, passed through a sterilisation filter, and the filtrate examined for urease, protease, and mucolytic activity. The filtrate failed to hydrolyse bovine serum albumin, or to degrade stable mucus glycoprotein structures of high particle weight that had been separated from human gastric mucus on Sepharose 2B. The high particle weight mucus glycoprotein was, however, extensively degraded when incubated with H pylori filtrate (which possessed urease activity) in the presence of 2 M urea, to release fragments of Mr approximately 2 X 10(6). The high particle weight mucus glycoprotein was also broken down to a comparable extent when incubated with Jack bean urease in the presence of 2 M urea, or 1 M ammonium carbonate, or 40 mM carbonate-bicarbonate buffer (pH 8.7), but not when treated with 4 M urea alone, or Jack bean urease alone. These results indicate that the loss of high particle weight mucus glycoprotein in gastric mucus from patients with gastritis and gastric ulcers is unlikely to be due to the mucolytic action of an extra-cellular protease produced by H pylori, but it may result from the destabilising effects of a carbonate-bicarbonate buffer, generated at the mucosal surface when H pylori urease hydrolyses transuded plasma urea.
Evaluation of Clinitek 200 and Rapimat II/T for screening for urinary tract infection.
Authors: Bowman R A , Riley T V
Published: June 2007

Two machines, the Clinitek 200 and the Rapimat II/T, were evaluated for their ability to screen urine samples for significant bacteriuria and other elements indicative of urinary tract pathology. The automated screening procedures were compared with a conventional approach of microscopy and quantitative culture for 1020 urine specimens obtained from patients in a 700 bed general hospital. When compared with the bacterial culture method both machines gave identical results with a negative predictive value of 0.99, while when compared with microscopy alone the Clinitek 200 and Rapimat II/T gave negative predictive values of 0.92 and 0.87, respectively. It is concluded that both machines would provide cost effective screening of urine specimens.
Detection of Epstein-Barr virus genomes in Hodgkin's disease: relation to age.
Authors: Jarrett R F , Gallagher A , Jones D B , Alexander F E , Krajewski A S , Kelsey A , Adams J , Angus B , Gledhill S , Wright D H
Published: June 2007

An investigation as to whether any particular subgroup of patients with Hodgkin's disease was particularly likely to be Epstein-Barr virus (EBV) genome positive was made on samples from 95 patients. These were grouped according to age and Hodgkin's disease subtype, and analysed using Southern blot analysis. Most samples from children or adults aged 50 years or over contained detectable EBV genomes; samples from young adults were only rarely positive. The differences in EBV positivity by age were highly significant, but there was no significant association between EBV and histological subtype after allowing for the effect of age. The results support the hypothesis that Hodgkin's disease in different age groups may have different aetiologies, and suggest that EBV does have a pathogenetic role in Hodgkin's disease in children and older age groups.
Staphylococcus lugdunensis.
Authors: Barker K F , O'Driscoll J C , Bhargava A
Published: June 2007

A fatal case of penicillin resistant Staphylococcus lugdunensis endocarditis on a native valve damaged by rheumatic fever is described. A retrospective examination of 978 tube coagulase negative staphylococcal blood culture isolates was also performed to determine how often this species is isolated. None of the 978 isolates was identified as S lugdunensis. It is concluded that ornithine decarboxylase production is the only reliable method of identifying this species.
Marking of resection margins.
Authors: Hunter-Craig C , Lee-McDonagh B , Penman H G
Published: June 2007

Starch was used to mark the resection margins of breast tissue simply by rolling formalin fixed specimens in, for instance, glove powder. Starch adheres satisfactorily to the specimen and is obvious, microscopically, if crossed polarisers are used. There is little "carry-over" of starch across the rest of the tissue, and subsequent radiology of specimen or blocks is not prejudiced. It is concluded that starch powder is eminently suitable in most cases as a single marker of the surgically cut surface. The method is quick, cheap, and clean. It should not be relied on, anymore than other methods, to mark the surgically cut surface of ragged or partly disrupted specimens.
New automated technique for assessing emphysema on histological sections.
Authors: Gillooly M , Lamb D , Farrow A S
Published: June 2007

The assessment of emphysema in human lungs has traditionally been based on observations made on whole lung slices. These methods are inappropriate for the study of early emphysema, because as much as 75% of the alveolar wall surface area may have been lost by the time airspaces are visible to the naked eye. A new, automated image analysis system, the Fast Interval Processor (FIP), was used to measure airspace wall surface area per unit volume of lung tissue (AWUV). AWUV was measured on histological sections of lung tissue and expressed in mm2/mm3. The study sample consisted of resection specimens from 40 patients (32 men and 8 women whose ages ranged from 23-74 years). Histological sections from the inflated specimens were scanned using the FIP, and a mean AWUV value was calculated for each. The intra- and interobserver reproducibility of this method of measuring AWUV were examined. The results obtained using the FIP were also compared with those from an established image analysis system. The FIP is a fast, efficient technique which gave highly reproducible results comparable with those obtained with an established and much more time consuming measuring technique.
Tissue distribution of human gamma delta T cells: no evidence for general epithelial tropism.
Authors: Vroom T M , Scholte G , Ossendorp F , Borst J
Published: June 2007

