bluuebunny/crossref_metadata_2025 huggingface dataset:
Pulmonary vascular candidiasis and use of central venous catheters in neonates.
Authors: Knox W F , Hooton V N , Barson A J
Published: June 2007

A retrospective study of infant deaths in this maternity hospital carried out from 1976-86 showed a recent increase in fatalities with systemic candidiasis. Ten of twenty five cases occurred between July 1985 and June 1986. Most of these infants had Candida plugging pulmonary vessels, often accompanied by vasculitis, thrombosis, and parenteral lipid embolism. The adoption of central venous catheters for prolonged parenteral feeding of very preterm infants may have accounted for this phenomenon. Over the same decade there was an increased incidence of Candida isolates from all admissions to the neonatal intensive care unit: the prolonged survival of very low birthweight infants and the use of multiple courses of antibiotics were also factors.
Heterogeneity of antibody response in infection with Legionella pneumophila serogroup 1.
Authors: Fallon R J , Johnston R E
Published: June 2007

The antibody response of patients infected with Legionella pneumophila serogroup 1 in a common source outbreak was investigated. Heat-killed antigens from L pneumophila serogroups 1-3 and 6-10, plus several other strains of L pneumophila, together with 13 other species of legionellas were used in an indirect fluorescence antibody test. Formolised yolk sac antigens made from L pneumophila serogroups 1, 6, and 7 were also used. Although antibodies were produced to several L pneumophila serogroups or Legionella species by individuals, there was no constant pattern, suggesting that the response is a characteristic of the infected individual and not of the infecting strain of Legionella. There is evidence that heat-killed antigen made from L pneumophila serogroup 7 may give unreliable results.
Analysis of latex agglutination test for Clostridium difficile toxin A (D-1) and differentiation between C difficile toxins A and B and latex reactive protein.
Authors: Borriello S P , Barclay F E , Reed P J , Welch A R , Brown J D , Burdon D W
Published: June 2007

Virulent toxigenic and avirulent non-toxigenic strains of Clostridium difficile gave a positive result in the latex agglutination test (LAT) for C difficile toxin A (D-1). Similar concentrations of latex agglutinating antigen were produced by these strains in vivo. Positive reactions were also given by C sporogenes, proteolytic C botulinum Types A, B, and A/F, and Bacteroides assaccharolyticus. The latex agglutinating antigen was denatured by boiling for 10 minutes, but not by heating at 56 degrees C for 30 minutes. The reaction was abolished by incubation of test material with crude C difficile antitoxin but not with other clostridial antitoxins or specific antitoxin to C difficile toxin A. The latex agglutinating antigen present in C difficile eluted between 0.39% and 0.47% M sodium chloride, and that produced by the other clostridia, between 0.35% and 0.43% M sodium chloride by fast protein liquid chromatography. The latex agglutinating antigen of C difficile was neither cytotoxic nor mouse lethal and was distinct from toxin A and toxin B. In the analysis of faecal specimens from patients with diarrhoea the latex agglutination test correlated better with the presence of C difficile than with toxin B and detected both toxigenic and non-toxigenic strains. The latex agglutination test should only be used in the laboratory as an alternative to culture for C difficile and not as a method for the detection of C difficile toxins.
Importance of postmortem changes in measurements of thyroid function in studies of sudden infant death syndrome.
Authors: Wellby M L , Farror C J , Pannall P R
Published: June 2007

Various measurements of thyroid function were made from serum sampled at necropsy by cardiac puncture in adults and compared with the equivalent values before death. There were significant increases in serum total T3 (0.66 before death, 1.14 nmol/l after death), free T3 (0.82 to 1.52 pmol/l), and reverse T3 (1.12 to 1.75 nmol/l); and significant decreases in total T4 (73.7 to 56.6 nmol/l), free thyroxine index (FTI) (83.2 to 56.6), and free T4 (14.2 to 11.9 pmol/l). The increase in serum T3, presumably from T4 deiodination after death, observed in this study may explain the increased T3 concentration reported in serum sampled from cases of sudden infant death syndrome (SIDS).
Unusual myeloid leukaemia in patient with Hodgkin's disease.
Authors: Horton M A , Barnett M J , Goff L , Czepulkowski B , Amess J A , Stansfeld A G , Lister T A
Published: June 2007

An unusual case of leukaemia in a patient with Hodgkin's disease is described. The leukaemic blast cell population was typified by the presence of a substantial proportion of binucleate and multinucleate cells, many of which had the morphological features of Sternberg-Reed cells. The circulating and bone marrow blast cells were shown by immunophenotyping to be of myeloid origin.
Influence of 5-hydroxytryptamine on crypt cell production rate of human duodenal mucosa cultured in vitro.
Authors: Wheeler E E , Challacombe D N
Published: June 2007

The effect of 5-hydroxytryptamine (5-HT) on the crypt cell production rate in normal human duodenal mucosa cultured in vitro was studied using a stathmokinetic technique with crypt microdissection. The addition of 5-HT (2 mg/ml) to the culture medium significantly increased the crypt cell production rate (p less than 0.001), suggesting that this amine may have a trophic effect on crypt cells in vitro. Increased synthesis and release of 5-HT from enterochromaffin cells in patients with coeliac disease may increase the crypt cell production rate and lead to a flattened small intestinal mucosa.
Abnormal intestinal permeability and jejunal morphometry.
Authors: Juby L D , Dixon M F , Axon A T
Published: June 2007

