bluuebunny/crossref_metadata_2025 huggingface dataset:
Impairment of cytomegalovirus and host balance in elderly subjects.
Authors: Musiani M , Zerbini M , Zauli D , Cometti G , La Placa M
Published: June 2007

The titres of IgG antibody against "late antigens", "immediate early antigens", and "early antigens" induced by cytomegalovirus (CMV) and IgM antibody against "late antigens" induced by CMV were analysed in 67 geriatric subjects by immunocytochemical techniques. The titres obtained were compared with those of an adult control population. Significantly increased titres of IgG antibody against induced antigens and a significant increase in CMV reactivated infections occurred in the elderly compared with control subjects. These findings indicate that the CMV and host balance in the elderly is disturbed, leading to activation of the CMV latent carrier state that follows primary CMV infection.
Neonatal screening for cystic fibrosis in Wales and the West Midlands: 1. Evaluation of immunoreactive trypsin test.
Authors: Ryley H C , Deam S M , Williams J , Alfaham M , Weller P H , Goodchild M C , Carter R A , Bradley D , Dodge J A
Published: June 2007

A study programme was set up in Wales and the West Midlands to evaluate serum immunoreactive trypsin screening for cystic fibrosis in neonates using blood spots collected for metabolic screening. By screening half the blood spots from each area, it was hoped to generate two comparable groups of fibrocystic children; those detected by screening and those not screened who would be diagnosed clinically. Over almost three years, more than 120,000 specimens were screened and 37 infants detected with cystic fibrosis. Four additional fibrocystic patients were missed on screening: two had negative immunoreactive trypsin values, of which one had meconium ileus, and two, although giving initial positive tests, were negative on follow up. Excluding infants known to be at risk, comparison of the numbers of children detected in the screened and unscreened groups showed more than a two-fold difference in favour of the screened group. There may be a large number of undiagnosed fibrocystic patients in the general population.
Rapid indirect enzyme linked immunosorbent assay (ELISA) for detecting antitoxoplasma IgG: comparison with dye test.
Authors: Francis J M , Payne R A , Joynson D H
Published: June 2007

A rapid and simple enzyme linked immunosorbent assay (ELISA) for the detection of specific IgG against Toxoplasma gondii was compared with the dye test on 533 serum samples. In general, results were comparable but not with sera that contained high concentrations of toxoplasma specific IgM or that had been heated at 56 degrees C. There were no false positive results with sera containing rheumatoid factor or anti-nuclear factor. It is concluded that if a dye test is not to be performed then the serum should be tested for both toxoplasma specific IgG and IgM to avoid misleading results. Heat inactivated serum should also not be tested in this type of specific IgG assay.
Differences in lipopolysaccharide profiles of serologically identical Legionella pneumophila serogroup 6 strains.
Authors: Zanen-Lim O G , Zanen H C
Published: June 2007

Over five years 18 strains of Legionella pneumophila serogroup 6 were isolated in Amsterdam from the hot water supply in three hospitals and from one patient. Immunodiffusion and immunoblot procedures showed that these strains were identical. Profiles of isolated lipopolysaccharides from the 18 strains and the reference serogroup 6 strain were visualised in polyacrylamide gels stained with silver. Four strains from hospital A, isolated in 1982, 1984, and 1985 displayed similar lipopolysaccharide profiles which were different in relative mobility from those of hospitals B and C. Those from hospital B (12 strains isolated in 1983 and 1986) and C (one strain) were similar in relative mobility but different in colour. The strain from a patient with acquired immune deficiency syndrome (AIDS) in hospital A displayed a lipopolysaccharide profile characteristic of hospital A. These reproducible profiles were all different in relative mobility from the reference serogroup 6 strain. They can be used as a marker system in epidemiological surveys of serologically identical serogroup 6 strains. Lipopolysaccharide patterns from strains isolated throughout the years in the same hospital were similar. This suggests an outgrowth from organisms inhabiting the plumbing system rather than reseeding from the Amsterdam mains supply.
Histological analysis of parotid and submandibular glands in chronic alcohol abuse: a necropsy study.
Authors: Scott J , Burns J , Flower E A
Published: June 2007

A quantitative histological analysis of the major salivary glands was carried out at necropsy in 28 alcoholics and in a series of age and sex matched controls. The findings were related to the different types of histologically diagnosed liver disease present. Significant quantitative changes of salivary gland structure were noted in cirrhosis but not in other forms of alcoholic liver disease. In cirrhotic subjects the parotid contained proportionally more adipose but less acinar tissues than in controls. The submandibular gland showed a proportional increase in adiposity and reduction in fibrovascular tissues but no noticeable reduction in its acinar proportional volume. Neither grossly detectable parotid enlargement nor acinar hypertrophy, a feature which has previously been noted as characteristic of alcoholic sialadenosis, were evident in this series. These findings provide little structural support for the reportedly increased secretory capacity of salivary glands in chronic alcohol abuse.
N-myc gene product expression in neuroblastoma.
Authors: Hashimoto H , Daimaru Y , Enjoji M , Nakagawara A
Published: June 2007