In man and mice only a small proportion of T cells in the peripheral lymphoid compartment express the gamma delta T cell receptor (TCR). In mice, however, gamma delta T cells comprise the predominant population at particular epithelial sites--in epidermis and epithelia of intestine, reproductive organs, and tongue. The distribution of gamma delta T cells in normal human tissues was investigated, paying particular attention to epithelial layers. In all lymphatic organs and in epithelia of a wide variety of non-lymphatic organs, including the respiratory tract, male and female reproductive organs and tongue, gamma delta T cells constituted less than 5% of total T cells, with the remainder expressing TCR alpha beta. The only exception was the intestine, where gamma delta T cells were preferentially situated in the columnar epithelium of the crypts, rather than in the lamina propria. It is concluded, therefore, that human gamma delta T cells do not display a general epithelial tropism and are, in terms of relative numbers, no more able than alpha beta T cells to carry out continuous surveillance of the immune system against infection or transformation in epithelia. gamma delta T cells may, however, have a specialised function in the epithelium of the intestinal tract.
Rapid screening for toxigenic Corynebacterium diphtheriae by the polymerase chain reaction.
Authors: Pallen M J
Published: June 2007

The polymerase chain reaction (PCR) was used to discriminate between toxigenic and non-toxigenic isolates of Corynebacterium diphtheriae. Primers specific to the diphtheria toxin gene were used to amplify a toxin gene fragment from simple boiled-cell preparations. Eight recent clinical isolates and four reference strains were tested. The result of the PCR agreed with the traditional toxigenicity assays (the Elek test and guinea pig inoculation) in all cases. PCR has several advantages over the Elek test: it gives a same-day result, it works on colonies taken from selective media, and it detects the toxin gene in mixed cultures. One potential drawback is that the PCR might give a false positive result with the occasional isolate carrying an inactive toxin gene. The good predictive value of a negative PCR result, however, should make it a valuable screening test.
Increased central immunoreactive beta-endorphin content in patients with Wernicke-Korsakoff syndrome and in alcoholics.
Authors: Summers J A , Pullan P T , Kril J J , Harper C G
Published: June 2007

beta-endorphin, adrenocorticotrophin, and alpha-melanocyte stimulating hormone were measured by radioimmunoassay in three areas of human brain at necropsy in seven subjects with Wernicke-Korsakoff syndrome and in 52 controls. Thiamin concentration in six brain areas was also measured. Mamillary body beta-endorphin concentrations were significantly increased in those with the syndrome compared with controls, and those controls with high alcohol intake showed increased mamillary body beta-endorphin compared with controls with low alcohol intake. Brain thiamin concentration was similar in both groups, with the exception of the brainstem, where it was reduced in subjects with Wernicke-Korsakoff syndrome. Thalamic beta-endorphin in controls was inversely correlated with thiamin in frontal white matter, frontal cortex, parietal white matter and parietal cortex, while beta-endorphin in the hypothalamus of patients was inversely correlated with thiamin in frontal cortex, parietal white matter, thalamus and brainstem. These results suggest that there is a disturbance of the endorphinergic system in Wernicke-Korsakoff syndrome which may be related to alcohol intake.
Immunohistochemical analysis of amylase isoenzymes in thyroid cancer.
Authors: Higashiyama M , Doi S , Tomita N , Monden T , Murotani M , Kawasaki Y , Kobayashi T , Shimano T , Ogawa M , Takai S
Published: June 2007

The expression of amylase in various histological types of thyroid cancer was studied by an immunohistochemical technique, using a polyclonal antiamylase antiserum and two monoclonal antibodies specific for salivary and pancreatic-type amylases, respectively. Amylase was expressed in 21 of 24 (88%) thyroid cancers by polyclonal antiserum analysis. Analysis by monoclonal antibodies, however, showed that only 13 (54%) cases and three (13%) cases contained salivary-type and pancreatic-type amylases, respectively. Moreover, immunoreactivity for pancreatic-type amylase was detected only in medullary carcinoma; other histological types were positive for salivary-type amylase. These results show that thyroid cancer frequently expresses amylase, and suggest that the differences between amylase isoenzymes in thyroid cancer may correlate with those found between cellular origin of tumour.
The need for primary quality control of commercially available immunoassay kits.
Authors: Hashimoto T , Matsubara F
Published: June 2007

Discrepancies among three commercially available luteinising hormone (LH) radioimmunoassay RIA kits, all calibrated against the second-IRP-HMG (World Health Organisation International Laboratory for Biological Standards), were observed. Even though the Japan Radioisotope Association carries out external quality control in Japan every year, inaccuracies still exist. This problem also exists elsewhere, and it is proposed that a global monitoring system of primary quality control (PQC) should be introduced by a body such as the World Health Organisation.
Occult papillary microcarcinoma of the thyroid--a potential pitfall of fine needle aspiration cytology?
Authors: Harach H R , Saravia Day E , Zusman S B
Published: June 2007

