bluuebunny/crossref_metadata_2025 huggingface dataset:
Granular cells as a marker of early amiodarone hepatotoxicity: a pathological and analytical study.
Authors: Shepherd N A , Dawson A M , Crocker P R , Levison D A
Published: June 2007

Two contrasting cases of amiodarone hepatotoxicity are described. In one, perivenular collections of swollen cells, probably macrophages, with granular cytoplasm in an otherwise nearly normal liver were observed. Transmission electron microscopy showed that the cytoplasmic granularity was due to lysosomal bodies of various sizes. X-ray energy and wavelength spectroscopic analysis showed a high iodine content in these lysosomal bodies, good presumptive evidence of the presence of amiodarone or one of its metabolites. In the second case there was a micronodular cirrhosis, and similar granular cells also containing iodine were seen in the fibrous connective tissue. These cases seem to represent the very early and late stages of amiodarone hepatotoxicity. In a patient taking this drug aggregates of swollen granular cells may be a sensitive and histopathologically useful marker of early amiodarone toxicity.
Appendicular schistosomiasis: a cause of clinical acute appendicitis?
Authors: Satti M B , Tamimi D M , Al Sohaibani M O , Al Quorain A
Published: June 2007

The role of schistosomes in the pathologenesis of acute appendicitis in an endemic area was investigated. Of 1600 appendicectomies received in our laboratory, 26 showed appendiceal schistosomiasis, which prompted what we believe to be the first detailed histopathological evaluation of all appendices with schistosomal infestation, without prior knowledge of the clinical and operative diagnoses. The results suggest that there are two types of schistosomal appendicitis, each with distinct clinicopathological features and different pathogenetic mechanisms. They could be called obstructive and granulomatous schistosomal acute appendicitis, respectively.
Embryonal carcinoma of testis simulating seminoma.
Authors: Alderdice J M , Johnston S R
Published: June 2007

The clinical and pathological features of two patients with testicular germ cell tumour are described. The cases illustrate the area of gross and histological overlap between seminoma and solid embryonal carcinoma, for which there are useful distinguishing features which might aid diagnosis.
Cost effectiveness of routine postmortem histology.
Authors: Reid W A
Published: June 2007

In a retrospective study of the records of 160 necropsies it was found that, according to the clinical and gross necropsy findings, no clinically important abnormality would have been anticipated in 46% of the tissue samples. The estimated annual cost of processing this material alone was pounds 10,500, including the salary of one full time medical laboratory scientific officer (MLSO). Few of the microscopic findings led to a change in diagnosis. It is suggested that unselected postmortem histology is, for diagnostic purposes, not cost effective.
Histochemistry of dipeptidyl aminopeptidase (DAP) II and IV in reactive lymphoid tissues and malignant lymphoma.
Authors: Khalaf M R , Aqel N M , Hayhoe F G
Published: June 2007

A modified histochemical method was used to show the presence of dipeptidyl aminopeptidase (DAP) II and IV in fixed, freeze dried, cryostat sections of tonsils, lymph nodes, and skin. In 14 reactive tonsils and lymph nodes both enzyme reactions were largely confined to T dependent areas where scattered positive lymphocytes were shown in the paracortical zones, while lymphocytes of germinal centres (B dependent areas) were negative. In either site some macrophages showed strong positivity for both enzymes. In 23 lymph node and two skin biopsy specimens of non-Hodgkin's lymphoma the neoplastic lymphocytes of 12 B cell lymphomas were completely unstained, whereas in the 13 cases of T cell lymphoma the neoplastic lymphocytes showed variable reactions with positivity for DAP II in eight and for DAP IV in seven, both reactions being positive in four and negative in two. Touch imprints of a lymph node from a case of Hodgkin's disease showed that the Reed-Sternberg cells were unreactive for both enzymes. The histochemistry of DAP II and IV may supplement other histochemical and immunological markers in the cytological classification of lymphomas.
Steroid hormone receptors in human salivary gland tumours.
Authors: Lamey P J , Leake R E , Cowan S K , Soutar D S , McGregor I A , McGregor F M
Published: June 2007

Major salivary gland tumours were studied for the presence of hormone receptors for oestrogen and progesterone. Of the eight salivary gland tumours exhibiting varied histology, none showed high affinity receptors for oestrogen or progesterone. Salivary tissue from four patients with non-neoplastic salivary gland disease was also studied and found not to contain high affinity receptor sites. The absence of hormone receptors in these glands suggests that such tumours are not dependent on endocrine function.
Unusual variant of primary sclerosing cholangitis.
Authors: MacSween R N , Burt A D , Haboubi N Y
Published: June 2007

Two cases of primary sclerosing cholangitis are described, in which the characteristic bile duct lesions were unusual because there was an exuberant and exaggerated fibrous replacement of the ducts which produced dense fibrotic scars in portal tracts.
Clinical evaluation of Abbott and Wellcome enzyme linked immunosorbent assays for detection of serum antibodies to human immunodeficiency virus (HIV).
Authors: Evans R P , Shanson D C , Mortimer P P
Published: June 2007