The presence and distribution of N-myc gene product were studied in 13 neuroblastomas and five ganglioneuroblastomas, using immunohistochemical techniques. Nine tumors (eight neuroblastomas and one ganglioneuroblastoma of composite type) contained neuroblastoma cells with positive nuclei for N-myc protein. Microscopic examination showed that most of the positive neuroblastoma cells seemed to be immature, with no apparent neuronal differentiation. Nine of 11 tumours with amplified N-myc gene copies exhibited tumour cells with positive immunostaining for the N-myc gene product, while none of the seven non-N-myc amplified cases contained immunoreactive tumour cells. The survival of the patients positive for N-myc protein was significantly low compared with that of the negative ones. It is concluded that immunohistochemical staining for the N-myc gene product will facilitate prediction of the prognosis of patients with neuroblastoma.
Primary acquired sideroblastic erythropoiesis in non-anaemic and minimally anaemic subjects.
Authors: Bowen D T , Jacobs A
Published: June 2007

Six patients had primary sideroblastic erythropoiesis together with a haemoglobin concentration of 12.0 g/dl or higher. In four cases this was associated with macrocytosis. Other abnormalities included failure of erythroid progenitor growth from peripheral blood in three cases and occasional dysplastic appearances in neutrophils and megakaryocytes. Sideroblastic erythropoiesis seems to be an early manifestation of the myelodysplastic syndrome and may present clinically at a pre-anaemic stage.
Morphometric and flow cytometric analysis of small cell undifferentiated carcinoma of the bladder.
Authors: Blomjous C E , Vos W , Schipper N W , De Voogt H J , Baak J P , Meijer C J
Published: June 2007

Eighteen cases of primary small cell carcinoma of the bladder were studied. Three patients survived for two years and one survived for five years, which was significantly worse when compared with poorly differentiated transitional cell carcinoma (WHO grade 3). Aggressive tumour behaviour was independent of the presence of neuroendocrine characteristics. Morphometric analysis showed that the nuclear size, which was comparable with that reported in pulmonary small cell carcinoma, was significantly smaller than in poorly differentiated transitional cell carcinoma. Nuclear morphometry may therefore help identify small cell bladder carcinoma, especially in the absence of neuroendocrine differentiation characteristics. DNA flow cytometry of paraffin wax embedded specimens showed aneuploidy in 14 tumours--five were peritetraploid and two multiple aneuploid--and only three were diploid. Aggressiveness of small cell bladder carcinoma usually coincides with aneuploidy in most cases, but diploid tumours may also follow a rapid, lethal clinical course.
Erythrocyte autoantibodies, autoimmune haemolysis, and myelodysplastic syndromes.
Authors: Sokol R J , Hewitt S , Booker D J
Published: June 2007

Immunohaematological investigations were carried out in 46 patients with erythrocyte autoantibodies associated with myelodysplastic syndromes. Eight patients had refractory anaemia, 17 refractory anaemia with ring sideroblasts, 11 refractory anaemia with excess of blasts, four chronic myelomonocytic leukaemia, five refractory anaemia with excess of blasts in transformation and one could not be classified. Standard agglutination direct antiglobulin tests showed that the red cells were most often coated with IgG and C3d, though increased amounts of IgM or IgA were also found in 15 of 35 cases (43%) when the more sensitive enzyme linked method was used. The IgG antibodies were predominantly of IgG1 subclass. Clinically important autoimmune haemolysis occurred in 15 patients, and was of "warm", "cold," and "mixed" types in seven, four, and four cases, respectively: it is important to recognise its presence in view of the good response to treatment. The increased incidence of erythrocyte autoantibodies in myelodysplastic syndromes is thought to be one manifestation of disturbed immune homeostasis.
Longitudinal study of circulating gastric antibodies in pernicious anaemia.
Authors: Davidson R J , Atrah H I , Sewell H F
Published: June 2007

Temporal changes in gastric antibody response were investigated in 113 (51 men, 62 women) patients with confirmed pernicious anaemia. Their ages ranged from 31-92 years (mean (SD 13.2) 66). At diagnosis, parietal cell antibody and intrinsic factor antibody were detected in 90.9% and 39.1% of all patients, respectively. When the tests were repeated after a mean follow up of 70 months (range 14-137), parietal cell antibody and intrinsic factor antibody were positive in 82.8% and 58.7%, respectively. There was a definite but not significant trend for the organ specific parietal cell antibody to disappear; intrinsic factor antibody became more positive. These results may indicate that with progressive parietal cell destruction, the antigen is no longer available to sustain an immunological response. On the other hand, this hypothesis does not explain the increased prevalence of intrinsic factor antibody which is also a product of parietal cells.
Changes in phagocytic function with glycaemic control in diabetic patients.
Authors: MacRury S M , Gemmell C G , Paterson K R , MacCuish A C
Published: June 2007

