bluuebunny/crossref_metadata_2025 huggingface dataset:
Spleen function and platelet kinetics.
Authors: Klonizakis I , Peters A M , Fitzpatrick M L , Kensett M J , Lewis S M , Lavender J P
Published: June 2007

In patients suffering from various platelet abnormalities, quantitative scanning after injection of indium-111 (111In) labelled platelets showed three different patterns of platelet destruction and distribution. In patients with a normal platelet life span but with evidence of increased splenic pooling, the spleen tended to be the main site of destruction. In patients with a moderately reduced platelet life span, the distribution of destruction in the system and variable destruction in the marrow. However, because of its rapidity this destruction was difficult to quantify, and it was difficult in these cases to distinguish reliably between spleen pool, sequestration, and destruction. Destruction of platelets on the liver appeared to be unimportant in all three groups. 111In, because of its physical characteristics, is preferable to chromium-51 as a platelet label in the assessment of abnormal platelet kinetics.
Jejunal mucosal morphometry in children with and without gut symptoms and in normal adults.
Authors: Penna F J , Hill I D , Kingston D , Robertson K , Slavin G , Shiner M
Published: June 2007

Nineteen diagnostic peroral biopsy specimens from 18 children without diarrhoea, vomiting, or abdominal pain ('control' children) were compared with those taken from 23 children with diarrhoea of varying aetiology to establish the morphometric characteristics of jejunal mucosa in childhood. Comparison was also made with normal jejunal mucosa from adults. Statistical analysis of each characteristic individually showed no significant difference between the 'control' children and those with diarrhoea, but there were significant differences between the mucosae of 'control' children and those of adults; the villi tended to be shorter and the crypts longer in children. Thirty-seven per cent of specimens from the 'control' children showed a partial villous atrophy, that is, they were abnormal by adult criteria. Discriminant analysis of the features measured showed effective separation of the following groups: normal histology from partial villous atrophy in children, healthy adults from 'control' children, and normal histology in adults from normal histology in children.
Viral hepatitis in Danish health care personnel, 1974-78.
Authors: Skinhøj P , Søeby M
Published: June 2007

The incidence of viral hepatitis in Denmark, as notified to the National Board of Health during 1974-78, was determined for health care personnel. Compared to the rate for the population as a whole, a fivefold increase was found for physicians and surgeons as well as for laboratory technicians. Dentists also had an increased rate of infection. No increase was apparent for the nursing staff in general, or for psychiatric hospitals or institutions for the mentally retarded. In hospitals, type B hepatitis was prevalent among doctors and technicians while 55% of the nursing staff did not have B hepatitis.
Characterisation of urinary isolates of Escherichia coli by multiple typing: a retrospective analysis.
Authors: Wilson M I , Crichton P B , Old D C
Published: June 2007

Cultures of Escherichia coli of urinary origin were examined after storage for 12 to 15 years by a combination of the techniques of biotyping, resistotyping, haemagglutinin typing, and colicin typing (multiple typing) which allowed strain identification to be made even when variation in one or more typing characters had occurred in vivo. Biotyping and resistotyping used in conjunction were sufficient to allow identification of as many as 106 of 110 pairs of E. coli examined. In the four pairs of isolates for which it was necessary to extend strain identification profiles to include data from other typing methods, probable strain identification was achieved for all but one pair. The multiple typing approach seems useful for retrospective analysis of stored cultures of E. coli.
A method for the quantification of human gastric G cell density in endoscopic biopsy specimens.
Authors: McIntyre R L , Piris J
Published: June 2007

A previously described method for estimating G cell density in endoscopic biopsy specimens has been modified to take into account observations of the way in which specimens behave when they are deformed and some of the length-measuring characteristics of a grid used to measure the length of tissue profiles. The relationships between particle densities in sections and particle densities in tissue of which the sections are representative are discussed.
Changes in thrombin-stimulated platelet malondialdehyde production during the menstrual cycle.
Authors: Tindall H , Zuzel M , Paton R C , McNicol G P
Published: June 2007

Forty normal women had thrombin-stimulated platelet malondialdehyde (MDA) production measured during their menstrual cycle. Twenty women in this group were taking the combined oral contraceptive pill (OCP). Platelet MDA production was found to fall by 30% during normal menstruation and the week when the subjects were not taking a combined OCP, but it remained constant throughout the remainder of the cycle. No significant change in initial platelet aggregation response to stimulation by thrombin, change in plasma thrombin clotting time, plasma heparin neutralising activity (HNA), or plasma antithrombin III (AT-III) activity was seen when the platelet MDA production was reduced. The bleeding time results showed some variation throughout the menstrual cycle but these did not appear to be related to the variation in platelet MDA production.
Interstitial nephritis.
Authors: Dixon A J , Winearls C G , Dunnill M S
Published: June 2007

The clinical and pathological findings are reviewed in ten cases where renal biopsy showed abnormalities predominantly within the interstitium. In six the nephritis was considered to be drug-induced; in two the aetiology was slightly obscure but the most likely diagnosis was considered to be sarcoidosis. Of the remaining two cases one was chronic pyelonephritis and the other polyarteritis nodosa. The diagnosis and pathogenesis of the renal lesions are discussed and attention is drawn to the importance of distinguishing primary interstitial changes from those found in association with glomerular disease.
Method for measuring fibrinolytic activity in a single layer of cells.
Authors: Raftery A T
Published: June 2007