Abbott and Wellcome enzyme linked immunosorbent assays (ELISAs) for detection of antibodies to human immunodeficiency virus (HIV) were compared in tests on 932 sera collected predominantly from male homosexuals attending a sexually transmitted disease (STD) clinic in central London. Two hundred and twenty three sera had HIV antibodies detected by both types of assay, with confirmation of the results by further tests carried out at the Virus Reference Laboratory (VRL) in Colindale. There was a 97.3% correlation between the results obtained by the two commercial ELISA assays on the tests carried out on unheated sera. The Abbott ELISA gave significantly more false positive results than the Wellcome test when the manufacturer's instructions for cut off values were followed. There was one false negative Abbott results: it failed to react to repeated Abbott ELISA but was positive by Wellcome and confirmatory assays. Of 283 heat treated sera 14.8% gave falsely reactive results with the Abbott assay whereas there were no differences between heated and unheated sera with the Wellcome assay. VRL or Western blot confirmatory assays, or both, confirmed all the 235 positive results obtained with the Wellcome assay.
Colonic pericrypt sheath cells: characterisation of cell type with new monoclonal antibody.
Authors: Richman P I , Tilly R , Jass J R , Bodmer W F
Published: June 2007

A new monoclonal antibody, PR 2D3, was raised against a crude homogenate of normal colorectal mucosa and found to react with the cells in the pericrypt sheath. It also reacted with smooth muscle throughout the body and, in specific sites, with those mesenchymal cells known as myofibroblasts. It did not react with cardiac or skeletal muscle, nor with fibroblasts. PR 2D3 is an IgG1 antibody and identifies a membrane component of about 140 K molecular weight. The pericrypt cells have been described as fibroblasts, but in view of the specificity of PR 2D3 for smooth muscle, and its selective staining of the colonic pericrypt cells, this cell type was re-examined for other smooth muscle properties. Ultrastructurally, the cells had many characteristics in common with smooth muscle and were identical with the myofibroblasts of the umbilical cord. On immunocytochemical examination they were found to contain desmin, myosin, and filamin. The confirmation that the pericrypt cells are myofibroblasts suggest that they have both contractile and secretory roles.
Colorectal goblet cell mucins in familial adenomatous polyposis.
Authors: Sugihara K , Jass J R
Published: June 2007

Ninety two tissue blocks from the left colon and 52 from the right colon were obtained from 112 patients with familial adenomatous polyposis (FAP). Tissues from 137 patients with other conditions served as controls. Within the main study a smaller investigation was performed to compare sections from the left and right colon in the same subject. Several well known histochemical techniques were used to investigate possible changes in sulphation, sialic acid structure (loss of O-acetyl substituents), and changes in the ratio of sialic acid to neutral sugars. In patients with FAP, as in controls, there was increased expression of periodic acid Schiff positive mucin and fucose in the right colon. The only difference between patients with FAP and controls was the indirect demonstration of less neutral mucin in the right colon in FAP, but this did not seem to affect neutral sugars binding to UEA-1, PNL, or HPA. As in the general population, a small proportion of patients with FAP showed a lack of O-acetyl substituted sialic acid. Sialic acid heterogeneity probably has a genetic basis, but this is not associated with the genetic defect underlying FAP.
Epithelial hyperplasia and malignant change in congenital lung cysts.
Authors: Sheffield E A , Addis B J , Corrin B , McCabe M M
Published: June 2007

Patients with congenital lung cysts are at increased risk of developing carcinoma, but the mechanisms concerned are not clear. The case of a young adult who developed a bronchioloalveolar carcinoma associated with a cystic congenital adenomatoid malformation is reported. The adjacent lung showed an unusual intra-alveolar hyperplasia of mucous cells. Two further cases of congenital adenomatoid malformation are also described; both patients presented in infancy and showed similar mucous cell hyperplasia in alveoli surrounding the cysts. In all three cases the staining characteristic of the mucus was identical with that of normal bronchial mucous glands. It is suggested that the benign proliferation represents a premalignant lesion. Its presence in infants shows that it may occur at an early age and reinforces the need for early removal of congenital lung cysts.
Diagnosis of molar pregnancy and persistent trophoblastic disease by flow cytometry.
Authors: Hemming J D , Quirke P , Womack C , Wells M , Elston C W , Bird C C
Published: June 2007

Histopathological assessment and flow cytometric analyses were carried out on 32 placentas (representative of each trimester) and 88 molar pregnancies. Three first trimester placentas were triploid, and the remaining 29 placentas were diploid. Of the 88 cases originally diagnosed as molar pregnancies, 26 were triploid (two complete moles, 20 partial moles, and four hydropic abortions); 59 were diploid (46 complete moles, 10 partial moles, three hydropic abortions); one was tetraploid (partial mole); and two were DNA aneuploid (one partial mole, one complete mole). A significantly increased hyperdiploid fraction (a measure of cell proliferation) was detected in diploid complete moles (p less than 0.0001) and cases of persistent trophoblastic disease (p less than 0.001) when compared with diploid placentas and diploid partial moles. All seven cases of established persistent trophoblastic disease, for which follow up was available, were diploid and showed high hyperdiploid fractions within the range for diploid complete moles. These findings suggest that flow cytometric DNA measurements may be an important aid in the diagnosis of molar pregnancy. The high degree of cell proliferation found in this study may explain the premalignant potential of complete hydatidiform moles.
Circulating secretory component in breast neoplasms.
Authors: Kvale D , Rognum T O , Thorud E , Fosså S D , Rø J S , Brandtzaeg P
Published: June 2007

