bluuebunny/crossref_metadata_2025 huggingface dataset:
Drug resistance in relation to use of silver sulphadiazine cream in a burns unit.
Authors: Bridges K , Lowbury E J
Published: June 2007

Topical chemoprophylaxis of extensive burns with silver sulphadiazine cream led to a large increase in the proportion of sulphadiazine-resistant Gram-negative bacilli in a burns unit. When all sulphonamide treatment in the ward was stopped; the incidence of sulphonamide-resistant strains fell back to levels similar to those recorded when silver sulphadiazine treatment was introduced. This was associated with a large reduction in the incidence of resistance of certain Gram-negative bacilli (especially Klebstella sp) to several antibiotics. Transferable resistance to sulphadiazine, shown by conjugation experiments with Escherichia coli K12, was found in a majority of the strains of Klebsiella sp tested, and in other species. A pattern of transferable resistance to tetracycline, cephaloridine, chloramphenicol, ampicillin, carbenicillin, and sulphadiazine (T Ce Cl A Ca S) was found in four of the 22 strains of Klebsiella tested, and closely related patterns were transferred by five other strains. These patterns of resistance were commonly found in Klebsiella sp isolated from burns in the period before the withdrawal of sulphonamides from the ward but were found in none of the Klebsiella strains isolated in the first six months after that period. Strains of Acinetobacter and Proteus, in which transferable resistance was not found, showed no appreciable fall or rise in sulphadiazine resistance; there was no fall in resistance of these organisms to tetracycline, cephaloridine, chloramphenicol, ampicillin or carbenicillin on withdrawal of sulphonamides from the ward, but there were substantial falls in resistance of Acinetobacter to kanamycin, gentamicin, trimethoprim, and tetracycline which were probably not caused by the withdrawal of sulphonamides.
API ZYM: a simple rapid system for the detection of bacterial enzymes.
Authors: Humble M W , King A , Phillips I
Published: June 2007

The API ZYM system of detection of enzymes has been applied to 81 bacteria belonging to several species. It was found to be easy to use and has produced results that may be useful in the identification of a variety of bacteria.
Characterisation of immunofluorescent heterophile antibodies which may be confused with autoantibodies.
Authors: Hawkins B R , McDonald B L , Dawkins R L
Published: June 2007

Approximately 6% of sera submitted for routine immunofluorescent autoantibody screeening produced characteristic reaction patterns against a variety of animal and human tissues. It is suggested that these non-tissue-specific patterns represent a complex family of heterophile antibodies which could be confused with certain autoantibodies. It is further suggested that these heterophile antibodies bear a relationship to IgG isohaemagglutinins.
A comparison of the erythrocyte sedimentation rate and plasma viscosity in detecting changes in plasma proteins.
Authors: Hutchinson R M , Eastham R D
Published: June 2007

The Westergren erythrocyte sedimentation rate (ESR) and plasma viscosity were compared in 114 patients and their correlations with total and differential plasma protein fractions were analysed. There is a linear correlation between these two screening tests. Higher correlation coefficients were obtained between the plasma viscosity and fibrinogen and alpha and gamma globulins than with the ESR. Albumin affected the two tests in opposite directions. The ESR was falsely increased by a fall in haemoglobulin even within two standard deviations from the mean. Both tests gave an appreciable number of incorrect values--the plasma viscosity in 21 cases and the ESR in 33. The cause for these is discussed. It is concluded that the plasma viscosity is the more sensitive and reliable measure of changes in acute phase protein reactants and more useful for monitoring clinical progress.
Aminoglycoside-resistant enterococci.
Authors: Basker M J , Slocombe B , Sutherland R
Published: June 2007

Thirty-four recent clinical isolates of Streptococcus faecalis were tested for sensitivity to amoxycillin, benzylpenicillin, streptomycin, kanamycin, gentamicin, tobramycin, and amikacin. Amoxycillin was two- to four-fold more active than benzylpenicillin and all strains were inhibited by low concentrations of the penicillins. The aminoglycosides were less active against the enterococci than were the penicillins and a significant number of strains were insensitive or relatively insensitive to one or more of the aminoglycosides. Thus, eight (23%) strains showed a high level of resistance to streptomycin and kanamycin (MIC greater 5000 microng/ml) but were sensitive to gentamicin, tobramycin, and amikacin. In addition, two strains of Strep. faecalis, isolated at different hospitals from patients who had received topical gentamicin therapy, were relatively resistant to gentamicin (MIC250 to 500 microng/ml) and were less sensitive also to the other aminoglycosides. Bactericidal synergy was demonstrated by amoxycillin/aminoglycoside combinations against the enterococci, provided that the test strain of Strep. faecalis was sensitive to the aminoglycoside in the combination. An exception to this was the combination of amoxycillin plus amikacin which was not synergistic against kanamycin-resistant strains of Strep. faecalis although these organisms were sensitive to amikacin in the growth inhibition tests. The gentamicin-resistant strains showed variable responses to amoxycillin/aminoglycoside combinations in tests for bactericidal synergy and were generally less sensitive than typical strains of Strep. faecalis.
Serum folates in man.
Authors: Thien K R , Blair J A , Leeming R J , Cooke W T , Melikian V
Published: June 2007