Phagocytic function was assessed by serial whole blood chemiluminescence in poorly controlled type 2 (non-insulin dependent) diabetic patients during efforts to improve glycaemic control and compared with a group of well controlled type 1 (insulin dependent) diabetic patients. Chemiluminescence (corrected to a standard polymorphonuclear count) remained below normal (0.15-0.30 photons/second/cell) for most of the type 2 patients until 12 weeks when the value was significantly increased in patients showing improved glycaemic control (mean (range) 0.25 (0.01-0.43) photons/second/cell) compared with those showing no improvement (0.12(0.01-0.31) photons/second/cell). There was a significant inverse correlation of delta HbA1 with delta chemiluminescence. Although mean chemiluminescence for the type 1 diabetic patients was within the normal range, there was a wide scatter of values (0.19 (0.04-0.43) photons/second/cell) and there was no significant difference compared with the final value of type 2 patients with improved control. Glycaemic control is therefore a major determinant of phagocytic function in diabetic patients, but other factors must contribute, particularly in type 1 (insulin dependent) patients.
Breast carcinoma cellularity and its relation to oestrogen receptor content.
Authors: Parham D M , Baker P R , Robertson A J , Vasishta A , Baker P G , Smith G
Published: June 2007

The cellularity of 104 primary breast carcinomata was determined by semiautomated image analysis to allow the relation between cellularity and oestrogen receptor content values to be assessed. The oestrogen receptor content of tumours detected by a steroid binding assay showed no correlation with cellularity, although a possible weak negative correlation was observed between tumour cellularity and oestrogen receptor content detected by enzyme immunoassay. It is concluded that there is no single direct correlation between tumour cellularity and oestrogen receptor content.
Pathology of tropical appendicitis.
Authors: Gupta S C , Gupta A K , Keswani N K , Singh P A , Tripathi A K , Krishna V
Published: June 2007

Over the past 25 years, 2921 appendicectomies were performed at this hospital. All were subjected to routine histopathological examination. In 95% of cases, histopathological examination did not add any further information but in 153 (5%) cases, clinically important pathological findings were detected for the first time. Seventy (2.3%) specimens showed typical evidence of tuberculosis. Parasitic infestation was detected in 75 (2.5%), including enterobiasis (1.4%), amoebiasis (0.5%), ascariasis (0.5%), ascariasis with trichuriasis (0.05%), and taeniasis (0.05%). Other lesions found were mucocele (0.1%) and carcinoid tumour (0.1%). It is concluded that routine histopathological examination of all appendicectomy specimens should be performed to avoid missing any clinically important and treatable condition.
Lectin binding properties of cells from serous effusion and peritoneal washing specimens.
Authors: Shield P W
Published: June 2007

The diagnostic value of staining cells from serous effusion and peritoneal washing specimens with a panel of four lectins was investigated and the results compared with those achieved with polyclonal anti-carcinoembryonic antigen (anti-CEA) sera. Cell blocks from 42 pleural effusions, 25 peritoneal effusions, and 14 peritoneal washing specimens were stained with Con A (D-mannosyl, D-glucosyl), WGA (n-acetyl glucosamine), UEA-1 (L-fucose), SBA (n-acetyl galactosamine) and anti-CEA. Con A and WGA were not useful in discriminating mesothelial cells from adenocarcinomas. In contrast, UEA-1 and SBA binding was present in 30 of 46 (65%) and in 31 of 46 (67%), respectively, of adenocarcinomas tested, but negative in 21 cases with reactive mesothelial cells, 10 cases with benign mesothelial cells, and one case of mesothelioma. All mesothelial cells were also negative for CEA, but 24 of 46 (52%) of adenocarcinomas were positive. All three cases of lymphoma were negative with UEA-1, SBA, and anti-CEA. UEA-1 and SBA lectins identified a higher proportion of metastatic adenocarcinomas than CEA and stained most cases of adenocarcinomas metastatic from sites which usually fail to express CEA. Combination of staining results for UEA-1, SBA, and anti-CEA produced a test with high sensitivity and specificity, identifying 40 of 46 (87%) of adenocarcinomas tested, with no false positive results. It is concluded that UEA-1 and SBA staining of effusion specimens warrants further study, and may provide a useful adjunct to CEA staining.
Detection of T cells in paraffin wax embedded tissue using antibodies against a peptide sequence from the CD3 antigen.
Authors: Mason D Y , Cordell J , Brown M , Pallesen G , Ralfkiaer E , Rothbard J , Crumpton M , Gatter K C
Published: June 2007

Rabbit polyclonal antibodies were raised against a proline rich, peptide sequence, comprising 13 amino acids, in the cytoplasmic domain of the CD3 epsilon chain. Immunoprecipitation experiments showed that this antibody preparation recognised the CD3 antigen on human T lymphoblasts. The antibody stained normal T cells strongly in tissue sections which had been fixed in formalin or Bouin's solution and embedded in paraffin wax. Its reactivity with T cell lymphoma, when evaluated on a series of 96 previously phenotyped cases, closely agreed with the results obtained on cryostat sections. These results indicate that the specific detection of T cells in routinely processed tissue biopsy specimens is now technically feasible on a wide scale in diagnostic laboratories using CD3 peptide antibodies, and they also suggest that in future the use of anti-peptide antibodies may detect other lineage specific antigenic markers in paraffin wax sections.
Comparison of immunodiffusion and enzyme linked immunosorbent assay for antibodies to four Aspergillus species.
Authors: Froudist J H , Harnett G B , McAleer R
Published: June 2007

