bluuebunny/crossref_metadata_2025 huggingface dataset:
DNA hybridisation of cervical scrapes: comparison with cytological findings in Papanicolaou smears.
Authors: Morse A R , Wickenden C , Byrne M , Taylor-Robinson D , Smith J , Anderson M C , Smith C , Malcolm A D , Coleman D V
Published: June 2007

One hundred and sixty four cervical scrapes were taken over 26 months from 143 women aged 17 to 53 years, using an Ayre spatula. A smear was prepared from each sample for Papanicolaou staining and for cytological examination for evidence of human papillomavirus (HPV) infection. The cells remaining on the spatula were harvested for DNA analysis. These samples were probed for HPV 6, 16, and 18 and the results of DNA hybridisation and cytology were compared. Cytological changes of HPV (anucleate keratinised and keratinised squamous cells, koilocytic change and dyskeratosis, or multinucleation, or both) were detected in 103 (72%) of the samples where HPV DNA was detected; koilocytic changes were present in only 67 (48%). It is concluded that screening for a range of viral changes is a more sensitive method of detecting HPV infection than screening for koilocytic change alone.
Immunocytochemical study of the cellular immune response in meningiomas.
Authors: Rossi M L , Cruz Sanchez F , Hughes J T , Esiri M M , Coakham H B
Published: June 2007

Twenty four meningiomas (17 benign and seven "atypical" were reacted with a panel of monoclonal antibodies to macrophages, lymphocytes, and HLA DR antigens. All the tumours contained macrophages but these cells were more numerous in the atypical meningiomas. Lymphocytes, almost exclusively of the CD8 subtype, were also present in 70% of benign meningiomas and in all atypical meningiomas and were more abundant in the latter. B lymphocytes were present in minimal numbers in three atypical meningiomas and in one benign meningioma. CD4 positive T lymphocytes were present in small numbers in one benign meningioma and in moderate numbers in one atypical meningioma. HLA DR antigen expression on tumour cells was present in about 60% of both tumour groups. The numbers of macrophages and T and CD8 lymphocytes in meningiomas seem to be related to atypical histological features, and the presence of these cells raises questions about host immune response and the relation of this to prognosis.
Use of lectin histochemistry in pancreatic cancer.
Authors: Ching C K , Black R , Helliwell T , Savage A , Barr H , Rhodes J M
Published: June 2007

Lectin peroxidase histochemical analysis was carried out on pancreatic tissue from patients with pancreatic carcinoma and chronic pancreatitis and from subjects with normal pancreas to find a tumour specific pattern of lectin binding that would aid histological and cytological diagnosis. There were striking differences between the lectin binding characteristics of the different cell types in the normal pancreas. Acinar cells were uniformly positive for binding with wheat germ agglutinin and soy bean agglutinin while islet cells were usually negative for these lectins. Ulex europaeus I lectin however, was found not to be specific for endothelium, showing positivity also for acinar and ductal tissue. Griffonia simplicifolia II lectin was found to be highly specific for ductal epithelium, and because of this was tested in a hamster pancreatic cancer model where it was not specific for ductal epithelium, reflecting differing carbohydrate expression in the hamster pancreas. Pancreatic carcinomas and chronic pancreatitis bound all five lectins without any qualitative distinction from each other or from normal pancreatic tissue, but there was increased intensity of peanut agglutinin binding to secreted mucins in pancreatic carcinoma, which may be of potential use in radiolabelled lectin scanning.
Flat in situ carcinoma of the bladder: cytological examination of urine in diagnosis, follow up, and assessment of response to chemotherapy.
Authors: Highman W J
Published: June 2007

Urine cytology was performed for the diagnosis and follow up of flat carcinoma in situ (CIS) of the bladder in a series of 35 patients without associated or previous bladder tumours. Ninety six per cent had positive or suspicious cytology at initial presentation. There were no false positive reports. Cytological diagnosis of malignancy was made before biopsy in 24 patients: CIS in voided urine presents as flat sheets of five to 15 cells with features of high grade malignancy. Development of tumour during follow up was suggested by the appearance of large thick sheets and clusters of 30 or more malignant cells which were large and pleomorphic in high grade tumours and relatively small and closely cohesive in low grade tumours. Eleven of 13 patients with these clusters had bladder or ureteric tumours and two had malignant disease in the prostate. Negative cytological results in the presence of degenerative changes caused by chemotherapy was an unreliable indicator of response to chemotherapy, and there were five patients with false negative reports during treatment, of whom three had developed tumour. Persistence of malignant cells with features similar to those seen in the urine before treatment reliably predicted failure to respond to chemotherapy.
Expression of epithelial membrane and 3-fucosyl-N-acetyllactosamine antigens in cervix uteri with particular reference to adenocarcinoma in situ.
Authors: Rollason T P , Byrne P , Williams A , Brown G
Published: June 2007