In an aseptic microbiological assay of folate compounds and their breakdown compounds, using Lactobacillus casei, Streptococcus faecalis, and Pediococcus cerevisiae, 4a-hydroxy-5methyl-4,5,6,7-tetrahydrofolate and 5-methyl-5,8-dihydrofolate were inactive under all conditions to all three organisms and 5-methyl-5,6-dihydrofolate was inactive unless ascorbate was present in the incubation medium, and then only to L. casei. 5-Methyltetrahydrofolate was active only for L. casei, and activity in purified samples to S. faecalis was due to trace amounts of folic acid. Analysis of S. faecalis values in the serum in normal subjects and in patients with various disorders showed that levels of 10-formyltetrahydrofolate are raised in coeliac disease, leukaemia, rheumatoid arthritis, and schizophrenia. 5-Methyltetrahydrofolate is readily absorbed by normal human subjects and by patients with pernicious anaemia but poorly absorbed by patients with coeliac disease or leukaemia. 5-Methyl-5,6-dihydrofolate was quickly absorbed by normal human subjects, being reflected by a considerably raised level of 5-methyltetrahydrofolate in serum when sodium bicarbonate was given by mouth before the 5-methyl-5,6-dihydrofolate. These higher levels were comparable to those in patients with pernicious anaemia after oral administration of 5-methyl-5,6-dihydrofolate. Oral 5-methyl-5,8-dihydrofolate and 4a-hydroxy-5-methyl-tetrahydrofolate did not appear as microbiologically active folates in the serum. The findings of this study suggest that the availability for biological utilisation of the major dietary folate compounds will depend on the amount of gastric acidity and of ascorbate in the intestinal chyme. Many may be unavailable for metabolic utilization in the body.
Mucin producing carcinoid tumours of the vermiform appendix.
Authors: Haqqani M T , Williams G
Published: June 2007

Six cases of an unusual mucoid variant of carcinoid tumour of the appendix are reported. These lesions are small, detected incidentally, and carry a good prognosis. Their histological features are distinctive and differ from those of ordinary carcinoid tumours and adenocarcinoma. They have been confused with adenocarcinoma, sometimes resulting in radical surgery. Surgery beyond appendicectomy is probably unwarranted in these cases. The mucin secreted by goblet cells of the normal mucosal epithelium and by the cells of these carcinoid tumours have certain histochemical similarities.
Estimation of serum gentamicin by quenching fluoroimmunoassay.
Authors: Shaw E J , Watson R A , Landon J , Smith D S
Published: June 2007

A new type of non-isotopic immunoassay, applied to the determination of serum gentamicin, is reported. The method is based on partial quenching of fluorescence observed when fluorescein-labelled gentamicin is bound by anti-gentamicin serum. The fluorescence intensity of the labelled gentamicin in an unseparated immunoassay incubation mixture therefore serves to indicate the extent of binding, which is related to the amount of competing unlabelled gentamicin present. Precision and accuracy are shown to be similar to those of the best existing methods for gentamicin, while the new assay is more rapid and technically simpler, and avoids the use of expensive radio-chemicals with their attendant health hazard. Assays of patient samples correlate with established bioassay and polarisation fluoroimmunoassay methods.
Intracellular lysozyme and lactoferrin in myeloproliferative disorders.
Authors: Mason D Y
Published: June 2007

Samples from 49 cases of myeloproliferative diseases were tested by an immunocytochemical technique for leucocyte lysozyme and lactoferrin. The presence of these constituents in myeloid precursors from cases of acute and chronic myeloid leukaemia reflected the degree of cellular maturation, lysozyme appearing (as it does in normal myeloid cells) at the stage of primary granule production (in promyelocytes), while lactoferrin wad detectable only in more mature, secondary granule-containing myeloid cells. Auer rods stained positively for lysozyme, in keeping with their relationship to primary granules. Monocytes from five cases of leukaemia showing predominantly monocytic differentiation were indistinguishable from normal monocytes in their staining reactions for lysozyme despite the presence of raised serum and urinary lysozyme levels. In four cases of acute myeloid leukaemia circulating polymorphs deficient in lactoferrin were detected: in one of these cases a similar percentage of polymorphs was lysozyme negative.
Microbial flora of the vagina and cervix.
Authors: Corbishley C M
Published: June 2007

The microbial flora of the vagina and cervix was assessed qualitatively and semiquantitatively in 40 women attending an intrauterine contraceptive device clinic. Both sites harboured many types of macroorganism, the mean number of microbial types isolated being five from the vagina and four from the cervix. Typical lactobacilli were detected in 61% of vaginal and in 53% of cervical specimens; faecal bacteria, including anaerobes, were even more frequently found at both sites. No differences in the microbial populations at either the vagina or the cervix were detected after fitting of the devices, in the different weeks of the menstrual cycle, or with various previously used contraceptive methods.
Practolol therapy associated with a systemic lupus erythematosus-like syndrome and an inhibitor to factor XIII.
Authors: Milner G R , Holt P J , Bottomley J , Maciver J E
Published: June 2007

A patient is described who had an inhibitor to coagulation factor XIII associated with serum autoantibodies to certain tissues. The relationship of these abnormal findings to practolol therapy suggests that this was practolol-induced lupus erythematosus. Further investigations delineating the site of action of the inhibitor to factor XIII are reported.
Subacute bacterial endocarditis due to Actinobacillus actinomycetemcomitans. Report of a case with a review of the literature.
Authors: Vandepitte J , De Geest H , Jousten P
Published: June 2007

