bluuebunny/crossref_metadata_2025 huggingface dataset:
Antimicrobial susceptibility testing of Haemophilus influenzae: trial organised as part of United Kingdom national external quality assessment scheme for microbiology.
Authors: Snell J J , Brown D F , Phua T J
Published: June 2007

Six strains of Haemophilus influenzae were distributed to 417 United Kingdom laboratories who were asked to test susceptibility of the strains to ampicillin, augmentin, tetracycline, chloramphenicol, and trimethoprim and to test for beta lactamase production. Laboratories were also asked to provide details of their methods by completing a questionnaire. The incidence of reports recording sensitive strains as resistant was 8% (ampicillin), 7% (augmentin), 3% (tetracycline), 1% (chloramphenicol), and 12% (trimethoprim). The incidence of reports recording resistant strains as sensitive was 9% (ampicillin), (2% with beta lactamase producing strains, 24% with non-beta lactamase producing strains), 51% (augmentin), 10% (tetracycline), 20% (chloramphenicol), and 3% (trimethoprim). High error rates were associated with several methods or practices. These included use of general purpose growth media rather than susceptibility testing media and failure to add lysed blood to the media when testing trimethoprim susceptibility; standardise the inoculum; use suitable control strains; and the use of high content discs for testing chloramphenicol, tetracycline, and ampicillin.
Asymptomatic carriage of Clostridium difficile in patients with cystic fibrosis.
Authors: Peach S L , Borriello S P , Gaya H , Barclay F E , Welch A R
Published: June 2007

Faecal samples from 37 patients with cystic fibrosis and 40 control patients at the Brompton Hospital and the London Chest Hospital were examined for the presence of Clostridium difficile. The organism was isolated from 2 (17%) of control patients who were receiving antibiotics and from one (3.6%) of control patients who had no antimicrobial treatment. Thirty two per cent of the patients with cystic fibrosis excreted C difficile, though none of them had diarrhoea. Two of the three isolates from control patients and nine of the 12 isolates from patients with cystic fibrosis produced toxin B (cytotoxin) in vitro. Toxin B was present in the stools of one of the control patients and three of the patients with cystic fibrosis; toxin A (enterotoxin) was not detected in the faeces of the patients with cystic fibrosis. Two cytotoxigenic strains of C difficile isolated from patients with cystic fibrosis were examined in hamsters; both were virulent, and the animals died.
Immunocytochemical study of 18 tumours causing ectopic Cushing's syndrome.
Authors: Coates P J , Doniach I , Howlett T A , Rees L H , Besser G M
Published: June 2007

Eighteen cases of Cushing's syndrome caused by ectopic production of peptide hormones were investigated by histological and immunocytochemical methods and the findings correlated with clinical and biochemical observations. Immunocytochemistry showed immunoreactive adrenocorticotrophic hormone (ACTH) or peptides derived from the ACTH precursor (pro-opiomelanocortin (POMC], or both, in a total of 10 cases: five of these also contained immunoreactive-alpha-melanocyte stimulating hormone, indicating more extensive translational processing of POMC than normally occurs in healthy corticotrophs of the anterior pituitary; in two further cases peptides capable of stimulating ACTH release from the anterior pituitary were present. In the remaining six cases immunocytochemistry failed to show the presence of ACTH, other POMC derived peptides, or peptides with ACTH releasing properties. These findings correlate well with the histological and clinical observations, in that the six tumours had been clinically overt, caused rapid death, and histologically seemed to be highly malignant. In contrast, the 12 other tumours were occult to radiological examination, patients had a much improved survival rate, and histologically the tumours seemed to be less aggressive. All but one of the tumours in this series showed a degree of neuroendocrine differentiation, indicated by the presence of neuron specific enolase. These results suggest that one feature of highly malignant tumours, which cause an ectopic endocrine syndrome, is a high secretion of peptide hormones, leaving amounts that are too small to be shown by immunocytochemistry.
DNA ploidy patterns and cytokinetics of non-Hodgkin's lymphoma.
Authors: Juneja S K , Cooper I A , Hodgson G S , Wolf M M , Ding J C , Ironside P N , Thomas R J , Parkin J D
Published: June 2007

Flow cytometry studies for cellular DNA analysis were performed in 115 cases of non-Hodgkin's lymphoma, 53 of which had not received any prior chemotherapy or radiotherapy. DNA content was measured in ethanol fixed cells stained with chromomycin A3. According to the criteria of the International Working Formulation there were 43 low grade, 58 intermediate grade, and eight high grade lymphomas; six cases were in the miscellaneous group. Seventy seven (67%) had only diploid DNA content. Thirty eight (33%) showed DNA aneuploidy; 20 of these had been previously treated with chemotherapy or radiotherapy, or both. DNA aneuploidy was seen as hyperdiploidy in all cases except one, and it varied from slightly hyperdiploid to tetraploid. The incidence of aneuploidy increased significantly with increasing histological grade (p = 0.0002) and was not related to previous treatment. The low, intermediate, and high grade lymphomas had 14% (six of 43), 47% (27 of 58), and 62.5% (five of eight) cases, respectively, that showed DNA aneuploidy. The percentage of cells in S phase increased significantly with a higher histological grade (p less than 0.0001). The median S fraction in the low, intermediate, and high grade lymphomas was 1.0 (0.5 to 10)% 4 (0.4 to 35)%, and 27 (4.6-56)%, respectively. There is a significant correlation between histological grade and S fraction and the presence or absence of aneuploidy. There is heterogeneity, however, within both histological grade and a histological subtype.
Routine papillomavirus antigen staining of cervical punch biopsy specimens.
Authors: Jenkins D , Tay S K , Maddox P H
Published: June 2007