A method has been developed for measuring fibrinolytic activity in a single layer of cells--for example, venous endothelium or peritoneal mesothelium. A single layer of cells was collected on a gelatin disc, incubated on a fibrin plate for 24 h, and the resulting area of lysis measured. This was converted to a measure of fibrinolytic activity expressed in Ploug units of urokinase by reference to areas of lysis created by standard amounts of urokinase placed on similar fibrin plates. The method has been used for measuring fibrinolytic activity in venous endothelium and peritoneal mesothelium and has demonstrated that the activity in a single layer of endothelial cells is only about one-quarter of that in an equivalent area of whole vein wall. It has also shown that peritoneal fibrinolytic activity is reduced after peritoneal trauma. This method maybe useful in the investigation of the fibrinolytic system in a variety of pathological conditions--for example, thrombosis and intraperitoneal adhesions.
Human rotavirus antigen detection by enzyme-immunoassay with antisera against Nebraska calf diarrhoea virus.
Authors: Sarkkinen H K
Published: June 2007

A four-layer solid phase enzyme-immunoassay (EIA) with antisera against Nebraska calf diarrhoea virus (NCDV) as immunoreagents was developed to detect human rotavirus antigens from stool specimens of patients with acute rotavirus gastroenteritis. Polystyrene beads were used as the solid phase, guinea-pig and rabbit anti-NCDV immunoglobulin as the catching and secondary antibody, and peroxidase-conjugated swine anti-rabbit immunoglobulin as the indicator antibody. A comparison of the developed NCDV-EIA with an identical EIA, using antisera against human rotavirus (HRV-EIA) instead of NCDV antisera, was made with 216 stool specimens positive or negative for rotavirus. A complete agreement was obtained between the two methods provided that appropriate confirmatory tests were included. The developed NCDV-EIA was as sensitive and specific for rotavirus as the HRV-EIA, and it allowed the detection of both established rotavirus types 1 and 2 from stools with equal sensitivity. The difficulties in cultivating human rotavirus in vitro for immunisation and the relative ease of growing NCDV in widely-used continuous cell lines make NCDV a good alternative in the preparation of the highly specific and sensitive rotavirus antisera required in immunoassays, and facilitate the setting-up methods for the routine diagnosis of rotavirus gastroenteritis by EIA or RIA in diagnostic virus laboratories.
Progressive renal failure in surgically treated hyperparathyroidism.
Authors: Dixon J , Smith J F
Published: June 2007

Of 570 patients operated on for hyperparathyroidism, 18 subsequently died (between one day and 12 yr after operation). Pathological findings at necropsy in these patients have been reviewed. Four necropsies on patients with untreated hyperparathyroidism have also been reviewed for comparison. Of these 22 cases, 14 had renal failure at the time of death. This was attributed to the following: nephrocalcinosis 6; chronic glomerulonephritis 4; analgesic nephropathy 1; cystinuria 1; sarcoidosis 1; and polycystic disease 1. Of those with renal failure due to nephrocalcinosis, three had persistent hypercalcaemia after operation; the other three survived only for a short time. There was no evidence of residual nephrocalcinosis producing progressive renal failure if the plasma calcium concentration was corrected. In those with chronic glomerulonephritis, cystinuria, and polycystic disease, the hyperparathyroidism was considered to be tertiary to the renal disease but renal failure was not always present at the time of diagnosis.
Gastritis and cirrhosis--no association.
Authors: Brown R C , Hardy G J , Temperley J M , Miloszewski K J , Gowland G , Losowsky M S
Published: June 2007

Endoscopically sited gastric mucosal biopsies were taken from 98 patients with hepatic cirrhosis, and from 48 control patients. Nineteen patients with cirrhosis were found to have gastric ulcers, including eight with multiple erosions. In four of these eight, erosions were shown to arise in histologically normal mucosa. Among the remaining 79 patients with cirrhosis, the prevalence of chronic gastritis was not increased compared with controls of the same age-group. There was no increase in chronic gastritis in patients with alcoholic cirrhosis compared with either controls or patients with chronic active hepatitis and cirrhosis. The increased proneness of patients with cirrhosis to acute and chronic gastric mucosal lesions cannot be explained on the basis of an underlying chronic gastritis.
Rectal biopsy in the diagnosis of systemic vasculitis.
Authors: Tribe C R , Scott D G , Bacon P A
Published: June 2007

Vasculitis has been seen in rectal biopsies from 22 patients over a six year period. The most common finding was a necrotising vasculitis of small arteries, indistinguishable from that seen in polyarteritis nodosa (PAN). Sub-acute, chronic ("burnt out") and leucocytoclastic changes were also seen. Sixteen patients had vasculitis complicating rheumatoid arthritis (RA), 3 PAN and 3 overlap syndromes. Patients with RA and rectal vasculitis had a higher mortality, and a greater incidence of neuropathy than those with negative biopsies. An adequate biopsy is positive in 40% of patients with clinical vasculitis and RA but was only positive in one of a control series of 46 RA patients with no clinical vasculitis. Rectal biopsy in experienced hands is a safe, and repeatable procedure. It is useful as a "blind" biopsy site in the diagnosis of systemic vasculitis, especially that complicating RA. It can also be used for serial studies of the evolution of vasculitis. Serial sections of the entire biopsy may be required to reveal the vasculitis which is often focal in nature.
Immunoperoxidase staining of formalin-fixed, paraffin-embedded, human renal biopsies with a comparison of the peroxidase-antiperoxidase (PAP) and indirect methods.
Authors: Sinclair R A , Burns J , Dunnill M S
Published: June 2007