A case of subacute bacterial endocarditis due to Actinobacillus actinomycetemcomitans is reported. The patient was successfully treated first by a combination of gentamicin and ampicillin and then, because of severe allergic reactions, ampicillin was replaced by co-trimoxazole; symptoms did not recur and blood cultures remained sterile. A synoptic table is presented of 19 reported cases of infection caused by A. actinomycetemcomitans not connected with actinomycosis, with particular regard to their clinical features, treatment, and outcome.
Astrovirus-associated gastroenteritis in children.
Authors: Ashley C R , Caul E O , Paver W K
Published: June 2007

In a small astrovirus-associated outbreak of gastroenteritis in a ward of a local children's hospital two out of five children with symptoms excreted astrovirus particles. No astrovirus particles were found in faeces from the remaining asymptomatic child, and no other viral or bacterial pathogens were found in any of the children. Virus excretion persisted for only a few days. Rising antibody titres to the astrovirus particles were demonstrated in one child, and IgM was also demonstrated in this patient's serum.
Platelet function, factor VIII, fibrinogen, and fibrinolysis in Nigerians and Europeans in relation to atheroma and thrombosis
Authors: Dupuy Evelyne , Fleming A. F. , Caen J. P.
Published: June 2007

Platelet function, factor VIII, fibrinogen levels, and fibrinolysis were studied in Europeans and in two groups of Nigerians living in Zaria, northern Nigeria, in order to see whether differences could help to explain the low incidence of atheroma and thrombosis in Nigerians. We confirmed the relative thrombocytopenia and observed a rapid disaggregation after ADP-induced platelet aggregation in Nigerians. The most striking difference was a reduced or absent ristocetin-induced platelet aggregation in Nigerian platelet-rich plasma, probably due to a plasma component interacting with the von Willebrand activity (VWF), since factor VIII coagulant activity, factor VIII related antigen, and isolated VWF were normal or high by European standards. Group II (rural population), but not group I (senior university staff in Zaria) of the Nigerians, tended to have high serum fibrinogen concentrations. Spontaneous fibrinolytic activity was enhanced in most Nigerians compared to the Europeans and was normally increased after venostasis in proportion to the initial activity. Fibrinolysis and ristocetin-induced platelet aggregation values for the Nigerians in group I were intermediate between European and Nigerian in the group II values, suggesting that differences were due more to environmental than to genetic factors.

Relative thrombocytopenia, disaggregation after ADP-induced aggregation, inhibition of ristocetin-induced platelet aggregation, and active fibrinolysis help to explain the infrequency of thrombotic disease in Africans. Also the low incidence of atheroma may follow from less platelet adherence and less platelet release of mitogenic factors, which cause intimal hyperplasia.
Hepatocellular carcinoma and hepatic cirrhosis in the west of Scotland: a 25-year necropsy review.
Authors: Burnett R A , Patrick R S , Spilg W G , Buchanan W M , Macsween R N
Published: June 2007

A two-fold increase in the incidence of hepatocellular carcinoma in the west of Scotland is reported on the basis of a 25-year retrospective necropsy review (313 cases). This increase is not accompanied by a corresponding increase in the incidence of hepatic cirrhosis. The relationship between hepatocellular carcinoma and hepatic cirrhosis is discussed in the light of these findings.
Squamous carcinoma of the breast.
Authors: Hasleton P S , Misch K A , Vasudev K S , George D
Published: June 2007

Two cases of primary squamous carcinoma of the breast are described. One of the tumours appeared to have an origin in an epidermoid cyst and had a pseudosarcomatous stroma. The other tumour arose from metaplastic ductal epithelium. A review of the literature is given.
Cerebral ventriculitis associated with Achromobacter xylosoxidans.
Authors: Shigeta S , Yasunaga Y , Honzumi K , Okamura H , Kumata R , Endo S
Published: June 2007

Six patients in the neurosurgical ward of Fukushima Medical College Hospital suffering from ventriculitis due to Achromobacter xylosoxidans infection had undergone craniotomy or cranial trepanation before the infection. The strains of A. xylosoxidans isolated from the patients were resistant to streptomycin, ampicillin, cephaloridine, gentamicin, and colistin. They were also resistant to chlorhexidine digluconate (Hibitane) in a concentration of 2%. When a study of the chlorhexidine used in the hospital was carried out four strains of A. xylosoxidans were isolated from 20 containers of chlorhexidine solution in the surgical ward but not from those in the operating theatre.
IgM lambda cytoplasmic crystals in three cases of immunocytoma: a clinical, cytochemical, and ultrastructural study.
Authors: Feremans W W , Neve P , Caudron M
Published: June 2007

Endoplasmic reticulum-associated crystals were seen in 1-10% of the bone-marrow lymphocytes and in the lymphocytes of the peripheral blood in three cases of immunocytoma. Their crystalline nature and their location in the cisternae of the rough endoplasmic reticulum was proved by ultrastructural study. IgM lambda in the crystals was demonstrated by fluorescent and peroxidase-labelled antibody methods. The crystals did not stain with the PAS reaction, suggesting that the immunoglobulin was not bound to a carbohydrate group. A defect in glucosyltransferase activity with failure to modify the immunoglobulins could explain the absence of the PAS reaction and the accumulation of immunoglobulin in crystalline before reaching the Golgi region.
Bone marrow fibrosis in acute lymphoblastic leukaemia of childhood.
Authors: Hann I M , Evans D I , Marsden H B , Jones P M , Palmer M K
Published: June 2007

