bluuebunny/crossref_metadata_2025 huggingface dataset:
Immunophenotypic differences between osteoclasts and macrophage polykaryons: immunohistological distinction and implications for osteoclast ontogeny and function.
Authors: Athanasou N A , Quinn J
Published: June 2007

The antigenic phenotype of human fetal osteoclasts was compared with that of human tissue macrophages and macrophage polykaryons in foreign body lesions using a large number of monoclonal antibodies directed against myeloid (granulocyte/mononuclear phagocyte) antigens. Osteoclasts expressed a restricted range of macrophage-associated antigens including CD13, CD15A, CD44, CD45, CD54, (ICAM-1), CD71 (transferrin receptor), and CD68. These antigens were also present on macrophages and macrophage polykaryons both of which also strongly expressed CD11a,b,c, CD18, (LFA family), CD14, CD31, CD36, CD37, CD39 and CD43 antigens. There was also weak and occasional expression of CD16 (FcRIII), CD25 (interleukin 2 receptor), CD32 (FcRII), CD35 (C3b receptor) and HLA-DR by macrophage polykaryons. The presence of some macrophage associated antigens on osteoclasts is consistent with their originating from cells of the mononuclear phagocyte system. The numerous differences in antigenic phenotype between osteoclasts and macrophage polykaryons, however, suggest that their pathways of development and differentiation are not identical. The differences discerned in antigenic phenotype should also permit distinction between these polykaryons (and possibly their mononuclear precursors) in normal and diseased tissues.
Circulating high molecular weight IgG fibronectin complexes in myeloproliferative disorders.
Authors: Baglin T P , Price S M , Boughton B J
Published: June 2007

The plasma of patients with myeloproliferative diseases was examined by polyethylene glycol (PEG) precipitation, analytical ultracentrifugation, and immunoaffinity chromatography for the presence of high molecular weight complexes of IgG and fibronectin. Abnormal circulating high molecular weight material was identified by ultracentrifugation in all patients. This was precipitated by PEG and was shown by exclusion chromatography to contain IgG in a high molecular weight form. Examination of plasma by immunoaffinity chromatography supported previous evidence for complex formation between IgG and fibronectin. These findings are further evidence that abnormal high molecular weight IgG complexes are a prominent feature of myeloproliferative disorders and implicate IgG fibronectin complex formation.
Familial increased serum intestinal alkaline phosphatase: a new variant associated with Gilbert's syndrome.
Authors: Lieverse A G , van Essen G G , Beukeveld G J , Gazendam J , Dompeling E C , ten Kate L P , van Belle S A , Weits J
Published: June 2007

Investigation of mild, inherited increased serum alkaline phosphatase activity partially combined with Gilbert's syndrome in one family showed, apart from a normal liver fraction, an intestinal isoenzyme pattern and an extra band in the agar electrophoresis. Analysis by agarose electrophoresis before and after incubation of neuraminidase showed that the extra fraction was an intestinal variant isoenzyme. The precise genetic background of the two disorders in this family could not be determined from the available data. Abnormal activities of (regular) intestinal alkaline phosphatase isoenzyme caused the increase in serum alkaline phosphatase in the absence of disease.
DNA hybridisation of routinely processed tissue for detecting HPV DNA in anal squamous cell carcinomas over 40 years.
Authors: Scholefield J H , McIntyre P , Palmer J G , Coates P J , Shepherd N A , Northover J M
Published: June 2007

To study possible changes in the incidence of human papillomavirus (HPV) associated anal squamous cell carcinomas (SCC) a simple, rapid, and sensitive technique (alkaline hydrolysis) to permit DNA hybridisation from formalin fixed, paraffin wax embedded tissue was developed. The sensitivity and specificity of the technique were established by comparison with Southern blot analysis and in situ hybridisation on the same tissue specimens. Ninety tissue specimens in a single analysis were examined using this technique. Alkaline hydrolysis was applied to fixed tissue samples which showed a two-fold increase over the past 10 years in the percentage of anal cancers containing HPV type 16 DNA when compared with the previous 30 years using 207 cases of anal cancer collected over a 40 year period. This method has several advantages over the polymerase chain reaction as it is simple, relatively inexpensive, and may be widely applied to the detection and quantification of DNA sequences, including cellular oncogenes.
Comparison of solid media for cultivation of anaerobes.
Authors: Heginbothom M , Fitzgerald T C , Wade W G
Published: June 2007

Two commercial agar media for the cultivation of anaerobes were compared with four other media for their ability to support the growth of a wide range of anaerobes from clinical specimens of subgingival plaque. Fastidious anaerobe agar (FAA, Lab M) and anaerobe agar (GAA, Gibco) allowed better growth of the pure cultures than the other media. FAA recovered the highest numbers of bacteria from subgingival plaque specimens which were composed predominantly of anaerobes. GAA performed poorly with these samples. It is concluded that FAA seemed to be superior to the other media tested for the cultivation and recovery of anaerobes.
Technical improvements in the immunoperoxidase study of renal biopsy specimens.
Authors: Howie A J , Gregory J , Thompson R A , Adkins M A , Niblett A J
Published: June 2007