The use of fine needle aspiration cytology detected papillary carcinoma in two patients with multinodular goitre measuring 0.7 cm and 0.9 cm in diameter, respectively. Like most of the cases from previous large series, the tumours progressed slowly as shown by absence of enlarged glands on surgical exploration and no clinical signs of metastasis after two and five years of follow up. This study shows that aspiration cytology can detect a virtually harmless occult papillary carcinoma that will oblige patients to have surgery. This very occasional "pitfall" of fine needle aspiration should not preclude this well known beneficial method from being used in the management of thyroid disease.
Automated microparticle enzyme immunoassays for IgG and IgM antibodies to Toxoplasma gondii.
Authors: Safford J W , Abbott G G , Craine M C , MacDonald R G
Published: June 2007

Fully automated microparticle enzyme immunoassays (MEIA) for the IMx immunoassay analyser were developed to detect IgG and IgM antibodies to Toxoplasma gondii. The IgG MEIA results are expressed in International Units (IU) of IgG antibody interpolated from a six point calibration curve covering the range from 0 to 300 IU/ml. Reproducible results were obtained from a calibration curve stored in the instrument for at least one month. The qualitative IgM MEIA expresses results as an index using a single calibrator included in each run. The Toxo IgG MEIA and Toxo IgM MEIA were in 98% and 97% agreement, respectively, with the reference assays used. Twenty four sera can be completely processed in about 35 minutes.
Recovery of CD3+ and CD5- lymphocyte subpopulation after autologous bone marrow transplantation and chemotherapy.
Authors: McKay P J , McLaren A , Andrews L M , Lucie N P
Published: June 2007

Although most circulating T cells in normal subjects express both CD3 and CD5 antigens on the cell surface, a small number lack the CD5 antigen. Recipients of allogeneic bone marrow transplants develop increased numbers of CD3+ CD5- cells, particularly those who develop graft versus host disease (GVHD). This CD3+ CD5- population may rise transiently in patients who have received an autologous bone marrow transplant (BMT) and in patients following completion of intensive chemotherapy for acute myeloid leukaemia (AML). These findings suggest that these CD3+ CD5- cells are a normal component of the regenerating lymphoid system after BMT or chemotherapy.
Influenza A and the virus associated haemophagocytic syndrome: cluster of three cases in children with acute leukaemia.
Authors: Potter M N , Foot A B , Oakhill A
Published: June 2007

At the height of the United Kingdom influenza A epidemic in December 1989, three children receiving treatment for non-T cell acute leukaemia developed pancytopenia with concomitant influenza A infection. Bone marrow histology showed prominent marrow erythrophagocytosis by morphologically mature histiocytes, consistent with the picture of virus associated haemophagocytic syndrome (VAHS). In two cases there was an initial spontaneous recovery, though recurrence of VAHS developed in one case in association with a different viral infection (cytomegalovirus) following autologous bone marrow transplantation. The third child died from cardiorespiratory failure secondary to infection with influenza A and Klebsiella pneumoniae sepsis. It is suggested that influenza A should be added to the list of infective causative agents.
Dysmegakaryopoiesis in myelodysplastic syndromes (MDS): an immunomorphometric study of bone marrow trephine biopsy specimens.
Authors: Thiele J , Quitmann H , Wagner S , Fischer R
Published: June 2007

An immunohistochemical and morphometric analysis was performed on trephine biopsy specimens of the bone marrow in 40 patients (23 men and 17 women, mean age 62 years) with different subtypes of myelodysplastic syndromes (MDS) to determine dysmegakaryopoiesis, but particularly precursor cells--that is, pro- and megakaryoblasts. In 31 of the 40 patients the numbers of megakaryocytes were increased which was associated with a predominance of smaller cell forms (micromegakaryocytes). Compared with periodic acid Schiff, immunostaining with a formalin resistant monoclonal antibody against glycoprotein IIIa (Y2/51(CD61) showed a clinically important proportion of immature elements. These could be designated pro- and megakaryoblasts by taking morphometric measurements on smears and bone marrow sections. There was a relevant increase in the number of promegakaryoblasts in 32 patients, consistent with uncontrolled expansion of the precursor pool. Seventeen repeated bone marrow biopsy specimens taken after chemotherapy largely showed a decrease in the numbers of megakaryocytes including the precursor cell population. Moreover, morphometric evaluation disclosed that micromegakaryocytes in MDS differ significantly from those in chronic myeloid leukaemia (CML) due to distinctive nuclear features and a disturbed nuclear:cytoplasmic ratio. These changes generate a more pleomorphic or atypical appearance of this cell population in MDS, compared with micromegakaryocytes in CML. It is concluded that the disproportionate increase in megakaryocyte precursors and the grossly abnormal aspects of micromegakaryocytes in MDS are characteristics of the severe defect involving haematopoiesis in this disorder.
Congenital mesoblastic nephroma: possible prognostic and management value of assessing DNA content.
Authors: Barrantes J C , Toyn C , Muir K R , Parkes S E , Raafat F , Cameron A H , Marsden H B , Mann J R
Published: June 2007

