bluuebunny/crossref_metadata_2025 huggingface dataset:
Complex nature of serum lysozyme activity: evidence of thermolability in inflammatory bowel disease.
Authors: Ward M , Mitchell W D , Eastwood M
Published: June 2007

In patients with Crohn's disease and ulcerative colitis, alterations in serum storage temperature produced significant changes in serum lysozyme activity (SLA) as measured by the lysoplate method. This was not the case in healthy controls or in a group with other gastrointestinal disorders. Electrophoretic separation of serum revealed two components of lysozyme-type lytic activity but only one in extracts of gut mucosa, leucocytes, and egg white. The major lytic component of serum migrated towards the cathode and reacted with specific antilysozyme serum, but the minor component which migrated towards the anode did not. Although the cause of this anionic lytic activity is uncertain, it contributes to total serum activity as estimated by any method utilising the lysis of Micrococcus lysodeikticus, and may possibly be related to the observed thermolability.
Early detection of folic acid deficiency in elderly patients.
Authors: Raper C G , Choudhury M
Published: June 2007

Folic acid deficiency is very common in elderly patients who have a mean red cell volume greater than 94 fl. Eighteen out of 40 elderly patients with red cell macrocytosis who initially had normal red cell folate and serum B12 levels subsequently developed folic acid deficiency.
Isolation of Staphylococcus aureus from sputum in cystic fibrosis.
Authors: Sparham P D , Lobban D I , Speller D C
Published: June 2007

The success in the isolation of Staphylococcus aureus of different methods of sputum processing was investigated in 60 specimens collected from 14 patients with cystic fibrosis during a seven-month period. Fifty specimens (83%) from 11 patients yielded Staph. aureus by one or more methods. Direct plating of purulent portions of sputum on to media designed for general use in respiratory infections gave unsatisfactory results (35% yield of Staph. aureus). Some increase in isolations was obtained with preliminary liquefaction of sputum; but the best results were given by the addition of a medium selective for staphylococci (mannitol salt agar, BBL) or by initial sonication of sputum (each 83% yield). Seven of the 11 strains of Staph. aureus were thymidine-dependent and otherwise atypical in laboratory characteristics; these were isolated from patients who had received co-trimoxazole.
Incomplete anaerobiosis as a cause of metronidazole 'resistance'.
Authors: Milne S E , Stokes E J , Waterworth P M
Published: June 2007

Clostridium welchii, used as a control, was found to grow well in a microaerophilic jar used for campylobacters but appeared resistant to a metronidazole disc although the campylobacter was sensitive. Minimum inhibitory concentrations for six strains of Cl. welchii were up to 64-fold higher in these conditions than when grown anaerobically. Zones of inhibition with both Cl. welchii and Bacteroides fragilis varied with the amount of air admitted to anaerobic jars.
Catecholamines and free fatty acids in plasma of patients undergoing cardiac operations with hypothermia and bypass.
Authors: Hirvonen J , Huttunen P , Nuutinen L , Pekkarinen A
Published: June 2007

Plasma concentrations of adrenaline, noradrenaline, and free fatty acids were measured at different stages of cardiac operations in which hypothermia and bypass were used. The rise of adrenaline, noradrenaline, and free fatty acid concentrations in plasma is consistent with the concept that these are important compounds in stress situations such as hypothermia and surgical operations. There is a more marked release of adrenaline and it may be a more specific hormone in response to hypothermia and bypass than is noradrenaline in man.
Haemoglobin A2 levels in vitamin B12 and folate deficiency.
Authors: Henshaw L A , Tizzard J L , Booth K , Beard M E
Published: June 2007

Haemoglobin A2 levels were measured in 50 patients with vitamin B12 deficiency, 50 patients with folate deficiency, and six patients with combined deficiencies of these vitamins. All were normal except for three patients with vitamin B12 deficiency, who had a slightly elevated Hb A2 level; this fell to normal after vitamin B12 therapy. It is concluded that haemoglobin A2 levels are usually normal in vitamin B12 or folate deficiency. However, raised levels of haemoglobin A2 may be found, but these are not as high as is found in beta thalassaemia trait and should not cause difficutly in diagnosis.
Demonstration of immunoglobulin in cryostat and paraffin sections of human tonsil by immunofluorescence and immunoperoxidase techniques. Effects of processing on immunohistochemical performance of tissues and on the use of proteolytic enzymes to unmask antigens in sections.
Authors: Curran R C , Gregory J
Published: June 2007

A fluorescein isothiocyanate (FITC) technique and one based on peroxidase-antiperoxidase (PAP) were used to study the distribution of immunoglobulin (Ig) in cryostat and paraffin sections of human tonsil. Trypsin and other proteolytic enzymes were used to 'unmask' the antigen in paraffin sections. The effects of processing, and particularly of fixation, on the immunohistochemical response of tissues were studied. The FITC and PAP methods detected Ig in paraffin and cryostat sections equally well. The distribution of the antigen was the same with both methods but the PAP method was the more informative. Formaldehyde-sucrose solution proved more suitable for fixing tissues for immunohistochemistry than glutaraldehyde. Trypsin revealed antigen in parraffin sections more efficiently than pepsin, papain, or pronase. Surface Ig (s-Ig) could be demonstrated in trypsinised paraffin sections but less effectively than in cryostat sections. Trypsinised paraffin sections were, however, more suitable for intracellular Ig (c-Ig) than cryostat sections although the performance of cryostat sections could be improved by prior fixation with a coagulative fixative.
Technical quality control in histopathology.
Authors: Barr W T
Published: June 2007