Antigenic extracts were prepared from Aspergillus fumigatus, A niger, A flavus and A terreus for use in enzyme linked immunosorbent assay (ELISA) and immunodiffusion (ID) tests for Aspergillus antibodies to determine whether the use of antigenic extracts from species other than A fumigatus increased the sensitivity of the ELISA. ELISA titres correlated well with positive ID tests. Patient titres by ELISA were significantly higher than control titres for all species. Patient titres to A niger were also significantly higher than titres to the other species. Total number of ID bands to A fumigatus correlated significantly with anti-A fumigatus ELISA titres. It is concluded that the use of antigenic extracts from species other than A fumigatus improves the sensitivity of the ELISA.
On-call service: the role of chemical pathologists.
Authors: Neithercut W D , Paterson J R , Spooner R J
Published: June 2007

The workload of the chemical pathology advisory on-call service was investigated. Over three years 317 calls were recorded, giving a mean of nine calls a month. Seasonal variation in the number of calls was observed, with an increase in calls during December, January, and February. Requests for the arrangement of analysis accounted for 231 calls, while there were 98 requests for advice. Authorization of a request for analysis was the outcome of 156 calls. Advice with respect to investigation, treatment, or interpretation of results was offered during 173 calls. The acute medical and surgical wards, the accident and emergency department, renal unit and intensive care unit accounted for 198 of the calls. The two analyses most frequently requested, through the advisory on-call service, were serum digoxin and blood ethanol, with 51 and 33 requests, respectively. The "acute" wards and accident and emergency department had the greatest request rate, accounting for 35 of the requests for digoxin and 26 of the requests for blood ethanol. The acute care areas were responsible for the major part of the workload, and a clinical requirement for the services of chemical pathologists out of hours, was observed.
Biochemical predictors of short term mortality in elderly residents of chronic care institutions.
Authors: Woo J , Chan S M , Mak Y T , Swaminathan R
Published: June 2007

A survey of 208 elderly subjects living in four long term care institutions was undertaken over three months to identify nutritional and other variables that could be used to predict mortality during the subsequent three months. There were 58 men (mean age (SD) 75.6 (9.6) years) and 150 women (79.5 (8.4) years). Twenty nine subjects died (12 men and 17 women) within three months of completing the study. Twenty eight out of 57 variables differed significantly between those who died and those who survived. Subjects who died had lower systolic blood pressure, poorer intake of protein calories, lower concentrations of haemoglobin, plasma retinol, zinc, total cholesterol, and higher albumin adjusted plasma calcium concentrations. Stepwise regression analysis identified five variables that predicted mortality: plasma fructosamine; transferrin; glycosylated haemoglobin; prealbumin; and haemoglobin. The sensitivity, specificity, and predictive values of the discriminant function score using 0 as the demarcation between survivors and non-survivors were 75%, 97%, and 95%, respectively. This score could therefore be used to identify those most in need of nutritional support.
Carriage of Candida species and C albicans biotypes in patients undergoing chemotherapy or bone marrow transplantation for haematological disease.
Authors: Odds F C , Kibbler C C , Walker E , Bhamra A , Prentice H G , Noone P
Published: June 2007

Six hundred and seventy four yeast isolates obtained from routine microbiological screening of 153 patients with haematological disease were identified and Candida albicans isolates biotyped over nine months to determine longitudinal and cross sectional patterns of yeast colonisation. A yeast microflora persisted in many patients despite the routine prophylactic use of oral antifungal agents. Analysis of the yeast species isolated on a cross sectional basis showed that C albicans accounted for 65% of yeasts isolated from the oral cavity but only 45% of the faecal yeast flora. Longitudinal changes in yeast flora occurred significantly more often in faecal samples than in oral samples and significantly less often in sites colonised with C albicans than in sites colonised with other species. No associations were found between the yeasts isolated and the nature of antifungal prophylaxis used, or the extent of a patient's stay in hospital.
Microtitre plate measurement of platelet response to hypotonic stress.
Authors: Farrugia A , Hughes C , Douglas S , Neal M , James J
Published: June 2007

The conventional method of assessing the platelet response to hypotonic stress (HSR) was adapted to allow microtitre plate technology to be used. After water is added to a platelet suspension two sequential readings are taken at 414 nM on a vertical microplate reader. The difference between the second (three minutes) and the first (one minute) was defined as the HSR. This method allowed the relation between platelet concentrate pH and viability to be confirmed, and an HSR value for use in quality control was established. The method correlated well with the conventional technique and permitted measurement of undiluted samples as well as of products with a high free haemoglobin concentration.
Comparison of clinical and postmortem diagnosis of pulmonary embolism.
Authors: Karwinski B , Svendsen E
Published: June 2007

The incidence of pulmonary embolism and the number of clinically missed diagnoses of it in necropsies carried out between 1960 and 1984 at this department were investigated. Pulmonary embolism primarily affects elderly people with serious underlying disease; in this study it was found more often in women. The incidence of pulmonary embolism (9% of all necropsies) was unchanged during the period studied. In contrast, pulmonary embolism as the "sole" cause of death increased (p less than 0.0005). Although most pulmonary emboli were the immediate cause of death, the clinical diagnosis was often missed (in 84% of all cases). Furthermore, such clinically missed diagnoses increased over the years (p less than 0.005), especially in patients with heart disease and cancer. Without necropsy there will be considerable underdiagnosis of pulmonary embolism, therefore providing a misleading figure in the death statistics for this often fatal disease.
Granulocytic sarcoma: misleading immunohistological staining with MT1 and S100 protein antibodies.
Authors: Elliott C J , McCarthy K P , Carter R L , Davies P
Published: June 2007