The case records and pathology of all children with kidney tumours treated in the West Midlands Health Authority Region (WMHAR) from 1957 to 1986 were reviewed. The histology was reviewed by a panel of three paediatric pathologists. Thirteen (6%) out of 211 cases were considered to have congenital mesoblastic nephroma (CMN). Nine were of the conventional type, three of the atypical cellular type, and one mixed. DNA ploidy was investigated and showed two of the tumours to be aneuploid and nine diploid (tissue was not available in the two other cases). The two aneuploid tumours were of atypical cellular and mixed histology, respectively; the diploid tumours were of the conventional type in eight cases and atypical cellular in one. The atypical cellular type has been reported to behave more aggressively, but the benefit of additional treatment after surgery to prevent recurrence remains unclear. Measurement of DNA content by flow cytometry, together with histological subclassification, may be useful in selecting patients who will benefit from further treatment after surgery.
Use of rapid carbohydrate utilisation test for identifying "Streptococcus milleri group".
Authors: Whitworth J M , Ross P W , Poxton I R
Published: June 2007

A short series of biochemical and serological tests were developed for the rapid presumptive identification of "Streptococcus milleri group" isolates. One hundred and seventy seven streptococcal isolates were recovered from the mouths of 10 out of 12 healthy adult volunteers by use of a simple sampling procedure and a single selective medium. In all, 127 oral "S milleri group" isolates were identified by biochemical and serological tests, confirming the indigenous nature of these streptococci in the mouth. Most (70.1%) of "S milleri group" isolates were non-haemolytic, 26% were alpha-haemolytic, and 3.9% beta-haemolytic. Fifty four (42.5%) were serologically typable, of which 46 were Lancefield group F, suggesting that the mouth is an important source of Lancefield group F streptococci. A collection of group F streptococci from a range of sources was indistinguishable from a collection of oral "S milleri group" isolates on the basis of the tests used, supporting the general synonymity of group F streptococcus with the broader "S milleri group". The battery of tests was cheap and simple to perform, and was capable of identifying "S milleri group" isolates from a range of sources, including variants with wide sugar fermentation patterns.
A silver enhanced, gold labelled, immunosorbent assay for detecting antibodies to rubella virus.
Authors: Patel N , Rocks B F , Bailey M P
Published: June 2007

A silver enhanced, gold labelled, immunosorbent assay (SEGLISA) for the detection of IgG antibodies to the rubella virus in human serum was developed. Pre-coated microtitre wells are used as the immobilised base of rubella antigens on to which any rubella antibodies from patient samples will bind. This antigen/antibody complex is then visualised firstly by gold labelled anti-immunoglobulin G, which binds to any human IgG that may be present, and then by silver amplification, resulting in a black permanent deposit on the microtitre well surface. Patient samples (n = 121) were screened using a commercially available enzyme linked immunosorbent assay (ELISA) and an equivalent SEGLISA. Results were comparable but the SEGLISA does not have the disadvantages associated with enzyme labels. The silver deposit may also be read visually or the dried plate may be stored for future reference.
Chronic myelomonocytic leukaemia associated with T cell receptor delta gene rearrangement.
Authors: Provan A B , Majer R V , Smith A G , Wilkins B , Hodges E , Smith J L
Published: June 2007

Morphological, immunophenotypic, and genetic analyses were carried out on peripheral blood, bone marrow, and pharyngeal biopsy material from a patient with chronic myelomonocytic leukaemia (CMML). Morphological analysis of bone marrow was diagnostic of CMML; immunophenotypic analysis of peripheral blood and bone marrow were negative for B and T cell antigens, and immunochemistry performed on the pharyngeal extramedullary infiltrate showed the presence of large monocytoid cells which stained positively for muramidase. Genotypic analysis, however, showed clonal rearrangement of the T cell receptor (TCR) delta chain gene, a marker of T cell or, less commonly, B cell lymphoid neoplasms. Other TCR genes, beta and gamma, were germline in all tissues examined. TCR delta is rearranged in precursor B cell and most T lymphoid neoplasms. A small proportion of cases (10%) of acute myeloid leukaemia (AML) also show rearrangement of the TCR delta gene. To date TCR delta rearrangement has not been described in CMML. The aberrant TCR delta rearrangement shown in this patient with CMML provides further evidence of the clonal nature of this disorder.
Simplification of procedures used to test urine samples for Chlamydia trachomatis.
Authors: Thomas B J , Gilchrist C , Hay P E , Taylor-Robinson D
Published: June 2007