The staining patterns obtained with antiepithelial membrane antigen (anti-EMA) and the monoclonal antibody to 3-fucosyl-N-acetyllactosamine (AGF 4:48) in the uterine cervix in intraepithelial and invasive neoplasia were compared to determine a possible role in differential diagnosis of reactive and neoplastic conditions. Both early invasive and in situ adenocarcinoma stained equally intensely with both agents and both antibodies stained diffusely tubal metaplasia, endometrial lined glands, and even occasional areas of normal endocervical mucosa. It is concluded that these agents are unlikely to be of use in the routine histological differentiation of glandular and squamous cervical dysplasia or neoplasia, but immunostaining with anti-EMA may help differentiate between reactive and metaplastic changes in endocervical glands and adenocarcinoma in situ.
Rapid diagnosis of whooping cough using monoclonal antibody.
Authors: Boreland P C , Gillespie S H , Ashworth L A
Published: June 2007

A counterimmunoelectrophoresis (CIE) method for antigen detection using monoclonal antibody was assessed for its ability to aid in the rapid diagnosis of Bordetella pertussis in 59 patients. A positive diagnosis from a combination of results from tests of serum and urine was obtained in 51 (87%) of cases. For sera, CIE had a sensitivity of 85% and a specificity of 94%; for urine samples the sensitivity was 81% and a specificity of 100%. Antigen detection by CIE is simple to perform and yields results on the same day, thus allowing treatment to begin at an early stage.
Microwave irradiation of human brain tissue: production of microscopic slides within one day.
Authors: Boon M E , Marani E , Adriolo P J , Steffelaar J W , Bots G T , Kok L P
Published: June 2007

A three step method using microwave irradiation enabled microscopic slides of human brain tissue to be obtained within one working day: steps 1 and 2 hardened and solidified brain tissue; step 3 completed formalin fixation. The efficacy and precision of the method was compared with slides of conventionally processed brain tissue that had been fixed in formalin for six weeks. The microscopic quality of the sections was excellent with good presentation of brain tissue and equalled that of conventionally processed slides.
Inflammatory pseudotumour of spleen.
Authors: McMahon R F
Published: June 2007

A case of inflammatory pseudotumour of spleen in which plasma cells were the predominant cell type, is described. It presented as multiple nodules in the spleen of a 37 year old woman who died of myocardial infarction, and was an incidental finding at necropsy. Plasma cells were the dominant cell type, and the admixture of other cells within the mass and the lack of a monotypic light chain/immunoglobulin phenotype on immunohistochemical analysis precluded a diagnosis of malignant disease. The potential for misinterpretation of this lesion as a neoplasm is considerable and its recognition may therefore be of great clinical importance.
Vegetarian diet and cobalamin deficiency: their association with tuberculosis.
Authors: Chanarin I , Stephenson E
Published: June 2007

To determine whether the high incidence of tuberculosis among Asiatic Indians in the United Kingdom was due to impaired killing of Mycobacterium tuberculosis by macrophages from patients deficient in cobalamin, a nutritional survey was carried out among 1187 Indians and the incidence of tuberculosis determined from medical records. The question asked was whether tuberculosis was significantly more common among life-long vegetarians compared with omnivores. The incidence of tuberculosis in vegetarians was 133 in 1000 and that in subjects on mixed diets 48 in 1000. These findings lend support to the hypothesis that dietary factors are of major importance in determining the susceptibility of Asiatic Indians to tuberculosis.
The confidential enquiry into maternal deaths: its role and importance for pathologists.
Authors: Dawson I
Published: June 2007

Comparatively few pathologists seem to know of the existence of the confidential enquiry into maternal deaths and fewer still know anything of its aims or its methods of obtaining confidential information. As the success of any such enquiry depends greatly on the accuracy and completeness of necropsy, histological, and other laboratory reports a brief account of the report itself and the role of pathologists in it may not be out of place.
Post mortem radiology in children with congenital heart disease.
Authors: Russell G A , Berry P J
Published: June 2007

Contrast radiology has valuable applications in routine necropsy practice. Contrast radiology was used to study the vascular anatomy in four normal fetuses, in five children with cardiovascular malformations, and in two hearts prepared by the perfusion fixation method. A contrast radiograph provides permanent documentation of anatomical associations before they are disrupted by dissection and permits a planned approach to the necropsy. While these injection studies are seldom undertaken by pathologists because they are felt to be too difficult and time-consuming, contrast studies should form part of the post mortem investigation of children with congenital heart disease, even when angiography has been performed in life.
Use of immunohistochemical methods in the differential diagnosis between primary cerebellar haemangioblastoma and metastatic renal carcinoma.
Authors: Gouldesbrough D R , Bell J E , Gordon A
Published: June 2007

The potential role of immunohistochemistry in making the distinction between primary cerebellar haemangioblastoma and metastatic renal carcinoma was investigated by examining the reaction pattern of 10 cerebellar haemangioblastomas (seven women, three men, aged 20-40 years) and 10 primary renal carcinomas (six men, four women, aged 49-82 years) to a panel of epithelial, glial, and neural/neuroendocrine antisera. The tumour cell membranes of the renal carcinomas stained strongly with epithelial membrane antigen (EMA); membrane staining was totally absent in the haemangioblastomas. Strong neurone specific enolase (NSE) and S100 staining were also seen in haemangioblastomas but were more variable than EMA staining in renal carcinomas. It is concluded that a panel of antisera is required to distinguish between histologically similar areas in primary haemangioblastomas and metastatic renal carcinomas, and that while complementing conventional histological techniques, new problems of interpretation result which must be taken into account.
Prognostic indicators in centroblastic-centrocytic lymphoma.
Authors: Griffin N R , Howard M R , Quirke P , O'Brien C J , Child J A , Bird C C
Published: June 2007