The cellobiose and mannitol differential sugar test is a non-invasive investigation of small bowel permeability, in which urinary recoveries of cellobiose and mannitol after a hyperosmolar oral load are expressed as a ratio to give a permeability index. Changes in the cellobiose:mannitol ratio often occur in coeliac disease, but some patients with abnormal permeability have normal jejunums by routine microscopy. Using computed morphometry the perimeter:lamina propria area index of jejunal biopsy samples was measured and compared with the cellobiose:mannitol ratio in three groups of patients: (i) those with coeliac disease with villous atrophy; (ii) those with normal jejunums and sugar test results: and (iii) those with normal jejunums but abnormal sugar test results. In addition to the expected difference in perimeter:lamina propria area index between patients with coeliac disease and those with normal findings (p less than 0.001), the index was also abnormal in patients with normal jejunums but abnormal sugar test results: (p less than 0.001 compared with group 1) and (0.01 greater than p greater than 0.001 compared with group 2). There was a significant overall correlation between the perimeter:lamina propria area index and cellobiose:mannitol ratio (p = 0.001). This study shows that computed jejunal morphometry can identify patients with subtle morphological changes that are related to abnormal intestinal permeability.
Expression of tissue polypeptide antigen (TPA) in fetal and adult liver: changes in liver disease.
Authors: Burt A D , Stewart J A , Aitchison M , MacSween R N
Published: June 2007

The distribution of tissue polypeptide antigen (40 kD molecular weight) in normal adult and fetal liver, and in liver disease was investigated and compared with the distribution of low and high molecular weight cytokeratins. In normal liver tissue polypeptide antigen was found only in bile duct epithelium; this distribution is similar to that of high molecular weight cytokeratin, but differs from that of low molecular weight cytokeratins. In liver disease it was found in areas of ductular transformation; in Mallory's bodies; and in alcoholic liver disease and primary biliary cirrhosis in some hepatocytes that did not contain Mallory's bodies.
Expression of class II major histocompatibility complex antigens on alveolar epithelium in interstitial lung disease: relevance to pathogenesis of idiopathic pulmonary fibrosis.
Authors: Kallenberg C G , Schilizzi B M , Beaumont F , De Leij L , Poppema S , The T H
Published: June 2007

To determine whether expression of class II major histocompatibility complex antigens on alveolar epithelium is relevant to the pathogenesis of idiopathic pulmonary fibrosis (IPF) lung biopsy specimens were investigated from nine patients with IPF with or without connective tissue disease, four patients with sarcoidosis, eight patients with lung disease of presumably infectious origin, and five controls. The alveolar epithelium stained strongly with anti-Ia (HLA-DR) or Leu 10 (HLA-DS) monoclonal antibodies, in eight of nine biopsy specimens from patients with IPF, in three of four biopsy specimens from patients with sarcoidosis, in all six biopsy specimens from patients with presumably viral, mycobacterial, or pneumocystic lung disease, but not in control lung tissue, nor in two biopsy specimens from patients with bacterial pneumonia. Mononuclear cell infiltrates consisted of T4 positive (helper/inducer) lymphocytes, predominantly present in a nodular arrangement in the interstitium, and T8 positive (cytotoxic/suppressor) cells, distributed equally in the interstitium and subepithelially or intraepithelially. T8 cells outnumbered T4 cells in six of nine biopsy specimens from patients with IPF, but in none of the biopsy specimens from patients with sarcoidosis or interstitial lung disease of infectious origin. Although the expression of class II antigens on the alveolar epithelium which is infiltrated by T8 cells in IPF is consistent with local presentation of autoantigens and an ensuing local immune response, class II expression is also present in interstitial lung disease of sarcoidosis and microbial infections: its role in the pathogenesis of IPF must therefore remain speculative.
Timing of infiltration of T lymphocytes induced by gluten into the small intestine in coeliac disease.
Authors: Freedman A R , Macartney J C , Nelufer J M , Ciclitira P J
Published: June 2007

Jejunal biopsy was performed on control subjects and patients with treated and untreated coeliac disease. Monoclonal antibodies to T lymphocyte surface markers were used to quantify T cell phenotypic subsets in the jejunal mucosa. The patients with untreated coeliac disease had significantly more of both suppressor/cytotoxic and helper/inducer T cells in the surface epithelium than either the control subjects or the treated patients. Serial jejunal biopsy specimens were taken from five treated coeliac patients for six hours after a gluten challenge. In four of these five infiltration of the surface epithelium by both T cell phenotypes, together with deterioration in the villus architecture, had occurred both within two hours of having started the challenge. This suggests that T lymphocytes may have a role in the pathogenesis of coeliac disease.
Pathology of the heart and conduction system in lymphoma and leukaemia.
Authors: Allen D C , Alderdice J M , Morton P , Mollan P A , Morris T C
Published: June 2007