Immunocytochemical staining for papillomavirus antigen was carried out on 1147 consecutive cervical punch biopsy specimens over 12 months. Of 876 cases with cervical intraepithelial neoplasia (CIN) 351, were antigen positive and of 49 cases with histological evidence of human papillomavirus (HPV) infection but no CIN, 14 were positive. There were 204 cases reported to be normal on routine histological examination and 12 cases reported to show features suggestive but not diagnostic of HPV infection. Of the normal group, 24 (12%) were antigen positive and of the equivocal group, two were positive. In 122 of the normal or equivocal groups cytological examination was repeated at the time of colposcopy, and dyskaryosis was reported in 36. In only four cases was disease shown by HPV antigen staining when there was no diagnostic histological or cytological abnormality. HPV antigen staining assists in the recognition of the range of histological changes associated with productive HPV infection but is an insensitive test and has only limited value in supplementing histological and cytological examinations as a diagnostic aid in routine colposcopic pathology.
Histological changes associated with wheat protein antibodies in the absence of villous atrophy.
Authors: O'Farrelly C , Graeme-Cook F , Hourihane D O , Feighery C , Weir D G
Published: June 2007

A retrospective study was conducted to assess the association of alpha-gliadin antibodies with intraepithelial lymphocyte counts. Twelve subjects with apparently normal small intestinal histology and raised alpha-gliadin antibody titres had significantly increased intraepithelial lymphocyte counts (42 (SEM) 5.9) when compared with 16 subjects with normal alpha-gliadin antibody titres (17 (3.2); p less than 0.001). These findings show that in the absence of gross pathology raised alpha-gliadin antibody titres are associated with increased numbers of intraepithelial lymphocytes and may reflect continuous immunological processes in the small intestine.
Iron state and hepatic disease in patients with thalassaemia major, treated with long term subcutaneous desferrioxamine.
Authors: Aldouri M A , Wonke B , Hoffbrand A V , Flynn D M , Laulicht M , Fenton L A , Scheuer P J , Kibbler C C , Allwood C A , Brown D
Published: June 2007

Liver biopsies were performed on 51 regularly transfused patients with beta thalassaemia, age range 5-36 (mean 18.6) years, who had received regular subcutaneous desferrioxamine (DFX) treatment for periods between one and eight years (40 for eight years). The biopsy specimens were examined by light microscopy and immunofluorescence for hepatitis B virus surface and core antigens (HBsAg and HBcAg), and the iron content was determined chemically. The results were compared with serum ferritin concentration and aspartate transaminase (AST) activity and with hepatitis B virus serology. Biopsy specimens, in which chemical liver iron had been determined in 12, were also available from 17 patients. Mean serum ferritin (+/- SD) had fallen from 5885 (3245) micrograms/l to 1638 (976) micrograms/l in 36 patients after eight years' chelation, while mean (+/- SD) liver iron concentration had fallen from 2945 (900) micrograms/100 mg dry weight to 857 (435) micrograms/100 mg dry weight in 12 of them. All biopsy specimens examined were negative for HBs and HBc antigens. The presence of histological features of hepatitis was associated with increased liver iron content, increased fibrosis, and with progression of fibrosis between the two biopsies. Procollagen III peptide was assayed in 28 patients but did not correlate with the degree of hepatitis, fibrosis, or with chemical liver iron content. We conclude that with regular subcutaneous DFX, mean concentrations of serum ferritin and liver iron are maintained in these patients at about five and 10 times the normal value, respectively, and that progression of liver damage is more likely to be due to viral hepatitis, presumably related to the parenterally transmitted non-A, non-B agents than to iron overload.
Prevention of endotoxaemia by non-absorbable antibiotics in heat stress.
Authors: Gathiram P , Wells M T , Brock-Utne J G , Wessels B C , Gaffin S L
Published: June 2007

Four anaesthetised monkeys were given oral kanamycin (15 mg 1 kg 12 hourly) over five consecutive days before being heat stressed. Four other anaesthetised monkeys served as controls. The plasma lipopolysaccharide concentration in control primates increased initially from 0.044 (SEM 0.004) ng/ml to 0.062 (0.006) ng/ml as the rectal temperature increased from 37.5 to 39.5 degrees C. A second increase in lipopolysaccharides started at 42 degrees C and reached 0.308 (0.038) ng/ml (p less than 0.01) at 44.5 degrees C. Before heat stress the plasma lipopolysaccharide concentration in the primates who had been pretreated with kanamycin was 0.007 (0.006) ng/ml, and despite heating these animals to 44.5 degrees C no increase in plasma lipopolysaccharide concentrations were seen in this group. The cardiovascular variable during heat stress were more unstable in the control group and began to deteriorate at a lower temperature than in the group receiving antibiotic. These data suggest that the increased plasma lipopolysaccharide concentration during heat stress originates mainly from the gut.
Association between production of toxins A and B and types of Clostridium difficile.
Authors: Wren B , Heard S R , Tabaqchali S
Published: June 2007