The results of immunoperoxidase staining of 33 routinely processed renal biopsies correlated with the results of direct immunofluorescence in 79% of tests performed. Most of the discrepant results were due to positive immunoperoxidase staining, possibly reflecting greater sensitivity of the method. A comparison of two immunoperoxidase methods showed that the indirect method produced less intense staining than the peroxidase-antiperoxidase (PAP) method when equivalent primary antibody titres were used. Lowering the primary antibody titres for the indirect technique resulted in equivalent staining by the two methods. Predigestion by protease VII effectively revealed the antigens under study without causing tissue damage or section loss.
Rapid identification of Corynebacterium vaginale in non-purulent vaginitis.
Authors: Wells J I , Goei S H
Published: June 2007

A simple set of tests is proposed to give excellent probability for the identification of Corynebacterium vaginale from clinical material. Using these tests, 380 C vaginale were isolated from genital tract specimens from 1402 patients. Of these isolates 70 were from symptomatic patients. These 70 isolates were subjected to a further set of tests to confirm their identity. The advantage of these primary tests is that they can be completed on the day of isolation of the organism. Of these 70 isolates 66 were confirmed as C vaginale thus giving the primary set of tests a 94% rate of accurate identification. However this rate may be increased beyond 97% by the promotion of one of the key secondary tests to the primary set.
Intra- and extracellular alpha 1-antitrypsin in liver disease with special reference to Pi phenotype.
Authors: Carlson J , Eriksson S , Hägerstrand I
Published: June 2007

In order to study the relation between intra- and extrahepatocellular alpha 1-antitrypsin (alpha 1-AT) concentrations in patients with various Pi phenotypes, a prospective series of needle liver biopsies was stained with both periodic acid-Schiff (PAS) and a specific immunoperoxidase technique to demonstrate intracellular alpha 1-AT. Concomitant blood samples from all patients were analysed for alpha 1-AT. Pi phenotypes were determined by isoelectric focusing. Non-globular intrahepatocellular alpha 1-AT can be seen in biopsies from Pi M patients with increased plasma alpha 1-AT concentrations and active liver disease. No evidence was found in this study of 250 patients (including 22 controls) for predisposition toward liver disease in any phenotypic group. PAS or immunoperoxidase staining (or both) for alpha 1-AT demonstrated characteristic globular inclusions in 11 of 15 cases having the Z allele, one case being diffusely positive and three negative. Biopsies from 3 of 207 patients with liver disease and lacking the Z allele had globular inclusions seen with both PAS and immunoperoxidase techniques. alpha 1-AT globules in absence of the Z allele are most often found in elderly patients with severe disease and high plasma alpha 1-AT concentrations.
A new case of congenital dyserythropoietic anaemia, type III: studies of the cell cycle distribution and ultrastructure of erythroblasts and of nucleic acid synthesis in marrow cells.
Authors: Wickramasinghe S N , Parry T E , Williams C , Bond A N , Hughes M , Crook S
Published: June 2007

The clinical and laboratory findings in an asymptomatic 19-year-old Welshman with congenital dyserythropoietic anaemia (CDA) type III are described. The blood film showed macrocytosis and red cell fragmentation and there was biochemical evidence of intravascular haemolysis. The bone marrow showed erythroid hyperplasia, megaloblastic erythropoiesis and several giant multinucleate erythroblasts. Some mononucleate erythroblasts were large and had relative DNA contents of 4-8c and the bi- and multinucleate erythroblasts had total DNA contents of 2-16c. Some of the multinucleate erythroblasts displayed a variety of ultrastructural abnormalities, including marked differences in the appearances of the individual nuclei within the same cell. The marrow cells gave a normal deoxyuridine-suppressed value indicating that the megaloblastic changes were not caused by an impairment of the methylation of deoxyuridylate. The rates of incorporation of 14C-glycine and 14C-adenine into both the DNA and RNA of bone marrow cells were within the normal range. Furthermore, the average rate of elongation of newly-synthesised, 3H-thymidine-labelled daughter DNA strands, assessed by hydroxyapatite chromatography of alkali-denatured DNA was found to be normal. The results suggest that there is no impairment of DNA replication in the majority of the erythroblasts and that the abnormality of erythropoiesis resulted from disturbances during mitosis and the G2 phase.
Enzyme-linked immunosorbent assay (ELISA) for detection of specific IgA antibodies to mumps virus
Authors: Halevy Benjamin , Sarov Israel
Published: June 2007

A sensitive enzyme-linked immunosorbent assay (ELISA) is described for detection of IgA antibodies to mumps virus. Specific mumps IgA antibodies could be demonstrated in 10 patients with mumps virus infections. No specific mumps IgA antibodies (titres <1/40) were detected by ELISA in 46 control sera (healthy adults; hospitalised patients with various other diseases). The potential application of the ELISA mumps IgA technique in serodiagnosis of mumps infections is discussed.
Comparison of a homemade blood culture broth containing a papain digest of liver, with four commercially available media for the isolation of anaerobes from simulated paediatric blood cultures.
Authors: Hunt G H , Price E H
Published: June 2007