A prospective study of bone marrow fibrosis was made in a group of 40 children with acute lymphoblastic leukaemia to see whether it affected the prognosis or course of the disease. Secondary myelofibrosis (SMF) was present at diagnosis in 57% of the cases. It was not statistically significantly related to the prognosis or course of the disease. Thus, although trephine biopsy occasionally provided useful information in different diagnosis and when aspiration was difficult, it provided little information of use for management.
Human polyomavirus (BK) infection and ureteric stenosis in renal allograft recipients.
Authors: Coleman D V , Mackenzie E F , Gardner S D , Poulding J M , Amer B , Russell W J
Published: June 2007

Human polyomavirus (BK) was detected in two renal allograft recipients as a result of routine examination of Papanicolaou-stained smears of urinary sediment in the light microscope. Infection with this recently identified virus was confirmed by virus isolation and electron microscopy. The cytological, histological, and ultrastructural changes due to the virus are described, and virus excretion is correlated with the clinical progress of the patients and the pathological findings. The transplant ureters in both patients were found to be ulcerated and stenosed, and virus-infected cells were observed in the ureteric epithelium. We suggest that the administration of high-dose steroids in transplantation may permit active infection with human polyomavirus to occur in ureteric epithelium which has been damaged by ischaemia or inflammation.
Hepatitis in clinical laboratories 1975-76.
Authors: Grist N R
Published: June 2007

The survey of British laboratories in 1970-74 was continued by a questionnaire to members of the Association of Clinical Pathologists covering the next two years. Only nine cases of hepatitis (three of hepatitis B) were reported. The annual attack rate of 34 per 100 000 was only one-quarter of that in earlier years. The findings suggest that control measures have had considerable success.
A case of Lennert's lymphoma.
Authors: MacGillivray J B , Macintosh W G
Published: June 2007

A 73-year-old man who presented with a tonsillar mass and generalised lymphadenopathy died two months after admission to hospital. The appearances in the surgical biopsy material resembled those of Lennert's lymphoma, while the necropsy findings were those of a diffuse lymphocytic lymphoma composed mainly of cells with small nuclei showing only slight irregularity. The implication of these findings in relation to the nature of Lennert's lymphoma are briefly discussed.
gamma-Glutamyl transferase isoenzymes in human bile.
Authors: Wenham P R , Price C P , Sammons H G
Published: June 2007

The gamma-glutamyl transferase isoenzymes of bile were studied using electrophoretic, gel filtration, and ultracentrifugation techniques. In view of the known association of other biliary enzymes with lipids the effects of butanol extraction were investigated. The results show the presence of four isoenzymes of gamma-glutamyl transferase in bile, differing in electrophoretic mobilities, molecular size, and density. The correlation between the properties of biliary gamma-glutamyl transferase and of alkaline phosphatase is discussed.
Quantitative histology in giardiasis.
Authors: Wright S G , Tomkins A M
Published: June 2007

The Weibel graticule was used to assess quantitatively histological changes in proximal jejunal mucosal biopsies from patients with Giardia lamblia infections. Most had malabsorption. A group of patients who had mild abdominal symptoms but no intestinal infection and normal absorption were the controls. There were significant differences in mean surface area (SA) measurements between patients with giardiasis and severe malabsorption and controls (P less than 0.001) and infected patients with normal absorption (P less than 0.05). SA measurements correlated significantly with D-xylose excretion results (r = 0.55; P less than 0.01) and daily facal fat output (r = -0.61; P less than 0.001). Significant correlations between duration of symptoms and SA measurements (r = 0.43; P less than 0.05) and D-xylose excretion (r = 0.43; P less than 0.05) in giardiasis suggest that histological and functional impairment are maximal soon after infection and resolve in time. Treatment with metronidazole or mepacrine was associated with a significant increase in SA (P less than 0.05) in patients with severe malabsorption but there was little change in SA in a similar group of patients who received tetracycline. The Weibel graticule was found to be useful in assessing the severity of histological changes and in following changes after treatment.
Retrospective identification of Acanthamoeba culbertsoni in a case of amoebic meningoencephalitis.
Authors: Willaert E , Stevens A R , Healy G R
Published: June 2007

Acanthamoeba culbertsoni was identified retrospectively in a case of amoebic meningoencephalitis, previously reported by Jager and Stamm (Lancet, 2, 1343, 1972). This is the second report of this species causing secondary infection in man. Positive results were obtained only with anti-A. culbertsoni sera when the brain sections were stained by the indirect immunofluorescence antibody test with various antisera produced against different Acanthamoeba species. Antiserum raised against purified plasma membranes of A. culbertsoni showed once more its highly specific diagnostic value.
Upper respiratory tract and aural flora of saturation divers.
Authors: Jones D M , Davis P
Published: June 2007

The conditions of helium saturation diving promote the proliferation of Gram-negative bacterial species in the external auditory meatus of divers. These changes in flora occurred in the absence of operational diving, that is, no contact with water. The colonising bacteria were autogenous in origin and cross-colonisation was observed between divers. On return to normal atmospheric conditions the aural flora became predominantly Gram-positive again within 48 hours.
Urinary excretion of cyclic adenosine 3',5'-monophosphate and cyclic guanosine 3',5'-monophosphate in malignancy.
Authors: Gennari C , Francini G , Galli M , Lore F
Published: June 2007

