bluuebunny/crossref_metadata_2025 huggingface dataset:
Foamy myocardial transformation of infancy: an inherited disease.
Authors: Suarez V , Fuggle W J , Cameron A H , French T A , Hollingworth T
Published: June 2007

Five cases of foamy myocardial transformation of infancy, a condition which predominantly affects female children under 2 years of age and which causes cardiac arrhythmia or sudden death, are reported. Of these five cases, four occurred in two sets of siblings, suggesting a possible hereditary basis for the disease. As far as we know, no other familial cases have been reported. The other case was of focal disease of the myocardium, as opposed to the diffuse myocardial changes seen in the four familial cases.
Value of charcoal media for recovering staphylococci incorporated in mupirocin ointment.
Authors: Barr J G , Hogg G M
Published: June 2007

The use of charcoal blood agar supported a good recovery of staphylococci incorporated in Mupirocin ointment in a test in vitro system. The efficacy of this medium was particularly emphasised in the recovery of staphylococci damaged by six hours' exposure to Mupirocin. The media will be of value in following the progress of staphylococcal carriage or infection in patients or carriers being treated with topical Mupirocin.
Oncogenic osteomalacia.
Authors: McClure J , Smith P S
Published: June 2007

Severe osteomalacia (confirmed by the examination of thin undecalcified bone biopsy sections) associated with hypophosphataemia developed in a 60 year old woman. A skeletal x-ray survey showed a lytic lesion in the right proximal femur, and this was curetted, showing a vascular tumour. The patient's symptoms improved almost immediately and serum phosphate concentrations returned to normal. Some time later the syndrome and the tumour recurred. The tumour was excised, and again the patient improved. Morphological examination of the tumour showed a lesion which closely resembled haemangiopericytoma. Review of published reports confirmed that most reported cases have been associated with "vascular" mesenchymal tumours both in intraosseous and extraosseous sites.
Restorative proctocolectomy with ileal reservoir: pathological and histochemical study of mucosal biopsy specimens.
Authors: Shepherd N A , Jass J R , Duval I , Moskowitz R L , Nicholls R J , Morson B C
Published: June 2007

Mucosal biopsy specimens from the ileal reservoirs of 92 patients who had undergone restorative proctocolectomy (12 with familial adenomatous polyposis, 78 with ulcerative colitis, and two with functional bowel disease) were studied. Chronic inflammation was found in almost all, as was villous atrophy of varying severity. Other changes included pyloric metaplasia and mucosal prolapse. Acute inflammatory changes and ulceration were less common but, when present, corresponded to the clinical condition of "pouchitis". A grading system was devised to score acute and chronic inflammatory changes. There was a significant increase in acute inflammatory scores in ulcerative colitis compared with those in familial adenomatous polyposis, and pouchitis was present only in patients who had had ulcerative colitis; the morphological features of pouchitis are similar to those seen in the colorectal mucosa in ulcerative colitis. Histochemical studies of mucin in the reservoirs of mucosa showed that there may have been a change from small intestinal mucin to colonic mucin.
Reactive thrombocytosis in pulmonary tuberculosis.
Authors: Baynes R D , Bothwell T H , Flax H , McDonald T P , Atkinson P , Chetty N , Bezwoda W R , Mendelow B V
Published: June 2007

The incidence of reactive thrombocytosis in active pulmonary tuberculosis was studied in 122 patients. Thrombocytosis was common, platelet counts often exceeding 1 X 10(12)/1. A significant inverse correlation was noted between the mean platelet volume and the platelet count (r = -0.54, p less than 0.0001). Interval estimation suggested that this relation was non-linear. Further studies were done in a small group of six patients. Platelet survival was considerably shortened, the platelets aggregated excessively in vitro, serum concentrations of thrombopoiesis stimulating activity were raised, and serotonin uptake and release were within normal limits. The degree of thrombocytosis correlated significantly with the degree of inflammation measured by the erythrocyte sedimentation rate (r = 0.40, p less than 0.003) and serum C-reactive protein concentration (r = 0.35, p less than 0.008).
Premedication with lorazepam before bone marrow biopsy.
Authors: Milligan D W , Howard M R , Judd A
Published: June 2007

Fifty patients were randomised in a double blind placebo controlled study to examine the influence of lorazepam (4 mg orally) before bone marrow aspiration and trephine biopsy. Assessment was made by a visual analogue linear pain scale compiled after the procedure and again 24 hours later. There was no difference in the pain recalled immediately after the procedure between the two groups, but the next day the patients who had received lorazepam showed amnesia with a 60% (p less than 0.01) reduction in the pain scale; 36% of the patients in this group had no recall of the procedure at all. There was no amnesic effect in the group taking placebo. Side effects were few, and it is concluded that lorazepam is a useful premedication agent before bone marrow biopsy.
Nucleolar organiser region associated proteins in cutaneous melanotic lesions: a quantitative study.
Authors: Crocker J , Skilbeck N
Published: June 2007