The serum concentrations of IgAp and IgMr associated secretory component (SIgA and SIgM) of 98 patients with neoplasms of the breast were measured. Of the 56 patients with carcinomas, 11 had increased concentrations of circulating SIgM, which was almost twice as sensitive as SIgA as a marker for carcinoma. Concentrations of circulating SIgA and SIgM were independent of expression of secretory component, IgA, and carcinoembryonic antigen (CEA); histological tumour grade; and tumour cell DNA ploidy, whereas a weak correlation between SIgA and SIgM and circulating CEA was seen. The three patients who had liver metastases indicated had particularly high concentrations of circulating SIgA and SIgM, whereas no difference was generally seen between patients with malignancy and those with benign tumours.
Splenic B cell lymphoma with circulating villous lymphocytes: differential diagnosis of B cell leukaemias with large spleens.
Authors: Melo J V , Hegde U , Parreira A , Thompson I , Lampert I A , Catovsky D
Published: June 2007

The clinical, haematological, morphological and histological features of a series of 22 patients presenting with splenic lymphoma with circulating villous lymphocytes were assessed and compared with those of patients with other forms of chronic B cell leukaemia in an attempt to differentiate this condition from hairy cell leukaemia, prolymphocytic leukaemia, and chronic lymphocytic leukaemia, with which this condition has many features in common. The disease was twice as common in men than in women, with a mean (SD) age at diagnosis of 72 (9) years, and the most consistent presenting feature was massive enlargement of the spleen, which showed white and red pulp disease with a plasmacytic component. Small monoclonal bands were found in 60% of cases.
Cytochemical profile of megakaryoblastic leukaemia: a study with cytochemical methods, monoclonal antibodies, and ultrastructural cytochemistry.
Authors: Pombo De Oliveira M S , Gregory C , Matutes E , Parreira A , Catovsky D
Published: June 2007

A cytochemical study using: Sudan black B; alpha-naphthyl acetate (ANAE) staining; estimation of alpha-naphthyl butyrate (ANBE) esterase activity; acid phosphatase activity; and 5' nucleotidase activity was carried out in 15 cases of megakaryoblastic leukaemia. These included cases of M7 acute myeloid leukaemia and blast crises of chronic granulocytic leukaemia. The megakaryoblastic nature of the blasts was first established using two monoclonal antibodies against platelet glycoproteins, and by estimating the platelet/peroxidase reaction at ultrastructural level. Our findings suggest that megakaryoblasts have a typical cytochemical profile comprising positive ANAE staining and acid phosphatase activity with a predominant localisation in the Golgi zone and negative or weak ANBE activity. A similar positive cytochemical pattern was also found in five cases of erythroleukaemia (M6). The specificity of the 5'nucleotidase activity for megakaryoblasts was not confirmed. In most cases of megakaryoblastic leukaemia there was no 5'nucleotidase activity only two cases showed positive reactions--reactions were positive in several cases of myeloblastic and lymphoblastic leukaemia. We suggest that cytochemical methods may be useful in diagnosing M6 and M7 acute leukaemia because less than 40% of leukaemic cells react with specific monoclonal antibodies.
Neutrophil chemotaxis in sickle cell anaemia, sickle cell beta zero thalassaemia, and after splenectomy.
Authors: Donadi E A , Falcão R P
Published: June 2007

Neutrophil chemotaxis was evaluated in 28 patients with sickle cell anaemia, 10 patient with sickle cell beta zero thalassaemia, 25 patients who had undergone splenectomy, and 38 controls. The mean distance migrated by patients' neutrophils was not significantly different from that of neutrophils from controls. Although several immunological variables have been reported to be changed after loss of splenic function, we were unable to show a defect in neutrophil chemotaxis that could account for the increased susceptibility to infection.
Isolation of Plesiomonas shigelloides from nutrient broth with brilliant green: its use in screening stool samples from an African population.
Authors: Nair P , Millership S E
Published: June 2007

The suitability and selectivity of nutrient broth with bile salts and varying concentrations of brilliant green as an enrichment medium was tested for the isolation of Plesiomonas shigelloides from faeces. The broth was most effective at a concentration of 0.001 g/l brilliant green, using faeces deliberately contaminated with Plesiomonas. Two hundred and nineteen faecal samples from Nigeria were then examined for the presence of Plesiomonas and other bacterial pathogens. One yielded Plesiomonas following enrichment in bile salts brilliant green broth (BBG broth) whereas no samples were positive on direct plating.
Immunogold-silver technique applied to showing malignant B cell infiltration of gastrointestinal tract in patients with chronic lymphocytic leukaemia and non-Hodgkin's lymphoma.
Authors: Smith G , Crocker J , Nar P , Chesner I , Leyland M J
Published: June 2007

Gastric, duodenal, and rectal biopsy specimens from 20 patients with chronic lymphocytic leukaemia (CLL) and non-Hodgkin's lymphoma (NHL), not primarily of gastrointestinal origin, were examined using the immunogold-silver staining (IGSS) technique. In paraffin sections the presence of kappa and lambda surface immunoglobulin in lymphoid infiltrates was shown. Using this technique, nine patients were shown to have infiltration of the gastrointestinal mucosa by monoclonal B cells at one or more sites. In a further case a lymphoid aggregate was shown to express both kappa and lambda surface light chains, suggesting that it had a benign nature.
Ulcerative colitis and Escherichia coli with adhesive properties.
Authors: Burke D A , Axon A T
Published: June 2007