The recovery of small inocula of fastidious organisms, mainly non-sporing anaerobes, was studied in simulated paediatric blood culture experiments where only 1.5 ml of blood was added to each broth. A 25 ml homemade Queen Elizabeth Hospital medium (QEH medium) containing a papain digest of liver showed the best overall performance during the first four days of incubation; this medium was also satisfactory for maintenance of the majority of the organisms tested for longer than one week. LAB M Fastidious Anaerobe Broth (75 ml) with thymidine, also showed early isolation and satisfactory survival of most organisms. Difco Thiol broth, 50 ml with Liquoid, yielded early growth of the three strains of Bacteroides fragilis tested and maintained these organisms well; however, variable results were obtained with some other organisms in Difco Thiol media. Southern Group Brewer's thioglycollate broth (80 ml) gave the least satisfactory performance.
Acquisition of new genes by oral Neisseria.
Authors: Ison C , Glynn A A , Bascomb S
Published: June 2007

It is suggested that part of the increased pharyngeal carriage of meningococci reported in patients with gonorrhoea is due to misidentification of gonococci which have been transformed to maltose fermenters by DNA from normal throat flora. The distribution of specific aminopeptidases in strains of gonococci, meningococci isolated from the throat and meningococci from systemic infections is consistent with this view. Gonococci oxidising maltose and gonococci with gamma-L-glutamyl aminopeptidase activity, both factors regarded as typical of Neisseria meningitidis, can be produced in vitro by transformation with DNA from N lactamica and N meningitidis. The clinical and theoretical implications of such changes are discussed.
Sensitivity tests with cephalosporins.
Authors: Waterworth P M
Published: June 2007

The sensitivity of 127 strains of miscellaneous Gram-negative bacilli to various cephalosporins was determined by three methods. Disc tests with cephaloridine (CLOR), cephalothin (CTIN) and cephalexin (CLEX) made most strains of beta-lactamase-producing Escherichia coli appear sensitive. Eight cephalosporins were tested by the agar break-point method using concentrations of 16 and 4 mg/l for all except cefotaxime (CTAX), when 8 and 1 mg/l were used. In repeated tests there was considerable variation in the response of many strains to the lower concentration of CLOR, CTIN, CLEX and to a lesser extent, cefoxitin (CFOX) and cefuroxime (CROX), and beta-lactamase-producing E coli appeared as sensitive or moderately sensitive to all. Cephalosporins CLOR, CLEX, and CROX were then tested by inoculating 2 ml volumes of broth containing a 30 microgram disc; all the beta-lactamase-producing E coli grew in CLOR and CLEX but were inhibited by CROX.
A simple method for the separation and quantification of urinary porphyrins.
Authors: Leahy D T , Brien T G
Published: June 2007

A simple routine method for the separation and quantification of urinary coproporphyrin and uroporphyrin using anion-exchange resin columns is described. The coproporphyrin is first removed from the urine by ether extraction. The anion exchange resin column is then used to isolate the uroporphyrin from the aqueous residue. The proposed method is compared with an existing method developed by Rimington in terms of recovery and reproducibility. Results from 15 urine specimens analysed by both methods are compared. The proposed method yielded lower values for coproporphyrin and higher values for uroporphyrin than the established method, but there was a good correlation between the two methods. This and its relative simplicity make it suitable for routine use.
Liver function in septic shock.
Authors: Banks J G , Foulis A K , Ledingham I M , Macsween R N
Published: June 2007

Serum liver function tests were estimated in 57 patients admitted to an Intensive Therapy Unit (ITU) with a diagnosis of septic shock. Following an initial biochemical disturbance, persisting hyperbilirubinaemia was associated with a poor prognosis. Post-mortem liver histology in 22 patients showed varying degrees of non-specific reactive change, venous congestion, ischaemic necrosis, fatty change and intrahepatic cholestasis in 16 cases. In the remaining six cases there was moderately severe cholestasis with inspissated bile in the cholangioles. The possible aetiology of the observed cholestasis is discussed.
Polycythaemia rubra vera and hairy cell leukaemia in the same patient: studies on the spleen
Authors: Mufti GJ , Hamblin TJ , Stevenson FK , Fitchett M
Published: June 2007

The first association of polycythaemia rubra vera (PRV) and hairy cell leukaemia (HCL) is reported. The secretion by spleen cells in short term culture of IfGλ to the exclusion κ demonstrated that despite aberrant surface marker studies the HCL was a monoclonal tumour of B cells. Chromosomal studies on splenic cells were not able to demonstrate the common clonal origin of the two tumours.
Neural-tube defect risk assessment for individual pregnancies using alphafetoprotein and acetylcholinesterase test results.
Authors: Strike P W , Smith J
Published: June 2007

Pregnancies at risk of being associated with (open) neural tube defects can be identified by maternal serum and amniotic-fluid alphafetoprotein (AFP) concentrations in excess of established screening cut-off valves in conjunction with the results of an amniotic fluid electrophoretic acetylcholinesterase screening test. The risk associated with the AFP cut-off values are formulated in terms of a population screening programme. These "population risks" are of little value in the assessment of test results from individual "at-risk" pregnancies, especially when the observed AFP concentrations are in proximity to the "cut-off" values. A complete risk assessment procedure for individual pregnancies is described and presented in graphical form to permit immediate access by clinical staff.
Is post partum rubella vaccination worthwhile?
Authors: Griffiths P D , Baboonian C
Published: June 2007