Using a silver staining technique, nucleolar organiser regions were identified in routinely processed paraffin sections of a range of dermal melanotic lesions. The technique shows argyrophilic NOR associated proteins (AgNORs), which are seen in nuclei as black dots. Although the nuclei of melanocarcinoma in situ, melanocarcinoma per se, and lentigo maligna contained similar numbers of AgNORs, in melanocarcinomas a mean of 7.9 AgNORs per nucleus was found, while in naevocellular naevi, this figure was 1.2. The AgNOR method, which is unknown to most histopathologists, could perhaps be used quantitatively or semiquantitatively to assist in the diagnosis of melanotic lesions in the skin (and elsewhere).
Some long term effects of smoking on the haemostatic system: a report from the Caerphilly and Speedwell Collaborative Surveys.
Authors: Yarnell J W , Sweetnam P M , Rogers S , Elwood P C , Bainton D , Baker I A , Eastham R , O'Brien J R , Etherington M D
Published: June 2007

Data from two community studies on men from South Wales and the west of England suggest that the effects of smoking on the haemostatic system remain for many years after giving up. Long term correlations between several variables, including plasma fibrinogen and white cell count, and the length of time after giving up were seen in ex-smokers. Dose response relations were apparent in current smokers in terms of the white cell count and two haematological variables, the packed and mean cell volumes. These long term correlations probably reflect the toxicity of other agents in tobacco smoke besides nicotine and carbon monoxide, which act only in the short term. Identification of these agents may further our understanding of the mechanism by which cigarette smoking is associated with atherosclerotic disease.
Haemophilia A: carrier detection and prenatal diagnosis by linkage analysis using DNA polymorphism.
Authors: Tuddenham E G , Goldman E , McGraw A , Kernoff P B
Published: June 2007

Restriction fragment length polymorphisms (RFLPs) within or close to the factor VIII locus are very useful for genetic linkage analysis. Such RFLPs allow a mutant allele to be tracked in a family, segregating haemophilia A even when, as is usually the case, the precise mutation causing failure to synthesise factor VIII is unknown. To date two markers tightly linked to the factor VIII locus have been described, one of which is highly polymorphic and therefore informative in most kindreds. A significant crossover rate, however, does not make diagnosis absolute. Three intragenic RFLPs have been defined, which, taken together, are informative in about 70% of women, providing virtually deterministic genetic diagnosis.
Serum C reactive protein in infective endocarditis.
Authors: McCartney A C , Orange G V , Pringle S D , Wills G , Reece I J
Published: June 2007

C reactive protein (CRP) was measured serially in 29 patients with infective endocarditis. Twenty one patients were initially treated with antimicrobial drugs. In 13, serial measurement of CRP concentrations showed a progressive return to normal (less than 10 mg/l), which correlated with a satisfactory recovery. Of the remainder (eight patients), five had persistently high concentrations of CRP, indicating a failure to respond to antimicrobial treatment alone. Two of these five patients died and three underwent valve replacement. Of 11 patients treated with antibiotics and valve replacement, CRP concentrations returned to normal in nine. Two patients had infective complications and the CRP concentration did not return to normal. A transient rise in CRP concentration during an otherwise uneventful fall to normal was a sign of allergic reaction in two and of intercurrent infection in three more patients. Serial measurements of CRP concentrations in patients with infective endocarditis may be useful to monitor treatment and also to detect other infections and complications.
Campylobacter associated gastritis in patients with non-ulcer dyspepsia.
Authors: Loffeld R J , Potters H V , Arends J W , Stobberingh E , Flendrig J A , van Spreeuwel J P
Published: June 2007

Gastric biopsy specimens from 109 patients with non-ulcer dyspepsia were retrospectively examined. Sixty one patients had gastritis and there was a strong correlation with the presence of Campylobacter pyloridis. Ninety eight per cent were positive in large numbers for C pyloridis by histological examination or by culture, or both. Of 48 patients with normal histological results, 21 had evidence of C pyloridis by histological examination or culture, or both, but in small numbers. It is concluded that there is a quantitative rather than a qualitative association between C pyloridis and gastritis.
Immunochemistry and electron microscopy of head and neck rhabdomyoma.
Authors: Helliwell T R , Sissons M C , Stoney P J , Ashworth M T
Published: June 2007

Rhabdomyomas are rare benign tumours originating in skeletal or cardiac muscle. Extracardiac tumours are usually situated in the head and neck. Four cases are presented, three arising in the larynx and the other in the cervical region. All four cases were studied by light and electron microscopy, and in three immunohistochemical staining for myoglobin, desmin, and vimentin was carried out to study the diagnostic features of the lesions and their histogenesis.
Influence of mucinous components on survival in colorectal adenocarcinomas: a multivariate analysis.
Authors: Halvorsen T B , Seim E
Published: June 2007

Of 534 resected colorectal adenocarcinomas, 165 (31%) contained some mucinous components; these represented the main part of the tumour in 67 (13%). Of the mucin containing tumours, 63 (38%) were in the right colon compared with 50 (13%) of the non-mucinous ones (p less than 0.001). Patients with predominantly mucinous tumours were significantly older than those with non-mucinous tumours, and they tended to present with tumours at a more advanced stage. A multivariate analysis did not show any significant independent prognostic influence of the mucinous component except when this had a predominantly signet ring cell pattern.
Cerebral infection with Escherichia coli O157:H7 in humans and gnotobiotic piglets.
Authors: Tzipori S , Chow C W , Powell H R
Published: June 2007