A quantitative assessment of the mannose resistant, adhesive property of Escherichia coli from patients with ulcerative colitis and from controls was made using a buccal epithelial cell adhesion assay, which also permitted assessment of adhesion to cells from other host sources. E coli from patients with ulcerative colitis adhered to buccal epithelial cells to a greater extent than those obtained from controls (p less than 0.0001), but did not show an increased affinity for the buccal epithelial cell of their host, compared with those obtained from other sources. The mannose resistant adhesive property of E coli raises the possibility that it has a role in the pathogenesis of ulcerative colitis.
Unresponsiveness to skin testing with bacterial antigens in patients with haemophilia A not apparently infected with human immunodeficiency virus (HIV).
Authors: Sharp R A , Morley S M , Beck J S , Urquhart G E
Published: June 2007

Unresponsiveness to skin testing with PPD and tetanus toxoid was commonly seen in patients with haemophilia A but not infected with human immunodeficiency virus but was uncommon in controls. Vaccination history indicated that the unresponsive patients had not been immunised in childhood. Other tests of immune competence (skin tests with other antigens, lymphocyte stimulation with mitogens and antigens, and viral serology) showed that the haemophilia A patients had an adequate response to pathogens to which they had been exposed. Five of 12 such patients had a mild T4 lymphopenia, and this may have been related to parenteral administration of large quantities of protein.
Demonstration of lymphoid antigens in decalcified bone marrow trephines.
Authors: Hall P A , Lindeman R , Butler M G , Amess J A , D'Ardenne A J
Published: June 2007

A panel of antibodies recognising lymphoid and epithelial antigens in formalin fixed, paraffin embedded sections was applied to a series of 54 bone marrow trephines decalcified by formic or edetic acids. Normal trephines and cases infiltrated by myeloid, lymphoid, and epithelial tumours were included. Patterns of reactivity were distinct and allowed the different diseases to be distinguished. All lymphoid tumours expressed leucocyte common antigen, with B cell tumours staining with MB1 and MB2, and T cell tumours staining with MT1 and UCHL1. T cell acute lymphoblastic leukaemia (ALL)/lymphoblastic lymphoma all stained with MT1, but some were negative with UCHL1. B cell ALL/lymphoblastic lymphoma also stained with MT1, but could be distinguished by its reactivity with MB1 and MB2. Reed-Sternberg cells did not stain with any reagent. Normal and neoplastic myeloid cells stained with MT1. Carcinomas stained with CAM 5.2 but were negative for lymphoid markers except MB2 staining in some cases. A case of neuroblastoma could be distinguished from ALL/lymphoblastic lymphoma by its lack of reactivity with all antileucocyte antibodies and its staining with antineurone specific enolase. Although not ideal, if used together, this panel of reagents may usefully be applied to routinely fixed and processed, decalcified bone marrow trephines.
Immunocytochemical analysis of HLA class II (DR) antigens in liver disease in man.
Authors: Barbatis C , Kelly P , Greveson J , Heryet A , McGee J O
Published: June 2007

The in situ distribution of the major histocompatibility (HLA) class II (DR) antigens was studied in 113 liver biopsy specimens and five livers obtained at necropsy, using monoclonal antibody CR3/43. In 20 normal livers HLA-DR antigens were not detected in bile duct epithelium, hepatocytes, or portal vein endothelium. Normal arteriolar, sinusoidal and central venous endothelium often expressed HLA-DR. Kupffer cells always expressed these antigens. HLA-DR positive spindle cells were identified in the connective tissue of portal tracts, large hepatic veins, and liver capsule: most shared antigens common to all leucocytes and reacted with the histiocytic maker EBM11. Bile duct epithelium expresses HLA-DR in primary biliary cirrhosis, large duct obstruction, and drug induced cholestasis, indicating that HLA-DR positive spindle cells are phenotypically similar to histiocytes.
Visceral brown fat necrosis in postperinatal mortality.
Authors: Stephenson T J , Variend S
Published: June 2007

Fat necrosis was present in 22 of 400 cases of consecutive postperinatal mortalities investigated to assess the presence and pattern of deep fat necrosis. In just over 50% of the cases of fat necrosis the cause of death was categorised as sudden infant death syndrome, which also showed more severe degrees of necrosis. The mechanism of necrosis may be vascular hypoperfusion, possibly related to shock, and brown adipose tissue, on account of its high metabolic activity and rich capillary plexus, may be particularly vulnerable to infarction. The occurrence of fat necrosis in association with other causes of death did not provide any definite clue as to the nature of the alleged shock.
Mesenteric venous thrombosis and antithrombin III deficiency.
Authors: Wilson C , Walker I D , Davidson J F , Imrie C W
Published: June 2007

Of the 123 patients with acute mesenteric infarction treated over the past 12 years, 16 (13%) had mesenteric venous thrombosis. Eight of the patients with mesenteric venous thrombosis survived the initial episode; two have since died. The remaining six patients were studied for evidence of haemostatic deficiencies or abnormalities. Antithrombin III deficiency, which is known to be associated with recurrent venous thrombosis, was found in three patients. It is recommended that all patients with mesenteric venous thrombosis should be screened for antithrombin III deficiency as treatment with coumarin anticoagulants may be indicated, providing effective prophylaxis against further thrombotic episodes.
Retroviruses and human disease.
Authors: Weiss R A
Published: June 2007