Sixty five renal biopsy specimens were used to compare a direct immunofluorescence technique on frozen sections with immunoperoxidase techniques on paraffin wax sections. For the immunoperoxidase techniques, dewaxed sections were treated with protease at 37 degrees C. Sections were examined at intervals on a microscope and digestion was stopped when plasma was removed from glomerular capillary loops. This permitted intense staining of immunoproteins on immunoperoxidase. There was agreement between immunoperoxidase and immunofluorescence in the staining for IgG, IgA, and IgM in 50 biopsy specimens and discordant findings did not affect the diagnosis. Immunoperoxidase did not detect C3 in 16 biopsy specimens. Findings with antiserum to another complement component, C9, detected by immunoperoxidase correlated with C3 findings detected by immunofluorescence in 17 biopsy specimens. It is concluded that microscopical observation of the progress of digestion permits optimal staining by immunoperoxidase methods, thus overcoming the problem of variability in proteolytic digestion of sections. Inconsistency in the demonstration of complement deposition can be avoided by staining for C9 rather than C3.
Monocyte esterase deficiency in malignant neoplasia.
Authors: Markey G M , McCormick J A , Morris T C , Alexander H D , Nolan L , Morgan L M , Reynolds M E , Edgar S , Bell A L , McCaigue M D
Published: June 2007

A survey of the incidence of monocyte esterase deficiency in 4000 inpatients (including 808 with malignant neoplastic disease) and 474 normal controls was performed using an automated esterase method. A highly significant excess of patients with malignant disease and the deficiency was evident when compared with normal controls or all other patients. Within the group of patients with malignant disease the demonstrable excess occurred in B chronic lymphocytic leukaemia, non-Hodgkin's and Hodgkin's lymphoma, and carcinoma of the gastrointestinal tract. There was also a significant excess of patients with the deficiency attending the renal unit, both among patients who had had renal transplants and those who had not. A familial incidence of monocyte esterase deficiency was found in 19 (35%) of first degree relatives of those patients in whom family studies were done. It is suggested that the reason for the increased prevalence of the anomaly in these disorders might be that the diminution of esterase activity has a role in their development.
Enhancement of c-sis proto-oncogene transcription in bronchoalveolar mononuclear cells from patients with pulmonary sarcoidosis.
Authors: Deguchi Y , Kishimoto S
Published: June 2007

The expression of c-sis proto-oncogene in bronchoalveolar mononuclear cells was studied in seven patients with pulmonary sarcoidosis. By means of nuclear run on transcription assay, the transcriptional level of c-sis proto-oncogene in bronchoalveolar mononuclear cells was investigated. Expression of c-sis proto-oncogene in bronchoalveolar mononuclear cells was enhanced. Enhancement of c-sis transcription may be involved in the process of activation of bronchoalveolar mononuclear cells in patients with pulmonary sarcoidosis.
Brush border enzymes in coeliac disease: histochemical evaluation.
Authors: Mercer J , Eagles M E , Talbot I C
Published: June 2007

Two hundred and ninety four duodenal and jejunal mucosal biopsy specimens from patients with coeliac disease, treated and untreated, and other conditions were examined histologically and by histochemical staining for five peptidase and three disaccharidase enzymes to determine profiles of activity. Suppression of activity paralleled the histology with the following enzymes: lactase, trehalase, brush border endopeptidase, dipeptidyl peptidase II and isomaltase. Lactase, trehalase, and brush border endopeptidase were specifically suppressed in untreated coeliac disease and were diagnostically useful. Examination of a combination of enzymes is recommended.
Observer reproducibility in grading dysplasia in colorectal adenomas: comparison between two different grading systems.
Authors: Fenger C , Bak M , Kronborg O , Svanholm H
Published: June 2007

The two most well known and well defined grading systems for dysplasia in colorectal adenomas were compared with regard to reproducibility. The Konishi-Morson system (KMS) operates with several histological and cytological variables and grades of mild, moderate, and severe dysplasia. The Kozuka system is based on the extent of nuclear pseudostratification and also has three grades of dysplasia (III-V). As the group of severe dysplasia is very large in this system, it was extended with two higher grades, similarly based on individual histological criteria, known hereafter as the extended Kozuka system (EKS). Fifty six adenomas were graded by two observers, each observer grading twice according to the KMS criteria and twice according to EKS criteria. Intraobserver reproducibility was excellent for the KMS and moderate for the EKS, but this was not significant. The overall interobserver reproducibility was similar (moderate) for the KMS and for the EKS. Kappa values for interobserver reproducibility on individual categories were excellent for severe dysplasia according to the KMS, but low for all other categories in both systems. By simplifying both systems into two groups a high reproducibility can be obtained, but this implies that all the original grades (III-V) for the EKS must be grouped together. It is therefore recommended that a simplified KMS is used for further studies on the biological importance of dysplasia and for comparison between histological changes and other markers for colorectal neoplasia.
Use of immunocytochemistry and biotinylated in situ hybridisation for detecting measles virus in central nervous system tissue.
Authors: McQuaid S , Isserte S , Allan G M , Taylor M J , Allen I V , Cosby S L
Published: June 2007