Escherichia coli O157:H7 was isolated from a fatal case of haemorrhagic colitis with haemolytic uraemic syndrome and neurological symptoms. This strain induced diarrhoea and neurological symptoms including incoordination, ataxia, and convulsions in piglets after oral inoculation. Similar neurological signs were seen in piglets inoculated intraperitoneally with bacterial extracts containing a shiga-like toxin that is elaborated by the bacteria. Histological examination of the brains from these piglets showed vascular damage and small infarcts confined to the cerebellum. Comparable lesions were also seen in the brain of the child from whom E coli O157:H7 was isolated. We suggest that the cerebral changes in the piglets and in the patient were caused by the shiga-like toxin elaborated by E coli O157:H7. The shiga-like toxin is thought to cause neurological abnormalities by damage to cerebral blood vessels rather than by a direct effect on the neurones.
Serum amyloid A protein, apolipoprotein A-I, and apolipoprotein B during the course of acute myocardial infarction.
Authors: Maury C P , Tötterman K J , Gref C G , Ehnholm C
Published: June 2007

Serum amyloid A protein (SAA), apolipoprotein A-I (apoA-I), apolipoprotein B (apoB) concentrations, and creatine kinase (CK)-MB isoenzyme activity were serially measured in 10 patients during the course of acute myocardial infarction. Pronounced increases in SAA concentrations were observed in all patients during infarction. The highest SAA values were observed, on average, 67 hours after the onset of chest pain. After infarction both apoA-I and apoB concentrations decreased. The reduction in apoA-I concentration 67 to 72 hours after the onset of chest pain was (31%) (p less than 0.01) and the reduction in apoB concentration 55 to 60 hours after the onset of pain was (34%) (p less than 0.01). Negative correlations were found between the concentrations of SAA and apoproteins A-I and B; this inverse relation was stronger between SAA and apoB than between SAA and apo-AI.
Immunoglobulin gene rearrangement and antigenic profile confirm B cell origin of primary cerebral lymphoma and indicate a mature phenotype.
Authors: Smith W J , Garson J A , Bourne S P , Kemshead J T , Coakham H B
Published: June 2007

Six cases of primary cerebral lymphoma were immunophenotyped and analysed by Southern blotting to determine the clonality and lineage of these neoplasms. Molecular analysis showed that they were of B cell origin, and the rearrangement of both heavy and light chain immunoglobulins in malignant cells showed that they were monoclonal populations of mature B cells. The characterisation of the genetic configuration of the immunoglobulin genes in these lymphomas is important because the ability to distinguish between primary lymphoma of the central nervous system and other malignant cerebral tumours has important implications for treatment and survival.
Clinical application of new technique that measures C4d for assessment of activation of classical complement pathway.
Authors: Davies E T , Nasaruddin B A , Alhaq A , Senaldi G , Vergani D
Published: June 2007

A new laser nephelometric technique that measures C4d for the assessment of the activation of the classical complement pathway was developed. C4d was isolated from other larger C4 related molecules at a final concentration of polyethylene glycol of 12% and then quantitated by laser nephelometry using a commercially available antiserum, which reacts with C4d determinants. C4d standard (100%) was produced by exhaustive activation of the classical pathway in pooled normal human serum using heat aggregated human immunoglobulin. Serial dilutions of the standard provided a reference curve against which clinical samples were read. Patients with rheumatoid arthritis showed significantly higher C4d values (mean 53.8%) than controls (21.7%; p less than 0.001). The technique proved accurate, rapid, and suitable for the routine laboratory evaluation of complement activation through the classical pathway, and it may be useful in the management of those conditions in which complement activation has a pathogenic role.
Quantitative method for determining serum alkaline phosphatase isoenzyme activity: estimation of intestinal component.
Authors: Peake M J , Pejakovic M , White G H
Published: June 2007

Intestinal alkaline phosphatase activity was measured using levamisole inhibition, and results were compared with a previously reported method using L-phenylalanine. Sixty two per cent intestinal, 39% placental, and 1.3% of either bone or liver alkaline phosphatase activity remained when alkaline phosphatase activity was inhibited in a 2-amino-2-methyl-1-propanol (AMP) buffer reagent system with 10 mmol/l levamisole (final assay concentration 8.1 mmol/l). The assay imprecision (SD) was 0.6 U/l compared with 3.9 U/l using L-phenylalanine for specimens with total alkaline phosphatase activity less than 250 U/l (reference range 30-120 U/l). In serum pools with raised total alkaline phosphatase activity errors in recovered intestinal activity were small (usually less than 3 U/l) when intestinal alkaline phosphatase was added. Much larger errors and many underestimated results were found using L-phenylalanine. For non-haemolysed specimens it is concluded that an assay based on levamisole inhibition provides a better measure of intestinal alkaline phosphatase activity than L-phenylalanine.
Risk of hepatitis B infection among medical and paramedical workers in a general hospital in Zimbabwe.
Authors: Emmanuel J C , Bassett M T , Smith H J
Published: June 2007

To evaluate the addition of hepatitis vaccine to health schemes for hospital workers in Zimbabwe we undertook a cross sectional study of viral markers in 226 hospital workers and compared the results with 97 volunteer blood donor controls. One hundred and thirty one (58%) hospital workers had hepatitis markers compared with 45 (46%) of the donor group. Racial group was the strongest risk factor. Blacks were 70% more likely to have markers than whites. This racial difference was not explained by job status or patient contact. Our data suggest that work in a district general hospital does not constitute a clinically important hazard for hepatitis B infection. Because of the high cost of the vaccine, additional studies to assess the risk of hospital work in other settings in Zimbabwe are required before health policy regarding routine hepatitis B vaccination is determined.
Artificial factor VIII deficient plasma: preparation using monoclonal antibodies and its use in one stage coagulation assays.
Authors: Hornsey V S , Waterston Y G , Prowse C V
Published: June 2007