Two methods of simplifying the procedure for examining urine samples for Chlamydia trachomatis were investigated. When 73 urine samples from 56 men with acute non-gonococcal urethritis were examined by direct immunofluorescence (MicroTrak), centrifuging 1 ml volumes of urine at 13,000 rpm for five minutes was at least as efficient for detecting C trachomatis as centrifuging larger volumes at 3000 rpm for 30 minutes. Furthermore, examination of urine produced during a visit to a sexually transmitted disease clinic was at least as efficient as examination of early morning urine for detecting C trachomatis by MicroTrak, or by an enzyme immunoassay (IDEIA). Both modifications have practical advantages and should encourage the use of urine samples for diagnosing chlamydial infections in men.
Estimation of prevalence of Helicobacter pylori infection in an asymptomatic elderly population comparing [14C] urea breath test and serology.
Authors: Newell D G , Hawtin P R , Stacey A R , MacDougall M H , Ruddle A C
Published: June 2007

A non-invasive serological assay devised in this laboratory had a sensitivity and specificity of 100% as determined by culture and confirmed by histology in a group of 47 patients who had undergone endoscopy. The correlation between serology and the non-invasive [14C] breath test was very good. Only one of 24 culture positive patients was, while all 23 culture negative patients were, breath test negative. In a group of 46 healthy elderly persons, however, significant anomalies between serology and breath test were observed. Only 83% of the breath test negative persons were seronegative, while only 68% of the breath test positive persons were seropositive. These results can be explained in terms of age related atrophic gastritis and immune incompetence, causing reduced colonisation and decreased antibody production, respectively. These investigations suggest that non-invasive tests for H pylori infection may not be reliable in the elderly.
In situ evidence for HPV 16, 18, 33 integration in cervical squamous cell cancer in Britain and South Africa.
Authors: Cooper K , Herrington C S , Graham A K , Evans M F , McGee J O
Published: June 2007

In a previous study three types of HPV signal were described in CIN. It was suggested that a type 1 signal represented episomal HPV while a type 2 signal represented integrated HPV; and a type 3 signal was indicative of both episomal and integrated HPV. To test this hypothesis 91 squamous cell cancers (SCC) of the cervix from Britain and South Africa were examined for HPV 6, 11, 16, 18, 31, 33, 35. Of the South African group (n = 69) 64% contained HPV types 16 (n = 29) and 18 (n = 15). The SCC in the British group (n = 22) contained HPV 16 and HPV 33 in 12 and three cases, respectively. Of the HPV positive biopsy specimens, 86% showed a type 2 signal in keratinising and non-keratinising tumours and the remainder a type 3 signal. Type 3 signal was present only in keratinising tumours. The presence of punctate signal in 100% of HPV containing SCC, together with localisation of HPV signal to sister chromatids in tumour cell mitotic figures in vivo, provides further evidence for type 2, and the punctate component of type 3 signal representing viral integration.
Epithelial-myoepithelial carcinoma of salivary glands.
Authors: Simpson R H , Clarke T J , Sarsfield P T , Gluckman P G
Published: June 2007

Four cases of epithelial-myoepithelial carcinoma of the salivary glands arose as painless masses in patients over 60 years old, three in the parotid and one in the submandibular gland. Histologically, all the tumours were composed of small ducts with a double cell lining surrounded by a basement membrane. The inner cells were epithelial and the outer cells myoepithelial, the latter usually possessing clear cytoplasm. There was a variable degree of intervening hyalinised stroma. All the tumours were partly encapsulated, but also displayed local invasiveness. One of the tumours also showed areas of dedifferentiation when it later recurred and metastasised. The other three were apparently cured by initial excision, with adjuvant radiotherapy in one instance. In the past this tumour has been described as clear cell adenoma, and it was only recently that its true malignant nature, albeit low grade, was recognised. Reports of epithelial-myoepithelial carcinoma are still relatively few, with only one case described from Britain. It is recommended that this histologically distinct neoplasm deserves wider recognition.
Spinous injury caused by a sea urchin.
Authors: McWilliam L J , Curry A , Rowland P L , Watson J S
Published: June 2007

A bather on holiday in Kenya injured a finger on a spiny marine creature living on the sea bed. A skin biopsy specimen from the injured finger contained several black spines about 0.5 mm in diameter and up to 1.5 cm in length. Spines removed from the specimen were embedded in plastic resin to facilitate transverse sectioning. Light microscopical examination using crossed polarisers showed an ornate symmetrical structure brightly illuminated against a dark background. These features are characteristic of sea urchin (Echinoderm) spines which are composed of ornately formed calcite crystals covered by an epithelium. The spines of sea mice, on the other hand, are chitinous in nature; they are also much finer and lack the ornate symmetry of sea urchin spines.
10 year review of invasive aspergillosis detected at necropsy.
Authors: Boon A P , O'Brien D , Adams D H
Published: June 2007