Optimised immunocytochemical (ICC) and in situ hybridisation (ISH) protocols for long term, formalin fixed, central nervous system tissue infected with measles virus were developed. The effectiveness of 10 proteases for the enzymatic unmasking of formalin fixed antigen and nucleic acid was investigated. Protease VIII gave maximal signal generation with optimal tissue preservation and no background staining for both techniques. The use of a microwave oven as an additional pre-hybridisation step for RNA-RNA in situ hybridisation produced a significant increase in the number of cells labelled for genomic RNA. The ability to show the presence of antigen and nucleic acid in long term, formalin fixed tissue facilitates the use of stored necropsy material available in pathology departments for ICC and ISH investigations.
Chronic myeloproliferative disorders: prognostic importance of new working classification.
Authors: Burkhardt R , Jaeger K , Kettner G , Helmer G
Published: June 2007

Variants of chronic myeloproliferative disorders (CMPD) were compared according to their clinical features and classified by bone marrow biopsy appearances. Subsequently, this classification was further evaluated using survival data and histological variables from iliac crest biopsy specimens of an additional 1391 patients, making a total of 2241 patients available for analysis of outcome. The patients were grouped again into three main classes: "typical"; "variant"; and "transformed". "Typical" comprised the "classic" groups. "Variant" included the less uniform myeloproliferative syndromes, distinguished also by more variable clinical features, a different prognosis, and a greater tendency to fibrotic and blastic transformation. "Transformed" defined the end stages of both "typical" and "variant" types. Ten subgroups were distinguished by different histology and prognosis. Particular prognostic importance was assigned to atypia and immaturity of haemopoiesis, predominance of individual haemopoietic cell line, number and anomalies of megakaryocytes and progressive fibrosis. It is suggested that the proposed subclassification would be helpful for studies of epidemiology and therapeutic trials by allowing more homogeneous groups to be recognised.
Contribution of the cytobrush to determining cellular composition of cervical smears.
Authors: Doornewaard H , van der Graaf Y
Published: June 2007

A study was made of the contribution of the cytobrush to determining the composition of the cervical smear. From a population of women screened in The Netherlands in 1987, 733 women were selected whose smears for the second time in a row lacked endocervical cells. Note was made of method of contraception, age of the woman, and day of the menstrual cycle. A control group was formed of women whose smears contained endocervical cells. Highly significant differences were found in the results between the two groups. Two new samples were collected, one made with the modified wooden Ayre spatula, the other with the cytobrush from the research group. The number of smears containing endocervical cells increased from 44% (by spatula alone) to 79% (spatula plus cytobrush). The cytobrush alone produced a high percentage of unsatisfactory smears (17.5%) due to a low content of squamous epithelial cells. No differences could be observed in the rate of cellular atypia because of the small number of cases.
Antral Helicobacter pylori in patients with chronic renal failure.
Authors: Shousha S , Arnaout A H , Abbas S H , Parkins R A
Published: June 2007

Patients with chronic renal failure who were undergoing dialysis were recently shown to have a low prevalence of duodenal Helicobacter (Campylobacter) pylori colonisation in spite of a high incidence of gastric metaplasia. The prevalence of the organism in the gastric antrum of 50 similar patients was estimated and compared with that in a control group comprising 120 consecutive patients with no renal failure who were being investigated for a variety of symptoms and signs related to the upper alimentary tract. Seventeen of the patients with renal disease had upper gastrointestinal symptoms. The prevalence of antral H pylori was significantly less in patients with renal disease (12, 24%) than in the control group (51, 42%), but was associated with a similar active chronic inflammatory reaction with prominent lymphoid follicles. The prevalence of the bacteria in patients with renal disease was similar to that reported in normal volunteers, and was the same whether the patients had upper gastrointestinal symptoms or not. This low prevalence may be related to the wide variety of medication, including antibiotics, which these patients are prescribed during the course of their illness.
Prevalence of chlamydial antibody in Malaysians.
Authors: Ngeow Y F , Rachagan S P , Ramachandran S
Published: June 2007

A single antigen indirect immunofluorescence test was used to screen for chlamydial antibody among Malaysian infants, children, sexually active adults and prostitutes. Of 794 serum samples tested, 361 (45.5%) were positive. Seropositivity increased with age and sexual activity and ranged from 10 to 16% among children under 10 years old to 94.4% among prostitutes. Pregnant women and female adolescents showed a higher antibody prevalence than nonpregnant and older women. Six (13%) infants under 6 months of age were positive for chlamydial IgM.
Combined assessment of intestinal disaccharidases in congenital asucrasia by differential urinary disaccharide excretion.
Authors: Maxton D G , Catt S D , Menzies I S
Published: June 2007

Investigation of intestinal disaccharide hydrolysis and permeability by means of a non-invasive differential sugar absorption test was performed in a family containing two siblings with primary sucrase-isomaltase deficiency. The procedure, which depends on measurement of urinary excretion ratios after the oral administration of lactose, sucrose, palatinose, lactulose and L-rhamnose, is capable of simultaneous determination of intestinal lactase, sucrase, and isomaltase activity and lactulose:rhamnose permeability. The results corresponded well with those of disaccharidase assay and histological findings in jejunal biopsy tissue obtained from the patients. Palatinose proved a satisfactory substrate for in vivo assessment of intestinal isomaltase activity. The method described provides a reliable and comprehensive assessment of intestinal disaccharide hydrolysis, and simultaneous estimation of permeability assists discrimination of primary from secondary disaccharidase deficiency. The ability to assess three different disaccharidase activities in addition to intestinal permeability by means of a single test, and the simplicity of preservation and transport of urine samples for sugar analysis, makes this a convenient, definitive method for the investigation of defective sugar absorption in both patients and population groups.
Rapid method for distinguishing clonal from polyclonal B cell populations in surgical biopsy specimens.
Authors: McCarthy K P , Sloane J P , Wiedemann L M
Published: June 2007