This study was designated to determine whether a program of screening for rubella antibodies during pregnancy, coupled with selective vaccination after delivery, could effectively increase herd immunity. One thousand women were studied when they returned for further antenatal care after having been screened, and possibly vaccinated, during an earlier pregnancy. Overall, the program was shown to be 83% effective since 108 women were truly seronegative in their initial pregnancies and 90 of them had been rendered immune by the time of their next pregnancy. The 18 failures of the program were attributed to the haemagglutination inhibition test employed (eight cases), failure to administer vaccine (seven cases) and true vaccine failures (three cases). Five pregnant women became infected with rubella virus during the study but all were in their initial pregnancies. All seronegative women were shown to follow the instruction not to become pregnant within three months of vaccination. We conclude that a program of screening for immunity, together with selective vaccination post partum, can significantly reduce both the number of susceptible women and the number who experience rubella infection during pregnancy. Such programs should be vigorously encouraged as a means of helping to prevent congenital rubella.
Lack of cross-reactivity between antibody against smooth muscle and antibodies to measles virus in sera from patients with chronic active hepatitis.
Authors: Sommer A I , Haukenes G
Published: June 2007

A majority of patients with HBsAg-negative chronic active hepatitis (CAH) show considerably raised titres of serum antibodies against measles virus antigens. Since these patients often have high titers of antiactin specific antibodies against smooth muscle, and since actin is also incorporated into the measles virion during replication, we have examined whether there was any cross-reactivity between the two antigen-antibody systems. Cross-absorptions of sera from patients with CAH were performed using measles virus antigens and smooth muscle from human uterus. The corresponding specific antibodies were removed from serum without significantly affecting the titres of the other antibodies. Absorption had no influence on the total amount of IgG in serum. The raised titres of antibodies against measles virus seen in CAH can therefore not be explained by cross-reaction with antibodies to smooth muscle.
Practical use of a word processor in a histopathology laboratory.
Authors: Briggs J C , Ibrahim N B , Mackintosh I , Norris D
Published: June 2007

Some of the facilities available with a commercially purchased word processing program, linked to a DEC PDP 11/23 computer are described, together with an account of the practical histopathological use. The system is based on a share of the computer with a Clinical Chemistry Department. Development was time-consuming and required the constant availability of the Department of Physics. However, once working, considerable saving in secretarial time has resulted and a number of projects have been started which would not have been contemplated without the use of the word processor and its linked computer.
Swabs and swab-transport media kits in the isolation of upper respiratory bacteria.
Authors: Ross P W , Cumming C G , Lough H
Published: June 2007

The recovery of upper respiratory tract bacteria on laboratory media from a variety of swabs and swab-transport media kits was examined. Organisms studied included strains of Streptococcus pyogenes, Streptococcus pneumoniae, Staphylococcus aureus, Neisseria meningitidis and Haemophilus influenzae. Although a wide range of results was obtained with regard to variables such as the type of swab or swab-transport media kit used, the time of plating, the temperature of storage of swab-transport media kits, and the nature of the suspension of the organisms, it was generally noted that recovery of organisms was better from swabs held in their plastic containers prior to plating than from swabs held in transport medium.
Comparative study of three tests (dye test, indirect haemagglutination test, latex agglutination test) for the detection of antibodies to Toxoplasma gondii in human sera.
Authors: Balfour A H , Fleck D G , Hughes H P , Sharp D
Published: June 2007

An evaluation has been made of a commercial latex agglutination test, Toxotest-MT (TMT) (Eiken, Japan), for the detection of antibodies to Toxoplasma gondii in human sera. In qualitative studies, 878 sera were examined in both the TMT and dye test (DT) and 96.6% agreement was found, In quantitative studies 339 sera were titrated in the TMT and DT, with 337 of these sera also titrated in the indirect haemagglutination test (IHAT). Agreement between the DT and TMT was best, 78% of the sera showing titres within +/- 1 dilution in the two tests. The IHAT and TMT gave 66% agreement, while the DT and IHAT showed least agreement, 40.9%. The results suggest that the pattern of antigenic determinants to which antibody levels are measured are different in the three test systems. The TMT is a better substitute for the DT than the IHAT.
Bone biopsy in haematological disorders.
Authors: Burkhardt R , Frisch B , Bartl R
Published: June 2007

Bone marrow biopsies are now widely used in the investigation and follow-up of many diseases. Semi-thin sections of 8216 undecalcified biopsies of patients with haematological disorders were studied. Observations were made on the cytopenias and the myelodysplastic syndromes, the acute leukaemias the myeloproliferative disorders, Hodgkin's disease and the malignant lymphomas including multiple myeloma, hairy cell leukaemia and angioimmunoblastic lymphadenopathy. Bone marrow biopsies are essential for the differential diagnosis of most cytopenias and for the early recognition of fibrosis which most frequently occurred as a consequence of megakaryocytic proliferation in the myeloproliferative disorders. Different patterns of bone marrow involvement were found in the lymphoproliferative disorders and both their type and extent constituted factors of prognostic significance. A survey of the literature is given and the conclusion is drawn that bone marrow biopsies provide indispensible information for the diagnostic evaluation and the follow-up of patients with haematological disorders.
Synovial fluid lactic acid measurement in the diagnosis and management of septic arthritis.
Authors: Riordan T , Doyle D , Tabaqchali S
Published: June 2007