The prognostic importance of ploidy and proliferative index (%S + G2) assessed by flow cytometry, mitotic and centroblast counts, and histological growth pattern were evaluated in biopsy specimens taken before treatment from 60 cases of centroblastic-centrocytic non-Hodgkin's lymphoma. Cases with a high proliferative index (greater than or equal to 18%) or DNA aneuploidy showed significantly poorer survival than those with a low proliferative index (less than 18%). A high mitotic count was also associated with a poor prognosis. On multiple regression analysis the flow cytometric assessments and mitotic counts were significant predictors of survival. Assessments of proliferative activity clearly have prognostic potential in centroblastic-centrocytic lymphoma and may permit more accurate characterisation of individual tumours.
Renal impairment in myeloma: negative association with isoelectric point of excreted Bence-Jones protein.
Authors: Norden A G , Flynn F V , Fulcher L M , Richards J D
Published: June 2007

The isoelectric point (pI) of the major form of Bence-Jones protein excreted by 62 patients with myeloma and six with macroglobulinaemia was measured by combining isoelectric focusing with immunoblotting techniques. The distribution of the pI values for both kappa and lambda type proteins was bimodal, most falling in the ranges 5.0-6.0 and 7.0-7.5. Plasma creatinine and creatinine clearance and the urine excretion of alpha-1-microglobulin and beta-2-microglobulin were measured in 24 of the patients. These patients, who were free of additional factors known to have an association with the development of renal impairment, were followed up for a mean period of 16 months (range three to 28 months). It was found that renal impairment was not related to the pI of the Bence-Jones protein excreted.
Circulating immune complexes after splenectomy.
Authors: Donadi E A , Carvalho I F , Falcão R P
Published: June 2007

Circulating immune complexes were evaluated in 25 patients (age range 10 to 46 years) who had undergone splenectomy for non-malignant conditions by studying a polyethylene glycol insoluble serum fraction. Although the extent of binding to Clq was within normal limits, these patients had increased concentrations of factor B in the immune complex serum fraction. These findings indicate that an unusual type of circulating immune complex may be detected after splenectomy, suggesting a possible role for the spleen in the removal of circulating immune complexes.
Use of immunochemistry in Britain: EQA forum antibody usage questionnaire.
Authors: Angel C A , Heyderman E , Lauder I
Published: June 2007

A questionnaire was prepared under the auspices of the Department of Health with the aim of defining the extent and nature of immunocytochemistry use within pathology departments. The questionnaire was circulated to 320 pathology laboratories within the United Kingdom, and a total of 178 replies were received, representing a response rate of 56%. One hundred and thirty eight (78%) of the respondents used immunocytochemical techniques: 64 used immunocytochemical kits, including 35 district general hospital and 29 teaching hospital laboratories. An extensive range of antibodies was being used on a variety of tissues, epithelial and lymphoid markers far exceeding all other antibodies. Several differences in the numbers of cases and the types of tissues studied were identified among laboratories. The techniques used, the problems encountered, and the procedures followed with unsatisfactory reagents were also analysed. Finally, an assessment of the resources allocated to immunocytochemistry, both in terms of staff and reagent costs was made. Taking into account the response rate of 56% and the uncertainty that all pathology departments in the United Kingdom had been circulated, the estimated annual total costs for immunocytochemistry for all pathology laboratories in the United Kingdom was 5.4 million pounds.
Imprint cytology in immunocytochemical analysis of oestrogen and progesterone receptors of breast carcinoma.
Authors: Helin H J , Isola J J , Helin M J , Helle M J , Krohn K J
Published: June 2007

Cytological imprint material from 26 mammary carcinomas was stained with monoclonal antibodies to oestrogen and progesterone receptors in an immunoperoxidase procedure. The staining result was compared with that of parallel stainings of frozen tissue sections of the same tumours. The peroxidase reactions in both techniques were semiquantitatively assessed (histoscore). In both sets of stainings the results agreed in 25 of 26 cases (oestrogen receptor: 19 positive, six negative; progesterone receptor: 14 positive, 11 negative). The histoscores of imprint preparations and cryostat sections showed a significant correlation in linear regression analysis (oestrogen receptor: r = 0.755, p less than 0.001; progesterone receptor: r = 0.740, p less than 0.001). Imprint cytology is simple, does not require expensive instruments, and no separate specimen has to be sequestered. It is especially suitable for immunocytochemical steroid receptor analysis of small breast carcinomas.
Prognostic value of prostaglandin F2 alpha concentrations in breast carcinoma.
Authors: van Dam P A , Vergote I B , Laekeman G M , Keersmaeckers G H , Uyttenbroeck F L , Herman A G
Published: June 2007

Prostaglandin F2 alpha (PGF2 alpha) concentrations were measured by radioimmunoassay in homogenised primary tumours from 57 patients with breast cancer. These patients were followed up from 60 to 78 months (median 63 months) after surgery and PGF2 alpha concentrations were related prospectively to metastatic spread and survival. The amounts of PGF2 alpha varied greatly in the different tumours (range 0-90 ng/mg protein), but no significant association was found between PGF2 alpha concentrations and disease free survival, time of relapse, site of recurrence, or overall survival. It therefore seems unlikely that measurement of PGF2 alpha in breast carcinoma is important in the prognosis of the disease.
Cytomegalovirus infection in gastrointestinal tracts of patients infected with HIV-1 or AIDS.
Authors: Francis N D , Boylston A W , Roberts A H , Parkin J M , Pinching A J
Published: June 2007