The polymerase chain reaction (PCR) was used to detect clonal rearrangements of the immunological heavy chain gene in frozen samples of human lymphoid tissue. DNA sequences in rearranged genes were amplified using oligomeric primers predicted from conserved sequences in the variable (VH) and joining (JH) regions. On polyacrylamide gel electrophoresis, polyclonal B cell proliferations showed a "smear", probably due to the variable lengths of the diversity (DH) region genes and the N regions separating the VH and DH and JH regions. In contrast, DNA from B cell lymphomas showed a clear single band in eight out of 10 cases. PCR undertaken on germ line DNA from non-lymphoid tumours showed no detectable bands or smears. The method can be completed within one day of biopsy, compared with several days in the case of conventional DNA blot analysis. Furthermore, it is cheaper, simpler, avoids the need for radioactive materials and requires very small amounts of DNA (about 1 micrograms).
Production and characterisation of a monoclonal antibody to human papillomavirus type 16 using recombinant vaccinia virus.
Authors: McLean C S , Churcher M J , Meinke J , Smith G L , Higgins G , Stanley M , Minson A C
Published: June 2007

A monoclonal antibody was raised against the major capsid protein L1 of human papillomavirus type 16, using a recombinant vaccinia virus that expresses the L1 protein, as a target for screening. This antibody, designated CAMVIR-1, reacted with a 56 kilodalton protein in cells infected with L1-vaccinia virus, and the protein was present in a predominantly nuclear location. The antibody also detects the HPV-16 L1 antigen in formalin fixed, paraffin wax embedded biopsy specimens and on routine cervical smears. The antibody reacts strongly and consistently with biopsy specimens containing HPV-16 or HPV-33, but very weak reactions were occasionally observed with biopsy specimens or smears containing HPV-6 or HPV-11. The potential advantages of using a vaccinia recombinant are (i) the target protein is synthesised in a eukoryotic cell so that its "processing" and location are normal; (ii) cells infected with vaccinia recombinants can be subjected to various fixing procedures similar to those used for routine clinical material. This greatly increases the probability that an identified antibody will be useful in a clinical setting.
Sialic acid histochemistry and the adenoma-carcinoma sequence in colorectum.
Authors: Agawa S , Jass J R
Published: June 2007

A change in sialic acid, notably loss of O acetyl substitution, was studied histochemically in a series of 93 colorectal adenomas that included 14 malignant polyps. Changes in sialic acid were uncommon in adenomas showing mild dysplasia but became increasingly common in moderately and severely dysplastic adenomas and were always present in carcinomatous areas. There was no correlation between a change in sialic acid and either size or villous architecture of benign adenomas. As mucin change often preceded the development of invasive cancer, it could not be used on its own to distinguish between epithelial displacement (pseudoinvasion) and malignant invasion. An abundant luminal accumulation of altered sialic acid in association with an epithelial lining that was non-mucin secreting, however, was specific for cancer. Conversely, the presence of unchanged intracellular or intraluminal O-acetyl sialic acid may help to exclude a diagnosis of malignancy in equivocal cases. The change is not specific for colorectal neoplasms and probably represents a metaplasia to a small intestinal phenotype.
Multiple drug resistance in salmonellae in England and Wales: a comparison between 1981 and 1988.
Authors: Ward L R , Threlfall E J , Rowe B
Published: June 2007

Each year from 1981 through to 1988 the most common serotypes isolated from man in England and Wales and identified at the Division of Enteric Pathogens were S typhimurium, S enteritidis, and S virchow. In 1981 these three serotypes accounted for 45%, 12%, and 7% of isolations. The remaining 35% comprised strains belonging to a further 188 different serotypes, none of which accounted for more than 1% of the total. In 1988 S typhimurium accounted for 24% of isolations, S enteritidis 57%, and S virchow 4%. The remaining 15% comprised strains of a further 184 serotypes. The resistances to the common antimicrobial drugs in non-typhoidal salmonellas isolated in England and Wales in 1981 and 1988 were reported with particular reference to resistance to four or more antimicrobial drugs (multiple resistance). For S typhimurium the overall percentage of resistant strains varied little, but multiple resistance more than doubled from 5% to 12%; in S enteritidis the incidence remained the same. In S virchow the percentages of strains resistant to all the antimicrobial drugs and in particular, to chloramphenicol, streptomycin, trimethoprim and furazolidone, rose from 0.2% to 10.4%. Salmonella enteritis in man is usually a self limiting disease and antimicrobial treatment is seldom required; but should spread beyond the intestine occur, effective antimicrobial treatment is essential. Under these circumstances a knowledge of the likelihood of resistances to commonly available drugs could be of considerable value to the clinician.
Evaluation of Cathra system for identifying gram negative aerobic bacteria.
Authors: Ling J M , Zhang L C , Hui Y W , French G L
Published: June 2007