One hundred and seventy two strains of Clostridium difficile isolated from 62 patients with antibiotic associated diarrhoea or pseudomembranous colitis were analysed for the production of toxins A and B and typed using 35S-methionine labelling followed by sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE). There was a correlation between production of toxins A and B and the type of C difficile. One hundred and forty four of 172 strains were either high or low producers of both toxins. Toxins were not detected in 28 of 172 strains. Types A and Y were consistently non-toxin producers; types B and E were high toxin producers. Type X, the epidemic strain, showed variable toxin production. Symptoms of 49 patients with haematological malignant pathology who were part of a documented outbreak of antibiotic associated diarrhoea, were analysed in relation to toxin production and type of the clinical strains isolated. In general, there was a correlation between symptoms of antibiotic associated diarrhoea, the type of C difficile, and its potential for producing toxins.
Vitamin B12 absorption after allogeneic bone marrow transplantation.
Authors: Milligan D W , Quick A , Barnard D L
Published: June 2007

The B12 absorption test (Schilling test) with intrinsic factor was used to examine ileal B12 absorption in 26 patients after allogeneic transplantation. The test was well tolerated and showed a profound fall in B12 absorption, which was maximal at two weeks after transplantation and recovered by eight weeks. The predominant influence on absorption at this stage was probably the conditioning schedule, and the presence of acute graft versus host disease (GVHD) was not associated with a further impairment of absorption. Six patients with chronic GVHD were studied. When compared with nine patients without GVHD there was a significant (p less than 0.005) reduction of B12 absorption. These findings suggest that the B12 absorption test may be a useful non-invasive method of studying bowel function after bone marrow transplantation.
Peripheral blood lymphocyte subpopulations in patients with primary proliferative and secondary polycythaemia.
Authors: Wilde J T , Barnett D , Forrest M J , Lawrence A C
Published: June 2007

Peripheral blood lymphocyte subpopulations were measured in 18 patients with primary proliferative polycythaemia and 13 patients with secondary polycythaemia. A decrease in numbers of suppressor T lymphocytes and an increase in the helper:suppressor T lymphocyte ratio was found in those with primary polycythaemia compared with normal subjects and patients with secondary polycythaemia. If other causes of an increased helper:suppressor ratio are excluded this variable may be useful in confirming the myeloproliferative nature of patients with erythrocytosis.
Public Health Laboratory Service enzyme linked immunosorbent assay for detecting Toxoplasma specific IgM antibody.
Authors: Payne R A , Joynson D H , Balfour A H , Harford J P , Fleck D G , Mythen M , Saunders R J
Published: June 2007

An enzyme linked immunosorbent assay (ELISA) based on the antibody class capture method for the detection of specific IgM against Toxoplasma gondii, using the microtitre plate format, was developed. Antigen binding was detected using a monoclonal antibody, CIE3, conjugated to horseradish peroxidase. Prior mixing of the conjugate and antigen improved the stability of these reagents as well as removing an incubation stage from the assay. The incubation time of less than four hours permits a rapid throughput of specimens. Using the assay, a total of 163 sera were examined in a three centre study and good agreement was found. Results were expressed as arbitrary enzyme immunoassay units (EIUs) against a freeze dried standard. Throughout the study the standard serum showed a coefficient of variation less than 10% across the microtitre plate. By measuring IgM titres in patients having toxoplasmic lymphadenopathy with a known date of onset, IgM class antibodies were shown to peak at two months, persisting for about six months. In addition, a case of laboratory acquired toxoplasmosis was monitored. Sera shown to contain rheumatoid factor and antinuclear factor did not give false positive results. This rapid, robust, and simplified assay is used by the Public Health Laboratory Service Toxoplasma Reference Units and will provide a standard with which other assays can be compared.
Prediction of human papilloma virus antigen in cervical squamous epithelium by koilocyte nuclear morphology and "wart scores": confirmation by immunoperoxidase.
Authors: McLeod K
Published: June 2007

Koilocytes (balloon cells) in cervical squamous epithelium can be distinguished by their nuclear morphology as members of two populations A and B. The proposition that population A was infected with human papilloma virus (HPV) and population B was not, was examined immunohistologically. A peroxidase-antiperoxidase technique using polyclonal HPV antibody failed to support the hypothesis and showed small fractions of both populations to be infected with the virus (A = 5 of 25; B = 2 of 19). Nuclear morphology alone is thus inadequate to distinguish infected from non-infected koilocytes, or balloon cells. When a number of well established histological changes in squamous epithelia infected with HPV were examined, graded, and summated to obtain a "wart score," however, a reasonably accurate prediction of HPV infection emerged.
Opsonisation and phagocytosis of group B meningococci by polymorphonuclear leucocytes: comparison of sulphonamide sensitive and resistant strains.
Authors: Ward K N , Fleer A , Verhoef J , Jones D M
Published: June 2007