All gastrointestinal tract biopsy specimens from 190 patients positive for HIV-1 or with AIDS were reviewed to assess the prevalence of cytomegalovirus (CMV) infection, morphology of infected cells, and the associated histopathological features. Eighteen patients (10 (7.7%) of 129 HIV antibody positive and eight (13.1%) of 61 with AIDS) had CMV identified in 35 biopsy specimens from the following sites: oesophagus (n = 3); stomach (n = 6); small intestine (n = 4); colorectum (n = 18) and perianal area (n = 4). Eleven patients had CMV alone as the potential cause of symptoms and in seven there were coexistent pathogens or Kaposi's sarcoma. The appearance and type of infected cells at different sites was highly variable. Immunocytochemical techniques and electron microscopic examination were performed to confirm the presence of CMV antigen and CMV virus particles and to exclude the possibility of an adenovirus producing similar cytopathic changes. It is important to recognise the different morphological forms of infected cells, and the use of immunocytochemical techniques is recommended in patients at risk for CMV or in whom CMV infection is suspected.
Comparative quality assessment in immunocytochemistry: pilot study of CD15 staining in paraffin wax embedded tissue in Hodgkin's disease.
Authors: Angel C A , Warford A , Day S J , Lauder I
Published: June 2007

The feasibility of comparative quality assessment studies in immunocytochemistry was examined. The reactions of three CD15 antibodies--anti-Leu M1, DM1, and Tü9--were examined in paraffin wax sections in Hodgkin's disease under a variety of different fixation and pre-treatment conditions, using four immunochemical detection techniques. All three antibodies stained Reed-Sternberg cells, but DM1 could be used at slightly higher dilutions to achieve comparable results. Tissue fixed in formol sublimate showed the most intense staining reactions, and formol saline and neutral buffered formalin gave relatively poor results. Although neuraminidase pre-treatment improved staining, its routine use is probably contraindicated by its high cost. Trypsinisation has some value for sections of tissue fixed in formol saline and neutral buffered formalin. The avidin-biotin complex technique produced the best results, but indirect immunoperoxidase produced acceptable results, is technically easier to perform, and is less expensive. It is concluded that information regarding variations in techniques and commercially available reagents, which may be of use in routine diagnostic histopathology, can be obtained by comparative quality assessment studies of this type.
New method for preserving cytology specimens.
Authors: McCorriston J
Published: June 2007

A method of freezing cytological material for long term storage, based on a modification of that used in tissue typing for the storage of lymphocytes, was developed. The method entails the centrifugation of the specimen, adding 1 ml AB or fetal calf serum and 1 ml 20% dimethyl sulphoxide aliquoted into 2 ml tubes, and storage at -70 degrees C. Cytological detail was well preserved in a variety of samples including fine needle aspirates, urine, and bronchial brushings. Three dimensional architecture was also preserved. The method is practical, easy to perform, and allows retrospective studies to be undertaken with the subsequent use of a variety of special staining techniques, including immunocytochemistry.
Diagnosis of acute myocardial infarction from sequential enzyme measurements obtained within 12 hours of admission to hospital.
Authors: Collinson P O , Ramhamadany E M , Rosalki S B , Joffe J , Evans D H , Fink R S , Greenwood T W , Baird I M
Published: June 2007

A prospective study was made of sequential changes in serum creatine kinase (CK) and CK-MB isoenzyme activity within the 12 hours following admission to the coronary care unit on 65 patients with recent chest pain. CK determinations were performed in the laboratory or in the coronary care unit using a dry reagent strip analyser. Slope values for log CK/hour and log CK-MB/hour were calculated, used to confirm or exclude the diagnosis of myocardial infarction, and compared with diagnosis by conventional means. Compared with retrospective diagnosis using all available information, the CK slope had a sensitivity of 100% and a specificity of 94%. This compared with a sensitivity of 94% and specificity of 90% for diagnosis using upper reference limits alone. Determination of CK slope permits very rapid and accurate biochemical confirmation or exclusion of myocardial infarction and the possibility of performing the measurements on the coronary care unit. It additionally offers the prospect of major cost savings resulting from early discharge or transfer from the coronary care unit.
Is low proteinuria an early predictor of severity of acute pancreatitis?
Authors: Shearman C P , Gosling P , Walker K J
Published: June 2007

Serial six hourly urine collections were made for seven days on 20 patients with acute pancreatitis. Quantitative immunoassay of urinary albumin and IgG on the first urine sample after admission showed increased excretion rates in 14 and 13 patients, respectively. Urinary protein excretion rates remained normal or approached normal by seven days in 17 patients who made uneventful recoveries. The maximum urinary excretion rates of both albumin and IgG within the first 36 hours correlated with the serum C-reactive protein concentration 72 hours after admission. The highest IgG excretion rates were found in three patients who later developed severe complications. These preliminary data suggest that low proteinuria is a very early response in acute pancreatitis, and that it may reflect the severity of inflammation.
Brown adipose tissue activity in pyrexial cases of cot death.
Authors: Lean M E , Jennings G
Published: June 2007