The Cathra system is a commercial multipoint inoculation method for the identification of aerobic Gram negative bacteria. The system uses a replicator technique in which 21 different agar media can be inoculated simultaneously with 36 organisms. Identifications are made by use of a special computer database. The performance of this system was compared with that of the API 20E for the identification of 372 clinical isolates of Enterobacteriaceae and 133 miscellaneous Gram negative bacteria. For enterobacteria, the Cathra system was in 97% agreement with API 20E at species level and 98% at genus level. For miscellaneous Gram negative strains the two systems were in 59% agreement at species level and 77% at genus level. The Cathra system is suitable for use in diagnostic laboratories, especially those with a heavy workload and a wish to use break-point sensitivity testing. The identification database for miscellaneous Gram negative organisms, however, needs to be expanded.
Use of benzidine for histological demonstration of haemoglobin in human bite marks.
Authors: Allison R T , Whittaker D K
Published: June 2007

Macroscopic evidence of bruising from human bite marks may be inconclusive and routine histochemical methods of showing extravasated erythrocytes can be unreliable. Leuco patent blue staining, for the presence of peroxidase, Amido black B, a tinctorial staining method for haemoglobin, Perls's reaction for ferric iron (haemosiderin), Masson-Fontana for melanin, Masson's trichrome, a connective tissue strain, and the benzidine reaction for haemoglobin peroxidase were carried out in three forensic cases and one experimental case. A modified benzidine method was the most reliable indicator of haemoglobin activity, especially where dispersion into extra-cellular tissues had occurred. The resilience of the erythrocyte peroxidase enzyme to temperature changes and fixation supports the concept of a "pseudo-peroxidase" in those cells. It is concluded that free haemoglobin from bite marks, or indeed other forms of blunt trauma, may best be shown by the benzidine reaction and that exemption certificates for use of this prohibited substance may be worth pursuing.
Differential marking of excision planes in screened breast lesions by organically coloured gelatins.
Authors: Armstrong J S , Weinzwieg I P , Davies J D
Published: June 2007

Traditionally India ink has been used to mark surgical resection margins, more recently with acetone to aid drying. Alternative methods have been suggested in recent months, including solutions of alcian blue, and Tippex. These methods use one colour only and Tippex is radiodense. Artists' pigments have been used, but their radiodensity makes them unsuitable for the detailed mammograms of the sliced screened specimens. An alternative method was specifically designed for impalpable breast lesions. It is based on coloured gelatins that are painted on to the biopsy specimen before dissection. The markers are radiolucent, quick to set, and do not penetrate the connective tissue. They can be applied to both fresh and fixed tissues, and the cost is about 0.05 pounds a specimen. The system is also suitable for marking other large specimens.
Virus infections in bone marrow transplant recipients: a three year prospective study.
Authors: Taylor C E , Sviland L , Pearson A D , Dobb M , Reid M M , Kernahan J , Craft A W , Hamilton P J , Proctor S
Published: June 2007

Over three years 81 consecutive bone marrow transplant recipients (32 allogeneic and 49 autologous) who received prophylaxis with acyclovir, were studied for symptomatic virus infection. Thirty nine infections were documented in a total of 28 patients. Thirty two infections were mild, five were moderately severe, and two were severe. Cytomegalovirus infection occurred in only six allogeneic recipients. Herpes simplex virus and varicella zoster virus infections occurred infrequently. Seven patients who were considered at the time of death to have died due to an infectious cause were studied virologically at necropsy. In only one patient was a virus infection thought to have been the cause of death. Prophylaxis with acyclovir may have influenced the rate and clinical prominence of herpes virus infections. In this study viruses were considered to have had a relatively minor role in causing morbidity and mortality.
Is candidiasis the true cause of vulvovaginal irritation in women with diabetes mellitus?
Authors: Rowe B R , Logan M N , Farrell I , Barnett A H
Published: June 2007

Vulvovaginitis is common in diabetic women and is often treated with antifungal agents on the assumption that the causative organism is Candida albicans. In a survey of 100 consecutive diabetic women attending a diabetes clinic 36 had complained to their general practitioner about vulvovaginal irritation during the past three years and 26 were treated with antifungal agents without a vaginal examination or swabs being taken. In a separate study 27 post-menopausal women with non-insulin dependent diabetes and symptoms of vulvovaginitis were investigated. The organisms cultured were: Candida albicans (n = 6), beta haemolytic streptococci (n = 14), Gardnerella vaginalis (n = 2), Staphylococcus aureus (n = 2), Streptococcus milleri (n = 1), Streptococcus faecalis (n = 1), Klebsiella oxytoca (n = 1), no organisms (n = 3). Where a bacterial organism was isolated symptoms resolved in all but one case with appropriate antibiotic treatment. It is recommended that the practice of initiating antifungal treatment without taking high vaginal swabs should be reviewed and treatment should be given specifically rather than empirically.
Signature patterns of DNA restriction fragments of Helicobacter pylori before and after treatment.
Authors: Owen R J , Fraser J , Costas M , Morgan D , Morgan D R
Published: June 2007