A large proportion of disease caused by sulphonamide resistant strains of group B type 15 meningococci affects patients 10-24 years. In contrast, disease caused by sulphonamide sensitive strains conforms to the usual pattern, and most infection occurs in early childhood. In an attempt to explain this phenomenon possible differences in susceptibility of resistant and sensitive strains to phagocytosis by polymorphonuclear leucocytes were investigated, using radioactively labelled bacteria. In initial experiments a group B resistant strain required higher concentrations of normal human serum and longer opsonisation times for phagocytosis than an ungroupable non-pathogenic meningococcus. Comparison of sulphonamide resistant and sensitive group B meningococci showed that with either heat inactivated serum or agammaglobulinaemic serum, phagocytosis did not occur with any of the strains, whereas if these two sera were used together, phagocytosis was restored to the level seen with normal human serum. Thus both antibody and complement are required for phagocytosis. Furthermore, opsonisation depended on an intact classical pathway of complement for each group B strain. In all the experiments there was no significant difference between the phagocytosis of sulphonamide sensitive and resistant group B strains neither with regard to the efficiency of opsonisation by normal human serum nor the exact requirements for antibody and complement.
Iron chelation studies using desferrioxamine and the potential oral chelator, 1,2-dimethyl-3-hydroxypyrid-4-one, in normal and iron loaded rats.
Authors: Kontoghiorghes G J , Sheppard L , Hoffbrand A V , Charalambous J , Tikerpae J , Pippard M J
Published: June 2007

A novel iron chelator, 1,2-dimethyl-3-hydroxypyrid-4-one, and desferrioxamine were compared for their ability to remove iron and for their site of action in iron release in rats. Repeated intraperitoneal injections of the chelators in rats with widespread tissue labelling by 59Fe derived from transferrin showed comparable 59Fe mobilisation by each chelator in normal and iron loaded rats. Specific labelling of a chelatable "cold" iron pool in hepatocytes by 59Fe derived from ferritin showed this pool to be equally accessible to parenteral doses of both chelators and also to oral 1,2-dimethyl-3-hydroxypyrid-4-one, which is an effective oral iron chelating agent that removes iron from parenchymal cells. This and other alpha-ketohydroxypyridines need further development as potential therapeutic agents in human iron overload.
Heat treatment for endocrinological investigations on plasma positive for human immunodeficiency virus (HIV).
Authors: Hancock M R , Knapp M L , Ghany H C , Mayne P D
Published: June 2007

The effects of heat treatment of serum samples on the hormone analyses used in this laboratory were studied. Total T4, testosterone, progesterone, and growth hormone were not systematically affected by heat treatment over the whole range of analyte concentrations studied; for thyroid stimulating hormone, no effect was noted on serum samples with concentrations of less than 10 mU/l. Significant changes occurred in total T3, cortisol, follicle stimulating hormone, luteinizing hormone, and prolactin. It is suggested that with appropriate preliminary study, heat treated plasma samples may be used in endocrinological investigations without adversely affecting the diagnostic validity of the results.
False negative rate in cervical cytology.
Authors: van der Graaf Y , Vooijs G P
Published: June 2007

All women in Nijmegen, The Netherlands, with a histological diagnosis of severe dysplasia, or carcinoma in situ, or invasive carcinoma were investigated to see whether they had participated in a population screening programme. Within two years of diagnosis of a negative cervical smear, 45 women were found to have histologically confirmed severe epithelial abnormality of the cervix. From the same population as these apparently false negative cases, the number of true positive cases was available, and hence the sensitivity of cervical screening for severe dysplasia, or carcinoma in situ, and invasive carcinoma could be assessed. This was found to be 83% after two years. The laboratory procedures which led to the high sensitivity for the cervical cytodiagnosis were analysed. Experienced sample takers and cytotechnologists are very important and can reduce sample and screening errors. A good administrative system is necessary to guarantee proper follow up for women with abnormal findings in their cervical smears.
Serum hyaluronic acid in patients with disseminated neoplasm.
Authors: Manley G , Warren C
Published: June 2007

Hyaluronic acid concentrations were measured by a laser nephelometric assay in serum samples from 50 patients with advanced disseminated neoplasm and 50 healthy controls matched for age and sex. The identity of hyaluronic acid was confirmed by a combination of electrophoretic and enzymatic techniques. The mean serum hyaluronic acid concentration for the control group was 1.09 mg/l, with a range of 0-4 mg/l. The mean concentration for patients with neoplastic disease was 10.38 mg/l, with a range of 0-100 mg/l. Sixty two per cent of the patients with disseminated neoplasm had serum hyaluronic acid concentrations above the control range. There was no correlation between the increased concentration of hyaluronic acid and tumour type, serum bilirubin, serum alkaline phosphatase, or serum urea concentrations. There was a higher incidence of hypercalcaemia in patients with increased hyaluronic acid concentrations, but the correlation between hyaluronic acid and calcium concentrations was not significant. In view of the possible role of hyaluronic acid in cellular differentiation and morphogenesis the finding of increased hyaluronic acid concentrations in patients with advanced neoplastic disease may be of fundamental importance in cancer biology.
Myeloid surface antigen abnormalities in myelodysplasia: relation to prognosis and modification by 13-cis retinoic acid.
Authors: Clark R E , Smith S A , Jacobs A
Published: June 2007