A pilot scheme for technical quality control in histopathology is described. The test material used and the methods of assessment and reporting are detailed. The scheme outlines not only interlaboratory comparison of technical performance but also provides a method of sharing uncommon material.
Human nails and body iron.
Authors: Sobolewski S , Lawrence A C , Bagshaw P
Published: June 2007

The iron content of human nails has been measured by atomic absorption spectrophotometry and compared with other measurements of iron status including the bone marrow. Four groups of individuals were studied: 40 healthy laboratory staff, five iron-deficient subjects before and during iron therapy, four patients at various stages of treatment with iron, and 15 postmortem cases. The iron status of the individual was reflected by the amount of iron present in nail samples. Nail sampling is proposed as a cheap, noninvasive method of assessing the iron status of the individual.
Pitfalls in the use of artificial substrates for the diagnosis of Gaucher's disease.
Authors: Ben-Yoseph Y , Nadler H L
Published: June 2007

A patient with Gaucher's disease is described, in whom the disease could not be diagnosed enzymically in liver and leucocytes using artificial substrate 4-methylumbelliferyl beta-glucoside. Normal activity was found in the liver, and about 60% of control activity was determined in the patient's leucocytes. In contrast, when [14C]-N-stearoyl glucocerebroside was employed as a substrate, activity as low as 5% of control has been found in all the proband's tissues, and carrier levels were determined in the proband's parents and maternal uncle.
Haemangioendothelioma (Kupffer cell angiosarcoma), myelofibrosis, splenic atrophy, and myeloma paraproteinaemia after parenteral thorotrast administration.
Authors: Jennings R C , Priestley S E
Published: June 2007

A case of thorotrastosis occurred 25 years after thorotrast angiography, with the previously unrecorded association of myeloma type paraproteinaemia. The relationship between haemangioendothelioma due to thorotrast and other vascular sarcomas of the liver is briefly reviewed.
An evaluation of two new haemagglutination tests for the rapid diagnosis of autoimmune thyroid diseases.
Authors: Cayzer I , Chalmers S R , Doniach D , Swana G
Published: June 2007

Two haemagglutination tests using preserved turkey erythrocytes are described for the detection of thyroglobulin and microsomal antibodies, respectively. Comparative studies with the more traditional sheep cell techniques show good correlation of titres when testing sera from patients with autoimmune thyroid disorders.
Determination of antibody levels to Candida albicans in healthy and hospitalised adults using a radioimmunoassay.
Authors: Cobb S J , Parratt D
Published: June 2007

A radioimmunoassay for antibody to Candida albicans is described. The test used whole, killed organisms as the antigen and radiolabelled sheep anti-human globulins to quantitate different classes of antibody to C. albicans. The assay has been compared with an Ouchterlony precipitin method and found to be simpler, more rapid, and more sensitive than the latter. Results obtained from two groups of symptomless adults indicated that the range of antibody level was wider for a hospitalised group than for a group of blood transfusion donors, particularly in respect of IgG and IgA antibody. The reason for the increase of antibody in hospital patients was not clear but may have been related to antibiotic therapy. The difficulties in interpretation of Candida serology have therefore been re-assessed in the light of more detailed knowledge of the range and type of antibody to be expected in normal individuals.
A computer system for clinical microbiology.
Authors: Williams K N , Davidson J M , Lynn R , Rice E , Phillips I
Published: June 2007

The Department of Clinical Microbiology at St Thomas' Hospital has been producing bacteriological reports on a computer for more than three years and is now producing some 2300 reports per week. The system is operated entirely by laboratory staff without special training, and involves the use of optical mark reader (OMR) forms as worksheets, automatic validation and release of most reports, the use of local terminals, and scrutiny of reports by pathologists using a visual display unit. The OMR worksheet records not only the final result but also most of the tests and observations made on the samples; it is the only working document used by technicians. One specialist clinic submits its laboratory requests on an OMR form, which is subsequently used to record the results. The reports are printed and also filed in the computer to produce analyses for hospital, laboratory, and clinical management.
Continuous-flow analysis of ammonia in perchloric acid supernate of blood or plasma using an ammonia-selective electrode.
Authors: Moses G C , Thibert R J , Draisey T F
Published: June 2007

A simple automated method for the estimation of ammonia in perchloric acid supernate of blood or plasma using an ion-selective electrode (Orion Ammonia-selective electrode, Model 95-10) is described. The reliability of the proposed method has been checked against an ion-exchange resin procedure, which has been chosen as a standard procedure. Regression equation and correlation coefficient for the proposed method are y = 0.7 X + 10 and 0.945, respectively, as compared with the chosen standard method. Within-run and between-run precision are 2.1% and 3.5% respectively. The average percent recovery is 97.5% and a tentative range is 13-73 microgram/dl (9-52 micronmol/l) ammonia nitrogen.
Benign oesophageal papillomatosis. A case report with a review of the literature.
Authors: Waterfall W E , Somers S , Desa D J
Published: June 2007