The clinical and pathological findings in two patients with non-Hodgkin's lymphoma and two patients with T helper cell prolymphocytic leukaemia affecting the heart are described. All four patients had extensive malignant disease, with infiltration of multiple organs. Cardiac infiltration varied from microscopic foci in one case, to grossly identifiable tumour deposits destroying and replacing normal heart structures in three cases. Two patients with infiltration of the conduction system had abnormal electrocardiograms and cardiac dysfunction: one died suddenly, and the other died in heart failure. A third patient with widespread cardiac lymphoma did not show any electrocardiographic abnormalities or dysfunction. Clinicians should be aware of the possibility of cardiac and conduction system disease, particularly in the light of the evolution of specific antitumour chemotherapeutic agents.
Lymph node cellular morphology: comparative study of imprints and cytocentrifuge smears.
Authors: Stevens M W , Fazzalari N L , Crisp D J
Published: June 2007

To assess the usefulness of the lymph node imprint technique in quantitating cell types a comparative study using cytocentrifuge smears as controls was undertaken. The cell dimensions and distribution of cell types were compared in 12 patients with non-Hodgkin's lymphoma (NHL) using semi-automated image analysis. The results show that the imprint procedure introduces selective bias in favour of certain cell types; moreover, certain cell measurements, such as nuclear shape, are easier to see on cytocentrifuge smears. The imprint technique compares unfavourably with cytocentrifuge smears when precise quantitation of cell types is required.
Application of chromosomal restriction endonuclease digest analysis for use as typing method for Clostridium difficile.
Authors: Peerbooms P G , Kuijt P , Maclaren D M
Published: June 2007

The usefulness of restriction endonuclease analysis of chromosomal DNA as a typing method for Clostridium difficile was tested. Over four months all faecal samples were routinely cultured for C difficile. DNA of all isolated strains was isolated and tested with the restriction endonuclease Hind III. The patterns obtained after electrophoresis in agarose gels seemed to be strain specific. Antibiotic susceptibility profiles agreed with the results of the restriction endonuclease analysis, though they were much less discriminating. Analysis of the results indicated that restriction endonuclease analysis is a suitable typing method for C difficile, which may be very valuable in epidemiological studies where a highly discriminating typing method is needed.
Antibody to coliform antigens in urine samples from patients with symptoms of urinary tract infection.
Authors: McKenzie H , Young D N
Published: June 2007

An enzyme linked immunoadsorbent assay (ELISA) was used to detect IgG, IgM, and IgA antibody in urine to a crude antigenic mixture prepared from six arbitrarily chosen strains of common coliform urinary pathogens. In a group of patients with symptoms of urinary tract infection 24 of 80 (30%) urine samples were positive on culture by conventional methods, 58 of 80 (72.5%) were positive for polymorphs on microscopy, and 72 of 80 (90%) were positive for antibody by ELISA. Secretory component was detected in 28 of 80 (35%) samples, and this is consistent with local antibody production. The results show that antibody can be detected in a wide range of urine samples using a simple antigen mixture, and this may form the basis of a useful test to diagnose urinary tract infection.
Campylobacter pyloridis and acid induced gastric metaplasia in the pathogenesis of duodenitis.
Authors: Wyatt J I , Rathbone B J , Dixon M F , Heatley R V
Published: June 2007

Biopsy specimens of gastric and duodenal mucosa from 290 patients were examined histologically for metaplasia and Campylobacter pyloridis. Estimates of pH on samples of fasting gastric juice from 55 of the patients were performed, and mucosal biopsy specimens from 33 patients were also cultured for C pyloridis. Active duodenitis was seen in 34 duodenal biopsy specimens. Thirty (88%) of the patients with active duodenitis had both greater than 5% gastric metaplasia in the duodenal specimen and C pyloridis associated gastritis. These two factors coexisted in only 0.43% of patients with no duodenal inflammation. When C pyloridis were seen histologically in duodenal biopsy specimens they were confined to areas of gastric metaplasia and never occurred in the absence of a polymorph infiltrate. Of the 55 patients with measurements of gastric juice pH, gastric metaplasia was present in the duodenum in 20 of 42 with a pH of less than 2.5, and in 0 of 13 with a pH of greater than 2.5. These results suggest that acid induced gastric metaplasia in the duodenum and C pyloridis associated gastritis may be synergistic in the pathogenesis of duodenitis; the metaplastic gastric epithelium allows C pyloridis to colonise the duodenal mucosa, where it produces an acute inflammatory response.
Detection of low copy human papilloma virus DNA and mRNA in routine paraffin sections of cervix by non-isotopic in situ hybridisation.
Authors: Burns J , Graham A K , Frank C , Fleming K A , Evans M F , McGee J O
Published: June 2007

In analysing human papilloma virus (HPV) infection of the cervix in formalin fixed paraffin sections by non-isotopic in situ hybridisation two main problems were found: detachment of sections from the glass during hybridisation and probe detection; inadequate sensitivity and inability to assess sensitivity of the in situ procedure. The first problem was investigated by assessing the efficiency of various tissue adhesives individually and in combination. The second problem was addressed by optimising conditions for DNA unmasking, hybridisation, and biotinylated probe detection. Sensitivity of the final in situ procedure developed was assessed by using the detection of pHY2.1 repeats as a built-in control. Extrapolation of data showed that less than 10 copies of HPV DNA can be visualised by these procedures. HPV nucleic acid, mainly in the form of DNA, was detected not only in koilocytic nuclei but also in suprabasal cells in condylomas and CIN lesions. HPV mRNA was also visualised in the cytoplasm (and probably also nuclei) of the same cell types. These non-isotopic in situ procedures give results comparable to those obtained with radiolabelled probes, but they are less time consuming and provide better morphological resolution.
Leucocyte populations in ectopic tubal pregnancy.
Authors: Earl U , Lunny D P , Bulmer J N
Published: June 2007