Brown adipose tissue was investigated in two cases of cot death in which core temperatures were above 40 degrees C on arrival at the mortuary. Evidence was obtained from mitochondrial (8-3H) guanosine diphosphate (GDP) binding and oxygen uptake of active thermogenesis with uncoupled mitochondrial respiration which was recoupled by GDP. Thermogenic capacity of brown adipose tissue, estimated by radioimmunoassay of the specific mitochondrial membrane "uncoupling protein" responsible for heat production, was similar to that measured in other infants or in experimental animals acclimated to moderately warm conditions (23 degrees C). Brown adipose tissue thermogenesis, occurring inappropriately in a warm, well insulated infant, could be a cause of some cases of cot death.
Portal lymphadenopathy associated with lipofuscin in chronic cholestatic liver disease.
Authors: Hübscher S G , Harrison R F
Published: June 2007

To determine whether portal lymphadenopathy in primary biliary cirrhosis is caused by deposition of lipofuscin pigment in sinus histiocytes and to compare primary biliary cirrhosis with other liver diseases a retrospective study on a consecutive series of 169 livers obtained at transplantation was carried out. There were grouped into eight diagnostic categories: primary biliary cirrhosis (n = 51), primary sclerosing cholangitis (n = 10), extrahepatic biliary atresia (n = 6), chronic rejection (n = 9), cirrhosis (other causes) (n = 38), primary liver neoplasia (n = 21), acute liver disease (n = 20), and retransplantation (other) (n = 14). Lymph nodes were present in 66 specimens. Fifty of these contained granules of lipofuscin pigment. The highest incidence of lymph node enlargement and the largest amounts of pigment were present in cases of primary biliary cirrhosis. A similar pattern of lymph node enlargement was also commonly observed in other chronic cholestatic conditions (primary sclerosing cholangitis, biliary atresia, chronic rejection). Much less pigment was seen in nodes draining livers with non-cholestatic cirrhosis or primary tumours. Nodes were not found in acute liver disease. It is concluded that portal lymphadenopathy associated with lipofuscin is a common finding in various chronic cholestatic liver diseases. The pathogenesis of this lesion is uncertain. Most cases are asymptomatic with enlarged nodes which may be detected only at laperotomy or necropsy and may be wrongly attributed to neoplastic disease. Diagnostically, the finding of large amounts of lipofuscin in enlarged portal lymph nodes is a good indicator of underlying chronic cholestatic liver disease.
Type IV collagen and laminin staining patterns in benign and malignant cutaneous lesions.
Authors: Mackie R M , Clelland D B , Skerrow C J
Published: June 2007

The presence of both laminin and type IV collagen was sought at the dermo-epidermal junction and in the dermis adjacent to benign melanocytic naevi of the junctional, compound, and intradermal types; dysplastic naevi; and both primary and secondary melanoma. In all, 154 lesions were studied, using antibodies to laminin and type IV collagen and an indirect immunoperoxidase technique. The staining patterns seen with the two antibodies were virtually identical, although that of laminin was generally fainter. Breaks in and thinning of the normally continuous line of type IV collagen and laminin at the dermo-epidermal junction were seen in association with the junctional activity of benign naevi, and in malignant melanomas in association with invasive tumour cells. Both benign and malignant cells of the melanocyte series showed relatively light pericellular staining around individual cells and clusters of cells in the papillary dermis. This staining pattern was much stronger in the deeper reticular dermis. It is concluded that the pattern of staining of these two antibodies and in particular the presence of breaks in type IV collagen and laminin at the dermo-epidermal junction are not specific for either benign or malignant melanocytic lesions and cannot be used as a diagnostic marker of invasive malignancy.
Quality assurance programme for necropsies.
Authors: Harrison M , Hourihane D O
Published: June 2007

One hundred and eight consecutive necropsies were entered into a quality assessment of the necropsy service in this hospital using a previously published American protocol. Our results were similar to those of the American series, with confirmation of the major clinical diagnosis in 75%, but a higher rate of unsuspected diagnosis (44%). Necropsy was helpful in 58% of cases. The presentation of selected cases at a monthly conference on causes of death was valuable in correlating clinical and pathological findings, and in helping integrate both services.
Use of APAAP technique on paraffin wax embedded bone marrow trephines.
Authors: Erber W N , McLachlan J
Published: June 2007

The immunoalkaline phosphatase (APAAP) technique was applied to the labelling of decalcified sections of formalin fixed, paraffin wax embedded bone marrow trephine biopsy specimens. A panel of monoclonal antibodies reactive with haemopoietic and epithelial antigens, which survive routine formalin fixation, was assessed on 72 cases of haematological malignancy (including acute and chronic leukaemias and lymphomas) showing bone marrow infiltration. The APAAP method showed clear distinct labelling of antigen positive cells without loss of antigens due to decalcification. Both normal or reactive single cells present in the sample and neoplastic cell populations could be identified morphologically and their antigenic phenotype and cellular origin, whether lymphoid or myeloid, established. The application of the APAAP method to routinely prepared paraffin wax embedded trephines has many advantages over the assessment of specially prepared cryostat sections of bone marrow.
Laboratory based study of undetectable thyroid stimulating hormone.
Authors: Pollock M A , Jones A
Published: June 2007