An 18-year-old boy presented with a four-year history of dysphagia which had been treated repeatedly by endoscopic removal of papillomata of the oesophagus. Eventually, due to increasing dysphagia and repeated recurrences of the papillomata, resection of the affected lower third of the oesophagus was deemed necessary. The resected segment of the oesophagus was carpeted with numerous benign squamous papillomata. The clinical features, radiographic appearances, and pathology of this extremely rare tumour are presented. Only two acceptable cases of oesophageal papillomata can be found in the literature, making this the third case, and apparently the only one with multiple lesions.
Sterilisation in the laboratory autoclave using direct air displacement by steam.
Authors: Everall P H , Morris C A , Yarnell R
Published: June 2007

A device using a steam injection funnel is described by means of which air can be driven quickly and surely from an autoclave load. It is simple and inexpensive, necessitates no changes in the working routine of a microbiology laboratory, and does not interfere with the operation of the autoclave in its normal mode.
Synergy between sulphonamide and trimethoprim in the presence of pus.
Authors: Edmunds P N
Published: June 2007

Synergy between sulphadiazine and trimethoprim against Escherichia coli has been demonstrated in culture media not containing lysed horse blood despite the presence of pus or a pus extract which inhibited the action of each drug separately. Synergy may therefore be important where pus is present in vivo.
Isolation of chlamydiae in untreated and Cytochalasin B treated McCoy cells.
Authors: O'Neill J J , McLean B M , Hambling M H
Published: June 2007

A comparison was made between untreated McCoy cells and McCoy cells treated with Cytochalasin B for the isolation of chlamydiae of subgroup A. Chlamydiae were isolated in both cell systems from 125 specimens, whereas six agents were isolated only in untreated cultures and seven agents were isolated only in Cytochalasin B treated cultures.
Identification of clinical isolates of Neisseria gonorrhoeae by a coagglutination test.
Authors: Barnham M , Glynn A A
Published: June 2007

Ninety-eight per cent of laboratory isolates of Neisseria gonorrhoeae from a veneral disease clinic gave positive reactions with a gonococcal coagglutination test. The prototype reagent, however, was poor at distinguishing between different species of the genus Neisseria: 75% of strains of Neisseria meningitidis and 40% of other Neisseria species tested gave positive reactions. None of the origanisms other than Neisseria growing on the diagnostic cultures from the clinic gave positive reactions. We therefore suggest that the present reagent is unsuitable for testing isolates from the upper respiratory tract. The technique is simple, rapid, and convenient and with a more specific antibody could be useful. Results of coagglutination reactions of 126 strains of Neisseria grown on serum-containing and serum-free media were very similar and there is no need to use special serum-free media.
Ultrastructure of Ebola virus particles in human liver.
Authors: Ellis D S , Simpson I H , Francis D P , Knobloch J , Bowen E T , Lolik P , Deng I M
Published: June 2007

Electron microscopy of tissues from two necropsies carried out in the Sudan on patients with Ebola virus infection identified virus particles in lung and spleen, but the main concentrations of Ebola particles were seen in liver sections. Viral precursor proteins and cores were found in functional liver cells, often aligned in membrane-bound aggregations. Complete virions, usually found only extracellularly, were mainly seen as long tubular forms, some without cores. Many tubular forms had 'enlarged heads' or 'spores' and some branched and torus forms were identified. The size and structure of the Ebola virus forms appear to be virtually indistinguishable from those of Marburg virus.
Evaluation of the Microcult system for isolating and identifying Neisseria gonorrhoeae.
Authors: Williams R J , Ratnatunga C S , Hamilton-Miller J M , Brumfitt W
Published: June 2007

Specimens from 95 patients attending a venereal diseases clinic were examined for gonococci by three methods--a conventional culture technique using modified Thayer-Martin medium, microscopy of a Gram-stained direct smear, and the Microcult system. For 56% of the specimens the results by all three methods agreed. Assuming the results obtained by culture on Thayer-Martin medium to be correct, the largest source of error was due to false-positive results: microscopy gave 26 and Microcult gave 15 such results. False-negative results were less common: Microcult gave 14, microscopy six. Microcult gave positive results more quickly than the conventional Thayer-Martin cultural method, but the gonococci were difficult to isolate by subculture from the Microcult culture pads. The Microcult medium was not absolutely specific for Neisseria gonorrhoeae. Nevertheless, the Microcult test may well prove to be a useful adjunct to the diagnosis of gonorrhoea, especially when laboratory facilities are not readily available.
Flavobacterium meningosepticum as an opportunist.
Authors: Mani R M , Kuruvila K C , Batliwala P M , Damle P N , Shirgaonkar G V , Soni R P , Vyas P R
Published: June 2007

Flavobacterium meningosepticum was isolated from the cerebrospinal fluid of an adult immunodeficient female. In spite of prompt therapy the patient succumbed to the infection. The opportunistic role of the organism is discussed.
Polyene antibiotics in assessing significance of antistreptolysin O activity.
Authors: Watson K C , Kerr E J
Published: June 2007

Antistreptolysin O activity in serum is due either to antibody or to altered lipoprotein molecules. The latter can be inhibited by performing antistreptolysin tests using a polyene antibiotic such as amphotericin B as diluent.
Lazy leucocyte syndrome--disorder of the granulocyte membrane?
Authors: Pinkerton P H , Robinson J B , Senn J S
Published: June 2007