An improved method of lactic acid estimation by gas liquid chromatography (GLC) is described. Synovial fluid lactic acid estimation was performed on 52 patients (15 with septic arthritis and 37 with non-septic arthropathies) and compared to routine microbiological methods and white cell counts. Lactic acid was found to be a useful and rapid test for differentiating between septic and non-septic arthritis being markedly raised (greater than 12 mmol/l) in all the septic joints. Raised lactic acid concentrations were of particular diagnostic value in patients in whom antibiotic therapy had commenced before joint aspiration. The results of lactic acid estimation on sequential samples were helpful in assessing the response of septic arthritis to treatment.
Distribution pattern of lysosomal granules in fibroblasts of the Chediak-Higashi syndrome.
Authors: Abe K , Arashima S , Honma M
Published: June 2007

Cultured fibroblasts from a patient with the Chediak-Higashi syndrome, the mother of the patient, and a normal control were studied by light and electron microscopy. The distribution pattern of PAS-positive and acid phosphatase-containing granules in the cytoplasm differed significantly in the fibroblasts from the patient when compared with those from the mother and control. The granules in the fibroblasts from the patient were clustered in the perinuclear area, whereas the granules in the fibroblasts from the mother and control were dispersed throughout the cytoplasm. After incubation with ascorbic acid, the clustered granules in the fibroblasts of the Chediak-Higashi syndrome showed a tendency to spread throughout the cytoplasm. The distribution pattern of the granules was studied by quantitative morphology.
Ovarian tumours of Wolffian or allied nature: their place in ovarian oncology.
Authors: Hughesdon P E
Published: June 2007

Two unusual ovarian tumours thought to be of Wolffian identity, one of them malignant, are described. They showed packed combinations of adenopapillary, tubular, trabecular and diffuse patterns, a sharp and generalised periodic acid-Schiff (PAS)-positive basement membrane and areas of elastic network. A review of published Wolffian tumours at various sites suggests that the prototypes of the two tumours occur chiefly in the cervix and broad ligament. The significance of Wolffian tumours and their differentiation from arrhenoblastoma and serous tumours is discussed.
Primary biliary cirrhosis: an increased incidence of extrahepatic malignancies?
Authors: Mills P R , Boyle P , Quigley E M , Birnie G G , Jarrett F , Watkinson G , MacSween R N
Published: June 2007

In a retrospective review of 85 patients with primary biliary cirrhosis (PBC), 10 (11.8%) were noted to have extrahepatic malignant neoplasm. In seven female patients the tumour developed within a mean of 3.5 yr after the clinical onset of PBC. This observed number of tumours, 3.5 times more common than the expected age-adjusted incidence, was statistically significant at the 0.5% level.
Clostridium difficile and cytotoxin in routine faecal specimens.
Authors: Nash J Q , Chattopadhyay B , Honeycombe J , Tabaqchali S
Published: June 2007

Over a five-month period 1239 unselected, routine faecal specimens from 856 patients were examined for Clostridium difficile. One hundred specimens representing 69 patients were culture-positive. Toxin was detected in the stool of ten. During the study period, there were 41 Salmonella, 12 Campylobacter and 9 Shigella infections. C difficile was isolated together with Salmonella from 12 patients. No patient required specific treatment for C difficile infection. The significance of these findings is discussed.
Heterotopic gastric mucosa in the duodenum.
Authors: Lessells A M , Martin D F
Published: June 2007

Thirteen patients are described who, on routine endoscopy of the upper gastrointestinal (GI) tract, were found to show a characteristic appearance in the proximal duodenum. This consisted of multiple small mucosal nodules, predominantly in the anterior wall. All cases were biopsied, and showed identical histological appearances of heterotopic gastric mucosa of body type. The incidence of this condition is probably much higher than reported previously, and may be present in up to 2% of the population. In all our patients a diagnosis was reached, other than heterotopic gastric mucosa, to explain the GI tract symptoms. In none was a healed or active duodenal ulcer evident and in none was there a history of a pre-existing ulcer. In our opinion these nodules are probably of little or no clinical significance.
Serum gamma-glutamyltransferase and alkaline phosphatase in rheumatoid arthritis.
Authors: Spooner R J , Smith D H , Bedford D , Beck P R
Published: June 2007

Serum gamma-glutamyltransferase (GGT) and alkaline phosphatase (AP) were assayed in 98 consecutive patients with rheumatoid arthritis. Twenty-three patients had increased GGT activities and 45 an increased AP activity. Twelve patients showed an increase in both enzyme activities and AP isoenzyme studies were performed on seven of this group. In three subjects an increase in the bone isoenzyme was observed and in three others the increase in activity was attributed to the liver isoenzyme. The remaining patient, who probably suffered from coexistent primary biliary cirrhosis, showed an increase in both bone and liver isoenzymes. The liver involvement, suggested by the alkaline phosphatase isoenzyme results, was largely confirmed by the butanol extraction of GGT. The changes in these enzymes in this small series could not be related definitely to drug therapy. It is concluded that though increases in GGT and AP are common in rheumatoid arthritis, this does not necessarily indicate hepatic involvement. Further isoenzyme studies are needed to define the extent to which organs other than the liver bring about increases in these serum enzymes in rheumatoid disease.
Antithrombin III and fibrinogen degradation product (fragment E) in diabetic nephropathy.
Authors: Chan V , Yeung C K , Chan T K
Published: June 2007