Monoclonal antibodies to factor VIII antigen (VIII:Ag) and von Willebrand factor (vWf:Ag) were immobilised on Sephacryl S-1000 and tested for their ability to deplete normal human citrated plasma of factor VIII. A combination of two antibodies to VIII:Ag and one antibody to vWf:Ag was required to produce plasma containing less than 0.01 IU/ml. Its performance in the one stage coagulation assay of VIII:C was equivalent to that of congenital VIII deficient plasma for the assay of normal and haemophilic plasma and factor VIII concentrates. Storage of freeze dried aliquots of this product at -20 degrees C, +4 degrees C, and 37 degrees C showed that it could be used as a substrate for at least six months when stored at temperatures +4 degrees C and below.
Rapid protein A assay for intrinsic factor and its binding antibody.
Authors: Sourial N A
Published: June 2007

A simple and rapid method for the measurement of cobalamin bound intrinsic factor (Cbl-IF) complex and intrinsic factor binding antibody is described. The method is based on the principle of affinity chromatography and adapted to a batch separation technique. A specific ligand staphylococcal protein A was coupled to Sepharose to form a convenient solid phase matrix. The intrinsic factor binding antibody in patients with pernicious anaemia was used to form an immune complex with Cbl-IF. This complex was adsorbed on to staphylococcal protein A. Gastric juice from control subjects and patients with pernicious anaemia was assayed for intrinsic factor activity and the results correlated very closely with two other established methods. Sera from 30 control subjects were assayed for binding intrinsic factor antibody and all were found to be negative; of 15 patients with pernicious anaemia, six were positive. These patients were selected with blocking antibody. The method does not require technologically advanced protein separation techniques and could therefore be applied in any clinical laboratory using radioisotopes. It could also be adapted to assay cobalamin in body fluids or in food.
Pooling of sera for human immunodeficiency virus (HIV) testing: an economical method for use in developing countries.
Authors: Emmanuel J C , Bassett M T , Smith H J , Jacobs J A
Published: June 2007

To determine whether donated blood samples in African countries could be pooled, then tested for the presence of human immunodeficiency virus (HIV) antibodies with a single test without loss of accuracy, a single test on five pooled samples was used, followed by individual testing of positive pools. This resulted in no loss of either sensitivity or specificity. Pooling 10 samples resulted in a loss of sensitivity for low antibody titre specimens. Pooling reduced the costs of screening by 70% and time needed for analysis. It is concluded that pooling of five samples for HIV screening may result in a substantial reduction in costs; in countries where the prevalence of HIV is higher than the 2-3% found in Zimbabwean donors, however, savings may not be as great.
Lymphoid aggregates in bone marrow: study of eventual outcome.
Authors: Faulkner-Jones B E , Howie A J , Boughton B J , Franklin I M
Published: June 2007

The practical importance of finding a morphologically benign lymphoid aggregate in the bone marrow of patients without known lymphoproliferative disease was assessed in 786 consecutive patients who had had 951 iliac crest bone marrow biopsies performed. Of these, 430 patients known to have lymphoproliferative disease at the time of biopsy were excluded. Of 356 patients, 86 (aggregate group) had at least one lymphoid aggregate in their biopsy specimen biopsy specimen (82 morphologically benign, three suspicious, and one malignant). Another 86 patients without aggregates (control group) were matched by age and sex. Both groups were followed up until death, or for a mean of 21.9 and 22.9 months, respectively, to assess their outcome. Eighteen (22%) of the 82 patients with morphologically benign lymphoid aggregates were later proved to have lymphoproliferative disease compared with none of the 86 control patients. Another 12 patients in the aggregate group and seven in the control group were suspected of having a lymphoproliferative disease on clinical grounds, so that altogether 30 (37%) and seven (8%), respectively, developed confirmed or suspected lymphoproliferative disease. In both cases the differences were highly significant (p less than 0.001). It is suggested that lymphoid aggregates in clinical biopsy material may not be a physiological finding and should alert pathologists or haematologists to the possibility of lymphoproliferative disease.
Bronchial gland duct ectasia in fatal bronchial asthma: association with interstitial emphysema.
Authors: Cluroe A , Holloway L , Thomson K , Purdie G , Beasley R
Published: June 2007

To determine the incidence of bronchial gland duct ectasia in fatal asthma and its association with interstitial emphysema, the histological features of 72 patients in whom death was considered to be due to asthma, and 72 matched control subjects in whom sudden death was not attributed to asthma, were reviewed. In all cases and controls, sections of two or more blocks of lung tissue stained with haematoxylin and eosin were obtained at necropsy. Bronchial gland duct ectasia was diagnosed if there was more than one abnormally dilated epithelial lined protrusion from a bronchus, extending through the smooth muscle layer. A histological diagnosis of asthma was made if four of the five following criteria were present: mucus plugging, basement membrane thickening, epithelial shedding, submucosal eosinophil leucocyte infiltration and smooth muscle hypertrophy. A histological diagnosis of asthma was made in 53 of 72 clinical cases of fatal asthma and in five of 72 control subjects. Interstitial emphysema was present in 10 clinical cases of fatal asthma, all of whom had bronchial gland duct ectasia and a histological diagnosis of asthma. Interstitial emphysema was not observed in control subjects. It is concluded that bronchial gland duct ectasia is a common histological feature of severe asthma, and that interstitial emphysema may be consequent on rupture of these dilated gland ducts.
Interrelation between factor VII, prekallikrein, and hyperfibrinolysis in advanced cirrhosis.
Authors: Violi F , Alessandri C , Ferro D , Saliola M , Cordova C , Musca A , Balsano F
Published: June 2007