An adult with long-standing neutropenia had the functional granulocyte abnormalities typical of the lazy leucocyte syndrome. Scanning electron microscopy of the patient's neutrophils showed alteration in the surface configuration of the cell with coarsening of the normal fine ruffles and the appearance of knob-like projections. Similar functional and anatomical changes were induced in normal neutrophils by treatment with vinblastine. The lazy leucocyte syndrome may be a consequence of altered membrane microfilamentous protein structure or function, and undue rigidity of the affected neutrophils may explain the clinicopathological features of the disease.
Distribution of transferrin, ferritin, and lactoferrin in human tissues.
Authors: Mason D Y , Taylor C R
Published: June 2007

An immunoperoxidase staining technique was used for detecting three major iron-binding proteins (transferrin, ferritin, and lactoferrin) in routine histological paraffin sections of human tissue. Transferrin was found mainly in hepatocytes, a variety of epithelial and myoepithelial cells, renal tubular cells, and histiocytes. Ferritin was most readily found in histiocytes and liver cells, with weaker reactions seen in epithelial cells. Lactoferrin was found in lactating breast tissue, bronchial glands, polymorphs, and gastric and duodenal epithelial cells. The technique is potentially valuable for investigating abnormal iron states.
Aberrant form of Pseudomonas aeruginosa in sputum and cerebrospinal fluid causing infection in a compromised patient.
Authors: Middleton J , Chmel H
Published: June 2007

A patient with non-Hodgkin's lymphoma developed meningitis due to an aberrant form of Pseudomonas aeruginosa observed on Gram stain. The organism was grown on primary isolation media without needing hypertonic media. The significance of aberrant forms in body fluids is discussed.
Comparison of susceptibility of Neisseria meningitidis to sodium sulphadiazine and sodium fusidate in vitro.
Authors: Miles R S , Moyes A
Published: June 2007

Out of 100 strains of meningococci examined 62 were resistant to 1 mg/l or more of sodium sulphadiazine, including 82% of group W135 strains and 69% of group B strains. All strains were sensitive in vitro to 0.5 mg/l of sodium fusidate. Sodium fusidate should be considered as a chemoprophylactic agent for those who may be at risk of meningococcal disease.
Purification of specific precipitinogen and extraction of endotoxin from Haemophilus influenzae.
Authors: van der Zwan J C , Dankert J , de Vries K , Orie N G , Kauffman H F
Published: June 2007

After purifying a Haemophilus influenzae precipitinogen from endotoxic activity by means of ultracentrifugation, column chromatography (Sepharose 6B) and ion exchange chromatography (DEAE Sephadex A25) a fraction was obtained which still contained a specific precipitinogen that was virtually free of endotoxin. Furthermore, during the chromatographic procedures fractions with a high and a low molecular weight endotoxic activity were found. The limulus lysate test was more sensitive in the high molecular weight fractions and the LD50 in mice in the low molecular weight fractions with endotoxic activity.
Quantitative recovery of spores from thermophilic spore papers.
Authors: Everall P H , Morris C A
Published: June 2007

A homogeniser (Stomacher 400) which does not damage bacteria has been used to produce an homogenate of spore papers, from which it was possible to make quantitative assessments of viable spores recoverable from such papers before and after exposure to sterilising procedures.
Use of polyvinylpyrrolidone in the testing of staphylococci for sensitivity to methicillin and cephradine.
Authors: Bayston R
Published: June 2007

The use of polyvinylpyrrolidone, an inert polymer resembling plasma proteins in its colligative effects, in the testing of micrococcaceae for sensitivity to methicillin and cephradine is described. Generally results are quite comparable with those of conventional methods. The absence of any inhibitory effect of the polymer compared to sodium chloride, and its physiological inertia compared to sucrose, along with its suitability for sterilisation by autoclaving are seen as advantages. It is suggested that the use of this substance may give results which are more applicable to the in vivo situation. This may apply particularly in the case of cephradine.
Urine xanthine oxidase activity in urinary tract infection.
Authors: Giler S , Henig E F , Urca I , Sperling O , de Vries A
Published: June 2007

Xanthine oxidase (XO) activity was found to be negligible in sterile human urines (less than 480 units, as presently defined, per litre). Significant XO activity was found in all urines containing more than 10(5) bacteria/ml, except for urines infected with Staphylococcus aureus, in which XO activity ranged from 347 to 714 units per litre. Plasma XO is not transferred to the urine, as demonstrated by the negligible XO activity found in sterile urines from patients with raised plasma XO activity. Determination of urinary XO activity is a suitable procedure for the detection of urinary tract infection.
Cell receptor studies on six anaplastic tumours of the thyroid.
Authors: Macaulay R A , Dewar A E , Langlands A O , Stuart A E
Published: June 2007

Cell suspensions from six anaplastic thyroid tumours were studied for expression of lymphocyte and macrophage surface markers, and results were correlated with electron microscopy, clinical extent of disease, and response to radiotherapy. The clinical presentation of the disease was similar in all six patients. In five cases, many of the cells showed surface immunoglobulin. Electron microscopy was available on three of these and showed appearances in keeping with malignant lymphoma. The single case whose cells did not show surface immunoglobulin had an entirely different ultrastructure and was probably a carcinoma. This case was the only one that did not achieve complete remission with radiotherapy and the patient died from extensive local recurrence. It is concluded that receptor techniques are of value in distinguishing between malignant lymphoma and other anaplastic tumours of the thyroid, particularly when the results are correlated with histology.
Enzyme immunoassays with special reference to ELISA techniques.
Authors: Voller A , Bartlett A , Bidwell D E
Published: June 2007