Plasma antithrombin III (AtIII), serum fragment E (FgE) and urine AtIII and FgE were measured in 25 diabetic patients with proteinuria above 1 g per day and compared to that in 25 patients with non-diabetic nephropathy, matched for the degree of proteinuria. Plasma AtIII concentrations were normal in both groups but FgE concentrations were increased. The level of plasma AtIII was directly related to HbA1 concentrations in the diabetics. For the same degree of proteinuria, the diabetic patients lost more AtIII and FgE in the urine. Urine AtIII was found to be mostly bound to activated procoagulants. Both urine AtIII and urine FgE correlated inversely with creatinine clearance. It was concluded that intraglomerular thrombosis probably contributes to the deteriorating renal function in diabetic nephropathy and is reflected in the concentrations of urine AtIII and FgE.
Gas-liquid chromatography in the diagnosis of anaerobic infections: a three year experience.
Authors: Watt B , Geddes P A , Greenan O A , Napier S K , Mitchell A
Published: June 2007

Nearly two thousand clinical samples were examined by direct gas-liquid chromatography over a three year period. Absence of volatile fatty acids (VFAs) in the samples correlated well with negative culture results for anaerobic bacteria. In general the presence of acetic acid alone correlated well with the presence of aerobic organisms, whereas the presence of a mixture of VFAs correlated well with the presence of anaerobic organisms, either alone or in combination with aerobes. However a proportion of such VFA-positive samples gave no growth on culture. Swabs gave comparable results to samples of pus or exudates except that a higher proportion of the former were VFA-negative but culture positive.
Occurrence of infection with a parvovirus-like agent in children with sickle cell anaemia during a two-year period.
Authors: Anderson M J , Davis L R , Hodgson J , Jones S E , Murtaza L , Pattison J R , Stroud C E , White J M
Published: June 2007

The occurrence of infection with a parvovirus-like agent during the period April 1979-May 1981 in children attending a single sickle cell clinic in London was investigated. Virus was detected in serum by counter-current immunoelectrophoresis (CIE) and immunoelectron microscopy (IEM). Viral antibody was detected by CIE and specific IgM antibody by an IgM-antibody capture assay. Of the 68 children studied nine presented in aplastic crisis and evidence of infection with the parvovirus-like agent at the time of the crisis was found in all nine. Eighteen of the other children were antibody-positive at some time during the study. In 11 children there was no evidence of recent infection; however, two of these had a history of aplastic crisis in previous years. The other seven seroconverted during the course of the study but did not show any haematological effects. Five of these had a primary infection, one appeared to have reinfection and in the seventh there were insufficient data to distinguish between the two. Possible explanations for the difference between those presenting with aplastic crisis and those with asymptomatic seroconversion are discussed.
Hyperplastic parathyroiditis—a new autoimmune disease?
Authors: Boyce BF , Doherty VR , Mortimer G
Published: June 2007

A case of parathyroiditis with epithelial hyperplasia is reported in which the histological features suggest an autoimmune process analogous to Hashimoto's disease.
Fibroma of tendon sheath.
Authors: Smith P S , Pieterse A S , McClure J
Published: June 2007

A series of nine cases of fibroma of tendon sheath is described including details of the ultrastructural features of two cases. The series was composed of lesions from six males and three females with a mean age of 38 yr. The most common site of involvement was the hand (including fingers) and the mean greater diameter was 19 mm. Typically the tumours were lobulated and microscopically there was a collagenous stroma with spindle and stellate cells in a moderate degree of cellularity. One recurrence was noted in the series. The lesion was distinguished from circumscribed fibromatosis, nodular fasciitis, neurofibroma, leiomyoma, scar tissue, giant cell tumour of tendon sheath (localised nodular tenosynovitis) and fibrous histiocytoma. Ultrastructural studies revealed that the large majority of cells present in the two cases studied were myofibroblasts and fibroma of tendon sheath is therefore the third instance of a benign tumour containing these cells (the other two being dermatofibroma and giant cell fibroma of the oral mucosa).
A new manifestation of thrombocytopenia: myocardial haemorrhage with symptomatic arrhythmia
Authors: Wyld PJ , Beck S , Slater DN
Published: June 2007

We describe a patient with thrombocytopenia who developed episodes of dyspnoea due to recurrent cardiac arrhythmia. Necropsy revealed that the apparent mechanism was extensive myocardial haemorrhage.
Frequency of Candida albicans serotypes in patients with denture-induced stomatitis and in normal denture wearers.
Authors: Martin M V , Lamb D J
Published: June 2007

A comparison has been made between the serotypes of oral Candida albicans taken from patients with denture-induced stomatitis and from a group of age and sex-matched controls. C albicans isolates were obtained from the fitting surface of the denture, the palatal mucosa supporting the denture, and the buccal mucosa. Twenty-nine of the 30 patients samples in the group affected by denture-induced stomatitis had only C albicans serotype A on their palatal mucosa and denture surface, while mixtures of serotypes were obtained from the buccal mucosa of these patients. Only one patient had serotype B isolates from the palatal mucosa and denture surface. In contrast, the control group had mixture of A and B serotypes from both the denture surface and the palatal mucosa, as well as from the buccal sites sampled. It would appear from these results that denture-induced stomatitis is associated with the proliferation of a single C albicans serotype, usually serotype A.
Basic isoferritin and hypercalcaemia in renal cell carcinoma
Authors: Mufti GJ , Hamblin TJ , Stevens John
Published: June 2007