The genomic DNA of Helicobacter pylori was studied by electrophoretic analysis of restriction endonuclease fragments. Twenty seven isolates from eight patients in the United Kingdom, obtained before and after treatment with nitrofurantoin, and two reference strains from Australia and Peru were investigated. Digestion of DNA with HaeIII, which gave the clearest band pattern of the 20 enzymes tested, showed that each set of isolates from a single patient had a unique band pattern. The DNA signature band patterns of strains from different patients were less than or equal to 62% similar (average 43%); similarities of patterns from the same patient were generally greater than or equal to 86%. Some minor but reproducible polymorphisms (less than or equal to five bands) in the signature region were detected in most consecutive isolates. Plasmid DNA was detected in isolates from five patients, but major pattern differences were attributed to genomic variation. It is concluded that the HaeIII DNA digest signature fingerprints provide a reproducible and sensitive method of discriminating between isolates of H pylori.
Nucleolar organiser regions in adenocarcinoma in situ and invasive adenocarcinoma of the cervix.
Authors: Darne J F , Polacarz S V , Sheridan E , Anderson D , Ginsberg R , Sharp F
Published: June 2007

Silver binding nucleolar regions (AgNORs) were evaluated in normal endocervix, adenocarcinoma, and its potential precursor, adenocarcinoma in situ (AIS), in an attempt to increase an understanding of the natural history of cervical adenocarcinoma and to identify a marker for abnormal endocervical (atypical glandular) cells which could aid diagnosis and follow up of endocervical lesions. For every 50 cells the mean AgNOR counts were as follows: normal endocervical cells (n = 15) 79.8 (95% Cl 68-91); AIS (n = 20) 200.7 (95% Cl 182-219); and invasive adenocarcinoma (n = 30) 299 (271-328). There was no overlap between the groups of normal endocervical cells and invasive adenocarcinoma, but there was significant overlap between cases of invasive adenocarcinoma and carcinoma in situ. In six out of 17 cases with AIS, NOR count in adjacent morphologically normal glandular cells ("internal" controls) was increased when compared with the "external" (normal endocervical) control group. This suggests the presence of wider field changes not previously identified using routine histological methods. The findings suggest that AIS is a potential premalignant precursor of invasive adenocarcinoma, but that assessment of NORs is of no practical use in discriminating between the histological types of cervical carcinoma.
Assessment of rapid ELISA test for detection of Epstein-Barr virus infection.
Authors: Matheson B A , Chisholm S M , Ho-Yen D O
Published: June 2007

A rapid test for the detection of IgM and IgG Epstein-Barr nuclear antigen (EBNA-1) has been extensively marketed. If IgM to Epstein-Barr viral capsid antigen (EBV VCA) is taken as evidence of current EBV infection, one observer detected 17 of 38 such samples and the other 22 of 38 as acute. The positive predictive value of the test was 63%, and the greatest difficulty was posed by the detection of IgM EBV VCA positive, heterophile antibody negative samples. Significant false positive results were obtained in sera with evidence of current Toxoplasma gondii, cytomegalovirus, and adenovirus infection. Rheumatoid factor was not a problem. Modification of the test protocol improved its performance: the positive predictive value rose to 87% and the negative predictive value to 81%. Although our modifications did not increase the speed of the test, there was reliable information on the EBNA-1 state. The test is best used as an adjunct to other EBV serology, and laboratories should be aware of the limitations of the rapid test.
Tartrate resistant acid phosphatase positive splenic lymphoma: a relatively benign condition occurring in a time-space cluster?
Authors: Kettle P , Morris T C , Markey G M , Alexander H D , Curry R C , Hayes D , Cameron C H , Toner P G
Published: June 2007

Conventional light and electron microscopic studies, together with cytochemical and immunocytochemical staining procedures, were carried out to ascertain whether the lymphomata of four elderly female patients living within 10 kilometers of each other, who presented within a short space of time with massive splenomegaly and varying cytopenia, belonged to any particular subgroup of lymphoma. In each case the lymphoma had a diffuse pattern and mature B cell phenotype. The malignant cells were of uniform cell type, slightly larger than admixed polymorphonuclear leucocytes, and showed minimal nuclear irregularity and positivity for tartrate resistant acid phosphatase (TRAP) staining. Their clinical and morphological features were compared with those of other lymphoproliferative disorders, but while sharing some features in common with each condition, this small group of patients seemed to have a unique combination of findings. The cytopenias of all four responded well after removal of the spleen and their disease has not been aggressive. It is concluded that these patients have a distinct subgroup of lymphoma, which it is important to recognise so that inappropriate use of aggressive cytotoxic drugs can be avoided.
Testicular sex cord stromal tumour with granulosa cell differentiation: detection of steroid hormone receptors as a possible basis for tumour development and therapeutic management.
Authors: Düe W , Dieckmann K P , Niedobitek G , Bornhöft G , Loy V , Stein H
Published: June 2007