In this review outlines are given on various types of enzyme immunoassay. The applications to such enzyme immunoassays, especially ELISA, are dealth with in detail. It is concluded that these techniques have high sensitivity and will be suitable in due course as routine laboratory tests.
Evaluation of the single radial haemolysis (SRH) technique for rubella antibody measurement.
Authors: Russell S M , Benjamin S R , Briggs M , Jenkins M , Mortimer P P , Payne S B
Published: June 2007

Sera from 1258 individuals have been tested by four laboratories for rubella antibody by both the haemagglutination-inhibition and single radial haemolysis techniques. There was good agreement between the results obtained by the two methods. Although sheep red blood cells were used in the single radial haemolysis plates, no problems were encountered with sera from patients with infectious mononucleosis. The single haemolysis technique was found to be simple, convenient, and reliable, and suited to the rapid screening of large numbers of sera to assess susceptibility to rubella in the context of a vaccination campaign. However, since the technique does not detect anti-rubella IgM, it should not be used as the only test to investigate suspected recent infection.
Phagocytosis and killing of staphylococci by human polymorphonuclear and mononuclear leucocytes.
Authors: Verbrugh H A , Peters R , Peterson P K , Verhoef J
Published: June 2007

The phagocytosis and killing of 3H-thymidine-labelled Staphylococcus aureus by polymorphonuclear leucocytes (PMNs) and monocytes (MNs) obtained from 50 health donors were evaluated. In addition, extracellular factors that might influence phagocytosis and killing were studied. The method described gave highly reproducible results. No significant difference was observed in the phagocytic and killing functions of a single donor's PMNs and MNs when studied several times in one day and longitudinally over a period of 1-12 weeks for six donors tested. Likewise, no signigicant difference in uptake and killing was observed when bacteria were opsonised with sera from 11 different normal donors. When Staph. aureus opsonised with normal serum was added to the leucocytes in a ratio of 10 bacteria: 1 leucocyte, the uptake by PMNs and MNs from 50 donors after 20 minutes' incubation was 85% +/- 7 standard deviation (SD) (range 75-98%) and 69% +/- 11 SD (range 54-90%), respectively. The rate of uptake by MNs in the first three minutes of the assay period was only 60% of that by PMNs.
Overlap in the spectrum of non-specific inflammatory bowel disease--'colitis indeterminate'.
Authors: Price A B
Published: June 2007

It is stated that 10-20% of cases of non-specific inflammatory bowel disease cannot be classified. Thirty such cases, designated colitis indeterminate at the time of colectomy, were identified from the pathology files of St. Mark's Hospital. The Histopathological features of the surgical specimens and any available biopsy specimens were studied. In nearly all the cases urgent surgery had been required and the features of incipient or established fulminating disease were present. The pathology of these cases of Crohn's disease and ulcerative colitis overlapped, and differentiating features were scant or unreliable. Accepted criteria of Crohn's disease--namely, fissuring ulceration, transmural inflammation, and a maintained goblet-cell population--were found in cases subsequently proved to be ulcerative colitis. Disease activity greatly affected the evaluation of morphological features. Many of the difficulties were resolved when biopsy material obtained during a quiescent phase was examined. The specimens gave a dynamic perspective of the disease process, often more valuable than the static, non-specific picture of acute disease seen in the surgical specimens. Case of colitis indeterminate form a small distinctive group in the spectrum of inflammatory bowel disease which is characterised by a common pattern of pathology that presents a diagnostic dilemma.
Ectopic ACTH syndrome: clinicopathological correlations.
Authors: Singer W , Kovacs K , Ryan N , Horvath E
Published: June 2007

Ten out of 164 cases of bronchogenic carcinoma showed pathological evidence at necropsy of the ectopic ACTH syndrome. All occurred in association with oat-cell carcinoma, constituting 19% of that group. The pathological features consisted of adrenocortical hyperplasia confined to the zona fasciculata and Crooke's hyaline change in the pituitary. Immunoperoxidase stainable ACTH was detected in the pituitary but not in the carcinoma tissue, a surprising finding, which may be due to the different nature of ACTH present in tumour tissue. The ectopic ACTH syndrome was diagnosed ante mortem in only four out of 10 patients on the basis of hypokalaemia and metabolic alkalosis. The lack of clinical pointers in all but terminal cases is discussed as well as possible measures for earlier diagnosis.
Blood cells and alcohol consumption with special reference to smoking habits
Authors: Eschwege E. , Papoz L. , Lellouch J. , Claude J. R. , Cubeau J. , Pequignot G. , Richard J. L. , Schwartz D.
Published: June 2007