Over the past 25 years animal retroviruses have been favoured subjects of research by virologists, oncologists, and molecular biologists. Retroviruses have given us reverse transcriptase, oncogenes, and cloning vectors that may one day be exploited for human gene therapy. They have also given us leukaemia and the acquired immune deficiency syndrome (AIDS). Kawasaki disease and tropical spastic paraparesis are thought to be associated with retrovirus infection, and other diseases such as de Quervain's thyroiditis, multiple sclerosis, acquired hypogammaglobulinaemia, and certain forms of non-A, non-B hepatitis have come under passing suspicion of a retroviral aetiology. With AIDS threatening to become pandemic, and a second AIDS virus appearing in West Africa, human retroviruses are under intensive study for new antiviral drugs targeted to their unique mode of replication, and for the development of vaccines.
Automation in clinical microbiology: a new approach to identifying micro-organisms by automated pattern matching of proteins labelled with 35S-methionine.
Authors: Tabaqchali S , Silman R , Holland D
Published: June 2007

A new rapid automated method for the identification and classification of microorganisms is described. It is based on the incorporation of 35S-methionine into cellular proteins and subsequent separation of the radiolabelled proteins by sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE). The protein patterns produced were species specific and reproducible, permitting discrimination between the species. A large number of Gram negative and Gram positive aerobic and anaerobic organisms were successfully tested. Furthermore, there were sufficient differences within species between the protein profiles to permit subdivision of the species. New typing schemes for Clostridium difficile, coagulase negative staphylococci, and Staphylococcus aureus, including the methicillin resistant strains, could thus be introduced; this has provided the basis for useful epidemiological studies. To standardise and automate the procedure an automated electrophoresis system and a two dimensional scanner were developed to scan the dried gels directly. The scanner is operated by a computer which also stores and analyses the scan data. Specific histograms are produced for each bacterial species. Pattern recognition software is used to construct databases and to compare data obtained from different gels: in this way duplicate "unknowns" can be identified. Specific small areas showing differences between various histograms can also be isolated and expanded to maximise the differences, thus providing differentiation between closely related bacterial species and the identification of differences within the species to provide new typing schemes. This system should be widely applied in clinical microbiology laboratories in the near future.
Plasma lipid concentrations: the concept of "normality" and its implications for detection of high cardiovascular risk.
Authors: Lewis B
Published: June 2007

The relation between serum cholesterol concentrations and the incidence of coronary heart disease is continuous and curvilinear; there is neither epidemiological nor biological evidence to support the existence of a threshold value. There is a clinical need, however, for an acceptable definition of action limits and desirable ranges, based on the evidence that raised cholesterol concentrations are causally related to atherosclerotic heart disease. The European Atherosclerosis Society has proposed a set of cut off points, which, together with age and the presence of other risk factors, direct the clinician to an appropriate level of treatment. Because the changes of serum cholesterol during adult life appear unphysiological, these action limits do not require adjustment for age. The distribution of serum cholesterol in the United Kingdom population is such that a case finding strategy is required to identify the many persons at very high risk of coronary disease. Measurements of triglyceride, high density lipoprotein, apolipoproteins, and the investigation of hyperlipoproteinemia are informative but less mandatory.
Prospects for cure in leukaemia.
Authors: Goldman J M
Published: June 2007

Patients with acute leukaemia have normal or near normal numbers of haemopoietic stem cells in their marrow at diagnosis. Remission is achieved when the administration of cytotoxic drugs eradicates the bulk of the leukaemic population while sparing normal haemopoiesis. The mechanism by which chemotherapy seems to act in this selective manner is essentially unknown. Nevertheless, remission rates of 80-95% can be achieved in children and in 50-80% of adults with acute leukaemia. Attempts to cure patients in remission may entail either "continuing curative chemotherapy" or "supralethal" doses of chemoradiotherapy followed by autologous or allogeneic bone marrow transplantation. The relative merits of these different methods remain highly controversial but chemotherapy is usually the preferred method of continuing treatment for children with acute lymphoblastic leukaemia in first remission; and allogeneic transplantation is recommended for younger adults with acute myeloid leukaemia who have suitable HLA-identical sibling donors. The role of autografting is still experimental. Patients with chronic myeloid leukaemia can achieve long term remission and probably cure following allogeneic bone marrow transplantation but the resultant risks of mortality are still appreciable. Chronic lymphocytic leukaemia currently remains incurable.
Topographical and histological presentation of mammographic pathology in breast cancer.
Authors: Gibbs N M
Published: June 2007

Between 1979 and 1985 surgical resections from 680 cases of primary breast cancer were examined histologically. The patients were divided into four groups: (i) patients aged between 45 and 69 years who had been screened (n = 316); (ii) those younger than 45 who had not been screened (n = 55); (iii) those aged between 45 and 69 who had not been screened (n = 104); and (iv) those older than 69 who had not been screened (n = 205). The material was compared in terms of the association between in situ and invasive carcinoma. There was a low incidence of lobular carcinoma in situ (LCIS) in all groups and a high incidence of ductal carcinoma in situ (DCIS) which declined with age. Ninety nine group i patients had in situ carcinoma or early invasive carcinoma (less than 1 cm in diameter) compared with 19 of group iii cases. Screened patients had fewer multicentric cancers and a lower incidence of large invasive cancer compared with unscreened patients. Group ii patients had a higher incidence of whole quadrant in situ carcinoma, multiple cancer, and lymph node metastases. Group iv patients had a lower incidence of in situ cancer, and more low grade cancer than the other groups. Cases were divided into four types on the basis of this analysis.
Haemorrhagic colitis: detection of verotoxin producing Escherichia coli O157 in a clinical microbiology laboratory.
Authors: Walker C W , Upson R , Warren R E
Published: June 2007