Tissue from two patients with granulocytic sarcomas stained positively for MT1 and S100 protein antibodies; both of these cases presented considerable clinical and histological diagnostic difficulties until acute myeloblastic leukaemia spread to the bone marrow. Tissues from a further eight patients with granulocytic sarcoma were also examined retrospectively. Seven of them stained for MT1 and four for S100 protein but the traditional histological markers for myeloid cells--chloroacetate esterase and lysosyme--often stained only weakly and focally. This pattern of staining should raise the possibility of a granulocytic sarcoma in otherwise problematic cases.
Discrepant toxoplasma latex agglutination test results.
Authors: Holliman R E , Johnson J , Duffy K , New L
Published: June 2007

The analysis of 4450 toxoplasma serology results showed that 59 (1.3%) latex agglutination reactions were not confirmed in the dye test. These discrepant results were associated with an unspecified IgM antibody but not associated with kit batch variation, inactivation of sera, concurrent cytomegalovirus infection, or the presence of hepatitis B virus "e" antigen. The latex agglutination test is useful as a screen for toxoplasma infection but false positive reactions do occur. Patients at risk of severe toxoplasmosis should be investigated by additional tests.
Intrinsic factor antibody tests.
Authors: Shackleton P J , Fish D I , Dawson D W
Published: June 2007

The sensitivity of methods to detect antibodies to intrinsic factor was assessed. Five sera of known antibody content were tested in 31 laboratories and 30 sera from patients with pernicious anaemia were tested in one laboratory. Five non-commercial methods and two kits for type I antibodies and one non-commercial method for types I and II antibodies are in current use. Differences in sensitivity of the non-commercial methods for type I antibodies related more to the antigen: antibody ratio in the test system than to the method itself. A radioimmune assay for types I and II antibodies showed the best sensitivity but that of an enzyme linked immunosorbent assay (ELISA) method was poor.
Signet ring cell lymphoma of T cell type.
Authors: Cross P A , Eyden B P , Harris M
Published: June 2007

A rare variant of non-Hodgkin's lymphoma, signet ring lymphoma of T cell phenotype (only the fourth to be reported) in a 75 year old man was studied by light microscopy, immunohistochemistry, electron microscopy and gene rearrangement studies. Ultrastructurally, a wider spectrum of cell size and nuclear shape was observed in this case than in the previously recorded cases. The morphology of the signet ring vacuoles was identical to that found in the commoner B cell signet ring lymphoma of clear vacuole type, and it is suggested that the vacuoles derive from multivesicular bodies. The four cases reported so far have all presented with skin disease, and the limited evidence available suggests that the prognosis may be good.
Gastric metaplasia and Campylobacter pylori infection of duodenum in patients with chronic renal failure.
Authors: Shousha S , Keen C , Parkins R A
Published: June 2007

Duodenal biopsy specimens from 80 patients with chronic renal failure, who were undergoing haemodialysis, were examined by light microscopy for evidence of inflammation, gastric metaplasia, and Campylobacter pylori infection. Chronic duodenitis was present in 47 (59%) of patients, of whom only seven (9%) showed evidence of active inflammation. Gastric metaplasia was present in 50 (62.5%) of patients, yet Campylobacter pylori was identified in only two patients (2.5%). It is suggested that the duodenal environment of patients with chronic renal failure remains hostile to the growth of these organisms in spite of the presence of gastric metaplasia.
Ultrastructural study of two subtypes of gastric adenoma.
Authors: Muratani M , Nakamura T , Nakano G I , Mukawa K
Published: June 2007

An ultrastructural study was performed to identify any differences in fine detail between type III and IV gastric polyps, which seem to differ from each other because they have different histological features and malignant potential. Clear ultrastructural differences were found, implicating microvilli, mucous granules, interdigitations, ribosomes, mitochondria and nuclei. Although these two subtypes have often been grouped together as borderline lesions or adenomas, the findings imply that they should be treated as essentially different.
Mucosal argyrophil endocrine cells in pernicious anaemia and upper gastrointestinal carcinoid tumours.
Authors: Sjöblom S M , Sipponen P , Karonen S L , Järvinen H J
Published: June 2007

The number and density of argyrophil endocrine cells were morphometrically calculated in gastric fundal mucosal biopsy specimens taken from 64 patients with pernicious anaemia (five with gastric carcinoids, 15 with nodular argyrophil cell hyperplasia, 44 with diffuse argyrophil cell hyperplasia) and from 14 healthy controls. Similar calculations were also made on the ileal mucosa away from the tumour of 10 patients with ileal carcinoids and 10 controls. In the stomach, the argyrophil cell counts were twice as high in the patients with pernicious anaemia than in controls and the densities in the whole mucosa or in the epithelial structures were similarly three to five times higher. The cell counts in the patients showed positive correlation with the serum gastrin concentration. The patients with nodular argyrophil cell hyperplasia and gastric carcinoids formed a uniform group with the highest cell counts and serum gastrin concentrations; the difference between the groups was in the longer duration of pernicious anaemia in the patients with carcinoid tumours. On the other hand, no endocrine cell hyperplasia was seen in those with ileal carcinoids. It is concluded that fundal mucosal endocrine cells show an increase in patients with pernicious anaemia that is related to the gastrin concentration. This phenomenon may favour the development of hyperplastic endocrine cell nodules and, eventually, carcinoid tumours.
Hepatitis B-DNA replication and histological patterns in liver biopsy specimens of chronic HBsAg positive patients with and without hepatitis delta virus superinfection.
Authors: Villari D , Raimondo G , Smedile V , Rodinó G , Brancatelli S , Longo G , Squadrito G , Batolo D
Published: June 2007