Leucocytes at the ectopic implantation site in 10 cases of early tubal pregnancy were characterised with a series of monoclonal antibodies using an indirect immunoperoxidase technique on cryostat sections. Most were HLA-DR positive macrophages, and there were a small number of mature T lymphocytes (UCHT1 and Dako-T1 positive cells). These results were compared with those reported in normal first trimester intrauterine pregnancies, and the contributions of the various leucocyte types to successful implantation at both the ectopic and intrauterine sites were assessed.
Some aspects of neuroendocrine pathology.
Authors: Polak J M , Bloom S R
Published: June 2007

The advent of modern microscopical investigative methods for the determination of neuroendocrine differentiation has increasingly given credence to the original concept of a "diffuse endocrine system". These methods include a variety of silver impregnation techniques, technologically advanced light and electron microscopical immunocytochemistry, and, lately, the ability to localise specific binding sites by in vitro autoradiography and mRNA species by in situ hybridisation. Further insight has been gained into the possible role of regulatory peptides contained in the so called "diffuse endocrine system" and into the nature of disease processes by investigating the role of the system in benign and malignant disease.
Megaloblastic anaemia, cobalamin, and folate.
Authors: Chanarin I
Published: June 2007

Developments relating to cobalamin and folate are reviewed. Current work on the relations between these two coenzymes are discussed, particularly those that have emerged in studies using nitrous oxide, which inactivates cobalamin.
Retrospective study of prognostic importance of DNA flow cytometry of urinary bladder carcinoma.
Authors: Blomjous C E , Schipper N W , Baak J P , van Galen E M , de Voogt H J , Meyer C J
Published: June 2007

Cellular DNA content was determined by flow cytometry on routinely processed paraffin sections of 61 primary and untreated transitional cell carcinomas of the urinary bladder, and correlated with tumour grade and stage and clinical follow up. All 16 (25%) grade 1 carcinomas were diploid and all 11 (20%) grade 3 tumours were aneuploid. The 34 (55%) grade 2 carcinomas comprised 13 (40%) diploid and 21 (60%) aneuploid cases. Among the 37 superficial carcinomas (stage Ta and T1), 25 (65%) were diploid; 20 (85%) of the 24 advanced tumours (stage T2 to T4) had aneuploid tracings. Ploidy was a significant prognostic indicator (p: 0.006) of five year survival. The initial presence of aneuploidy in superficial bladder carcinoma (stage Ta and T1) is a strong argument for more aggressive treatment than is customary.
Histopathology of benign non-palpable breast lesions identified by mammography.
Authors: Barnard N J , George B D , Tucker A K , Gilmore O J
Published: June 2007

Over four years the histological features of benign breast diseases, diagnosed after biopsy of non-palpable mammographic abnormalities, were reviewed and correlated with the mammographic appearances. The histological features were compared with those from all other benign biopsy specimens taken during the same period. The incidence of sclerosing adenosis and microcalcifications was considerably higher in the group of non-palpable mammographic lesions; fibrous disease of the breast and radial scar (infiltrating epitheliosis) were also more common. There was no difference in the incidence of epithelial hyperplasia between the two groups. Correlation with the mammographic appearances showed that microcalcification was most often associated with blunt duct adenosis and that stromal distortion or masses were most often caused by fibrous disease.
Application of radioimmunoassay to monitor treatment of human cerebral gliomas with bleomycin entrapped within liposomes.
Authors: Firth G B , Firth M , McKeran R O , Rees J , Walter P , Uttley D , Marks V
Published: June 2007

A radioimmunoassay was assessed for its suitability for monitoring the blood and urinary concentrations of bleomycin entrapped within large unilamellar liposomes in patients receiving therapeutic doses of the drug. Bleomycin entrapped within liposomes was administered by direct intracerebral injection to three patients with grade III to IV cerebral gliomas, twice weekly for up to six weeks. No clinically important toxic effects were observed which could have been attributed to these preparations, although all three patients showed progressive deterioration in their clinical condition. This type of treatment may be more beneficial to patients at an earlier stage of their disease.
Characterisation of connective tissue cells containing factor XIII subunit a.
Authors: Adány R , Glukhova M A , Kabakov A Y , Muszbek L
Published: June 2007

Paraffin embedded sections of human liver, lymph node, and placenta showed that certain connective tissue cells were positive for factor XIII subunit a. These cells were further characterised by double immunofluorescence labelling and by combined immunofluorescence and enzyme cytochemical staining on frozen sections. They were labelled by the monoclonal antibodies RFD7 and anti-Leu M3 (markers of the macrophage cell line) but gave a negative reaction for the fibroblast marker IIG10 and showed no alkaline phosphatase activity. Immunoblotting detected factor XIII subunit a in macrophages isolated from placenta but not in human fibroblasts. At lower dilutions, the commercially available antibody against the b subunit of factor XIII also positively reacted with the same cell population. The facts that immunoblotting showed that the antiserum crossreacted with the a subunit and that placental macrophages did not stain strongly for the b subunit also indicate that this antigen is not present in adult connective tissue cells.
Fifty cases of human immunodeficiency virus (HIV) infection: immunoultrastructural study of circulating lymphocytes.
Authors: Feremans W W , Huygen K , Menu R , Farber C M , de Caluwe J P , van Vooren J P , Marcelis L , Andre L , Brasseur M , Bondue H
Published: June 2007