Faeces (n = 1319) were examined over three months for the presence of non-sorbitol fermenting, verotoxin producing Escherichia coli (serotype O157). Seven isolates were found, four from patients with bloodstained diarrhoea and three from patients with no evidence of blood in the faeces. Screening of all faecal samples with specific O157 antiserum for non-sorbitol fermenting organisms and agglutination was an important adjunct to clinical and microscopic findings and helped detect cases of verotoxin producing E coli which might otherwise have been missed.
Nucleolar organiser regions in normal, cirrhotic, and carcinomatous livers.
Authors: Crocker J , McGovern J
Published: June 2007

A series of 54 liver biopsy specimens was studied by means of the argyrophil (AgNOR) technique for nucleolar organiser region (NOR)-associated proteins. These included normal livers and livers affected by chronic active hepatitis, cirrhosis, hepatocellular carcinoma and adenoma. Four of the cases of cirrhosis showed liver cell dysplasia. The mean numbers of NOR sites in normal, cirrhotic, and carcinomatous livers were significantly different: adenoma had similar mean counts to those in chronic active hepatitis (CAH). There was no overlap between the ranges of NOR counts in normal, cirrhotic, and malignant liver specimens. Where cirrhosis and hepatocellular carcinoma were present in the same specimen, the AgNOR counts were higher in the carcinomatous than cirrhotic areas. To investigate the prospective value of the method a further seven biopsy specimens were studied; in these it had not been possible to decide on a diagnosis between normality and cirrhosis or cirrhosis and hepatocellular carcinoma. In all seven specimens a repeat biopsy or necropsy gave results as predicted by AgNOR staining. It is therefore proposed that quantitation of staining for NOR-associated proteins is a diagnostically useful method in liver disease.
Tumour marker immunoreactivity in adenocarcinoma.
Authors: Ellis I O , Hitchcock A
Published: June 2007

To determine whether variations in the expression of tumour related antigen can predict the origin of tumours, the immunoreactivity of a series of adenocarcinomas from a wide range of sites was studied with a panel of monoclonal antibodies with specificity for carcinoembryonic antigen, carcinoembryonic antigen with non-specific cross reacting antigen co-specificity, epithelial membrane antigen, OC 125, and OC 19.9. A range of reactivity was seen in tumours from most sites. No distinctive results were identified for a particular site of origin. Some patterns of consistent positivity or negativity for the panel of antisera used were seen, however, which if applied to metastatic deposits have the potential to assist prediction of the site of origin. These results also imply that immunohistological reactivity should be considered in the selection of a tumour marker for serological monitoring.
Shedding of oocysts of Cryptosporidium in immunocompetent patients.
Authors: Shepherd R C , Reed C L , Sinha G P
Published: June 2007

Forty nine patients (19 adults and 30 children) with oocysts of Cryptosporidium in their faeces had repeated stool specimens taken until oocysts could no longer be identified. They were found in the stools up to 35 days after the onset of symptoms in one patient, but most had stopped shedding them by 20 days. In 25 of the 49 patients in whom symptoms could be compared with the shedding of oocysts, 19 (76%) had symptoms corresponding to the shedding period while symptoms persisted in four (16%) after shedding had stopped.
Low serum haemolytic function of the fourth complement component (C4) in insulin dependent diabetes.
Authors: Senaldi G , Millward B A , Hussain M J , Pyke D A , Leslie R D , Vergani D
Published: June 2007

Low serum concentrations of the fourth component of complement (C4) are found in insulin dependent diabetes, and may be important in the aetiology of the disease. To ascertain whether function of C4 is also impaired both its haemolytic activity and its concentration were measured in 34 insulin dependent diabetics, 15 non-insulin dependent diabetics, 20 healthy subjects, and 12 pairs of monozygotic twins discordant for insulin dependent diabetes. C4 function was measured by a radial immune haemolytic assay, and C4 concentration by laser nephelometry. Both measurements were significantly lower in insulin dependent diabetics (C4 function: median 47%, range 4-100%; C4 concentration: 0.22 g/l, 0.10-0.38 g/l) than in non-insulin dependent diabetics (67%, 33-138%, p less than 0.01; 0.27 g/l, 0.16-0.50 g/l, p less than 0.02) and controls (74%, 33-138%, p less than 0.01; 0.27 g/l, 0.18-0.40 g/l, p less than 0.03). C4 function and concentration were lower in both diabetic (48%, 12-100%; 0.17 g/l, 0.08-0.31 g/l) and non-diabetic twins (47%, 12-100%; 0.17 g/l, 0.07-0.36 g/l) than controls (p less than 0.01; p less than 0.01). Thirteen (38%) of the insulin dependent diabetics had a reduction in either C4 function or concentration, but in only five were both features reduced. Values of function and concentration were strongly correlated in both diabetic and non-diabetic twins (r = 0.95, p less than 0.001; r = 0.92, p less than 0.001). These results show defects in C4 function and concentration in insulin dependent diabetes, which--being present in the non-diabetic co-twin of diabetics--may represent a genetic predisposition to the disease.
Extraction of DNA from small sections of frozen tissue with simultaneous histological examination.
Authors: Cotter F E , Hall P A , Young B D
Published: June 2007