A testicular sex cord stromal tumour with granulosa cell differentiation, typical of granulosa cell tumours of the adult type, was investigated immunohistologically on snap frozen and paraffin wax embedded material. The predominance of vimentin and the additional expression of cytokeratin subtypes 8 and 18, as well as the negative staining for epithelial membrane antigen, accorded with results previously reported, for ovarian granulosa cell tumours; the lack of expression of desmoplakin, however, was a distinctive feature. Together with negative staining for leucocyte common antigen, the antigen pattern facilitates the differential diagnosis between granulosa cell tumour and undifferentiated carcinoma or gonadal lymphoma, although its suitability for differentiating within the group of gonadal stromal tumours seems to be limited. The small growth fraction, shown by the monoclonal antibody Ki-67, is typical of the clinical behaviour of granulosa cell tumours. The expression of oestrogen and progesterone receptors, also recently found in testicular Leydig cell tumours, may provoke new approaches to the management of testicular granulosa cell tumours, as well as a new hypothesis on the development of these tumours.
Upper gastrointestinal pathology in familial adenomatous polyposis: results from a prospective study of 102 patients.
Authors: Domizio P , Talbot I C , Spigelman A D , Williams C B , Phillips R K
Published: June 2007

Multiple gastric and duodenal biopsy specimens from 102 asymptomatic patients with familial adenomatous polyposis, taken during a prospective endoscopic screening programme were examined. One hundred patients had microscopic gastroduodenal pathology, often in the absence of macroscopic lesions. Adenomas were found in 94 patients in the duodenum, in the second and third parts. Hyperplasia of villous and crypt epithelium was also seen, sometimes in the absence of adenomas: this may be a precursor of neoplastic change. In the stomach fundic gland polyps were the commonest abnormality, seen microscopically in 44 patients. Chronic antral gastritis was common in patients without fundic polyps. Gastric adenomas were present in six patients, all of whom also had duodenal adenomas. If duodenal adenomas in familial adenomatous polyposis have a similar malignant potential to those in the colorectum sequential endoscopy and biopsy are necessary to detect cancer in these patients.
Latex enzyme immunoassay for measuring IgG antibodies to rubella virus.
Authors: Duverlie G , Roussel C , Driencourt M , Orfila J
Published: June 2007

A latex enzyme immunoassay (LEIA) for detecting IgG class antibody to rubella virus was compared with the latex agglutination test (LA) and a haemagglutination inhibition assay (HI). Of 243 sera tested, four discrepant results were observed among all three techniques, corresponding to borderline values. Except for one sample containing specific IgM class antibody, the difference between quantitative results from each pair of tests was always within a value corresponding to two doubling dilutions and was considered to have acceptable variation. The LEIA technique allowed 10 seroconversions to be detected, as determined by the other techniques. The LEIA required a single 1 in 8 sample dilution, took 30 minutes, and provided a useful alternative assay for the quantitation of rubella antibodies.
Multiple breakpoint method for measuring effect of antibiotics on endocarditis strains of streptococci.
Authors: Marks J , Paull A
Published: June 2007

The activity of penicillin alone and combined with aminoglycoside on endocarditis strains of streptococci was examined. Good assay reproducibility was obtained by the use of logarithmic phase cultures standardised by opacity, careful inoculation of well-plates, removal of antibiotic by membrane transfer and incubating survival counts in hydrogen plus carbon dioxide. The use of 10-fold intervals for penicillin concentration simplified assay design without loss of efficiency.
Audit in histopathology: description of an internal quality assessment scheme with analysis of preliminary results.
Authors: Zuk J A , Kenyon W E , Myskow M W
Published: June 2007

In the first six months of a formal Internal Quality Assessment Scheme operating in the Department of Histopathology, Broadgreen Hospital, Liverpool, 1005 items of data were gathered, relating to 80 cases. The scheme entails a random 2% sample of biopsy specimens being selected, each case being analysed using a structured proforma, and a numerical scoring system being allocated to all aspects of specimen handling. Technical and secretarial performance was good while the quality of clinical information provided by the requesting clinician was poor. There was a wide variation in reporting times, which related partly to the complexity of the specimen, and partly to the degree of supervision required by the reporting pathologist. Month by month analysis of reporting times showed a significant increase in reporting times associated with rotation of junior staff, but not with periods of annual leave. Pathologist performance scores were good, but close examination of components of the overall score for an individual pathologist indicated occasional areas of weakness (such as the adequacy of the macroscopic report). It is concluded that this scheme is worthwhile and its practice will be continued indefinitely. The comprehensive nature of the analysis allows for the formal identification of areas of work which need improvement, and the allocation of a formal numerical score allows improvement in these areas to be monitored. The monthly meetings provide a means whereby performance scores are fed back to the participating pathologists, and they are also of general educational value regarding histological reporting practice. It is intended that the scheme be extended to include the assessment of special stains, frozen sections, and adequacy of the report delivery service. The system is easily adaptable for use within other histopathology departments.
Continuous assessment of performance in External Quality Assessment Schemes.
Authors: Ardern J C , Hyde K , Hickman L , Urmston A , Burgess R , Burn A M , Geary C G
Published: June 2007

A simple, standardised procedure was used for processing data from External Quality Assessment Schemes and for producing performance charts. A graphic presentation of cumulative performance is generated for each test, using an integrated software package to display results in a standardised format. This permits interpretation of satisfactory and poor performances and facilitates identification of "outlying" results. Although most results are recorded as Deviation Indices, the system is flexible and can be used to present other performance variables, such as Percentage Deviations and relevant textual information relating to interpretative assessments. It is therefore readily adaptable for use by other pathology disciplines.
Evaluation of the pre-S (pre-S(1)Ag/pre-S(2)Ab) system in hepatitis B virus infection.
Authors: Galán M I , Tomás J , Bernal M C , Salmerón F J , Maroto M C
Published: June 2007