In the course of the Paris study on risk factors of cardiovascular disease in a large professional group, 7710 active and apparently healthy men aged between 48 and 54 were examined. This study measured the relationship between clinical abnormalities suggesting alcoholic liver disease (ALD) and the following blood parameters: white (WBC) and red (RBC) blood cell counts, haematocrit (H), and mean corpuscular volume (MCV), the former computed as H/RBC ratio. A subsequent analysis was performed on a random sample of 485 subjects without ALD who were questioned on their daily average alcohol consumption. Each subject was classified as `smoker' or `non-smoker' according to his daily tobacco consumption for the last five years. Analysis of the data confirmed that smoking and alcohol were related to the blood parameters; but, according to smoking habit, different relationships between alcohol consumption (or ALD) and MCV, RBC, or WBC counts were found: for smokers, RBC count significantly decreased and MCV increased with alcohol consumption (or ALD); for non-smokers, WBC count significantly increased with alcohol consumption (or ALD). So, it would be of interest to consider the relation between alcohol and tobacco in interpreting possible changes in blood parameters and in formulating hypotheses on the mechanisms of their specific action.
Serum total lipids, lipoprotein cholesterol, and apolipoprotein A in acute viral hepatitis and chronic liver disease.
Authors: Vergani C , Trovato G , Delù A , Pietrogrande M , Dioguardi N
Published: June 2007

Serum total lipids, lipoprotein cholesterol, apolipoprotein A (Apo A), and liver function tests have been investigated in patients with acute viral hepatitis and chronic liver disease. Hypertriglyceridaemia, absence of alpha and pre beta bands on the lipoprotein electrophoresis pattern, low level of Apo A, and presence of abnormal lipoproteins (beta-VLDL and beta2-LP) were observed in the early phase of acute hepatitis. A positive correlation was found between Apo A and high-density lipoprotein cholesterol, and a negative one between Apo A and triglyceride, bile acids, total bilirubin, and serum alanine aminotransferase. Lipoprotein abnormalities found in the early phase of acute hepatitis are probably due to low lecithin-cholesterol acyltransferase activity. The reappearance of alpha lipoprotein and the increase of Apo A are sensitive indices of improvement of liver function. In chronic liver disease low levels of cholesterol and Apo A indicate the severity of liver cell injury.
Serum elastase and its inhibitors in the blood of heavily burnt patients.
Authors: Miskulin M , Moati F , Robert A M , Robert L , Monteil R , Guilbaud J
Published: June 2007

Serum elastase and its inhibitors were determined in the sera of heavily burnt patients. Serum elastase levels were elevated at two to eight days after a severe burn-accident and returned towards normal values from the 10th day on. Both alpha1-antitrypsin and alpha2-macroglobulin levels were also elevated in the sera of heavily burnt patients. alpha1-Antitrypsin showed a parallel evolution to the elastase level but alpha2-macroglobulin followed a somewhat different time curve. Plasminogen and antithrombin were not elevated significantly. It is suggested that serum elastase may play a role in tissue degradation in burnt patients.
Viruses in the stools.
Authors: Madeley C R
Published: June 2007

It has long been possible to isolate viruses from the stools by culture, though the viruses found are rarely implicated in disease of the gut. In contrast, only recently has it been possible to identify viruses in the stools of patients with diarrhoea. Initially, such identifications were made by electron microscopy but the unsuitability of the microscope for large-scale screening has led to the development of other methods. The new methods have concentrated on rotaviruses but other viruses are also implicated and an overall view of the significance of finding a virus in any stool specimen has to take into account the evidence about all viruses, old and new.
Fatal anaphylaxis in systemic mastocytosis.
Authors: Dodd N J , Bond M G
Published: June 2007

A 42-year-old woman died after an episode of anaphylaxis associated with a raised serum histamine level. A diagnosis of systemic mastocytosis was established, with lymphadenopathy and hepatosplenomegaly, not associated with the usually pre-existing skin lesions of urticaria pigmentosa.
Identification of Gram-negative non-fermenters and oxidase-positive fermenters by the Oxi/Ferm Tube
Authors: Holmes B. , Dowling J. , Lapage S. P.
Published: June 2007

Since the recent introduction of the Roche Oxi/Ferm Tube to the UK two identification schemes have been developed by the manufacturer for use with the kit. We evaluated the success of these two schemes in identifying 222 predominantly culture collection strains belonging to 45 taxa of non-fermenters and nine taxa of oxidase-positive fermenters. The strains were chosen to represent all the taxa included in the two identification schemes developed by the manufacturer and we have therefore been able to assess the overall success of identification by the two schemes. Since, however, our choice of strains does not reflect their incidence in clinical material, our identification rates are not necessarily those that might be obtained in a routine clinical laboratory. The most advanced identification scheme so far developed for the Oxi/Ferm Tube (CCIS System 1977-1432) allowed 62% of the 222 strains to be correctly identified although a disturbing feature was that more of the strains that were not correctly identified were incorrectly identified (24%) rather than not identified (14%); these figures represent an improvement over the earlier identification scheme (CCIS System 1976-621-74346) for which the corresponding figures were 56%, 32%, and 12%. CCIS System 1977-1432 seems likely to give a better performance in a routine clinical laboratory than in this study since for those taxa which, we would judge from the material sent to us for identification, are most commonly seen in a routine laboratory (Acinetobacter calcoaceticus, A. lwoffii, Pseudomonas aeruginosa, P. fluorescens, P. maltophilia, P. pseudoalcaligenes,andP. putida) 89% were correctly identified, none remained unidentified, and 11% were incorrectly identified. Thirty strains, each of a different taxon, were tested in triplicate to assess the reproducibility of reactions in the Oxi/Ferm Tube.
Serum immunoreactive trypsin concentration after a Lundh meal. Its value in the diagnosis of pancreatic disease.
Authors: Lake-Bakaar G , McKavanagh S , Redshaw M , Wood T , Summerfield J A , Elias E
Published: June 2007