The role of active hepatitis B virus (HBV) infection in chronic HBsAg positive hepatitis with and without hepatitis delta virus (HDV) superinfection was analysed in percutaneous liver biopsy specimens from 50 patients. Each specimen was divided into two--one part for histological evaluation and for the detection of HBcAg and delta antigen; the other part was tested for HBV-DNA using Southern blotting. Ten cases were of chronic lobular hepatitis, 10 of chronic persistent hepatitis, and 30 of chronic active hepatitis. Ten cases were delta antigen positive and showed high grade lobular activity but no evidence of HBV-DNA episomal forms or HBcAg reactivity. Twenty one cases showed HBV-DNA replicative intermediate forms; 19 had high grade lobular activity, which occurred in five cases without evidence of free viral DNA. Of the 21 biopsy specimens with HBV-DNA episomal forms, 14 were positive for HBcAg; only one of the 19 cases without detectable viral DNA was positive for such antigen. These data indicate that the presence of HBV or HDV active infection correlates with the histological finding of prominent lobular necrosis. Moreover, intrahepatic HBV-DNA seems to be a more sensitive marker than the presence of viral antigens for indicating HBV replication.
Laryngeal papillomatosis: correlation between severity of disease and presence of HPV 6 and 11 detected by in situ DNA hybridisation.
Authors: Quiney R E , Wells M , Lewis F A , Terry R M , Michaels L , Croft C B
Published: June 2007

A technique using a biotin-streptavidin polyalkaline phosphatase complex was applied to routinely fixed and processed biopsy specimens of laryngeal papillomata from 45 patients taken over the past 20 years to detect human papilloma virus (HPV) types 6 and 11. Two thirds of both adult and juvenile onset cases were positive for HPV 6 or HPV 11 or both. Five specimens of normal vocal cord epithelium were negative for HPV 6 and 11. The detailed clinical history, endoscopic findings, success of treatment and eventual prognosis were compared with the HPV state of biopsy material for each patient. Patients with multiple confluent lesions when first seen, whose histology showed florid koilocytosis and who had strongly positive reactivity for HPV 6 or 11 present in the surface epithelial cell nuclei, had a poor prognosis requiring multiple endoscopies to control their disease.
Comparative study of iliac crest and proximal femur histomorphometry in normal patients.
Authors: Fazzalari N L , Moore R J , Manthey B A , Vernon-Roberts B
Published: June 2007

The relation between the bone histomorphometric profile of the iliac crest and regions of the proximal femur was investigated. In the proximal femur four blocks were selected, representing the subchondral principal compressive (SPC) and tensile (SPT) regions, the zone near the medial cortex in the principal compressive region (MPC), and the zone medial to the greater trochanter (MGT). Undecalcified tissue sections stained by the von Kossa silver method and counterstained with haematoxylin and eosin were used for quantitation. The SPT region was most representative of the iliac bone profile, in particular the structural parameters of mineralised bone, trabecular thickness, and trabecular spacing and resorption surface. Most parameters in the regions studied showed inconsistent and variable results when compared with those of the iliac crest. There was only a weak association, therefore, between the histomorphometric parameters of the iliac crest and the proximal femur despite the appeal of the use of the iliac biopsy specimen as a simple clinical test.
Detection of cytomegalovirus antigens and DNA in tissues fixed in formaldehyde.
Authors: Jiwa N M , Raap A K , van de Rijke F M , Mulder A , Weening J J , Zwaan F E , The T H , van der Ploeg M
Published: June 2007

Immunohistochemical techniques with monoclonal antibodies against cytomegalovirus (CMV) immediate early (IEA) and early antigens (EA), and in situ hybridisation, were used to detect CMV infection in routinely obtained, formaldehyde fixed and paraffin wax embedded tissues taken from bone marrow transplant patients, who had died form interstitial pneumonia. To improve the rates of detection of CMV-IEA and EA the wax embedded material was pretreated with 0.4% pepsin/HCl at 37 degrees C for 30 minutes. This pretreatment was also advantageous for in situ hybridisation. In the patients with histological evidence of CMV infection or positive viral culture from the lung tissue, or both, viral proteins and nucleic acids were detected in lung, as well as in other organs. Immunohistochemical techniques proved superior in heavily infected but necrotic tissues. In control patients (patients who had died from interstitial pneumonia without any evidence of CMV, or with no interstitial pneumonia at all) in situ hybridisation showed no positive signal, while immunohistochemical techniques showed only a few positive cells in lung tissue of one of nine patients. In addition to CMV-DNA analysis, formaldehyde-fixed, paraffin wax embedded tissue is amenable to immunohistochemical analysis with CMV monoclonal antibodies.
Lack of significant effect of therapeutic propranolol on measurable platelet function in healthy subjects.
Authors: Pamphilon D H , Boon R J , Prentice A G , Rozkovec A
Published: June 2007