The urinary excretion of cyclic adenosine 3',5'-monophosphate (cAMP), corrected for urinary creatinine, was determined in 177 patients with primary or metastatic tumours and in 149 normal subjects. In 26 patients with malignancy and in 10 control subjects the excretion of cyclic guanosine 3',5'-monophosphate (cGMP) was also evaluated. The urinary cAMP/Cr ratio in human neoplasms of epithelial origin was often significantly lower than normal, irrespective of the extension of malignancy. Surgical resection of the tumour, radiotherapy, or theophylline treatment increased urinary excretion of the nucleotide. In patients with malignancy, intravenous infusion of glucagon failed to produce the degree of elevation of plasma cAMP seen in normal subjects. Urines from patients with malignant neoplasms had low values of cAMP/Cr ratio with increased values of cGMP/Cr ratio. These findings could be the result of systemic alteration in synthesis or breakdown of the nucleotides.
Measurement of ferritin in serum by radioimmunoassay.
Authors: Barnett M D , Gordon Y B , Amess J A , Mollin D L
Published: June 2007

A method for the measurement of circulating ferritin concentrations by direct radioimmunoassay is presented. The method described is simple to operate, precise, and sensitive and is suitable for the routine diagnostic measurement of ferritin in either plasma or serum.
The liver and pancreas in acute necrotising pancreatitis.
Authors: Blenkinsopp W K
Published: June 2007

Pancreatic fibrosis was found in 23 of 31 cases of acute necrotising and haemorrhagic pancreatitis; however, in the cases with a history of six days or less neither the extent nor the frequency of fibrosis differed significantly from those in controls. There was no histological evidence that duct or vascular lesions are necessary for the disease to occur. The liver was examined in 26 cases and showed cholestasis in 12, including 10 of 20 cases without a biliary aetiology and only two of six cases with biliary tract disease. In no case did the liver show specific features of alcoholic damage.
Remote metastases from intracranial tumours.
Authors: Jackson A M , Graham D I
Published: June 2007

A review of the primary tumours of the nervous system encountered over the past 16 years from the population of the west of Scotland uncovered only three tumours in which remote extracranial metastases had developed. In all three, there had been surgical intervention before the appearance of metastases. The findings in these patients are compared with those in other published accounts of this unusual complication.
A microtechnique for measuring red cell osmotic fragility of infants.
Authors: Ryall R G , Chittleborough A J , Kane A
Published: June 2007

Chloramphenicol (D-threo-2-dichloroacetamido-1-p-nitrophenylpropane-1,3-diol) added to blood samples did not alter the observed shift in the red cell osmotic fragility curves as the samples were aged in vitro for 24 hours at 37 degrees C. Nor was the normal rate of loss of 2,3-diphosphoglycerate, ATP, or glutathione from the red cells affected by the presence of chloramphenicol over the same period. Consequently, this bacteriostatic agent can be added to blood samples taken under non-sterile conditions, such as from the heel of an infant, in order to preserve them from the effects of microbial contamination. In this way red cell osmotic fragility results can be obtained on non-sterile samples after their incubation at 37 degrees C for 24 hours. A miniaturisation of the standard osmotic fragility procedure is described, which allows results to be produced from the small, non-sterile samples obtained by heel-prick of infants.
C3d antiglobulin haemagglutination of human red blood cells. A demonstration of two types of cell-bound C3d by means of typsin digestion.
Authors: Hsu T C , Steinberg J , Sawitsky A
Published: June 2007

Washed human red blood cells from blood collected in EDTA were tested by Auto-Analyzer for a percentage of maximum antiglobulin haemagglutination (AH) using monospecific antisera to human C3d and C3c. The cells from normal persons were found to be agglutinated by anti-C3d but not by anti-C3c. To a fixed dilution of antiserum, the normal C3d AH values (X +/- 2 SD) were 34 +/- 19% for adult cells (n = 29) and 14 +/- 19% for cord cells (n = 19); the difference was significant (P less than 0.0001). By pretreatment of these cells with trypsin the C3d AH was either completely abolished or markedly reduced. Its difference between the adult and cord cells was eliminated as the observed values were 4 +/- 7% and 3 +/- 4% respectively (P = 0.15). The supernatant fluid of cell-trypsin mixture, treated with trypsin inhibitors, was found to be inhibitory to C3d AH but not to C3c AH. In contrast, the AH of C3d-coated red blood cells resulting from complement fixation in vivo (ie, cold agglutinin disease) or in vitro (eg, sucrose water reaction) was resistant to trypsin treatment. The difference between the trypsin-sensitive and trypsin-resistant cell-bound C3d is postulated to be at its attachment mechanism to the cell membranes. In addition, both the advantage and limitation of using trypsinised cells for C3d antiglobulin tests are demonstrated.
Antithrombin activities in childhood malnutrition.
Authors: Jiménez R A , Jiménez E , Ingram G I , Mora L A , Atmetlla F , Carrillo J M , Vargas W
Published: June 2007

Antithrombin activities in 30 severely malnourished children and 40 normal children were estimated in clotting tests by thrombin neutralisation as anti-Xa and by a heparin antithrombin assay; and by immunodiffusion as alpha 2-globulin and alpha 1-antitrypsin. The patients' mean alpha 2-globulin was severely depressed, and there were less marked depletions in mean values for thrombin neutralisation, anti-Xa, and in the heparin antithrombin assay (which showed the flat curve thought to reflect a thrombotic tendency). The alpha 1-antitrypsin values were normal. The findings support the concept of antithrombin as the summation of alpha 2-globulin and alpha 1-antitrypsin (with alpha 2-macroglobulin); and the low values may be related to the high incidence of thrombosis reported in childhood malnutrition, although it was not seen in these patients.
EB virus-specific IgA in serum of patients with infectious mononucleosis and of healthy people of different ages.
Authors: Edwards J M , Woodroof M
Published: June 2007