The relation between prognosis and lineage specific surface antigen expression on peripheral blood granulocytes and monocytes was studied using monoclonal antibodies and flow cytometry in 37 patients with myelodysplastic syndromes (MDS). Abnormalities in antigen expression were summarised as a score, and cases were divided into low (few abnormalities) and high (many abnormalities) groups. Survival was significantly worse in the "high" group (logrank chi 2 = 5.793, p = 0.016), this group having a median survival of 31 weeks, compared with more than 67 weeks in the "low" group. No correlations were found between the score and any of the following: peripheral blood platelet and granulocyte count; FAB subtype; bone marrow blast cells and sideroblast count, or erythroid and myeloid progenitor growth. Antigen expression was also studied in six further cases of MDS before and after six weeks of treatment with 13-cis retinoic acid (CRA), 20 mg given orally, and a comparison was made with six untreated patients studied before and after a similar time interval. In the treated group 58% of initially abnormal measurements reverted to normal, compared with 24% in the untreated group. Five of the six treated patients showed a decrease in the score, whereas only two of the six improved in the untreated group. The data indicate that myeloid antigen expression is a useful indicator of prognosis in MDS, and that antigen expression may be affected by treatment.
Use of hybridot assay to screen for BK and JC polyomaviruses in non-immunosuppressed patients.
Authors: Cobb J J , Wickenden C , Snell M E , Hulme B , Malcolm A D , Coleman D V
Published: June 2007

Urine samples from 50 patients attending a genitourinary outpatient clinic and from 13 renal allograft recipients were investigated for evidence of infection with human BK and JC polyomaviruses using cytology and a new DNA hybridot assay. Forty four per cent of samples from the renal allograft recipients were positive by cytology and 75% by DNA hybridisation, indicating that hybridot assay is more sensitive than cytological screening. BK and JC viral DNA was found in 20% of the patients attending the genitourinary clinic, showing infection with BK virus and JC virus in a group of patients with clinical conditions not normally associated with immunological deficiency-a finding that has not been reported before.
Infections in British clinical laboratories, 1984-5.
Authors: Grist N R , Emslie J A
Published: June 2007

During 1984-5 this continuing survey showed that 41 infections occurred in the staff of 193 laboratories, representing 23,043.5 person years of exposure. The community was the probable source of two cases each of hepatitis A and B, one of tuberculosis, two of campylobacter enteritis, and 12 of Norwalk viral diarrhoea. Occupational exposure was the probable cause of six hepatitis B infections (affecting haematology, biochemistry, and microbiology staff), three of tuberculosis (affecting mortuary and morbid anatomy workers), seven shigella, three salmonella (including one typhoid) and one pseudocholera infection (all in microbiology medical laboratory scientific officers), and a streptococcal infection in a mortuary technician. An episode of hepatitis of uncertain cause affected a carrier of hepatitis B. The incidence of reported infections of all types was 178 per 100,000 person years (91 for infections of suspected occupational origin). The highest incidence was in morbid anatomy and mortuary workers, followed by microbiology medical laboratory scientific officers.
"Mucin secreting" and "mucinous" primary thyroid carcinomas: pitfalls in mucin histochemistry applied to thyroid tumours.
Authors: Rigaud C , Bogomoletz W V
Published: June 2007

Forty primary carcinomas of the thyroid of different histological types were reviewed and studied histochemically, with the aim of identifying and assessing "mucin secretion". The patterns of extracellular "pure alcianophilia" and "mixed alcianophilia" were noted in 7.5% and about 50% of these tumours, respectively. A critical review of the pitfalls in methods and interpretation of mucin histochemistry--as performed in previously reported cases of "mucin secreting" or "mucinous" primary thyroid tumours--is presented. The apparent "mucin secretion" described in these unusual neoplasms could be due to histochemical staining of carbohydrate components or breakdown products of thyroglobulin and colloid.
Effects of catecholamines on secretion of adrenocorticotrophic hormone (ACTH) in man.
Authors: Al-Damluji S , Rees L H
Published: June 2007

The hypothalamus receives a rich supply of adrenergic and noradrenergic nerve fibres from the brain stem, terminating in many hypothalamic regions, including the paraventricular nucleus, which is the site of the cell bodies of corticotrophin releasing factor (CRF) neurones in man. Experimental evidence has shown that an alpha 1 adrenoceptor mechanism stimulates adrenocorticotrophic hormone (ACTH) secretion in man. The site of action of this mechanism seems to be within the blood brain barrier, presumably modulating the secretion of the CRF complex. This mechanism is important in the control of ACTH secretion in some physiological conditions in healthy subjects.
Clinical biochemistry of the neonatal period: immaturity, hypoxia, and metabolic disease.
Authors: Harkness R A
Published: June 2007

This review attempts to provide practical information on common problems in the laboratory medicine of newborn infants and also considers unresolved problems in achieving neonatal diagnoses. A common cause of upset in the newborn--intrapartum asphyxia--can now be positively diagnosed. This leaves a small group whom it is necessary to investigate because they may have metabolic disease. The initial investigation of metabolic disease at the district general hospital should be limited to the commoner conditions.
British postgraduate training in pathology.
Authors: Tighe R J
Published: June 2007

There is growing pressure for a review of postgraduate training in pathology. The establishment of monodisciplinary practice, the rapid advancement of subspecialities with their attendant problems of recruitment, and the decline of research activity by those in training identifies the need for an early change in the pattern of training.
Ultrastructural and immunocytochemical study of a case of invasive cribriform breast carcinoma.
Authors: Wells C A , Ferguson D J
Published: June 2007

A case of recurrent invasive cribriform carcinoma of the breast mimicked the histological and mucin staining characteristics of adenoid cystic carcinoma. The diagnosis was based on negative immunocytochemical staining for laminin and ultrastructural evidence of luminal differentiation by cells lining the cystic spaces. Accurate characterisation of this type of breast tumour can be facilitated by retrospective immunocytochemical or ultrastructural examination, or both.
Comparison between cell culture and serology for detecting Chlamydia trachomatis in women seeking abortion.
Authors: Csángó P A , Sarov B , Schiøtz H , Sarov I
Published: June 2007