Between 1980 and 1989, 32 cases of invasive aspergillosis were identified out of 2315 consecutive necropsies, an incidence of 1.4%. The incidence in immunosuppressed "high risk" patients was 10.7%. Twenty out of 32 cases showed spread beyond the lungs, with the brain the most common site. There was an increase in cases in the second half of the decade, attributable to the start of a liver transplantation programme. Liver transplant recipients and patients with haematological malignancies were at significantly greater risk of acquiring aspergillosis than kidney transplant recipients or those with solid malignancies treated with chemotherapy. There was also a greater risk of haematogenous dissemination in liver transplant recipients than in all other groups, and this was significantly associated with the use of high dose steroids as anti-rejection treatment. Aspergillus was isolated during life in only eight cases, which indicates a continuing need for and emphasises the value of necropsy.
Toxin production by Bacillus pumilus.
Authors: Hoult B , Tuxford A F
Published: June 2007

Two strains of Bacillus pumilus (M11 and M38) and one strain each of Bacillus cereus (M27), Bacillus subtilis (M67), and Enterobacter agglomerans (M14) were identified from the air of Lancashire cotton mills. These strains were tested for cytopathic effects in Vero cells; B pumilus and B cereus strains were also examined for haemolytic activity, lecithinase production, and proteolytic action on casein. Rounding and clumping of the Vero cells occurred after the addition of supernatants prepared from B pumilus and B cereus strains; finger-like projections developed in the cells treated with B pumilus supernatants. Minimal effects occurred with B subtilis and E agglomerans. After two hours of exposure B pumilus (M11) produced the greatest effect, but treatment with trypan blue showed that most cells exposed to the M11 strain were still alive after 96 hours of exposure; those exposed to the supernatant prepared from the M38 strain of B pumilus were dead. Sheep erythrocytes were lysed more rapidly by B cereus than by B pumilus, B cereus (strongly positive) had a greater effect on lecithin than either of the B pumilus strains (M38 weakly positive, M11 negative). All hydrolised casein but the effect was more rapid with one of the B pumilus (M11) strains. It is concluded that not only do the toxins of B pumilus differ from those of B cereus, but there are also differences between the toxins produced by the two strains of B pumilus (M11 and M38).
Isoenzymes of alkaline phosphatase in epileptic patients receiving carbamazepine monotherapy.
Authors: Okesina A B , Donaldson D , Lascelles P T
Published: June 2007

The effects of carbamazepine monotherapy were investigated in 20 female and 21 male epileptic patients to determine whether treatment would induce an increase in serum alkaline phosphatase (ALP) activity, a known effect of many anticonvulsant drugs. Serum total ALP activity was increased in nine out of the 41 patients (22%), serum bone ALP activity was increased in 10 (24%), and serum non-bone ALP activity was increased in three (7%). There was no significant difference when the mean of the patients' serum total ALP was compared with that of the controls. Twenty per cent of the patients with increased serum bone ALP had normal serum total ALP, indicating that increased serum bone isoenzyme activity may precede an increase in the total enzyme activity. This should be considered when interpreting results of increased total ALP in epileptic patients.
Detection of single copies of Epstein-Barr virus in paraffin wax sections by non-radioactive in situ hybridisation.
Authors: Coates P J , Mak W P , Slavin G , d'Ardenne A J
Published: June 2007

A highly sensitive non-isotopic in situ hybridisation technique was developed for the localisation of Epstein-Barr virus (EBV) in paraffin wax embedded tissue sections. The method uses a repeated sequence of the EBV genome as a probe, labelled with the novel reporter molecule, digoxigenin. The method can identify individual copies of EBV by detection of both EBV DNA and highly localised RNA transcripts. A combination of careful proteolytic digestion of tissue sections, high temperature denaturation of probe and target DNA, and sensitive immunocytochemical detection are used to attain single copy sensitivity. The technique is quicker and simpler to perform than some other methods used for the identification of EBV, and provides simultaneous morphological information which cannot be obtained by methods using tissue extracts. This method permits the investigation of the role of EBV in neoplastic conditions of lymphoid and epithelial cells, and may prove valuable in determining the sites of latent virus in healthy subjects.
Histological diagnosis of intestinal microsporidiosis in patients with AIDS.
Authors: Peacock C S , Blanshard C , Tovey D G , Ellis D S , Gazzard B G
Published: June 2007

Fifty nine patients seropositive for human immunodeficiency virus (HIV) and diarrhoea and 20 with weight loss were investigated for microsporidiosis using light and electron microscopical examination of duodenal and jejunal biopsy specimens. Eight cases of microsporidiosis were found, in five of whom it was the sole pathogen. In all eight cases the organism was identified at light microscopy without prior knowledge of the electron microscopical findings. All stages of the life cycle are best seen in resin sections cut at 1 micron and stained with Giemsa, but spores could easily be identified in paraffin sections cut at 5 microns and stained with haematoxylin and eosin. In all cases the parasite was identified both in duodenal pinch and jejunal "Crosby" capsule biopsy specimens. All cases of microsporidiosis occurred in patients with diarrhoea. Both electron and light microscopical examination suggested that the pathogenic mechanism involves the shedding of infected enterocytes containing large numbers of spores. It is suggested that the optimal way to diagnose microsporidiosis is by light microscopical examination of duodenal pinch biopsy specimens.
Breslow thickness of cutaneous malignant melanoma in paraffin wax and frozen sections.
Authors: Kirkham N , Blessing K , Gibson B , Price M L
Published: June 2007