The following sera were tested for EB virus-specific IgA: serial sera from 61 cases of infectious mononucleosis (IM) and from 195 EBV IgG positive healthy students; single sera from each of 1469 persons of different ages, 63 cases of untreated Hodgkin's disease, and 22 neonates. EBV specific IgA was found in the sera from 88% of cases of IM, from 18.5% of EBV IgG positive healthy students, and in 13.5% of repeat samples from the same students three years later. The incidence of EBV IgA varied from 5 to 30% at different ages in single sera from EBV IgG positive persons aged 2 to 70 years. The higher percentages occurred in the age groups where recent sero-conversion rates were high. Fifteen percent of sera from cases of Hodgkin's disease were positive for EBV IgA, an incidence similar to that for healthy adults in the age group 25-45 years. None of the EBV IgG positive sera from neonates gave a positive reaction for EBV IGA.
Splenomegaly and splenectomy in sarcoidosis.
Authors: Webb A K , Mitchell D N , Bradstreet C M , Salsbury A J
Published: June 2007

The natural history of 30 patients with sarcoidosis who showed histological evidence of granulomatous involvement of the spleen has been studied; 24 patients had splenomegaly, 16 of whom had splenectomy. The main indication for splenectomy was splenomegaly and resultant discomfort. Corticosteroids reduced spleen size but reduction or withdrawal of the relatively high dosage required resulted in rebound splenomegaly within a period of three months to three years. Haematological abnormalities were controlled by splenectomy in all patients so affected, but the natural history of their sarcoidosis remained unaltered.
Analysis of reproducibility of subjective grading systems for breast carcinoma.
Authors: Stenkvist B , Westman-Naeser S , Vegelius J , Holmquist J , Nordin B , Bengtsson E , Eriksson O
Published: June 2007

The inter- and intra-observer reproducibility of three grading systems for breast cancer has been analysed: those of the World Health Organisation, of Black, and of Hartveit. In addition, the components forming the basis of these grading systems were analysed separately with regard to reproducibility and interrelationship. In this analysis, degree of differentiation was also included as a parameter. The grading systems of WHO and of Black gave a stratification of the material into three categories of tumours, but that of Hartveit did not. All three systems had a low inter- and intra-observer reproducibility. Truncated component analysis indicated that the grading systems of WHO and of Black are closely related to each other and to the 'nuclear lobulation' component of Hartveit's system. The components 'pleomorphism', 'mitotic frequency', and 'hyperchromasia' of the WHO system were closely interrelated. Descriptors such as 'differentiation' and 'tubule formation' were interrelated but acted in a different direction from the others.
Campylobacter colitis.
Authors: Willoughby C P , Piris J , Truelove S C
Published: June 2007

A patient is described in whom a campylobacter enteritis closely resembled ulcerative colitis on clinical, sigmoidoscopic, and histological grounds. Selective stool culture techniques may be necessary to differentiate campylobacter colitis from ulcerative colitis proper.
Acute diarrhoea: Campylobacter colitis and the role of rectal biopsy.
Authors: Price A B , Jewkes J , Sanderson P J
Published: June 2007

Campylobacter spp. were the organisms isolated most frequently from 29 consecutive patients admitted with acute diarrhoea to an infectious disease unit. Rectal biopsies taken from 21 of the patients were abnormal in all but four, and in the patients with campylobacter infection there was a characteristic proctocolitis in each case. The histopathology was similar to that described for salmonella and shigella infections but clearly different from typical ulcerative colitis and Crohn's disease. Therefore in patients with acute diarrhoea we suggest that selective culture for Campylobacter spp. should be made a routine and that rectal biopsy has an important diagnostic role, particularly in patients with negative cultures.
Carcinoma in situ of the male breast.
Authors: Cole F M , Qizilbash A H
Published: June 2007

Two cases of carcinoma in situ of the male breast are described: in one patient it arose as a complication of gynecomastia; in the other, it occurred 'de novo' and proceeded to infiltration with widespread metastases. We reviewed 233 cases diagnosed clinically and histopathologically as gynecomastia to see if we could discover other instances of malignant transformation but none was found. Thirty-two cases of infiltrating male breast cancer were also examined. In 11 there was associated intraduct change. In only one of the 32 cases was there evidence of associated microscopic gynecomastia.
Identification of viridans streptococci on the Minitek Miniaturised Differentiation System.
Authors: Holloway Y , Schaareman M , Dankert J
Published: June 2007

A total of 227 strains of viridans streptococci were simultaneously identified on the Minitek Miniaturised System (BBL) and by a conventional method according to Colman and Williams. The Minitek discs were each overlaid with a drop of sterile liquid paraffin, and the trays were incubated in GaSPak jars (BBL) with CO2 generator envelopes. Identification was possible three to four days earlier than with the conventional method. The results were found to be in agreement with the conventional method. Compared to the identification schemes of Cowan and Steel and of Facklam, the results were also in good agreement. Minor differences were found in the number of positive and negative results in those reactions that are variable in all three schemes.
Detection of anaerobic wound infection by analysis of pus swabs for volatile fatty acids by gas-liquid chromatography.
Authors: Reed P J , Sanderson P J
Published: June 2007