Propranolol, a non-selective beta blocker, was administered orally in therapeutic doses. The effects of a single dose (160 mg) and one week's treatment (80 mg twice a day) on platelet function were compared in healthy young subjects. There were no significant changes in circulating platelet aggregates, template bleeding time, platelet factor 3 availability and thromboxane beta 2 (TX beta 2) generation. Platelet aggregation responses as assessed by angle of slope and maximal percentage aggregation (all agonists) and lag phase (collagen) showed no changes of biological importance, although minor changes reaching significance were observed with some agonists. These findings suggest that propranolol does not significantly affect platelet function when taken at doses commonly encountered in clinical practice.
Use of protein profiles to identify Acinetobacter calcoaceticus in a respiratory care unit.
Authors: Dijkshoorn L , Wubbels J L , Beunders A J , Degener J E , Boks A L , Michel M F
Published: June 2007

The presence of acinetobacters in a respiratory care unit was prospectively studied because of an increase in the number of isolations of Acinetobacter calcoaceticus. Cell envelope protein electrophoresis was used to distinguish strains. Eleven protein patterns were observed in isolates from patients and their environment. One pattern (pattern 1) was seen in several patients and environmental samples. Another pattern (pattern 2) was identified repeatedly in samples from skin and mucous membranes of patients in the same ward. After thorough cleaning was undertaken throughout the unit, the pattern 1 strain was no longer cultivated from clinical samples. It is concluded that cell envelope protein electrophoresis is a useful method for tracing epidemic strains of A calcoaceticus.
Orcein-alcian blue staining: a new technique for demonstrating acid mucins in gastrointestinal epithelium.
Authors: Singh R , Gorton A W
Published: June 2007

Orcein-alcian blue staining, a new method for the simultaneous demonstration of sulphated and sialomucins in gastrointestinal epithelium was compared with the standard high iron diamine-alcian blue technique. Sections were oxidised with potassium permanganate and decolourised in oxalic acid. They were stained with orcein for four hours, differentiated for a few seconds in acid alcohol, and then counterstained with alcian blue for half to one minute. There was a good correlation of results between the two methods. Orcein-alcian blue is a safer, cheaper, and quicker method than high iron diamine-alcian blue which can be safely introduced into routine laboratories for the study of acid mucins in the gastrointestinal diseases.
Necropsies in clinical audit.
Authors: Anderson N H , Shanks J H , McCluggage G W , Toner P G
Published: June 2007

The need for specialised forms of clinical audit was highlighted by the report of the Confidential Enquiry into Perioperative Deaths (CEPOD). Necropsy rates in a Northern Ireland teaching hospital were studied with particular reference to perioperative deaths. To provide an overall context for these observations, the pattern of the necropsy services in Northern Ireland as a whole was also determined. For 600 consecutive deaths in a major teaching hospital, the overall necropsy rate was 180 (30%). In the 74 perioperative deaths in this group (as defined by the CEPOD) the necropsy rate was 26 (35%), compared with 16 out of 72 (22%) for other surgical deaths and 89 out of 386 (23%) for medical cases. More coroners' necropsies were carried out in the perioperative group. These figures are within the range of the CEPOD experience. In 1987, in the whole of Northern Ireland, there were 8859 hospital deaths, 520 (5.9%) hospital necropsies, and 516 (5.8%) coroners' necropsies, giving an overall necropsy rate of 11.7%. Outside the two major Belfast teaching hospitals, however, there were 6799 hospital deaths, 76.6% of all hospital deaths for Northern Ireland. In this group there were 180 (2.6%) hospital necropsies and 383 (5.6%) coroners' cases, the overall necropsy rate being only 8.2%. These wide variations reflect the fact that the number of pathologists in post in the peripheral areas of the province falls substantially short of levels recommended by the Royal College of Pathologists. If clinical audit along CEPOD lines is to be effective nationally, more emphasis should be placed on the value of necropsy and local deficiencies in provision will have to be identified and remedied. It is suggested that this could be achieved by combining audit provisions with budgetary incentives.
Oestrogen receptors in mucinous carcinoma of the breast: an immunohistological study using paraffin wax sections.
Authors: Shousha S , Coady A T , Stamp T , James K R , Alaghband-Zadeh J
Published: June 2007

An immunohistological method (Shintaku-Said method) for the demonstration of oestrogen receptors in routinely processed paraffin wax embedded tissue was applied to 19 cases of mucinous carcinoma of the breast. Seventeen (89%) tumours showed variable degrees of positivity and two were negative. In eight cases the receptors were also assayed biochemically using a dextran-coated charcoal method, and the results of the two methods showed good correlation. No difference in the distribution of positive and negative cases was noted between pure and mixed mucinous tumours, and in the latter group the pattern of staining of the mucinous elements was similar to that seen in the solid elements. It is concluded that the major advantage of this method is its ability to offer for study the distribution of the receptors in individual cells and specific histological structures. The results also indicate that most mucinous carcinomas of the breast are oestrogen receptor positive, irrespective of whether they are pure or mixed type.
Calcification of umbilical artery: two distinct lesions.
Authors: Khong T Y , Dilly S A
Published: June 2007