The clinical importance of an undetectable thyroid stimulating hormone (TSH) concentration (less than 0.2 mU/l) was studied in a consecutive series of 2573 requests for routine thyroid function tests. Two hundred and seventeen (8.4%) patients had an undetectable TSH concentration, and of these 39 (18%) had otherwise normal thyroid hormone concentrations and no history of thyroid disease. In a follow up study 71 patients (34 outpatients and 37 inpatients) with undetectable TSH concentration associated with otherwise normal thyroid hormone concentrations were randomly selected during routine reporting of thyroid function test results. None of these patients had a history of thyroid disease. Sex hormone binding globulin concentrations were increased in five out of 50 of these patients and antithyroid antibodies were detectable in four out of 49, suggesting that in most cases the isolated undetectable TSH concentration was not associated with thyroid dysfunction, particularly hyperthyroidism. Isolated undetectable TSH concentration was observed in both inpatients and outpatients and was not associated with any particular clinical condition. Repeat specimens were received in 54 of the 71 patients and TSH concentration remained persistently undetectable in 35 of these.
Are AgNORs useful in distinguishing follicular hyperplasia from follicular lymphoma?
Authors: Cronin K , Loftus B M , Dervan P A
Published: June 2007

Argyrophilic nucleolar organiser regions (AgNORs) in 28 follicular lymphomas and 30 lymph nodes showing reactive follicular hyperplasia were studied to see if they were helpful in distinguishing follicular lymphoma from follicular hyperplasia in paraffin wax tissue sections. Mean nuclear counts were greater in follicular hyperplasia (3.71 v 3.11). This difference was significant but counts overlapped so much that they were of no practical value in distinguishing between both conditions. Higher counts may reflect greater proliferative activity in follicular hyperplasia.
Immunoreactive determinants of CA 125 in women with endometriosis.
Authors: Mojiminiyi O A , Bramwell M E , Kennedy S H , Shepstone B J , Humm S M , Barlow D H
Published: June 2007

Among 10 patients with endometriosis CA 125 was increased (greater than 35 U/ml) in endometriotic cyst fluid in all the patients, but only two had increased serum concentrations. Gel electrophoresis of serum, endometriotic cyst fluid, and endometriotic tissue resolved the CA 125 immunoreactive fragments from the three sources into bands of similar electrophoretic mobilities. Electrophoresis under reducing and non-reducing conditions showed immunoreactive fragments of apparent masses of 55,000 and 140,000 daltons, respectively. Analysis under reducing conditions did not result in loss of activity. CA 125 antigen is thought to be a high molecular weight glycoprotein complex. As far as is known, this is the first report describing lower molecular weight immunoreactive determinants of CA 125.
Comparison of six commercial enzyme linked immunosorbent assays for detecting IgM antibodies against Toxoplasma gondii.
Authors: Verhofstede C , Van Renterghem L , Plum J
Published: June 2007

To evaluate the usefulness of different commercial enzyme linked immunosorbent assays (ELISAs) for the detection of IgM antibodies against Toxoplasma gondii the results of six of these assays for a panel of 81 sera were compared. The following tests were selected: Toxoplasma gondii IgM ELISA (Clark Laboratories), Toxoplasma IgM EIA (Labsystems), Toxo-M EIA (Abbott), Toxonostika M (Organon), Toxo M Enzyme Immunoassay (Hybritech) and Platelia Toxo IgM (Diagnostics Pasteur). An antibody capture ELISA developed at our laboratory was used as the reference test. An IgM immunoblotting assay was also performed. Four (Toxoplasma IgM EIA, Tox-M EIA, Toxonostika M, and Platelia Toxo IgM) of the commercial IgM ELISAs gave a high sensitivity and a high specificity. Toxo-M EIA, Toxonostika M, Toxoplasma IgM EIA and the Toxo M Enzyme Immunoassay were too insensitive, and the Toxoplasma gondii IgM ELISA was both insensitive and unspecific. No remarkable differences were observed between the results of indirect or antibody capture ELISAs, and between the results of ELISAs performed with polyclonal or monoclonal antibodies.
Campylobacter-like organisms and heterotopic gastric mucosa in Meckel's diverticula.
Authors: de Cothi G A , Newbold K M , O'Connor H J
Published: June 2007

To assess the possibility that Campylobacter pylori might colonise heterotopic gastric mucosa a detailed histological review of 69 cases of Meckel's diverticula resected over 17 years was undertaken. Twenty three were resected incidentally while 46 were excised as the suspected cause of symptoms. Gastric mucosa was found in 13 diverticula (19%), 10 from the symptomatic group and three from the incidental cases, of which eight showed active gastritis affecting the heterotopic mucosa. Specific staining showed spiral bacteria with the typical morphology of C pylori adherent to gastric mucosa in four of the diverticula showing active gastritis. Campylobacter-like organisms were not seen on normal heterotopic gastric mucosa or on adjacent intestinal epithelium. The findings show that Campylobacter-like organisms, identical in appearance, staining, and distribution with C pylori, colonise and possibly inflame heterotopic gastric mucosa in Meckel's diverticulum.
C-myc oncogene product P62c-myc in ovarian mucinous neoplasms: immunohistochemical study correlated with malignancy.
Authors: Polacarz S V , Hey N A , Stephenson T J , Hill A S
Published: June 2007