The changes in serum trypsin concentration have been measured in 47 subjects for up to 2 hours after a Lundh meal. In 18 healthy controls, mean fasting trypsin concentration was 285 +/- 125 ng/ml (mean +/- 2 SD). The maximum increase after the Lundh meal (the trypsin response ratio) was 6.7 +/- 7.5%. Six patients with chronic renal failure had elevated fasting serum trypsin concentrations (range 460-1100 ng/ml) but trypsin response ratios fell within the control range. Of five patients with relapsing pancreatitis, two had raised and three normal or low fasting trypsins. After stimulation two had elevated trypsin response ratios; one of the two had evidence of main duct obstruction. Eleven out of 12 patients with chronic pancreatitis (with or without insufficiency) had low fasting trypsin concentrations (range 0-120 ng/ml) Seven of the 12 also had raised trypsin response ratios. In six patients with cancer of the pancreas, fasting trypsin was low in three, normal in two, and raised in one. Both patients with a normal fasting level had a raised trypsin response ratio. The combination of a single estimation of fasting serum trypsin concentration followed by serial measurements after a Lundh meal provides a useful screening test for chronic pancreatic disease.
Acquired von Willebrand's syndrome with IgM inhibitor against von Willebrand's factor.
Authors: Gouault-Heilmann M , Dumont M D , Intrator L , Chenal C , Lejonc J L
Published: June 2007

This report describes a patient without evident underlying disease, in whom an acquired von Willebrand's syndrome was discovered before surgery. Coagulation abnormalities included a borderline bleeding time, a low retention of platelets on glass beads, decreased levels of factor VIII procoagulant activity (VIIIAHF), factor VIII-related antigen (VIIIAg), and ristocetin-induced agglutination cofactor (VIIIVWF). After cryoprecipitate infusion the patient did not have the expected rise and there was no secondary increment in VIIIAHF. The patient was treated with prednisone for three weeks without significant improvement in the laboratory findings. Spontaneous resolution was observed long after this therapy. The haemostatic abnormalities were attributable to the presence of an inhibitor directed against VIIIVWF. The inhibitor was found in the IgM fraction. Its autoimmune nature is probable although we failed to demonstrate any inhibitory effect of Fab obtained from the patient's purified IgM. Despite the lack of inhibitory effect against VIIIAHF and VIIIAg, the low levels of all three activities of the factor VIII complex could be explained by the short half-life of immune complexes between factor VIII and the inhibitor.
Clinical evaluation of eosinophils in the sputum.
Authors: Vieira V G , Prolla J C
Published: June 2007

The sputum differential eosinophil/neutrophil count was done in 384 patients using Leishman staining. The patients were distributed in four groups: bronchial asthma (197 patients); chronic bronchitis with wheezing (45 patients); chronic bronchitis and/or emphysema without wheezing (73 patients); other pulmonary diseases (64 patients). Eosinophils were present in patients from all groups but more frequently (P less than 0.001) in asthma: 142 (72%) of 197 patients. In bronchial asthma and chronic bronchitis with wheezing the percentages of eosinophils were more frequently (P less than 0.001) above 80%: 57% and 58% of the patients respectively. The other two groups had more cases with 19% or less eosinophils. There is no percentage level specific for asthma but levels above 80% of eosinophils are strongly suggestive of asthma or of chronic bronchitis with wheezing.
Significance of the detection of beta-galactosidase and of beta-xylosidase in the taxonomic study of the genus Haemophilus.
Authors: Hansen W , Schoutens E , Yourassowsky E
Published: June 2007

A total of 314 strains of Haemophilus, isolated from clinical samples, were studied for the production of beta-galactosidase and beta-xylosidase. None of the H. influenzae strains studied (9 beta-lactamase positive strains and 129 beta-lactamase negative strains) possessed these enzymes. Both enzymes were almost constantly observed among strains of H. paraphrophilus (10 strains studied) and of H. paraphrohaemolyticus (9 strains studied). Among the other species (H. parainfluenzae, 55 strains; H. haemolyticus, 5 strains; H. parahaemolyticus, 97 strains), beta-galactosidase was present in about 30% of the strains studied whereas beta-xylosidase was detected occasionally (3% of the strains studied). Detection of these two enzymes could be a valuable test for the taxonomic study of the genus Haemophilus. However, the type of substrate used for the detection of beta-xylosidase is important: use of the para-nitro-phenyl-beta-xylopyranoside yielded more positive results than the use of its ortho-isomer.
Evaluation of bacteriological swabs and transport media in the recovery of group B streptococci on laboratory media.
Authors: Cumming C G , Ross P W
Published: June 2007

The survival of group B streptococci on a variety of swabs, held either in their containers or in transport media for periods of up to 48 hours, at room temperature and at 4 degrees C, has been assessed. Results indicated that holding swabs in transport media did not favour prolonged survival of the streptococci and that the yield of organisms was much greater from swabs held in their ordinary plastic tubes. A holding temperature of 4 degrees C rather than room temperature is recommended if any delay in plating out swabs is anticipated.
Pulmonary carcinoid tumours: a comparative regional study.
Authors: Cooney T , Sweeney E C , Luke D
Published: June 2007