Factor VII and prekallikrein activities were studied in 37 patients with liver cirrhosis who were in a decompensated state. Sixteen of them died 30-70 days after admission; 21 survived and were discharged after 30-80 days. Seven who died and six survivors had signs of hyperfibrinolysis: factor VII activity differentiated the two groups independently of the presence of hyperfibrinolysis. The presence of hyperfibrinolysis significantly reduced prekallikrein activity, which did not differentiate clearly survivors from non-survivors. Long term follow up of survivors showed a good correlation between factor VII and prekallikrein activities with long term survival. Hyperfibrinolysis seemed to influence the clinical course of patients: 87% of patients with hyperfibrinolysis who died had fatal haemorrhagic episodes. Low factor VII activity may be a precursor of terminal liver insufficiency.
Association between invasiveness, inflammatory reaction, desmoplasia and survival in colorectal cancer.
Authors: Halvorsen T B , Seim E
Published: June 2007

Five hundred and twenty seven colorectal carcinomas were reviewed histologically. A multivariate analysis (Cox) was used to test the prognostic importance of certain histological features (invasiveness, inflammatory reaction, and amount of fibrous tissue) at the tumour edge after allowance had been made for clinicopathological stage, tumour site, and histological type and grade. A poorly defined tumour border, lack of inflammatory reaction, and a pronounced fibrosis (desmoplasia) at the tumour edge were associated with unfavourable stage distributions, but each of these features also had an independent effect on prognosis.
Diurnal variations in serum biochemical and haematological measurements.
Authors: Pocock S J , Ashby D , Shaper A G , Walker M , Broughton P M
Published: June 2007

Twenty five biochemical and haematological measurements were determined on nonfasting blood and serum samples collected between 9 am and 7 pm from a representative group of 7685 British middle-aged men. Most measurements showed significant diurnal variations, but only for bilirubin, phosphate, and triglyceride did time of day account for more than 5% of the between subject variance. Serum bilirubin concentrations showed a pronounced downward trend in the afternoon, the mean value after 6 pm being 30% lower than the mean value in the morning. Mean serum triglyceride and phosphate concentrations increased steadily through the day. Mean concentrations of potassium, haemoglobin, and haematocrit and red cell count were higher in the morning, while urea and creatinine concentrations and white cell count had higher means in the afternoon. Glucose showed a pattern consistent with short term response to meals. The effects of these diurnal trends on routine use of biochemical tests needs careful consideration, and a greater understanding of their biological mechanisms is required.
Observer variability in histopathological reporting of cervical biopsy specimens.
Authors: Robertson A J , Anderson J M , Beck J S , Burnett R A , Howatson S R , Lee F D , Lessells A M , McLaren K M , Moss S M , Simpson J G
Published: June 2007

Sections from 100 cervical biopsy specimens were studied by 12 consultant histopathologists to determine the robustness of the existing pathology terminology and classification. Analysis by kappa statistics showed good agreement in the diagnosis of CIN 3 and squamous carcinoma but an inability to distinguish accurately between the lesser grades of CIN. It is recommended that the classification be changed to low grade (present CIN 1 and 2) and high grade (present CIN 3) categories alone. There was very poor agreement in the identification of cellular changes associated with human papilloma virus (HPV) infection.
Percutaneous fine needle aspiration cytology of the pancreas: advantages and pitfalls.
Authors: Kocjan G , Rode J , Lees W R
Published: June 2007

Fine needle aspiration of the pancreas was performed in 62 patients with radiological suspicion of malignancy. All fine needle aspirates were taken under computed tomography or ultrasound guidance. Fine needle aspirates were positive in 31 of 41 patients with histologically or clinically confirmed pancreatic carcinoma. There were no false positive results. The sensitivity of this method for detecting malignant disease was 86%. Cytology was not able to provide conclusive results of benign conditions. Difficulties were encountered in diagnosing well differentiated carcinoma and neuroendocrine tumours and distinguishing them from reactive epithelium and islet cell hyperplasia, respectively. This resulted in a 12.1% false negative rate. There were no complications in our series. Percutaneous fine needle aspiration proved a reliable method of diagnosing pancreatic carcinoma.
Aberrant phenotypes in peripheral T cell lymphomas.
Authors: Hastrup N , Ralfkiaer E , Pallesen G
Published: June 2007

Seventy six peripheral T cell lymphomas were examined immunohistologically to test their reactivity with a panel of monoclonal antibodies against 11 T cell associated antigens (CD1-8, CD27, UCHL1, and the T cell antigen receptor). Sixty two (82%) lymphomas showed aberrant phenotypes, and four main categories were distinguished as follows: (i) lack of one or several pan-T cell antigens (49, 64% of the cases); (ii) loss of both the CD4 and CD8 antigens (11, 15% of the cases); (iii) coexpression of the CD4 and CD8 antigens (13, 17% of the cases); and (iv) expression of the CD1 antigen (eight, 11% of the cases). No correlation was seen between the occurrence of aberrant phenotypes and the histological subtype. It is concluded that the demonstration of an aberrant phenotype is a valuable supplement to histological assessment in the diagnosis of peripheral T cell lymphomas. It is recommended that the panel of monoclonal antibodies against T cell differentiation antigens should be fairly large, as apparently any antigen may be lost in the process of malignant transformation.
Giemsa staining for cysts and trophozoites of Pneumocystis carinii.
Authors: Walker J , Conner G , Ho J , Hunt C , Pickering L
Published: June 2007