The peripheral lymphocytes of 50 cases of human immunodeficiency virus (HIV) infection (13 of acquired immune deficiency syndrome (AIDS), 17 of AIDS related complex (ARC), and 20 healthy carriers) were studied immunoultrastructurally. The prevalence of "tubuloreticular structures" and "tubular confronting cisternae" increased with the progression of the disease. Numerous tubular confronting cisternae were noted in patients presenting with a high serum acid labile alpha-interferon values. The patients with depressed natural killer cell activity were characterised by circulating immature natural killer cells with abundant multivesicular bodies that were devoid of "parallel tubular arrays". With an immunogold staining technique the location of HIV antigen was detected ultrastructurally, both at the surface of "hand-mirror" natural killer cell lymphocytes and inside vacuolised cells, probably corresponding to infected T4 lymphocytes. These findings indicate the usefulness of electron microscopic techniques in evaluating the pathology and the pathogenetic outcome of AIDS.
Tuberculous lymphadenitis associated with human immunodeficiency virus (HIV) in Uganda.
Authors: Nambuya A , Sewankambo N , Mugerwa J , Goodgame R , Lucas S
Published: June 2007

Sixteen adults presented with lymphadenopathy which was tuberculous on biopsy; they were all seropositive for human immunodeficiency virus (HIV-1), but none had the clinical criteria of the acquired immunodeficiency syndrome (AIDS). The biopsy specimen showed caseating tuberculosis, with scanty or no visible acid fast bacilli in seven cases; the remaining nine had a poor cellular reactivity with numerous bacilli. Antituberculous chemotherapy for two months reduced the lymphadenopathy. Two patients subsequently developed AIDS. Mycobacterial cultures were not performed, but the infection was almost certainly Mycobacterium tuberculosis. The space-time clustering of tuberculous lymphadenitis now seen in Kampala, and the unusual non-reactive histopathology, are typical of the impairment of cellular immunity induced by HIV infection.
Primary malignant melanoma of the gall bladder.
Authors: Heath D I , Womack C
Published: June 2007

A case of primary malignant melanoma of the gall bladder is reported, in which a 29 year old man presented with acute cholecystitis which led to perforation of the gall bladder and biliary peritonitis. To help in the differentiation between primary and secondary malignant melanoma in the gall bladder and to overcome some of the difficulties posed by the clinical identification of what is often a small or relatively inaccessible primary tumour, it is suggested that certain criteria should be fulfilled before primary melanoma is diagnosed. (i) Tumours must be solitary and arise from the mucosal surface of the gall bladder; (ii) they must either be papillary or polypoid; (iii) they must either display junctional activity or have any other primary sites excluded by history taking, examination, and investigation. If these criteria are applied to the published case reports of primary malignant melanoma, only six cases, including the present one, can be regarded as true primary tumours.
Assessment of DNA content and cell cycle distribution of erythroid and myeloid cells from bone marrow.
Authors: Hodgetts J , Hoy T G , Jacobs A
Published: June 2007

A method is described for the measurement of DNA index and cell cycle distribution in purified erythroid and myeloid populations from human bone marrow. Erythroid cells were prepared after complement mediated lysis of non-erythroid marrow cells. Myeloid cells were obtained by fluorescence activated cell sorting by forward and wide angle light scatter. Mononuclear marrow cells were prepared with a density gradient. Nuclei prepared from the separated populations were stained with propidium iodide. Myeloid cells had a higher DNA index than erythroid cells, and the mononuclear preparation had an intermediate value. There were more erythroid than myeloid cells in the S and G2M phases of the cell cycle. These lineage differences are particularly relevant when considering data derived from unseparated bone marrow cells, and further experiments are needed to determine the origin of these anomalies.
Screening for bacteriuria with Clinitec-200.
Authors: Doran H M , Kensit J G
Published: June 2007

A method of testing for bacteriuria with multiple reagent strips for blood, nitrite, and leucocyte esterase was evaluated. Of 669 urine specimens tested, 267 were negative on the reagent strips and so would ordinarily be discarded, creating a reduction in the workload of culturing urine specimens of 40%. Thirteen of these were false negative results, however, which represented 10% of all the samples with definite bacteriuria. Additional time was required for the screening test which reduced potential savings in manpower. Overall, we found costs to be slightly increased. In our laboratory this screening test was not economic and would produce an unacceptable rate of false negative results.
In vivo oxidation of the methyl group of hepatic 5-methyltetrahydrofolate.
Authors: Lumb M , Chanarin I , Deacon R , Perry J
Published: June 2007