The efficiency of an immunoperoxidase serological assay and culture of Chlamydia trachomatis were compared in 127 women seeking first trimester abortion. Serum IgG and IgA antibodies specific for C trachomatis were detected by a single serovar (L2) inclusion immunoperoxidase assay (IPA). Eighty (63%) women were seropositive for chlamydial IgG and 31 (24%) for IgA antibodies. C trachomatis was isolated from 21 of 127 (17%) women. Twenty of the 80 women (25%) seropositive for specific IgG antibodies and one of 47 (2%) patients without these antibodies were culture positive (p less than 0.001). Compared with isolation, chlamydial antibodies at a titre of greater than or equal to 16 showed high sensitivity and negative predictive value (95% and 98%, respectively), but low specificity and efficiency (43% and 52%, respectively). Chlamydial IgA antibodies at a titre of greater than or equal to 8 showed low sensitivity (52%), but a higher specificity, negative predictive value, and efficiency of 81%, 90%, and 76%, respectively. C trachomatis IgG antibodies at a titre of 16 as determined by IPA can be used as an efficient negative exclusion marker for active chlamydial infection in screening women seeking abortion.
Non-invasive investigation of liver disease in haemophilic patients.
Authors: Miller E J , Lee C A , Karayiannis P , Hamilton-Dutoit S J , Dick R , Thomas H C , Kernoff P B
Published: June 2007

Liver biopsy specimens previously taken from 16 haemophilic patients with chronic non-A, non-B hepatitis were reviewed. The degree of fibrosis correlated with serum procollagen III peptide (sPIIIP) concentrations, measured both at the time of biopsy and 4.25 years later. Two patients with extremely high sPIIIP concentrations had collateral veins on computed tomography, suggesting portal hypertension. Twenty eight of 47 patients (60%) had splenomegaly on computed tomography, and of 28 patients in whom intravenous contrast medium was used, seven (25%) had collateral oesophageal veins. Serum procollagen III peptide estimations and computed tomography, both non-invasive investigations, indicated that hepatic fibrosis and portal hypertension had developed in a proportion of haemophilic patients with non-A, non-B hepatitis. Infection with the human immunodeficiency virus (HIV) may modify the course of this presumably cytopathic virus infection of the liver.
DNA content and MHC class II antigen expression in malignant melanoma: clinical course.
Authors: Zaloudik J , Moore M , Ghosh A K , Mechl Z , Rejthar A
Published: June 2007

To assess the clinical value of two comparatively new properties (DNA content and MHC class II antigen expression (HLA-DR, DP, DQ) of melanoma cells) which have been independently reported to reflect the outlook for patients with malignant melanoma, we investigated retrospectively 50 stage I nodular melanomas in two comparably homogeneous groups of 23 and 27 patients, the course of whose disease differed at five years. Flow cytometry and immunohistology were used on paraffin wax embedded archival material for the analysis of DNA ploidy and detection of class II antigens, respectively. A close association was found between class II antigen expression, detected by monoclonal antibody CR3/43 (antimonomorphic DR, DP, DQ) present in 23 of 50 (46%) melanomas and unfavourable clinical course (p less than 0.005, by log rank test), but no such association was found for DNA ploidy. It is suggested that immunohistology for MHC class II antigen expression may help to predict the behaviour of nodular melanomas whereas the prognostic value of DNA ploidy is more limited. The finding that class II positive cells are found predominantly in melanomas with a substantially increased risk of metastases has implications both for concepts of tumour heterogeneity and host immunity.
Campylobacter-like organisms and Candida in peptic ulcers and similar lesions of the upper gastrointestinal tract: a study of 247 cases.
Authors: Kalogeropoulos N K , Whitehead R
Published: June 2007

Campylobacter-like organisms were detected by light microscopy in association with 57 of 102 (56%) of gastric ulcers, all the gastric erosions associated with gastritis, three of five (60%) of gastric erosions without gastritis, five of 13 (39%) of mild superficial gastritis and two of 36 (6%) of normal gastric mucosa. They were also seen in four of 20 (20%) of duodenal ulcers, but not in duodenal erosions with duodenitis or normal duodenal biopsy specimens. They were seen in association with 12 of 64 (19%) of cases of Barrett's oesophagus. Moniliasis was seen in nine of 78 (12%) of the gastric ulcers in which campylobacter-like organisms were found, and the incidence of moniliasis was three of 15 (20%) in association with duodenal ulcers when ulcer debris was present in biopsy material, and in association with six of 25 (24%) of cases of Barrett's oesophagus. These findings do not support the hypothesis that campylobacter-like organisms cause inflammatory and ulcerative lesions of the upper gastrointestinal tract.
Plasma oxalate concentration and secondary oxalosis in patients with chronic renal failure.
Authors: Tomson C R , Channon S M , Parkinson I S , Morley A R , Lennard T W , Parrott N R , Laker M F
Published: June 2007