The monoclonal antibody Myc 1-6E10 was used to determine the cellular distribution of the c-myc oncogene product p62c-myc in 60 mucinous ovarian tumours. Three patterns of immunostaining were apparent: (i) nuclear staining alone; (ii) staining of the nucleus and basal cytoplasm; and (iii) staining of the entire cell. Of the 21 cases of mucinous cystadenoma, 11 showed nuclear staining alone, and a further case showed additional weak staining of the basal cytoplasm. Nuclear staining alone was not present in any of the 17 borderline mucinous tumours examined. Strong staining of the nucleus and basal cytoplasm was seen in 16 of these borderline cases, six of which also showed focal staining of the apical cytoplasm. All 22 cases of mucinous cystadenocarcinoma showed staining of the cell nucleus and entire cell cytoplasm. Focal staining of the apical cytoplasm in six of 17 borderline mucinous tumours produced a pattern of c-myc immunostaining similar to that of cystadenocarcinoma. Retrospective analysis of the clinical data showed that no significant differences between patients with borderline tumours of these two categories could be defined. Although immunostaining with Myc 1-6E10 can be used in the categorisation of mucinous ovarian tumours, it is concluded that standard histological criteria are more accurate indicators of tumour behaviour than is an assessment of c-myc expression.
Diagnosis of progressive multifocal leucoencephalopathy by hybridisation techniques.
Authors: Boerman R H , Arnoldus E P , Raap A K , Peters A C , ter Schegget J , van der Ploeg M
Published: June 2007

In situ hybridisation with acetyl-aminofluorene (AAF) and 35S-labelled DNA probes for polyomaviruses, was used to detect JC virus DNA in brain necropsy material in a patient with progressive multifocal leucoencephalopathy (PML). In a second patient PML was diagnosed from a brain necropsy specimen using the same technique. The main infected cell type were oligodendrocytes; dot hybridisation was used to estimate the number of viral copies in each infected cell. Southern blot hybridisation for further analysis of the viral genome was also carried out. In situ hybridisation with non-radioactive labelled polyomavirus DNA provides a simple and specific means for studying viral DNA in formaldehyde fixed tissue sections from patients with suspected PML. Even in small biopsy samples hybridisation results can be correlated with standard histopathological, immunocytochemical, and electron microscopic findings.
Toxoplasmosis in heart and heart and lung transplant recipients.
Authors: Wreghitt T G , Hakim M , Gray J J , Balfour A H , Stovin P G , Stewart S , Scott J , English T A , Wallwork J
Published: June 2007

Of the first 250 heart and 35 heart and lung transplant recipients at Papworth Hospital, Cambridge, who survived for more than one month after transplantation, 217 heart and 33 heart and lung patients were investigated serologically for evidence of Toxoplasma gondii infection. Six patients acquired primary T gondii infection, most probably from the donor organ. Five patients experienced T gondii recrudescence, two of whom had recovered from primary infection a few years earlier. Two patients died from primary T gondii infection and the severity of symptoms in the other patients with primary infection was related to the amount of immunosuppressive treatment. Prophylaxis with pyrimethamine (25 mg a day for six weeks) was introduced for T gondii antibody negative transplant recipients who received a heart from a T gondii antibody positive donor after the first four cases of primary toxoplasmosis. Of the seven patients not given pyrimethamine, four (57%) acquired primary T gondii infection. This compared with two of the 14 patients (14%) given prophylaxis.
False positive latex tests negative by ELISA for toxoplasma IgG.
Authors: Sutehall G M , Wreghitt T G
Published: June 2007

An enzyme linked immunosorbent assay (ELISA) kit for detecting IgG class antibody to T gondii was compared with the latex agglutination test to determine the specificity as a screening method in 12 patients who had undergone heart transplantation (recrudescence of T gondii infection n = 3, donor acquired infection n = 3; acute cytomegalovirus infection n = 6). The latex agglutination test detected antibodies to primary T gondii infection much earlier in the infection than the ELISA, but the ELISA method was useful for detecting previous infection. It is concluded that the ELISA technique is more complex to perform than the latex agglutination test but the use of IgM and IgG assays combined could reduce the number of samples sent to the reference laboratory and thus reduce the time taken to obtain a final result.
Biotin-labelled antigen screening test for toxoplasma IgM antibody.
Authors: Joss A W , Skinner L J , Moir I L , Chatterton J M , Williams H , Ho-Yen D O
Published: June 2007

A method for the simple preparation of biotin-labelled toxoplasma antigen was used with avidin peroxidase in an IgM-capture enzyme linked immunosorbent assay (BAM-ELISA). Although the overall predictive value of a positive result was only 38%, its low cost and 100% sensitivity makes it a very suitable screening test. Positive results can be confirmed by an alternative assay, thus providing a more economical and effective diagnostic service than either screening all sera by a commercial test or selecting sera for IgM testing.
Bulky extramedullary plasmacytomata: rare mode of relapse in myelomatosis.
Authors: Davies S V , Jones B , Starkie C M , Murray J A
Published: June 2007