The clinical and pathological features of five cases of calcification of umbilical cord vessels were reviewed. Two distinct lesions were identified: calcification could produce either sclerosis of the wall or obliteration of the lumen. In three cases there was calcification within the media and adventitia of the umbilical arteries, with extension into Wharton's jelly in one case. The pathogenesis of this pattern of calcification--the sclerotic variant--is unclear but the findings of inflammation in the umbilical cord and its vessels, membranes, and decidua suggest intrauterine infection. In two cases there was complete calcification of umbilical arterial lumina resulting in total obliteration. The findings of fetal vessels in the chorionic plate with medial calcification in one of these two cases raises the possibility of thrombosis within the umbilical cord vessels as a cause, but the latter was not found. One infant from each group was liveborn. Both had shown signs of fetal distress in utero and delivered prematurely. The other three pregnancies resulted in macerated stillbirth preterm.
Immunohistological localisation of staphylococcal toxic shock syndrome toxin (TSST-1) antigen in sudden infant death syndrome.
Authors: Newbould M J , Malam J , McIllmurray J M , Morris J A , Telford D R , Barson A J
Published: June 2007

A polyclonal antiserum to toxic shock syndrome toxin (TSST-1) and a standard immunoperoxidase technique were used on formalin fixed tissues from 50 cases of sudden infant death syndrome (SIDS) to determine if the syndrome was associated with bacterial infection. There was strong specific staining in the renal tubular cells in nine (18%) cases. A similar pattern of staining was seen in three of a series of 50 kidneys selected for comparison from a wide range of necropsy cases. The staining was finely granular within the cytoplasm of proximal convoluted tubular cells and diffuse in tubular cell nuclei. In an attempt to validate the staining pattern the immunoperoxidase technique was also performed on formalin fixed kidneys from rats which had been given intravenous injections of crude bacterial products containing TSST-1. These showed coarse granular cytoplasmic staining in proximal convoluted tubules with some diffuse nuclear staining. This pattern was not seen in controls injected with saline. These results indicate that TSST-1 might have a pathogenic role in some cases of SIDS.
Molecule detected in formalin fixed tissue by antibodies MT1, DF-T1, and L60 (Leu-22) corresponds to CD43 antigen.
Authors: Stross W P , Warnke R A , Flavell D J , Flavell S U , Simmons D , Gatter K C , Mason D Y
Published: June 2007

Three monoclonal antibodies MT1, L60 (Leu-22), and DF-T1, were reported independently as recognising human T cells in routinely processed, paraffin wax embedded tissue. The present study was performed to compare these three reagents in terms of their immunocytochemical reactions and target molecule(s). On Western blotting of white cell extracts the three antibodies reacted with antigens of the same molecular weight (range 110-160 kilodaltons). Furthermore, their immunocytochemical reactivity with normal human cells, as analysed by two-colour flow cytometry, was essentially identical (labelling of monocytes, most T lymphocytes, and weak reactions with some B cells), and the antibodies gave closely similar reactions on 54 white cell derived neoplasms. To identify the target antigen for these three reagents, antibodies from the Third International Workshop on Leucocyte Antigens were reviewed and it was shown that the Western blotting and immunocytochemical reactions of MT1, L60 (Leu-22), and DF-T1 were identical with those of the reagents which defined the CD43 antigen (also known as leucosialin or sialophorin). Furthermore, all these antibodies reacted with cells transfected with a cDNA clone encoding CD43. It is concluded that antibodies MT1, L60 (Leu-22), and DF-T1 all recognise the heavily glycosylated myeloid/lymphoid associated CD43 antigen.
Improved silver technique for showing nucleolar organiser regions in paraffin wax sections.
Authors: Chiu K Y , Loke S L , Wong K K
Published: June 2007

An improved technique for the demonstration of nucleolar organiser regions (NORs) was devised. It has the advantage that any non-specific background deposits which mimic the NOR dots formed during staining are trapped by the celloidin film. The specificity of the silver staining is also increased by the postfixation treatment of sections in an acetic acid-ethanol mixture. Moreover, it is economical because of the low silver content and small volume of the incubation solution used.
Assessment of oestrogen receptor content of breast carcinoma by immunohistochemical techniques on fixed and frozen tissue and by biochemical ligand binding assay.
Authors: Paterson D A , Reid C P , Anderson T J , Hawkins R A
Published: June 2007

The oestrogen receptor content of 61 breast carcinomas was assessed by biochemical ligand binding assay and three immunohistochemical techniques--a frozen section method (Abbott ER-ICA) and on paraffin wax sections after fixation by two methods. The two fixatives used were Carson's buffered formalin and methacarn, and a DNAse pretreatment of sections was used. Overall agreement for the immunohistochemical methods with the ligand binding technique were 95%, 85%, and 86% for the frozen, formalin, and methacarn methods, respectively. A semiquantitative staining score was performed and all three methods gave significant correlations of staining scores with biochemical ligand binding values. The frozen section method was best (r = 0.88) with the fixed tissue methods yielding poorer correlation coefficients. Several factors affected staining, including the nature of the fixative and variable activity of DNAse. It is concluded that immunohistochemical assessment of oestrogen receptor content on fixed tissue provides acceptable qualitative information but that standardisation of protocols for tissue processing will be necessary for optimal utility and especially for quantitative assessments.