Though analysis of small sections of biopsy material by molecular techniques permits increased sensitivity, it also requires accurate histological examination of the tissue in order to reduce sampling error. A technique for the extraction of DNA from small sections of frozen biopsy material with simultaneous histological examination from adjacent sections is described that may enhance the accuracy of characterisation of the tissue, particularly where there is focal variation. The quality of the DNA obtained enables a full range of molecular studies to be carried out.
Mixed lymphocyte reactions do not predict severity of graft versus host disease (GVHD) in HLA-DR compatible, sibling bone marrow transplants.
Authors: Lim S H , Patton W N , Jobson S , Gentle T A , Baynham M , Franklin I M , Broughton B J
Published: June 2007

Mixed lymphocyte reactions (MLRs) were measured in 25 HLA-A, B and DR compatible sibling bone marrow transplants. Only four of 25 MLRs were positive and in these the low reactivity was of doubtful clinical importance. There was no correlation between MLR and the subsequent development or severity of graft versus host disease (GVHD). A survey of bone marrow transplant units in the United Kingdom showed that most centres perform HLA-DR typing as well as an assessment of the MLR. Factors other than histocompatibility are important in the pathogenesis of GVHD and the data from this study suggest that conventional MLRs can be omitted in HLA-A, B and DR compatible sibling bone marrow transplants.
Evaluation of five commercial kits to detect dsDNA antibodies.
Authors: McMillan S A , Fay A C
Published: June 2007

Experiments were performed to evaluate five commercial kit assays used for the detection of antibodies to dsDNA. The kits were compared using a performance index score as recommended by the guidelines of the European Committee for Clinical Laboratory Standards. The highest performance score was obtained using the radioimmunoassay from Immunodiagnostic Services Ltd, with the Amersham kit second, the immunofluorescence test using Crithidia luciliae third, the Walker ELISA kit fourth, and the haemagglutination assay fifth. The results showed that none of the kits was outstanding, each appeared to detect a different anti-DNA antibody type as different results were obtained using each kit in assays of quality control sera, linearity of the method, antibody detection in various patient groups, and interference by various substances. It is suggested that laboratories using commercial assay kits for the detection of antibodies to dsDNA should decide which is the most appropriate to their particular needs and that a performance index scoring system may be useful in the comparison of assay evaluations between different laboratories.
Clinicopathological importance of primary dysplasia of bladder.
Authors: Zuk R J , Rogers H S , Martin J E , Baithun S I
Published: June 2007

A retrospective study of 15 patients with primary dysplasia of bladder urothelium was performed in an attempt to clarify some of the clinical and histopathological features. The lesion occurs predominantly in middle aged men who present with irritative bladder symptoms with or without haematuria and show no evidence of bacteriological urinary tract infection. Appearances at cystoscopy are non-specific. Thirteen patients showed no progression to carcinoma in situ after a long period of follow up, but primary dysplasia cannot be regarded as an entirely innocuous condition as the remaining two patients did develop carcinoma in situ. The grade of dysplasia on presentation bears no relation to the final outcome. Regular cytological analysis of urine seems to be the best means of follow up, and more active treatment does not seem to be justified.
EBM/11 reactivity in malignant histiocytosis.
Authors: Kelly P M , McGovern M , Gatter K C , Theaker J M , McGee J O
Published: June 2007

A patient presented initially with a testicular mass, which on biopsy had morphological features consistent with malignant histiocytosis. The tumour cells labelled strongly with EBM/11, a murine monoclonal antibody with high specificity for cells of the human mononuclear phagocyte system. Subsequent clinical and laboratory studies confirmed the diagnosis. As poorly differentiated tumour cells reacted with EBM/11, this antibody may be useful in positively identifying malignant tumours with histiocytic differentiation from malignancies of other types where morphological detail alone is inconclusive in tumour classification.
Diagnosis of nasopharyngeal tuberculosis by detection of tuberculostearic acid in formalin fixed, paraffin wax embedded tissue biopsy specimens.
Authors: Arnold M , Chan C Y , Cheung S W , Van Hasselt C A , French G L
Published: June 2007

The use of gas chromatography and mass spectrometry with selected ion monitoring detected tuberculostearic acid (TBSA) in 10 of 12 formalin fixed, paraffin wax embedded nasopharyngeal and head and neck biopsy specimens from patients with confirmed tuberculosis and carcinoma, and in one of 50 control specimens (giving a sensitivity of 83% and a specificity of 98%). The two false negative cases had very small tissue fragments and the patient with a false positive result may have had pulmonary tuberculosis. Tuberculostearic acid (TBSA) was also detected in nine of 16 specimens from the head and neck region with non-caseating granulomas suspected, but not confirmed, to be tuberculosis. It is concluded that nasopharyngeal tuberculosis is relatively common in Hong Kong and should be considered when biopsy specimens show granulomas. The detection of TBSA in tissue biopsy specimens is a useful, rapid method for the diagnosis of tuberculosis and other mycobacterial infections, and can be conveniently performed within two days on formalin fixed and paraffin wax embedded material.
Gonadal function in patients with beta thalassaemia major.
Authors: De Sanctis V , Vullo C , Katz M , Wonke B , Tanas R , Bagni B
Published: June 2007