In two cases of myelomatosis relapse was accompanied by the development of bulky extramedullary plasma cell tumours, which created serious management problems. In both cases the histology was of a poorly differentiated plasmacytoid tumour with frequent mitoses. In one case paraprotein had completely disappeared from the serum and urine after six months' treatment with melphalan alone but did not correlate with improved survival. It is concluded that extramedullary spread of myelomatosis in the form of bulky tumour deposits is a rare and ominous mode of tumour progression or relapse. Rises in serum and urinary paraprotein concentrations are not the inevitable signs of relapse.
Reproducibility of flow cytometric assessment of follicular tumours of the thyroid.
Authors: van Thiel T P , van der Linden J C , Baak J P , van de Sandt M M , van Galen C , Bezemer P D
Published: June 2007

The reproducibility of the DNA index of paraffin wax sections from 44 follicular tumours of the thyroid (18 follicular adenomas and 26 follicular carcinomas), which had been assessed by flow cytometry was analysed in two laboratories, using consecutive sections of the same specimens and two different commercially available flow cytometers. Two slightly different cell preparation and staining techniques were used in the two laboratories. Using strictly defined criteria the histograms were classified blind as diploid, peritetraploid, aneuploid, or inadequate and insufficient by two independent investigators. Both the concordance between the two different flow cytometers and the agreement of duplicate assessments within the same flow cytometers were assessed. The mean coefficient of variation of the G0/G1 peak of the diploid tumours in the PARTEC flow cytometer was 5.5 (range 2.3-9.8) and in the FACS flow cytometer 5.2 (range 3.7-8.3); this difference was not significant. There was concordance of classification between the two laboratories in 35 of 36 cases. In 25 cases (18 diploid, seven aneuploid) the intralaboratory variation showed a 100% concordance in histogram classification. It is concluded that flow cytometer DNA index assessment of follicular tumours of the thyroid is reproducible and can be used to evaluate the discriminating and prognostic value of this feature.
Association between CAM 5.2 and anti-CD1a reactivity in lymph nodes and gastrointestinal tract epithelium.
Authors: Jack A S , Grigor I , O'Brien C J , McMeekin W , Lewis F , McNicol A M
Published: June 2007

Immunocytochemical studies, using the antibodies CAM 5.2 and NA1/34 (CD1a), were performed on normal lymphoid tissue and malignant lymphomas. A population of dendritic cells in the paracortex of lymph nodes and in T cell lymphomas reacted with both antibodies. Colocalisation with antibodies was also found in gastrointestinal epithelium. Immune blotting shows that the likely basis of this reactivity is a 12 kilodalton peptide which is recognised by both antibodies. This is almost certainly the beta t peptide which has been described as the light chain of CD1a.
Patterns of antigenaemia and antibody response in patients infected with human immunodeficiency virus (HIV) according to clinical state.
Authors: Re M C , Furlini G , La Placa M
Published: June 2007

Five hundred and fifty six subjects, known to be homosexuals or intravenous drug abusers and seropositive for HIV antibody, were selected on the basis of their clinical state--symptom free, lymphadenopathy syndrome (LAS), AIDS related complex (ARC), and AIDS. The presence of antigenaemia and the humoral response to viral polypeptides was investigated. The prevalence of patients positive for p31 antibody was significantly increased in those with AIDS and detectable antigenaemia.
Distribution of HBcAg in hepatitis B detected by immunoperoxidase staining with three different preparations of anti-HBc antibodies.
Authors: Kakumu S , Arao M , Yoshioka K , Tsutsumi Y , Inoue M
Published: June 2007

To evaluate the role of the expression of hepatitis B core antigen (HBcAg) in liver cell damage the immunoperoxidase staining pattern of cryostat liver biopsy specimens from 16 chronic carriers of hepatitis B surface antigen (HBsAg) was investigated using three different kinds of anti-HBc antibodies. Polyclonal antibody prepared from recombinant HBcAg seemed to be more sensitive in detecting HBcAg than did monoclonal antibody from the same antigen. The topographical distribution of HBcAg detected by these two antibodies was similar, showing a close correlation to the histological activity of disease. Furthermore, the predominant localisation of cytoplasmic HBcAg usually reflected an active and severe ongoing hepatitis. On the other hand, monoclonal antibody prepared from purified Dane particles resulted in the prominent cytoplasmic staining for HBcAg regardless of histological severity of the hepatitis. The quantitative expression and topographical distribution of HBcAg depended on the type of anti-HBc antibodies used.
Outer membrane protein and biotype analysis of non-serotypable strains of Haemophilus influenzae.
Authors: Coverdale C H , Temple G S
Published: June 2007

Strains of Haemophilus influenzae (n = 161) were isolated from inpatients with symptoms of pulmonary infection. Conventional tests showed that 144 strains were non-serotypable and all belonged to one of eight biotypes. The common biotypes were 2 (41%), 3 (27.1%), 1 (13.2%) and 5 (10.4%). The outer membrane protein (OMP) profiles of 59 non-serotypable strains were examined by sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE). A comparison of OMP profiles suggested a possible association between several strains belonging to biotype 2. Although no clear correlation was established between biotype or OMP profile cluster groups and the age or clinical state of the patients from whom the strains were isolated, SDS-PAGE analysis was a useful technique for the epidemiological study of non-serotypable H influenzae.