Although Giemsa staining has been routinely used for the detection of trophozoites and intracystic bodies in smears of bronchoalveolar lavage fluid (BAL) from patients with Pneumocystis carinii pneumonia, it does not normally stain the cyst wall. For detection of the cysts other stains such as toluidine Blue 'O' and methenamine silver must be used as well. Sulphation of smears before staining with Giemsa allows cysts to be visualised, thus enabling a single stain to be used to show all the stages of BAL or sputum, which is particularly useful, considering the increase in the prevalence of P carinii pneumonia in conjunction with the spread of AIDS.
Peptic (contact ulcer) granuloma of the larynx.
Authors: Miko T L
Published: June 2007

Review of published work and analysis of clinical data and pathology of four biopsy specimens from two patients with laryngeal contact granuloma showed that its peptic origin was derived from a gastro-oesophago-laryngeal reflux. It is proposed that the term "peptic granuloma" should be given to this phenomenon. This term is given further support on account of the spectacular recovery of the laryngeal lesion following antacid and antireflux treatment, rather than the traditional method of using vocal rest and speech therapy, assumed to be the best way of treating a result of mechanical irritation, the previously accepted cause of laryngeal contact granuloma.
Comparison of immunofluorescence and enzyme linked immunosorbent assays for diagnosing Lyme disease.
Authors: Cutler S J , Wright D J
Published: June 2007

A new enzyme linked immunosorbent assay (ELISA) method was assessed in parallel with an indirect immunofluorescence assay (IFA) for the serological testing of specimens submitted for detection of Lyme disease. Wells of an ELISA microtitre plate were coated with sonicated whole cells of Borrelia burgdorferi in carbonate buffer. After overnight incubation at 4 degrees C the plates were washed three times, then incubated at 37 degrees C for an hour sequentially with a blocking solution, diluted test serum, anti-human IgG horseradish peroxidase conjugate, and finally for half an hour at room temperature with o-phenylenediamine substrate before being read at 492 nm. Absorbance results were converted into arbitrary ELISA units. Of a total of 1760 sera, 146 (8.3%) were positive: of these 92 (63%) were positive by both methods, five (3.4%) by IFA alone, and 49 (33.6%) by ELISA alone. The ELISA was better suited for testing large numbers of specimens and easier to interpret than IFA.
Acquired platelet dysfunction with eosinophilia: review of seven adult cases.
Authors: Lim S H , Tan C E , Agasthian T , Chew L S
Published: June 2007

Seven adults with acquired platelet dysfunction with eosinophilia presented with histories of spontaneous bruising and three also had moderate thrombocytopenia. Six patients had platelet function tests performed and all showed variable storage pool defects. When assayed, IgE concentrations were raised. Although only two patients had parasites isolated in their stools, all seven responded to antihelminth treatment. It is speculated that the IgE response to parasites mediates mast cell degranulation, which leads to in vivo platelet activation.
Effect of isoniazid, a haem inhibitor, on globin chain synthesis in reticulocytes from non-thalassaemic and beta thalassaemic subjects.
Authors: Chalevelakis G , Yalouris A G , Lyberatos C , Economopoulos T , Anastasiou C , Hatziioannou J , Raptis S
Published: June 2007

The effect of isonicotinic acid hydrazide (INH), a potent haem inhibitor, on globin chain synthesis was studied in reticulocytes from the following groups of patients: four non-thalassaemic patients (group i); five beta thalassaemia heterozygotes (group ii); three Hb S/beta thalassaemia heterozygotes (group iii); and two additional patients--one with homozygous beta thalassaemia and the other with thalassaemia intermedia (group iv). This was done to determine whether haem inhibitors depress alpha globin chain synthesis. The progressive increase of INH concentration (10-40 mmol l-1) in reticulocytes from a beta thalassaemia heterozygote resulted in a remarkable decrease of the alpha and beta chain synthesis, ranging from 80% to 97% and from 74% to 96% of control values, respectively, and in a gradual drop of alpha:beta ratio from 1.87 to 1.38. Furthermore, in the samples incubated with 40 mmol l-1 INH, a pronounced inhibition of globin chain synthesis 77 (19%) for alpha chain and 67 (27%) for beta or beta S chain) and a substantial drop of the alpha:beta or beta S ratio in samples with INH (median 1.16) compared with that in samples without INH (median 1.70) were observed. The inhibitory effect of INH was significantly or completely corrected by adding exogenous haem. It is suggested that haem inhibition and the resulting preferential diminution of alpha chain synthesis could provide a new approach to the treatment of homozygous beta thalassaemia with an excess of detrimental free alpha chain in erythroid cells.
Serological diagnosis of neurobrucellosis.
Authors: Sanchez-Sousa A , Torres C , Campello M G , Garcia C , Parras F , Cercenado E , Baquero F
Published: June 2007