Endocrine studies were made on 23 female patients aged 13 to 29 years, with delayed puberty or primary amenorrhoea and beta thalassaemia major, and 12 healthy controls, of whom six were prepubertal and six were in Tanner's stage 3-4. Each patient and control received a single intravenous dose of 100 micrograms gonadotrophin releasing hormone (GnRH), and one week later, 10 U/kg body weight of human menopausal gonadotrophin (hMG) to stimulate ovarian function. The patients had decreased gonadotrophin reserves when compared with those of normal controls, only one of 23 patients had an intact luteinising hormone and follicle stimulating hormone response. Most of the thalassaemic patients with delayed puberty showed normal gonad response to human menopausal gonadotrophin (hMG), but three had very low responses, when compared with that of controls. The gonadal failure was even more severe in four of six patients with primary amenorrhoea. It is important to assess hypothalamic-pituitary-gonadal function in young women with beta thalassaemia major, so that those with glandular dysfunction may be started on replacement therapy.
Morphometric analysis of breast carcinoma: association with survival.
Authors: Parham D M , Robertson A J , Brown R A
Published: June 2007

In a retrospective study of 126 cases of infiltrating ductal adenocarcinoma of the breast the percentage area of sections of each neoplasm occupied by malignant cells was assessed by morphometry. The duration of postoperative survival was related to the area occupied by tumour cells within a neoplasm; the greater the tumour cell area to stroma the more prolonged the survival. This variable seemed to be independent of histological grade and was of greater prognostic importance than the diameter of the neoplasm. Furthermore, combination of percentage of tumour area with histological grade provided greater information on the survival characteristics of these patients. Extensive tumour necrosis was a particularly poor prognostic feature.
Incidence of vaginal Weeksella virosa (formerly group IIf).
Authors: Mardy C , Holmes B
Published: June 2007

The antimicrobial susceptibilities, biochemical properties, and cultural characteristics of six strains of Weeksella virosa (formerly group IIf) were determined. The main characteristics of this non-fermentative organism were production of cytochrome oxidase, gelatinase, and indole, but a lack of saccharolytic activity. A study was then made of the isolation rates of Weeksella virosa from high vaginal swabs from 300 women: a healthy control group (n = 100), a general group with symptoms of vaginal infection (n = 100), and 100 women from a remand centre, where likelihood of exposure to sexually transmitted disease might be expected to be higher. The incidence of Weeksella virosa was found to be 2% in the first two groups. This suggests that, irrespective of the presence of pathogens, the incidence of the species in the general female population is around 2%. A much higher incidence (15%) was found in the third group, suggesting sexual transmission of the organism.
Quality assessment in cervical cytology: a pilot study.
Authors: Thomas G D , Head C , Thorogood J
Published: June 2007

A pilot study of an external quality assessment scheme was run between February 1985 and September 1986 to (i) assess the feasibility of running one from a district general hospital; (ii) to estimate the time required to organise and run it with a computer; (iii) to provide sound statistical results with which future schemes could be compared. Seven laboratories participated, and the 20 smears selected from each laboratory were circulated in three rounds in batches of seven, seven, and six according to a prearranged order. Results analysed using the kappa statistic showed moderate levels of interlaboratory agreement, with complete agreement emerging only on a small proportion of cases.
Comparison of hospital staff performance when using desk top analysers for "near patient" testing.
Authors: Nanji A A , Poon R , Hinberg I
Published: June 2007

The quality and reliability of four desk top analysers were evaluated. In the context of an outpatient clinic, intensive care unit, and a mock up of a physician's office. Seventeen nurses, 14 physicians, and 12 medical office personnel took part in the study. The instruments and tests evaluated were Reflotron (glucose, cholesterol, triglycerides, gamma-glutamyl transferase), Seralyzer (creatinine, glucose, potassium, aspartate aminotransferase), Vision (glucose, (creatinine, glucose, potassium, aspartate aminotransferase), Vision (glucose, urea, cholesterol, triglycerides alkaline phosphatase, uric acid), and DT60 (sodium, potassium, glucose, amylase, uric acid and creatinine). Of the 320 tests performed on the Vision, only two differed by more than 10% between the specialist staff and other groups. For those performed on the Seralyzer, 95 of 254 results differed by more than 10%, 19 of 199 by more than 10% for the Reflotron, and 50 of 318 by more than 10% for the DT60. In general, the nurses were more adept at using the analysers than the physicians and medical office personnel.
Clinical and biochemical assessments of damage due to perinatal asphyxia: a double blind trial of a quantitative method.
Authors: Laing I , Brown J K , Harkness R A
Published: June 2007

Using conventional criteria, a series of 26 infants was selected for intrapartum asphyxia from about 4000 deliveries over one year at a single hospital to assess the efficacy of a new biochemical method. Tissue damage was estimated from urinary excretion of hypoxanthine, an important and central intermediate in purine metabolism. The overall pattern showed agreement between the grading (by previously accepted methods) of asphyxia in the perinatal period and our new biochemical approach. The association with handicap at one year of age following asphyxia was complex. This biochemical technique could be used to exclude postasphyxial damage as a cause of clinical disturbances and to select a small group (0.1% of all births) who require further investigation for rarer disorders which may also cause long term handicap.