To examine the association between hyperoxalaemia and secondary oxalosis, measurement of plasma oxalate concentration was combined with a search for tissue deposition of calcium oxalate crystals in patients with chronic renal disease. Two groups of patients were studied. In the first, samples of the inferior epigastric artery were taken from 35 patients at the time of renal transplantation. In the second, sections taken at necropsy from 23 patients with chronic renal failure in whom plasma oxalate had been measured before death were examined. Though plasma oxalate concentrations ranged between 6 and 116 mumol/l (four to 78 times greater than the upper limit of the reference range), no extrarenal deposits of oxalate were found in either study. Renal deposition of oxalate was associated with a plasma oxalate concentration of greater than 20 mumol/l. This study gives no support to the suggestion that hyperoxalaemia of the degree seen in patients with the type of chronic renal failure that is not due to primary hyperoxaluria confers an appreciable risk of extrarenal oxalosis.
Lactoferrin in aspirates of odontogenic cyst fluid.
Authors: Smith A J , Matthews J B , Mason G I , Browne R M
Published: June 2007

The possibility that the presence of lactoferrin in aspirates of odontogenic cyst fluid might be a useful preoperative diagnostic marker for odontogenic keratocyst was investigated. Using qualitative and quantitative immunodiffusion methods fluid from 29 of 29 dental (radicular) cysts, 12 of 14 dentigerous cysts and 27 of 31 keratocysts were found to contain lactoferrin. Although some of the highest concentrations of lactoferrin were detected in fluids from keratocysts, there was no significant difference between lactoferrin concentrations among the three groups. Neutrophil elastase was detected in 20 of 24 samples tested, 22 of which also contained lactoferrin. Immunocytochemical localisation of both lactoferrin and elastase was confined to neutrophils infiltrating cyst walls. These results suggest that lactoferrin in fluid from odontogenic cysts is derived from infiltrating neutrophils and that its presence in aspirated fluids is not a useful diagnostic marker for odontogenic keratocyst.
Leukotriene B4 synthesis and neutrophil chemotaxis in chronic granulocytic leukaemia.
Authors: Reilly I A , Knapp H R , Fitzgerald G A
Published: June 2007

A sensitive gas chromatography-mass spectrometric method was used to measure the generation in whole blood of leukotriene B4 (LTB4), a potent stimulator of neutrophil chemotaxis, in eight patients with chronic granulocytic leukaemia (CGL) and 12 healthy controls. LTB4 was detectable in unstimulated samples from all the patients (mean 194 (70 SEM) pg/ml), and the capacity for LTB4 production after stimulation with calcium ionophore (A23187) was similar in patients (32.1 (11) ng/10(6) leucocytes) and controls (38.1 (4) ng/10(6) leucocytes). In response to stimuli which induce neutrophil activation, LTB4 production was significantly greater in the patients than in controls: 35.6 (13) v 13.0 (3) ng/ml, p less than 0.05 (f-met-leu-phe); and 42.4 (16) v 14.7 (4) ng/ml, p less than 0.02 (opsonised zymosan). Anti-IgE stimulated considerably more LTB4 production in patients with CGL than in controls (3.86 (1.6) v 0.83 (0.43) ng/ml; p less than 0.005) and this correlated significantly (p less than 0.05) with the basophil count. Neutrophil chemotaxis to LTB4, however, was significantly impaired in the patients with CGL even at the highest concentration of LTB4 (10(-5) M). Chemotaxis to f-met-leu-phe, phagocytosis, and bacterial killing were normal. Thus although LTB4 synthesis is normal or even enhanced in patients with CGL, specific defects in LTB4-mediated responses may contribute to neutrophil dysfunction in this disease.
Demonstration of aluminium in iliac bone: correlation between aluminon and solochrome azurine staining techniques with data on flameless absorption spectrophotometry.
Authors: Ellis H A , Pang M M , Mawhinney W H , Skillen A W
Published: June 2007

The presence of excess aluminium was investigated in 204 samples of iliac bone from 197 patients with chronic renal failure by using the aluminon and solochrome azurine staining techniques. The results were compared with values obtained by atomic absorption spectrophotometry (AAS). Overall, the staining reactions correlated with the AAS data, but the solochrome azurine stain was positive more often than was the aluminon stain (in 90.6% and 62.3%, respectively, of bone samples with greater than the control group mean +3SD (that is, in the range 17.8 to 113.4 micrograms aluminium/g Solochrome azurine staining was consistently positive in all cases, with greater than 23.1 micrograms aluminium/g bone but the corresponding aluminon stain was occasionally inexplicably negative in this range. In some samples solochrome azurine was positive in parts of old unresorbed cement lines when the aluminon stain was negative and the bone aluminium concentration was within the normal range or slightly increased. The stains, particularly solochrome azurine, have the advantage over AAS in that they indicate the location as well as the presence of excess bone aluminium.
Measurement of protein HC (alpha 1 microglobulin) and protein HC-IgA complex in different body fluids.
Authors: Fernández-Luna J L , Leyva-Cobián F , Méndez E
Published: June 2007

Protein HC and protein HC-IgA complex were measured in 18 different types of fluid sample from healthy subjects and patients with different illnesses to determine if the concentrations of protein HC and protein HC-IgA complexes could be used to monitor certain diseases, when measured separately. The normal values for HC ranged from between 0.30 mg/l in saliva and 11.7 mg/l in blood plasma. HC-IgA complex has a greater range, from undetectable concentrations (urine, colostrum, and cervical mucus) up to 59.2 mg/l in blood plasma. Undetectable concentrations of HC-IgA complex were also shown in serum from patients with IgA immune deficiency and in cerebrospinal fluid from patients with multiple sclerosis. Increased concentrations of HC were noted in bronchoalveolar fluid from a patient with pulmonary alveolar proteinosis, serum from patients with Behcet's syndrome, and in synovial fluid from patients with gout, chondrocalcinosis, and rheumatoid arthritis. On the other hand, the concentrations of HC-IgA complex were raised only in those patients with pulmonary alveolar proteinosis or rheumatoid arthritis.
Nucleolar organising regions in cervical intraepithelial neoplasia.
Authors: Rowlands D C
Published: June 2007