The presence of antibodies was determined in the serum and cerebrospinal fluid in six patients with neurobrucellosis using the Rose Bengal test, the microdilution agglutination test, and the Coombs' test. Four of the patients were followed up for more than three months. The Rose Bengal test and the microagglutination test were positive in cerebrospinal fluid in five of the six cases at some stage. The Coombs' test was positive in cerebrospinal fluid in every patient and in one was the only positive serological test. Cerebrospinal fluid positivity is not excluded by low titres or negative results of antibodies in the serum for any of the three methods. A Coombs' test or some equivalent must always be made on the cerebrospinal fluid to diagnose neurobrucellosis.
Sensitivity of digoxigenin and biotin labelled probes for detection of human papillomavirus by in situ hybridisation.
Authors: Morris R G , Arends M J , Bishop P E , Sizer K , Duvall E , Bird C C
Published: June 2007

The sensitivity of digoxigenin and biotin labelled DNA probes for the detection of human papillomavirus (HPV) by dot blotting and in situ hybridisation was compared in tissues from cervical, laryngeal, and anogenital neoplasia. Probes were either labelled with digoxigenin by the random primer technique and detected with anti-digoxigenin antibody, or labelled with biotin by nick translation and detected with streptavidin, both methods having a common final visualisation procedure using alkaline phosphatase. Digoxigenin labelled probes proved two to 10-fold more sensitive by quantitative dot blotting and four-fold more sensitive in detecting HPV 16 DNA in a series of 31 anal carcinomas, compared with biotinylated probes. The digoxigenin method also produced less non-specific background staining of tissue sections than biotin labelled probes. It is concluded that digoxigenin DNA labelling and detection provides a simple, reliable, and efficient alternative to the use of biotin or radioactive isotopes for the detection of HPV DNA by in situ hybridisation. Digoxigenin labelled probes also offer the possibility of double labelling in situ hybridisation procedures when used with biotin labelled probes to provide simultaneous identification of different DNA sequences.
Adenomyosis in Pakistani women: four year experience at the Aga Khan University Medical Centre, Karachi.
Authors: Shaikh H , Khan K S
Published: June 2007

As part of a quality assurance programme at the Aga Khan University Medical Centre, Karachi, Pakistan, all hysterectomy specimens were reviewed from January 1986 to December 1989. Adenomyosis was found in 237 of the 419 (56.5%) specimens studied. Of these 237 patients, 232 (97.9%) were parous and 196 (82.8%) were in the fourth and fifth decades of life. This high prevalence in parous women aged 40-59 years was significant. Fibroids, cervicitis, and endometrial hyperplasia were the most common associated diagnoses. Of all the associations studied, only endometrial hyperplasia was significantly more prevalent in the group with adenomyosis. Adenomyosis was stated as an indication for surgery in 69 patients and was confirmed by histopathology in 49 (71%). Preoperative suspicion of adenomyosis was present in 49 (20.6%) patients of all those ultimately found to have the disease. There is a high prevalence of adenomyosis in the population studied, which indicates that the condition may have been underdiagnosed in the past, especially as it is difficult to diagnose without surgery and hysterectomy is currently the only treatment.
Spherical connective tissue inclusions in epithelial hyperplasia of the breast ("collagenous spherulosis").
Authors: Wells C A , Wells C W , Yeomans P , Viña M , Jordan S , d'Ardenne A J
Published: June 2007

Partial myoepithelial differentiation is common in simple epithelial hyperplasia (epitheliosis) of the breast but functional myoepithelial differentiation with basement membrane production is exceedingly rare. A peculiar change of hyaline globules within benign epithelial hyperplasia has been recognised before as "collagenous spherulosis" and type IV collagen has been shown by immunohistochemistry. Another seven cases are described which show the presence of laminin and collagens IV and III within the proliferation. Electron microscopy examination of two cases using material retrieved from the wax block showed varying degrees of myoepithelial differentiation of the cells immediately surrounding the spherules and basal lamina material, including mature collagen fibrils in one case. The degree of myoepithelial differentiation of the cells surrounding the spherules seemed to correlate with the differing types and amounts of extracellular matrix in the spherule. Histopathologists should be aware of this rare change as it may be misinterpreted as in situ carcinoma.
Helicobacter pylori in dyspeptic patients in Kuwait.
Authors: Britt D P , Barakat M H , Tungekar M F , Painchaud S M , Adlouni M , Kern K , Malhas L
Published: June 2007

Two hundred and four patients, mainly Arabs, attending for upper gastrointestinal endoscopy at the gastroenterology clinic in Mubarak Al-Kabeer Hospital, Kuwait, were examined for evidence of infection with Helicobacter pylori and associated inflammation. Biopsy specimens of antrum, body, and duodenum; gastric juice; and antral mucosal brushings were investigated by microbiological, cytological, and histopathological methods. Clinical conditions diagnosed at endoscopy included gastritis, gastric ulcer, duodenitis and duodenal ulcer, but half the patients had endoscopically normal gastric and duodenal mucosae. H pylori was detected by one or more of the procedures in at least one specimen from 197 (96.6%) of the patients. Histological and cytological analysis showed equal sensitivity, but bacteriological culture was less reliable. The proportion of positive cases was high, compared with other reported series, which may have been accounted for by the variety of diagnostic techniques used in this study, the selected population (all with gastrointestinal symptoms) or genetic or environmental predisposing factors peculiar to the sample population.
Hepatic iron in dialysed patients given intravenous iron dextran.
Authors: Fleming L W , Hopwood D , Shepherd A N , Stewart W K
Published: June 2007