A 63-year-old man with iron loss anaemia and hypercalcaemia was found to have a renal cell carcinoma. Despite the iron-deficient blood and bone marrow picture, the serum ferritin concentration was markedly raised. This was mainly due to a “basic isoferritin”. The serum parathormone concentration was normal. The serum ferritin and calcium concentrations returned to normal after the tumour was removed. We propose that the renal cell carcinoma cells in this patient secreted the basic isoferritin as well as humoral factor(s) responsible for hypercalcaemia.
Radioimmunoassay of serum glycocholic acid, standard laboratory tests of liver function and liver biopsy findings: comparative study of children with liver disease.
Authors: Matsui A , Psacharopoulos H T , Mowat A P , Portmann B , Murphy G M
Published: June 2007

Serum glycocholic acid (SGC) was measured by radioimmunoassay in 277 samples from 122 children with hepatobiliary disorders and from 23 healthy age-matched controls. In patients with hepatobiliary disease the SGC was more frequently abnormal (83%) than values for serum albumin (7%), prothrombin time (17%), bilirubin (22%), alkaline phosphatase (45%), aspartate transaminase (57%) and gammaglutamyl transpeptidase (63%). The cumulative frequency of abnormality of these six tests was equal to that of SGC alone. Serum glycocholic acid concentrations were raised in 13 patients in whom all other tests of liver function were normal. Two of these had clinical and histological evidence of liver disease, while four had biopsy-proven hepatic fibrosis or cirrhosis, and two of three with chronic active hepatitis in remission subsequently relapsed. Four patients have as yet, no other clinical or biochemical evidence of continuing liver disease. Serum glycocholic acid was normal in seven children with abnormal aspartate transaminase or gammaglutamyl transpeptidase in whom there is strong suspicion of significant hepatic disease. A wide range of values of SGC was found with marked overlap between the values found in the different disease entities studied. The SGC value was related to the serum concentration of aspartate transaminase and gammaglutamyl transpeptidase but not to other tests of liver function. Serum glycocholic acid concentration was considered in relation to the severity of histological abnormality in 25 percutaneous liver biopsies. The extent of the rise in SGC was related to the presence or degree of histological severity of oedema in the portal tracts, disruption of the limiting plate, parenchymal fibrosis and hepatocellular necrosis but not to other histological features. The very high incidence of abnormal SGC values found in this study does suggest that in an ordinary inpatient and outpatient service SGC determination is a practical and sensitive indicator of the presence of significant liver disease but for its comprehensive identification aspartate transaminase and gammaglutamyl transpeptidase must also be determined.
The maternal autopsy
Authors: Rushton DI , Dawson IMP
Published: June 2007

Careful study of reports prepared for the Confidential Enquiries into Maternal Deaths in England and Wales has made it clear that many maternal autopsy reports are not as informative as they might be. This is, in part at least, because no pathologist who does not work in a maternity unit can expect to see more than a handful of such deaths in a working lifetime. This paper describes briefly the particular features to look for at autopsy, stresses the importance of taking adequate material for histology and discusses some of the more significant histological findings, both of conditions which cause death and of those commonly associated with it.
Neutrophil granulocytic cell antigen defined by a monoclonal antibody--its distribution within normal haemic and non-haemic tissue.
Authors: Schienle H W , Stein N , Müller-Ruchholtz W
Published: June 2007

Monoclonal antibodies were raised against normal human bone marrow cells. One of the antibodies obtained, monoclonal antibody 3C4 (MA 3C4), the subject of this paper, was characterised by immunofluorescence studies with viable normal peripheral blood and bone marrow cells and by immunoperoxidase studies using paraffin sections. In bone marrow and peripheral blood MA 3C4 reacts selectively with cells of late neutrophilic granulopoiesis (myelocytes, metamyelocytes, and neutrophilic granulocytes). Cells of erythropoiesis, thrombopoiesis and lymphopoiesis are negative. In lymph node and spleen only neutrophils react with MA 3C4. In non-haemic tissue reactivity was seen with epithelial cells of a variety of different gland ducts. Thus the antigen detected by MA 3C4 can serve as a marker for neutrophil differentiation in normal haemopoiesis and as a marker for ductal epithelial cells of a variety of organs within non-haemic tissue. The antigen is formalin-resistant and can be detected in paraffin sections. The antibody thus appears to be a valuable reagent for both haematological research and for routine pathology.
A simple quantitative assay of tissue plasminogen activator.
Authors: De Cossart L , Marcuson R W
Published: June 2007

A simple method for the quantitative assay of tissue plasminogen activator is described. Human veins and uterus obtained at operation are disintegrated in a membrane disintegrator at -70 degrees C and a known weight of the powder, suspended in buffered saline and thoroughly mixed. Assay of the dilutions of this homogenate on isotope-labelled fibrin clots gives straight line plots of log weight against log activity of the dilution and the sample activity is calculated from this. The method has been compared with the conventional histochemical technique. A highly significant correlation between the results of the two methods has been obtained (r = 0.79; p less than 0.001).