Breslow tumour thickness was measured in frozen and paraffin wax sections from 21 excision biopsies of cutaneous malignant melanomas by two observers. There was no consistent variation between frozen and paraffin wax sections, with recorded differences ranging from +0.3 mm to -0.2 mm. Interobserver differences ranged from +0.4 mm to -0.2 mm. The interobserver variations exceeded the intraobserver variations, but neither were significant. These findings show conclusively that, when using high quality frozen sections, there is no significant difference between Breslow thickness measured in frozen or paraffin wax sections and therefore that frozen sections can be used to microstage melanoma. Interobserver variations seem to be a more likely source of erroneous measurements of tumour thickness.
Prognostic value of proliferating cell nuclear antigen in gastric carcinoma.
Authors: Jain S , Filipe M I , Hall P A , Waseem N , Lane D P , Levison D A
Published: June 2007

A new monoclonal antibody to proliferating cell nuclear antigen (PCNA), PC10, which can be used on routinely processed tissue, was applied to 93 cases of gastric carcinoma. Significant intra-tumoural variation in staining occurred. In addition to a PCNA index (percentage of positive cells per 1000 tumour cells), a semiquantitative PCNA grading system was devised, based on estimates of less than or more than 50% of positive tumour cells in whole sections. Neither PCNA index nor PCNA grade showed any correlation with established histological variables, tumour stage, or the presence of lymph node metastases. No significant correlation was observed between PCNA index and S + G2M phase fraction measured by flow cytometric analysis. To analyse survival tumours with PCNA indices above and below the median level (41%) were compared. Those with a higher index tended to have a worse prognosis, but when PCNA grade was considered, it was found to have definite independent prognostic value, tumours of low grade surviving better than those of high grade. The ability of semiquantitative PCNA grading to allow for intra-tumoural variation suggests it may have advantages over absolute counting, which is prone to sampling error when tumour heterogeneity is a major factor. The prognostic value of PC10 staining in gastric carcinoma is therefore promising.
Use of monoclonal antibodies to recognise osteoclasts in routinely processed bone biopsy specimens.
Authors: Athanasou N A , Puddle B , Quinn J , Woods C G
Published: June 2007

In decalcified (5% nitric acid) and undecalcified (glycol-methacrylate or resin embedded) routinely processed bone specimens osteoclasts against resorbing surfaces were identified with monoclonal antibodies directed against leucocyte common antigen (LCA) (PD7/26, 2B11), CD68 (KP1), and gpIIIa (Y2/51) but not against HLA-DR (CR3/43 and Ta11B5). Mononuclear cells on resorbing surfaces and occasional mononuclear cells against or near resting surfaces showed a similar pattern of reactivity. This study shows that immunohistochemistry is a sensitive and useful technique for identifying osteoclasts in routinely processed bone specimens. It also suggests a role for mononuclear cells (possibly pre-osteoclasts) in bone resorption.
Infections in British clinical laboratories, 1988-1989.
Authors: Grist N R , Emslie J A
Published: June 2007

During 1988-89 this continuing survey showed 18 infections in the staff of laboratories reporting from 166 centres, representing 21,756 person-years of exposure. Shigella and other bowel infections (one caused by S typhi) predominated, affecting 11 microbiology medical laboratory scientific officers. Three shigella infections originated from quality control samples. Pulmonary tuberculosis affected four workers, including two mortuary technicians, but without detected occupational exposure to Mycobacterium tuberculosis. Other infections included one caused by Brucella melitensis. Hepatitis was not reported. The sustained low level of hepatitis is encouraging and suggests a low risk to staff of bloodborne infections such as human immunodeficiency virus.
Treatment of acute myeloid leukaemia in a renal allograft recipient: implications of cyclosporin immunosuppressive treatment.
Authors: Cuthbert R J , Russell N H , Jones P A , Morgan A G
Published: June 2007

The clinical effects of cyclosporin were evaluated during cytotoxic treatment in a 61 year old man with acute myeloid leukaemia. He had required a renal transplant 18 months before presenting with acute myeloid leukaemia (FAB subtype M4). He had received cyclosporin 3.5-4.0 mg/kg daily to maintain a plasma cyclosporin concentration of 75-150 ng/ml. Cyclosporin was continued during induction chemotherapy with daunorubicin, cytarabine, and 6-thioguanine (DAT). He had fever and oropharyngeal candidiasis that was unresponsive to anti-bacterial drugs but responsive to systemic amphotericin. Bone marrow examination 14 days after chemotherapy showed complete haematological remission. Subsequently he tolerated consolidation treatment with DAT with no serious complications. Unfortunately he developed fatal septicaemia following a second consolidation with mitozantrone and cytarabine. Inhibition of P-glycoprotein activity by cyclosporin may not significantly increase the toxicity of aggressive chemotherapeutic regimens, and as benefit may be achieved by this approach further clinical evaluation is justified.
Antibiotic treatment and associated prolonged prothrombin time.
Authors: Williams K J , Bax R P , Brown H , Machin S J
Published: June 2007