Five percutaneous biopsy and 17 necropsy liver specimens were analysed histologically and chemically for iron content in 22 patients receiving dialysis for chronic renal failure, 13 of whom were given intravenous iron-dextran. Brissot scores for assessing histological hepatic iron deposition and chemically measured liver iron concentrations correlated closely. Both variables depended on total cumulative dose of iron, and to a lesser extent, on time since the last dose. Fibrosis (seen in five patients) was minimal and non-specific. Electron microscopic examination showed that there was no generalised damage and confirmed the presence of iron in the hepatocytes in the form of ferritin. High liver iron concentrations, in excess of 1000 micrograms/100 mg dry weight, were seen in two patients. Four others given comparable cumulated amounts (18-23 g iron) did not have such high concentrations. Plasma ferritin concentrations were high in eight patients, some with and some without fibrosis. The risk of temporarily high iron deposition in the liver causing damage seemed to be minimal when weighed against the benefit of increased haemoglobin in most of the patients. Intravenous iron treatment merits further evaluation, particularly with the advent of erythropoietin treatment, which requires continuously available iron.
Immunohistochemical and electron microscopic findings in benign fibroepithelial vaginal polyps.
Authors: Rollason T P , Byrne P , Williams A
Published: June 2007

Eleven classic benign "fibroepithelial polyps" of the vagina were examined using a panel of immunocytochemical agents. Two were also examined electron microscopically. In all cases the stellate and multinucleate stromal cells characteristic of these lesions stained strongly for desmin, indicating muscle intermediate filament production. In common with uterine fibroleiomyomata, numerous mast cells were also often seen. Myoglobin staining was negative. Electron microscopical examination confirmed that the stromal cells contained abundant thin filaments with focal densities and also showed the ultrastructural features usually associated with myofibroblasts. It is concluded that these tumours would be better designated polypoid myofibroblastomas in view of the above findings.
Incidence of thin membrane nephropathy: morphometric investigation of a population sample.
Authors: Dische F E , Anderson V E , Keane S J , Taube D , Bewick M , Parsons V
Published: June 2007

To explore the incidence of thin membrane nephropathy (thin basement membrane syndrome, benign familial haematuria), glomerular basement membrane thickness was assessed by light and electron microscopy and by morphometry in a series of newly transplanted allograft kidneys, in lieu of normal kidney specimens. Five of the 76 donors possessed an abnormally thin basement membrane, similar to that observed in thin membrane nephropathy, while in two others the measurements fell in the overlap range between thin and normal. Seven donors therefore had a definite or possible basement membrane lesion. After taking account of an additional series of controls, unrelated to transplantation, it is suggested that the incidence of this abnormality in the general population lies between 5.2% and 9.2%. Circumstances did not allow any association between a thin basement membrane and haematuria or other clinical manifestations to be detected.
Activity of duodenal disaccharidases in relation to normal and abnormal mucosal morphology.
Authors: Langman J M , Rowland R
Published: June 2007

Endoscopic duodenal biopsy specimens from 100 predominantly adult Caucasian patients under investigation for gastrointestinal symptoms were used to establish reference ranges for lactase, sucrase, and maltase in the duodenum. Duodenal and jejunal disaccharidase values were compared and the association between disaccharidase activity and morphology in the duodenum was examined. Mean lactase activities were about 40% lower in the duodenum compared with the jejunum; maltase was reduced to a lesser extent; and sucrase activities were much the same in the two sites. Lactase deficiency was found in 24 patients of whom 14 (58%) had duodenal disease. The presence of moderate to severe duodenal lesions was associated with a significant decrease in all disaccharidase activities, while only lactase was reduced in mild lesions. Twelve patients had normal lactase activity, despite the presence of duodenal disease. It is concluded that specific reference ranges for duodenal mucosal disaccharidase activity are required as this is less than that of jejunum. Reduced duodenal disaccharidase activity is usually but not invariably associated with morphological abnormality.
Adenoacanthoma of the endometrium: morphological changes induced by human papillomavirus.
Authors: Kealy W F , Annis P G , Barry J A , Hogan J M
Published: June 2007

The observation of koilocyte-like features in the squamous epithelium of some endometrial adenoacanthomas prompted an investigation into a possible viral aetiology. These changes closely resemble those that occur in the ectocervical mucosa which are accepted as morphological evidence of human papillomavirus (HPV) infection. Sections of 87 hysterectomy specimens removed for endometrial carcinoma over 12 years, together with preoperative curettings, were reviewed for the presence of acanthomatous change and for appearances suggestive of HPV infection. The ages of the women ranged from 36 to 84 years, average age 62.6. Light microscopical examination showed koilocytosis, papillary formations, and intranuclear eosinophilic inclusions of both squamous and glandular epithelium in some tumours. Immunocytochemistry and DNA in situ hybridisation indicated the presence of HPV antigen in squamous and glandular cells, and perinuclear virus particles characteristic of HPV were seen on electron microscopical examination in those cells with nuclear inclusions. HPV probably infects endometrial adenocarcinomas directly from the cervix but it is unlikely that it has an aetiological role. It is possible, however, that in addition to being a "passenger," the virus may stimulate squamous metaplasia in some adenocarcinomas of the endometrium and may also exert some influence on their behaviour.