Swabs were able to absorb enough extractable volatile fatty acids from broth cultures of anaerobic organisms for detection and analysis by gas-liquid chromatography (GLC). Similarly, volatile fatty acids were often detected in swabs dipped into liquid pus. Fifty-three liquid pus specimens were then investigated fully to determine if GLC analysis of swab samples gave the same result as microbial culture of the specimens and GLC analysis of the liquid pus. Anaerobic bacteria failed to grow from 36 and volatile fatty acids were not extracted from swabs of 31 of these pus samples but were extracted from swabs of five. Anaerobic bacteria were isolated from 17 of the specimens, and in 15, volatile fatty acids were also detected in the swab samples; in two, volatile fatty acids were absent from both swab samples and liquid pus. In this study, results by culture and GLC analysis of swabs were similar in 87% of specimens.
Serodiagnosis of Trichomonas vaginalis infection by the indirect fluorescent antibody test.
Authors: Mason P R
Published: June 2007

The indirect fluorescent antibody test was used to detect antibodies to Trichomonas vaginalis in 200 antenatal patients. A total of 104 (52%) gave a positive reaction with antigen prepared from cultures of trichomonas isolated from seven of the patients. Antitrichomonal antibody was detected at a 1/4 dilution in 90% of patients with proven trichomoniasis, while the highest dilution at which antibody was detected was 1/32. IgG rather than IgM appeared to be the antibody class involved. Of those patients with no demonstrable trichomonal infection, 17% gave positive reactions at 1/4 dilution, while 64% had no demonstrable antibody. One of 30 children under 11 years of age gave a positive reaction.
Pseudomembranous colitis in a leukaemia unit: a report of five fatal cases.
Authors: Milligan D W , Kelly J K
Published: June 2007

Five cases of clindamycin-associated pseudomembranous colitis in leukaemic patients are reported. These cases were all fatal, and it is suggested that the use of clindamycin in leukaemic patients should be reserved for specific indications.
Hairy-cell leukaemia: an immunoperoxidase study of paraffin-embedded tissues.
Authors: Gooi J H , Burns G F , Cawley J C
Published: June 2007

Paraffin sections of a variety of tissues from 12 patients with typical hairy-cell leukaemia (HCL) were stained for immunoglobulin heavy and light chains by the peroxidase-antiperoxidase (PAP) technique. Plasma cells were frequent, particularly in a lymph node from a severely infected patient. The reactive nature of the plasma cells of HCL was suggested by the fact that there was no restriction of light-chain expression, although viable hairy cells were shown to express monoclonal surface immunoglobulin. This, together with the absence by both light and electron microscopy of forms intermediate between hairy cells and plasma cells and the lack of ribosome-lamella complexes in the plasma cells, suggested that hairy cells do not differentiate into plasma cells. Although hairy cells are known to contain immunoglobulin, this was not demonstrable in hairy cells in the paraffin-embedded tissue. The PAP technique was also useful for demonstrating abundant splenic macrophages in HCL.
Detection of human antibodies to hepatitis B surface antigen (HBsAg) by an enzyme-immunoassay for HBsAg.
Authors: Wolters G , Kuijpers L , Schuurs A
Published: June 2007

We studied the feasibility of detecting antibody to hepatitis B surface antigen (anti-HBs) by an inhibition assay using the reagents of an enzyme-immunoassay for HBsAg (Hepanostika). Several modifications of the basic assay were investigated. Sensitivity was greatest when the test sample was incubated with a predetermined amount of HBsAg before the usual procedure of HBsAg detection. The presence of anti-HBs in the test sample was shown by a reduction of the solid-phase bound enzyme label. Results were obtained with a dilution series of serum samples containing anti-HBs, the anti-HBs Reference Panel of the American Bureau of Biologics, sera of hepatitis B patients, and sera of two individuals passively immunised with anti-HBs. The enzyme-immunoassay method showed at least the same sensitivity as passive haemagglutination. It was less sensitive than a commercially available radioimmunoassay (Ausab). There are no indications that non-specific reactions occur frequently. This study also revealed that the antigenaemia of acute hepatitis-B patients can be interrupted by a transient seroconversion.
An approach to quality and performance control in a computer-assisted clinical chemistry laboratory.
Authors: Undrill P E , Frazer S C
Published: June 2007

A locally developed, computer-based clinical chemistry laboratory system has been in operation since 1970. This utilises a Digital Equipment Co Ltd PDP 12 and an interconnected PDP 8/F computer. Details are presented of the performance and quality control techniques incorporated into the system. Laboratory performance is assessed through analysis of results from fixed-level control sera as well as from cumulative sum methods. At a simple level the presentation may be considered purely indicative, while at a more sophisticated level statistical concepts have been introduced to aid the laboratory controller in decision-making processes.
An interfering factor in the automated analysis of calcium.
Authors: Gosling P , Sammons H G
Published: June 2007

The widespread use of stainless steel for sample probes, connectors, and sample stream splitters in autoanalyser systems can lead to significant differences in the amount of calcium available for analysis. At alkaline pH calcium can be adsorbed onto the metallic components of the sampling system, and under more acidic conditions calcium can be released. Thus an alkaline sample will have an apparently reduced calcium content, while a more acidic sample may have an apparently increased concentration of calcium. By using non-metallic components in the sampling system this source of error an be eliminated.
Hepatitis Be antigen and antibody in hepatitis B surface antigen positive blood donors.
Authors: Barr A , Black S H , Burrell C J , Dow B , Macvarish I
Published: June 2007