Methionine given parenterally to rats caused rapid disappearance of methyltetrahydrofolate from the liver and a corresponding rise in tetrahydrofolate and formyl-tetrahydrofolate concentrations. When [14C]H3--H4folate was given, methionine caused an increased [14C]0(2) excretion, indicating that oxidation of the methyl group had occurred. Methionine was more effective than S-adenosylmethionine at causing oxidation, but serine was ineffective. The lowest dose of methionine to produce an effect was 0.5 mumol, which is less than the daily dietary intake in a rat. The data suggest that the concentration of methylfolate in rat livers is controlled by the concentrations of methionine.
Red cell hypoplasia, thrombocytosis, and leucocytosis: myelodysplastic and proliferative syndrome.
Authors: Craig A , Geary C G , Love E M , Liu-Yin J
Published: June 2007

Three patients with chronic red cell aplasia also showed thrombocytosis or granulocytosis, or both. All had morphological evidence of myelodysplasia on examination of bone marrow aspirate but none had a detectable chromosomal abnormality. These patients seem to provide evidence of a separate entity within the spectrum of myelodysplastic and myeloproliferative disease.
Brush cytology of the colon and rectum in ulcerative colitis: an aid to cancer diagnosis.
Authors: Melville D M , Richman P I , Shepherd N A , Williams C B , Lennard-Jones J E
Published: June 2007

In a prospective study of 100 patients with ulcerative colitis, 82 of whom had extensive colitis, carcinoma and dysplasia were distinguished cytologically from reactive hyperplasia. Six patients had carcinoma complicating colitis and satisfactory samples were obtained from five; the cytological appearances were interpreted as carcinoma in three and as dysplasia in two. Seventy eight patients had not developed carcinoma or dysplasia; the cytological appearances were interpreted as negative for dysplasia in 75 and indefinite for dysplasia in three. In patients who had developed dysplasia the changes seemed to be more widespread on cytological rather than on histological examination. Brush cytology may complement histological assessment in patients with ulcerative colitis who have developed strictures or in whom there is a high suspicion of neoplastic change.
Use of endoscopic biopsy for diagnosing congestive gastropathy.
Authors: Corbishley C M , Saverymuttu S H , Maxwell J D
Published: June 2007

The specificity of endoscopic biopsy specimens in diagnosing congestive gastropathy in 20 patients with portal hypertension, 20 patients with liver disease without portal hypertension, and 20 patients with a normal stomach at endoscopy without liver disease was examined. Histological assessment, which was performed without knowledge of the clinical details, showed changes previously reported to be indicative of congestive gastropathy in 9 (47%) of patients with portal hypertension. Similar changes were also seen in 17 (85%) of patients with liver disease without portal hypertension and in 16 (84%) of patients with normal endoscopies without liver disease. These results show that the histological changes seen in endoscopic biopsy specimens of congestive gastropathy are not specific for this condition and therefore cannot be used to diagnose objectively the disease or assess management.
HMFG-2 as a prognostic indicator in superficial bladder cancer.
Authors: Conn I G , Crocker J , Emtage L A , Wallace D M
Published: June 2007

A series of transitional cell carcinomas and mucosal biopsy specimens of bladder were stained immunohistochemically with the monoclonal antibody HMFG-2. Staining characteristics ranged from luminal staining in well differentiated, superficial lesions to staining of all cells in invasive carcinomas. Invasive tumour nests also stained strongly with the antibody. There was good correlation between the staining pattern and histological assessment of both tumours and mucosal biopsy specimens. Correlation with clinical course showed that it was also a good predictor of subsequent disease progression of superficial tumours. It is suggested that HMFG-2 staining is a sensitive indictor of malignant transformation and that it may have a role as an adjunct to conventional histological examination in the assessment of urothelial carcinomas.
Anatomical variations in human carotid bodies.
Authors: Khan Q , Heath D , Smith P
Published: June 2007

The variations in anatomical structure and position of both carotid bodies were noted in 100 consecutive subjects who came to necropsy. Considerable variations in form were found. Although most carotid bodies (83% on the right and 86% on the left) were of the classic ovoid type, an appreciable minority was bilobed (9% on the right and 7% on the left) or double (7% on the right and 6% on the left); 1% were leaf shaped. All these anatomical variants have to be distinguished from the pathologically enlarged carotid body that may have a smooth or finely nodular surface. Anatomical variants (such as the bilobed) may themselves enlarge as a consequence of carotid body hyperplasia.
Automated measurement of plasma viscosity by capillary viscometer.
Authors: Cooke B M , Stuart J
Published: June 2007

Plasma viscosity has several advantages over the erythrocyte sedimentation rate as a measurement of an acute phase response of more than 24 hours' duration. A new capillary viscometer (Coulter Viscometer II), which gives an automated measurement of plasma viscosity, was compared with the selected manual method (Harkness viscometer) of the International Committee for Standardization in Haematology. Automated measurement of plasma viscosity at 25 degrees C showed close correlation (r = 0.979, p less than 0.002) with the selected method for 160 specimens of plasma. Satisfactory precision both within batch and between batch (coefficients of variation of 1.7% or less) was obtained at viscosity values up to 5.7 mPa.s. There was no detectable carry over between samples and viscosity values were corrected adequately for ambient temperature for the range 15-32 degrees C. Careful daily cleaning was required to prevent accumulation of protein within the automatic sampling valve of the instrument. Automated measurement of plasma viscosity is an attractive alternative to measurement of the erythrocyte sedimentation rate.
Sensitive avidin biotin based technique for identifying liver membrane antigens in tissue sections.
Authors: Sipos J , McFarlane B M , Williams R , McFarlane I G
Published: June 2007