The diagnostic and prognostic value of pre-S(1)Ag and pre-S(2)Ab was investigated in 69 HBsAg surface antigen positive patients--14 with acute hepatitis B, 30 with chronic liver disease (six chronic persistent hepatitis, 14 chronic active hepatitis, 10 with cirrhosis) and in 25 asymptomatic carriers. Pre-S(1)Ag was found in all patients with chronic hepatitis B virus (HBV) infection regardless of viral replication. In contrast, pre-S(2)Ab was not detected in any patients. Acute hepatitis was studied sequentially with periodic controls at 20 day intervals. Pre-S(1)Ag cleared before HBsAg in six of 14 (43%) patients who progressed favourably, and the two antigens cleared simultaneously in eight of 14 (57%) cases. Patients with early clearance of pre-S(1)Ag progressed favourably, thus indicating the prognostic value of this test, which, however, is still of limited practical application given the small temporal difference between the moment of clearance of the two antigens. The first markers to clear, however, were HBeAg and DNA-HBV, which showed significant differences with respect to the clearance of HBsAg. Moreover, pre-S(2)Ab appeared before HBsAb in 57.1% of our patients and was found in some patients before pre-S(1)Ag and HBsAg had cleared (42.8%), thus allowing complete viral clearance and acute HBV infection to be predicted earlier.
Monocytoid B cell lymphoma.
Authors: Banerjee S S , Harris M , Eyden B P , Radford J A , Harrison C J , Mainwaring A R
Published: June 2007

The clinical, light microscopic, ultrastructural, immunocytochemical and cytogenetic features of a case of monocytoid B cell lymphoma were investigated. The tumour initially affected the cervical and supraclavicular nodes, but 33 months later affected the left parotid salivary gland. The patient had subclinical Sjögren's syndrome. The neoplastic cells showed characteristic morphological features and had peri- and interfollicular distribution in the node. Immunocytochemically the tumour cells were L26, 4KB5, MB2, CD19, CD20, CD22 and IgM/kappa positive. Prominent plasmablastic plasmacytoid differentiation was present in the recurrent tumour, suggesting an origin from post-follicular B cells. The lymphoma cells showed unusual cytogenetic abnormalities.
Serum non-organ specific autoantibodies in human immunodeficiency virus 1 infection.
Authors: Cassani F , Baffoni L , Raise E , Selleri L , Monti M , Bonazzi L , Gritti F M , Bianchi F B
Published: June 2007

Serum samples from 66 seropositive subjects (56 with a history of intravenous drug abuse), including asymptomatic carriers and patients with persistent generalised lymphadenopathy (PGL), AIDS related complex (ARC), and AIDS, were tested by indirect immunofluorescence on rat tissue sections and HEp-2 cells for the presence of antibodies to nuclei, smooth muscle, intermediate filaments (anti-IMF) and microfilaments (anti-MF). Counterimmunoelectrophoresis was also used to detect antibodies to extractable nuclear antigens. Smooth muscle antibodies with the V pattern or antinuclear antibodies, mainly of the speckled type, or anti-IMF, occurred in 35 cases, being widely distributed in all groups. Such an autoantibody response resembles the "viral" autoimmunity described in various infectious diseases and in particular that of non-A, non-B post-transfusion hepatitis. Autoantibodies may be of some prognostic relevance, as the prevalence of smooth muscle antibodies V increased as the disease progressed (asymptomatic carriers 20%, those with PGL 29%, those with ARC 47%, and those with AIDS 63%. In the PGL group autoantibody positivity correlated with the presence of skin anergy. The fact that autoantibodies were more frequently detected in patients with circulating immune complexes suggests that these can contain autoantibodies and the corresponding autoantigens.
Immunoassay of P2 protein in cerebrospinal fluid in neurological disorders.
Authors: Colover J
Published: June 2007

Cerebrospinal fluid samples were obtained at lumbar puncture from 53 patients with a wide variety of neurological disorders. Cerebrospinal fluid samples were tested for the presence of P2 protein, a constituent of myelin, with an enzyme linked immunosorbent assay technique using a specific polyclonal antibody. High concentrations of P2 in the cerebrospinal fluid paralleled a raised IgG index (clearance ratio), the presence of oligoclonal bands, as well as raised white cell counts or depressed albumin:IgG ratios. Twenty one patients had been diagnosed as having definite or probable multiple sclerosis and the remaining 32 had other conditions. Of the 13 patients with high positive P2, 12 (92%) were in the multiple sclerosis category; of the 40 patients with low (12) or undetectable (28) P2 concentrations, only nine (23%) were diagnosed as having multiple sclerosis. In this patient population the presence of high immunoreactive P2 concentrations in cerebrospinal fluid was closely associated with evidence of intrathecal immunoglobulin synthesis and with the clinical diagnosis of multiple sclerosis. On this basis it is suggested that immunoassay of P2 concentration in the cerebrospinal fluid may be of potential value in the investigation of patients with demyelinating disorders.