In a study of 105 asymptomatic HBsAg positive blood donors, 9 (8.6%) were found to have HBeAg, 38 (36.2%) anti-HBe, and the remaining 58 (55.2%) neither marker detectable by gel diffusion. There was no correlation between HBeAg/anti-HBe status and HBsAg sub-types, Glm allotypes, the presence of anti-Gm, red cell antibodies, or rheumatoid factor. Rheumatoid factor activity could be removed from anti-HBe positive sera without removing anti-HBe activity, indicating that separate entities were involved. HBeAg was found only in donors under the age of 30 (P less than 0.005), while anti-HBe did not show an age-related trend. HBeAg was also found less commonly in donors of blood group A than in the total carrier population (P less than 0.05), indicating an apparent protection in carriers of group A. The blood group distribution for the 105 HBsAg positive donors was similar to that of the general population.
Anti blood group-M autoantibodies with livedo reticularis, Raynaud's phenomenon, and anaemia.
Authors: Sangster J M , Kenwright M G , Walker M P , Pembroke A C
Published: June 2007

A 63-year-old woman presented with Raynaud's phenomenon and extensive cold-induced livedo reticularis. A skin biopsy showed no abnormality of the blood vessels but the blood contained high titres of a very unusual autoantibody against the M blood group, most active at low temperatures. An IgM cryoglobulin was detected, and anti-M activity was found in this fraction. The cells of the patient were grouped as MM. The direct antiglobulin test was positive due to C3 component of complement bound to the red cells. The haematological and biochemical results indicate a mild haemolytic process, which is at present well compensated.
Serum cystyl aminopeptidase activity in the 36th week of pregnancy.
Authors: Durham B H , Rewell R E
Published: June 2007

Serum cystyl aminopeptidase (CAS) activity was estimated at 36 weeks' gestation in 209 normotensive pregnancies. The highest activity was found in 31 women who had spontaneous deliveries before 38 weeks' gestation and the lowest in 76 women who were induced after term. The enzyme levels in 117 women who developed hypertension of pregnancy were higher than for normotensives; the highest levels were found in 32 women with pre-eclampsia. A correlation was found between serum CAS activity at 36 weeks' gestation and the birth weight of babies of women who went into spontaneous labour at term (277 to 283 days' gestation).
A case of gamma 3 heavy chain disease with vacuolated plasma cells: a clinical, immunological, and ultrastructural study.
Authors: Feremans W , Caudron M , Bieva C
Published: June 2007

A patient with lambda Bence-Jones proteinuria, Waldenström's macroglobulinaemia, and Franklin's disease (gamma HCD), but without clinical evidence of a lymphoproliferative disorder, is presented. The serum contained two distinct immunoglobulin abnormalities: a monoclonal immunoglobulin M (IgM) of lambda type, and a protein fragment which was immunologically related to immunoglobulin G (IgG) and devoid of light chain activity. This gamma HCD protein belongs to the gamma 3 subclass with a molecular weight of approximately 60,000 daltons. The urine contained a Bence-Jones lambda protein as well as the gamma HCD fragment. The two paraproteins were probably secreted by two different malignant clones. Ultrastructural study revealed pathological vacuolated plasma cells of a sort that has hitherto been principally described in association with micron HCD. The mechanism of the intracellular storage of pathological immunoglobulins is discussed in the light of the ultrastructural study.
Limits to progressive reduction of resident skin bacteria by disinfection.
Authors: Lilly H A , Lowbury E J , Wilkins M D
Published: June 2007

Antiseptic preparations used repeatedly to disinfect the skin caused a reduction in yield of resident flora to a low equilibrium level beyond which further reduction did not occur. This equilibrium varied with the antiseptic preparation used. In a comparison of three preparations, the lowest equilibrium level was obtained with 95% ethyl alcohol. The further reduction in yield of skin bacteria on using alcohol after repeated disinfection with an antiseptic detergent preparation ('two-phase' disinfection) was not paralleled by a further reduction when the preparations used in the two phases were reversed, the antiseptic detergent being used after repeated disinfection with ethyl alcohol. 'Two-phase' disinfection was therefore seen to be due to further reduction in skin bacteria from the low equilibrium obtained with the antiseptic detergent to the lower level obtainable by alcohol disinfection. When repeated disinfection to equilibrium with alcohol was followed by a 'second-phase' handwash with a non-antiseptic detergent and water, there was a large increase in the yield of skin bacteria. This finding supports the view that a low equilibrium level occurs when the reduction in density of accessible bacteria through disinfection is balanced by the emergence of bacteria drawn from deeper layers of the skin.
Platelet function in beta-thalassaemia major.
Authors: Hussain M A , Hutton R A , Pavlidou O , Hoffbrand A V
Published: June 2007

Abnormal platelet aggregation was found in eight (44%) of 18 patients with beta-thalassaemia major and transfusional iron overload. The aggregation defect bore no correlation with the degree of hepatic fibrosis, liver function tests, whether or not splenectomy had been performed, the degree of iron overload, haematocrit, platelet count, serum vitamin E level, or leucocyte ascorbate concentration. Only three of the 18 patients showed prolonged bleeding times as well as abnormal platelet aggregation, and only one of these suffered clinically significant haemorrhage. The results show that a proportion of patients with beta-thalassaemia major have abnormal platelet function. It is possible, however, that the in vitro abnormality might be due partly to artefacts induced by manipulations required to remove the abnormal thalassaemic red cells, and this may explain the much lower incidence of significant haemorrhage.