The incidence and type of pathology causing a prolonged prothrombin time and clinical bleeding episodes were assessed in a multicentre study of 1109 patients receiving cefotetan, a N-methyl-thiotetrazole (NMTT), or equivalent antibiotics. There was no significant difference in the incidence of a prolonged prothrombin time (9.9% with cefotetan, 8.0% with comparable antibiotics) of clinical bleeding episodes. However, prothrombin time increases of greater than 12 seconds were significantly (p = 0.002) greater with cefotetan (3.8%) than with comparators (0.8%). In both antibiotic groups increases in prothrombin time were more likely following surgery and in patients who were older, with a high platelet count, low albumin, or higher urea and creatinine concentrations. All antibiotic treatment can be associated with prolonged prothrombin times and new agents should always be assessed in a large multicentre study before the practical, clinical importance of haemostatic defects can be defined.
Diamond-Blackfan syndrome and neutropenia.
Authors: Schofield K P , Evans D I
Published: June 2007

Neutropenia is a rare complication of Diamond-Blackfan syndrome (congenital hypoplastic anaemia). Three patients are reported: all had neutropenia as well as anaemia, and to investigate the cause of the neutropenia culture of bone marrow for granulocyte-macrophage colony forming cells (GMCFCs) was performed. Two cases had a low incidence of GMCFCs, but the third case had a high incidence. These findings suggest that myeloid precursors can be abnormal in Diamond-Blackfan syndrome and that the mechanism of neutropenia may, like that of anaemia, vary from patient to patient.
Silver enhancement of polymerised diaminobenzidine: increased sensitivity for immunoperoxidase staining.
Authors: Peacock C S , Thompson I W , Van Noorden S
Published: June 2007

Unambiguous identification of lymphocytes is sometimes difficult because of weak immunostaining of the cell membrane immunoglobulins. A simple method of intensifying the diaminobenzidine (DAB) peroxidase reaction was therefore devised. Paraffin wax sections of formalin fixed tonsils and lymphomas were digested with trypsin and immunostained for kappa and lambda light immunoglobulin chains and CD3 antigen by various peroxidase linked detection systems. After reaction with hydrogen peroxide and DAB the sections were immersed in methenamine silver solution at 60 degrees C for three to seven minutes. The light brown stain on the cell membranes of the mantle zone lymphocytes became dark brown and the stronger stain of the plasma cells became black. Mantle zone B lymphocytes and CD3 positive T lymphocytes were precisely outlined even at low magnification and the lymphomas were easily classified as monoclonal or polyclonal. At high magnification, staining was clearer than with the immunogold-silver stain. Cryostat and paraffin wax sections of other tissues immunostained for various antigens showed similar intensification. Silver methenamine provides an easy means of increasing the sensitivity and visual impact of an immunoperoxidase/DAB reaction in any preparation.
Comparison of cell culture with an amplified enzyme immunoassay for diagnosing genital herpes simplex infection.
Authors: Kudesia G , Van Hegan A , Wake S , Van Hegan R J , Kinghorn G R
Published: June 2007

An amplified enzyme immunoassay (EIA) for herpes simplex virus (Novo Nordisk) was compared with cell culture in 853 genital specimens from a genito-urinary medicine clinic. The sensitivity of the EIA was 86% and its specificity 99.6%. The sensitivity increased to 94% for lesion swabs but decreased to 68% for cervical swabs. Sensitivity for urethral and vulval swabs was 83% and 82%, respectively. It is concluded that the EIA is specific and quick and easy to perform. It will be suitable for testing for genital herpes simplex infections in laboratories without access to local cell culture facilities.
Screening tests for pathogenic corynebacteria.
Authors: Colman G , Weaver E , Efstratiou A
Published: June 2007

AIM: To provide simple tests that would help in the identification of corynebacteria that produce diphtheria toxin. METHODS: A collection of 99 freshly isolated corynebacteria was assembled and the cultures identified by conventional tests confirmed by an identification kit. Modifications were made to procedures for preparation of the culture medium for the Elek test and to the test for detection of pyrazinamidase (pyrazine carboxylamidase) activity. These two together with an indicator medium for cystinase activity were applied to the collection of organisms. RESULTS: Cystinase was detected in all 61 members of the toxigenic species and none produced pyrazinamidase. In contrast, all but two of the 38 representatives of non-toxigenic species yielded pyrazinamidase and none formed cystinase. Of the 61 cystinase producing cultures (which were also pyrazinamidase negative), 21 gave a positive Elek test with the modified culture medium. A total of 30 of these 61 were tested for toxigenicity in guinea pigs and the results of the animal and plate tests concorded. At least seven cultures could have been reported as non-toxigenic if Elek tests based on media prepared in the conventional way had been the only test available. CONCLUSION: The three procedures described go some way towards meeting the needs of diagnostic laboratories for efficient procedures for distinguishing pathogenic corynebacteria.