Twenty-two pulmonary carcinoid tumours (18 central, 4 peripheral) were seen in this department over an 11-year period. The majority of the tumours displayed a mixed pattern on microscopic examination, and cell-nest formation was a prominent feature in sixteen. The findings are at variance with the results of a similar series reported from Japan and suggest that there is regional variation in the tumour pattern of pulmonary carcinoids. Various aspects of the histopathology are discussed, and a causal relationship between ossification of bronchial cartilage in these tumours and locally produced calcitonin is postulated.
Sea blue histiocytosis in a patient with chronic non-neuropathic Niemann-Pick disease.
Authors: Dewhurst N , Besley G T , Finlayson N D , Parker A C
Published: June 2007

A patient with Niemann-Pick disease is reported together with family studies. Her liver and bone marrow were shown to be infiltrated with sea blue histiocytes. Other organs, spleen and lung, were presumably also involved but histological proof was not obtained. Enzyme assay of leucocytes, lymphocytes, and cultured skin fibroblasts showed the patient to be deficient in sphingomyelinase activity. In fibroblasts, activity was 5% of normal while for the parents activity was about 50% of normal. The expected partial deficiency was not found using leucocytes or lymphocytes from the parents. Heat stability studies on fresh fibroblast extracts from the propositus indicated that residual sphingomyelinase activity was slightly more labile than that of the controls. It seems clear that chronic Niemann-Pick disease without neurological involvement is associated with sea blue histiocytosis.
Changes in the heparin neutralising activity of platelet poor plasma after immunisation.
Authors: Baker I A , Howells C H , O'Brien J R
Published: June 2007

Acute myocardial disease, which may be associated with abnormal platelet activity, has been reported after routine immunisation. Thirty-two army apprentices undergoing immunisation were studied for changes in the heparin neutralising activity (HNA) of platelet poor plasma. HNA increased after immunisation. This increase in HNA may represent an increase in platelet activation but may also relate to changes in acute phase proteins. These changes were not observed in elderly subjects undergoing immunisation with influenza vaccine.
Ultrastructure of Legionella pneumophila.
Authors: Rodgers F G
Published: June 2007

Eleven lung samples positive for Legionnaires' disease, 12 strains of Legionella pneumophila cultured on various bacteriological media, and one strain growth in the yolk sac of fertile hens' eggs were examined by negative staining, thin sectioning, and scanning electron microscopy. All organisms studied were ultrastructurally similar irrespective of strain, source, or method of cultivation, presenting mainly as short rods, 0.6 x 1.5 micrometer, with tapered ends, though long forms and filaments were also evident. In this they resembled typical Gram-negative organisms. Division was by non-septate binary fission, and the cell wall was composed of two triple-unit membranes with morphological evidence of a peptidoglycan layer. The bacterial cytoplasm was rich in ribosomes and nuclear elements and often contained vacuoles. No acid polysaccharides or bacterial appendages were detected surrounding the organisms. In lung tissue and yolk sac membranes, the organisms replicated within the cytoplasm of infected cells and in the intercellular spaces and were specifically identified in thin sections by immunoferritin techniques.
A histochemical comparison of the O-acylated sialic acids of the epithelial mucins in ulcerative colitis, Crohn's disease, and normal controls.
Authors: Culling C F , Reid P E , Dunn W L
Published: June 2007

Two histochemical techniques, the PAT/KOH/PAS and the PBT/KOH/PAS, were used to investigate the side chain O-acyl substitution patterns of the sialic acids of the colonic epithelial mucins in cases of ulcerative colitis and Crohn's disease. In both diseases there was, as compared to normal, a reduction in the proportion of sialic acids O-acylated at C7C8, the reduction being greater in ulcerative colitis. Further, there appeared to be an association between the severity of the disease and the reduction in the staining of O-acylated sialic acids. This relationship was more marked in ulcerative colitis. In some cases of both diseases there was evidence for epithelial mucins containing predominantly C7-substituted sialic acids. This study has confirmed our previous conclusion that, in Crohn's disease of the terminal ileum, the disease is associated with an increase in the proportion of sialic acids bearing side chain substituents.
Anaerobic organisms in postoperative wounds.
Authors: Sanderson P J , Wren M W , Baldwin A W
Published: June 2007

A survey of the bacteria found in postoperative wounds was undertaken during a 14-month period. The yields of aerobic and anaerobic bacteria in 65 appendicectomy wounds were compared; 42 wounds yielded aerobes and 51 anaerobes. Seventy-eight other operation wounds yielded anaerobes, and, overall, 33 wounds yielded anaerobes only. Bacteroides sp were the most common anaerobic organisms isolated from all operation sites except the lung.
A new technique for Gram staining paraffin-embedded tissue.
Authors: Engbaek K , Johansen K S , Jensen M E
Published: June 2007

Five techniques for Gram staining bacteria in paraffin sections were compared on serial sections of pulmonary tissues from eight bacteriological necropsies. Brown and Hopp's method was the most satisfactory for distinguishing Gram-positive and Gram-negative bacteria. However, this method cannot be recommended as the preparations were frequently overstained, and the Gram-negative bacteria were stained indistinctly. A modification of Brown and Hopps' method was developed which stains larger numbers of Gram-negative bacteria and differentiates well between different cell types and connective tissue, and there is no risk of overstaining.