An enzyme immunohistochemical technique for the localisation of liver membrane antigens in tissue sections by antisera raised in guinea pigs against the liver preparation known as "liver specific membrane lipoprotein (LSP)" was developed, based on the alkaline phosphatase avidin biotin complex (ABC AP) system. Of a wide range of fixatives and fixation conditions investigated, a short (five minute) exposure of cryostat sections to Bouin's fluid provided the most satisfactory results and--together with procedures to block endogenous biotin and alkaline phosphatase--yielded clear sections with no background staining or other artefacts to interfere with specific staining patterns. The sensitivity of the technique approaches that of a radioimmunoassay, as shown by the staining of the sinusoidal domains of hepatocellular plasma membranes by the guinea pig anti-LSP antisera at dilutions up to 1/50,000. Apart from its reliability and sensitivity the procedure offers additional advantages over techniques such as indirect immunofluorescence in that it provides a permanent preparation with well defined morphological details which can be seen by ordinary light microscopy.
Clinical laboratory environmental contamination: use of a fluorescence/bacterial tracer.
Authors: Kennedy D A , Stevens J F , Horn A N
Published: June 2007

A "Centrifichem" centrifugal analyser was found using a double fluorescence/bacterial tracer method to be a source of airborne and surface contamination in the laboratory. The airborne contamination was controlled by a modification incorporating a filter. Ubiquitous surface contamination generally accompanied the processing of simulated patients' sera. Double tracer samples could be used in laboratories to assess the quality of hygiene practices in the same way as quality control samples are currently used to assess the quality of analytical performance. The findings indicated a lack of understanding of basic hygiene practices in the laboratory.
Vitronectin (serum spreading factor): its localisation in normal and fibrotic tissue.
Authors: Reilly J T , Nash J R
Published: June 2007

The distribution of vitronectin and fibronectin in normal and fibrotic tissue was directly compared using indirect immunofluorescence. Both glycoproteins were ubiquitiously localised to loose connective tissue. Vitronectin, unlike fibronectin, was not detected in basement membranes, in normal renal glomeruli, or around smooth muscle cells of both musculares mucosae and propria of the gastrointestinal tract. The presence of vitronectin could not be shown in washed permeabilised platelets. Vitronectin was very much increased in reactive and fibrotic tissue, as was fibronectin. This was observed in lymph nodes affected by both nodular sclerosing Hodgkin's disease and by metastatic carcinoma as well as in myelofibrotic bone marrow and sclerotic glomeruli. These findings suggest that vitronectin may have an important role in the processes of inflammation and repair.
Feasibility of new prognostic classification for rectal cancer.
Authors: Dundas S A , Laing R W , O'Cathain A , Seddon I , Slater D N , Stephenson T J , Underwood J C
Published: June 2007

Sixty slides from 60 blocks taken from 30 colonic carcinomas were circulated twice to six histopathologists of varying experience. Five of the six pathologists showed a good to excellent intraobserver agreement for assessment of the character of the invasive margin (0.44 less than kappa less than 0.82), which was not significantly affected by sampling (0.40 less than kappa less than 0.56, comparing both slides from each tumour) or observer (five of six pathologists agreeing on 46 of 60 slides). Pathologists were unreliable in assessing peritumoural lymphocytic infiltrates, with only two pathologists achieving moderate levels of intraobserver agreement (-0.03 less than kappa less than 0.52). The interobserver agreement for peritumoural lymphocytic infiltrates was also low (kappa less than 0.29) between the three most experienced pathologists. The assessment of peritumoural lymphocytic infiltrates was significantly affected by sampling, the two pathologists with the lowest intraobserver variation achieving kappa values of 0.21 and 0.10 between the 30 paired slides from each tumour. The character of the invasive margin was reliably assessed, was not dependent on sample, and added useful prognostic information, but peritumoural lymphocytic infiltration is not a reproducible observation and may therefore not add useful prognostic information in routine use.
Use of histological examination to assess ultrastructure of liver in patients with long standing jejuno-ileal bypass for morbid obesity.
Authors: Boon A P , Thompson H , Baddeley R M
Published: June 2007

To assess the pattern and severity of liver disease in patients who had undergone jejuno-ileal bypass for the treatment of morbid obesity, 23 patients were biopsied, all of whom had had intact bypasses for more than 10 years. These were examined by light and electron microscopy. Previous biopsy specimens from each patient, including specimens taken before bypass, were reviewed. Similar biopsy specimens were obtained from six obese patients undergoing gastroplasty. There was no evidence of cirrhosis, and mild or moderate degrees of fibrosis were found in only a few patients. Steatosis tended to persist after bypass, albeit to a lesser degree. Giant mitochondria and intramitochondrial filamentous inclusions were present in four of six specimens taken before gastroplasty and in 15 of 23 specimens taken after jejuno-ileal bypass, being especially numerous in those specimens showing little or no steatosis. It is suggested that such features reflect ultrastructural evidence of adaptation to an abnormal metabolic environment both in the morbidly obese and even many years after jejuno-ileal bypass. Their prognostic importance is unclear.
Immunohistochemistry of cytokeratin proteins in squamous and transitional cell lesions of the urinary tract.
Authors: Tungekar M F , Gatter K C , Al-Adnani M S
Published: June 2007