The variations in the numbers of nucleolar organising regions (NORs) among different grades of cervical intraepithelial neoplasia (CIN) were investigated using a silver staining technique. Twenty four biopsy specimens were studied (six normal and six of each of the three grades of CIN) by staining paraffin wax sections using a silver (AgNOR) method that stains the NORS as multiple black dots within nuclei (AgNORs). The number of AgNORs in the nuclei of cells in the basal half of the squamous epithelium was counted, and the average number of AgNORs in each cell calculated for each specimen (the AgNOR count). There was no difference in the number of AgNORs in the squamous epithelium of normal biopsy specimens and those showing CIN1 and CIN2, but there was a small but significant increase in the CIN3 group.
Enzyme linked immunosorbent assay (ELISA) for cytomegalovirus antibody in donor plasma.
Authors: Ramskill S , Senior P , Barlow P , Tovey L A
Published: June 2007

An adaptation of an enzyme immunoassay technique was developed to screen donor plasma for high titres of antibodies to cytomegalovirus (CMV). The technique uses microtitre plates treated with glutaraldehyde and coated with CMV antigen and an anti-IgG alkaline phosphatase conjugate to detect the captured antibody. Using an anti-CMV standard with a 1/64 titre by complement fixation, 34 (6.8%) of 500 sera were shown to have an antibody titre that was acceptable to the Blood Products Laboratory in England for anti-CMV immunoglobulin production.
Human herpes virus type 6 (HHV-6) and its in vitro effect on human immunodeficiency virus (HIV).
Authors: Pietroboni G R , Harnett G B , Farr T J , Bucens M R
Published: June 2007

Human herpes virus type 6 (HHV-6) was isolated from the peripheral blood lymphocytes of a patient infected with human immunodeficiency virus (HIV). Antibodies to this herpes virus were found to be widespread among adults and children in Western Australia. Co-infection studies indicated that HIV replication was inhibited by the presence of HHV-6.
Comparison of latex and haemolysin tests for determination of anti-streptolysin O (ASO) antibodies.
Authors: Curtis G D , Kraak W A , Mitchell R G
Published: June 2007

A latex agglutination test was compared with the micro-titration haemolysin inhibition method for the detection of anti-streptolysin O (ASO) antibodies in 428 serum samples. After slight modification of the latex method to produce maximal agglutination good agreement was shown between the results obtained by the two methods. The latex test had a sensitivity of 83.6%, a specificity of 93.3%, a predictive positive value of 86.5% and a predictive negative value of 91.6%. It was convenient, required less labour than the haemolysin test, and permitted economic testing of small numbers of sera.
Antisera against epitopes resistant to denaturation on T3 (CD3) antigen can detect reactive and neoplastic T cells in paraffin embedded tissue biopsy specimens.
Authors: Mason D Y , Krissansen G W , Davey F R , Crumpton M J , Gatter K C
Published: June 2007

Polyclonal rat antisera, raised against affinity purified CD3 antigen, gave strong immunoenzymatic labelling of T cells in routine paraffin embedded sections, with negligible background staining. The specificity of these reactions was confirmed by staining biopsy specimens from 21 previously phenotyped non-Hodgkin's lymphomas (including 14 of T cell origin and six of B cell origin). It is suggested that the ability of the polyclonal anti-CD3 antisera to detect T cells in paraffin sections is due to the presence in these sera of antibodies against fixation resistant epitopes on CD3 antigen, and that immunisation with purified denatured preparations of other white cell associated antigens may broaden the range of antibodies suitable for the phenotypic analysis of leucocytes in routine histological samples.
Routine and rapid enzyme linked immunosorbent assays for circulating anti-glomerular basement membrane antibodies.
Authors: Wheeler J , Simpson J , Morley A R
Published: June 2007

Microtitre plate modifications of the original tube enzyme linked immunosorbent assay (ELISA) of Wheeler and Sussman were used for the routine and rapid assays of anti-glomerular basement membrane antibodies in human sera. In a prospective study of 238 sera from 200 patients, the routine assay (about 24 hours) detected circulating antibodies in seven sera from three patients with active anti-glomerular basement membrane disease. The remaining sera, from patients with a variety of other glomerulonephropathies, were negative by the assay. The rapid assays took less than four hours, and in a retrospective study, detected anti-glomerular basement membrane antibodies in a range of 15 positive sera, with a level of discrimination similar to that observed in the routine assay and with no false positive/negative results.
Breast lumps: rare presentation of oat cell carcinoma of lung.
Authors: Kelly C , Henderson D , Corris P
Published: June 2007

Two cases of oat cell carcinoma are described. Both patients presented initially with a lump in the breast. A review of the published reports on breast metastases as a presenting feature of malignant disease was performed and lung cancer was found to be the commonest extramammary tumour to present as a breast mass (80% of cases) and usually as small cell carcinoma.