Expression of low and high molecular weight cytokeratin proteins was investigated immunohistochemically in a variety of transitional and squamous epithelial lesions of the urinary tract with and without schistosomiasis. The monoclonal antibodies used were CAM 5.2 and NCL5D3 for low, PK 63 and 121 for high, and MAK 6 for a broad range of intermediate molecular weight cytokeratins. On staining with CAM 5.2 and NCL5D3, urothelial hyperplasias (n = 12) and grades 1 (n = 5) and 2 (n = 10) papillary transitional cell carcinomas showed labelling patterns quite distinct from carcinoma in situ (n = 4) and non-papillary grades 2 (n = 6) and 3 tumours (n = 3). Among squamous lesions only focal positivity was obtained in 14 of 22 moderate to poorly differentiated squamous cell carcinomas. By contrast, PK 63 and 121 stained squamous lesions exclusively. MAK 6 stained the whole range of urothelial and squamous lesions with the exception of squamous metaplasias. Polyclonal antikeratin adequately labelled spindle cell areas of high grade tumours. The distinctive staining patterns given by these or similar antibodies may help in the identification of squamous metaplasia and in diagnosing tumours of the urothelium.
Immunohistochemical study of 22 cases of thymoma.
Authors: Lee D , Wright D H
Published: June 2007

The histological and clinical features of 22 thymomas were reviewed. Immunohistochemical studies were performed using antibodies to cytokeratins (CAM 5.2 and S29) and to desmosomal protein. The heterogeneity of staining patterns seen in the epithelial cells supported the concept of separating thymomas into cortical, medullary, or mixed groups. Interdigitating cells were identified by antibody to S100 protein, and these varied in number between different tumours. Clustering of interdigitating reticulum cells occurred in association with foci of mature lymphocytes which were shown by staining of the leucocyte common antigen (CD45). The extent to which this occurred was used to assess the degree of medullary differentiation within the thymomas and this was correlated with the histological and clinical features. The lymphocyte population of six of the thymomas was studied using a range of antibodies to T and B cells; this showed the presence of B lymphocytes in thymomas.
Retrospective study of Campylobacter-like organisms in patients undergoing partial gastrectomy.
Authors: Loffeld R J , Loffeld B C , Arends J W , Flendrig J A , van Spreeuwel J P
Published: June 2007

One hundred and five stoma biopsy specimens and 108 corpus biopsy specimens from 108 patients who had undergone a partial gastrectomy because of peptic ulcer disease were examined retrospectively for the presence of Campylobacter-like organisms and gastritis. In the corpus biopsy specimens Campylobacter-associated gastritis was found in 55 (71%) of the cases and in 42 (48%) of the stoma biopsy specimens. It is concluded that Campylobacter-like organisms have a role in gastritis after partial gastrectomy, although this role is more prominent in the corpus region. The role of Campylobacter pylori in peptic ulcer disease is not clinically important.
Association between necropsy evidence of disseminated intravascular coagulation and coagulation variables before death in patients in intensive care units.
Authors: Wilde J T , Roberts K M , Greaves M , Preston F E
Published: June 2007

The necropsy findings in 21 patients on an intensive care unit, on whom coagulation studies had been performed immediately before death, were assessed. Eleven of the patients were retrospectively studied and 10 were reviewed consecutively in a prospective study. Fifteen patients (eight retrospective and seven prospective) had evidence of disseminated intravascular coagulation. Microthrombi were most often found in the lungs and kidneys. The most common abnormal coagulation tests in patients with necropsy evidence of disseminated intravascular coagulation were raised serum concentrations of fibrinogen and fibrin degradation products, prolonged prothrombin time, and reduced platelet counts. Reduced fibrinogen concentrations and a prolonged thrombin time were the least commonly observed abnormalities. There was no difference in either the prevalence or magnitude of abnormality of any particular coagulation variable test result between those patients with evidence of disseminated intravascular coagulation at necropsy and those without.
Osteoarticular amyloidosis associated with haemodialysis: an immunoultrastructural study.
Authors: Depierreux M , Goldman M , Fayt I , Richard C , Quintin J , Dhaene M , Van Herweghem J L
Published: June 2007

Osteoarticular amyloidosis occurred in a patient receiving long term haemodialysis. Histological examination showed that the amyloid deposit was surrounded by inflammatory cells and macrophages filled with haemosiderin. Electron microscopy showed that the amyloid fibrils were in close contact with cytoplasmic expansions, or located in intracytoplasmic pockets of the infiltrating cells. Immunohistological and immunoultrastructural observations confirmed that beta 2-microglobulin was a major constituent of amyloidosis associated with dialysis. Amyloid P component was also detected within the amyloid deposits. These findings suggest that amyloid P component, iron overload, or macrophage derived factors could have a role in the polymerisation of beta 2-microglobulin into amyloid deposit.
Autosomal recessive distal myopathy.
Authors: Isaacs H , Badenhorst M E , Whistler T
Published: June 2007

Five patients with an autosomally recessively transmitted distal myopathy were investigated. Of these, three belonged to a single sibship. Studies included electromyography, histological examination of muscle tissue, histochemical, electron microscopical, and biochemical analyses. One of the cases resembled the Nonaka form while the others were regarded as expressions of the commoner variety of recessive distal dystrophy.