bluuebunny/crossref_metadata_2025 huggingface dataset:
Haemophilus aphrophilus endocarditis in pregnancy.
Authors: Anand C M , Mackay A D , Evans J I
Published: June 2007

The clinical and microbiological features of a case of Haemophilus aphrophilus endocarditis in pregnancy are described. The complicating effect of pregnancy on treatment and the difficulties in identifying the organism in the laboratory are discussed.
Detection of staphylococcal enterotoxin in gastric juice.
Authors: Dickie N , Park C E , Robern H
Published: June 2007

The gastric juice of a patient showing symptoms of staphylococcal food poisoning was examined by a radioimmunoassay for the presence of enterotoxins. Assays gave markedly higher results at 35 degrees than at 5 degrees. The source for this discrepancy was attributed to interference due to trypsin activity on the basis of (1) the demonstration of hydrolysis of p-toluenesulfonyl-L-arginine methyl ester by the specimen, (2) inhibition of this activity by trypsin inhibitor from lima bean, and (3) lowered values produced for enterotoxins in gastric juice when the inhibitor was included in the assay system.
Serological diagnosis of infection of the urinary tract by yeasts.
Authors: Warnock D W , Speller D C , Morris J A , Mackie P H
Published: June 2007

Precipitins to mannan and cytoplasmic antigens of Candida albicans and Torulopsis glabrata were determined in 25 patients with colonization of the bladder urine by yeasts and in 25 control patients with bacteriuria. Precipitins were present in 64% of the patients with funguria and in 56% of the patients with bacteriuria. There was no correlation between the reactions obtained and the clinical significance of the yeast colonization. It is suggested that a single precipitin test is unhelpful in the assessment of the significance of urinary colonization by yeasts in hospital patients.
A case of small-cell Sézary's syndrome with null-cell features.
Authors: Goldstone A H , Cawley J C , Roberts S O , Leventine A , Barker C R
Published: June 2007

A case of the small-cell variant of Sézary's syndrome (SS) is reported in which the SS cells lacked the surface-marker characteristics of both T- and B-cells. In particular, the SS cells failed to form E-rosettes even with a sensitive technique using 2-amino-ethylisothiouronium bromide (AET)-treated sheep red blood cells. The significance of these findings is briefly considered in relation to the existing literature.
Rate of clearance by the spleen of heat-damaged erythrocytes.
Authors: Bowring C S , Glass H I , Lewis S M
Published: June 2007

The rate of uptake in the spleen of heat-damaged red blood cells labelled with 99mTc has been measured by radioisotope scanning in 38 patients. The values obtained for the half-clearance time into the spleen using this method have been compared with the values obtained simultaneously by blood sampling for the rate of loss of radioactivity from the circulation. It was found that the uptake into the spleen was approximately three times faster than the measured rate of loss of radioactivity from the blood. The reasons for this are discussed and it is suggested that the scanning technique is more reliable as a measure of this aspect of splenic function.
Rapid electron microscopy in oncology.
Authors: Carr I , Toner P G
Published: June 2007

The case is argued for wider use of electron microscopy as an aid to histological diagnosis in problem cases such as tumours of uncertain histogenesis. In practical terms, electron microscopy can produce results as "immediate" as many special stains in regular use. The cost of providing an effective service can be favourably compared with that of various other diagnostic aids commonly called upon in normal clinical practice. It is suggested that exploitation of this growth area of morphological pathology will enhance the attractions of the discipline of histopathology to talented potential recruits.
Role of in vitro and in vivo tests of hypersensitivity in beryllium workers.
Authors: Price C D , Williams W J , Pugh A , Joynson D H
Published: June 2007

The value of the beryllium macrophage migration inhibition (Be MIF) and Mantoux tests in the diagnosis of chronic beryllium disease and in the detection of hypersensitivity in healthy beryllium workers is demonstrated. In the absence of steroid treatment the Be MIF test is positive in chronic beryllium disease patients. Seven of 50 (14%) helathy beryllium workers were Be MIF positive, while all the control subjects, normal and sarcoidosis patients, were negative. Healthy beryllium workers tend to be more often Mantoux negative than a comparable group of non-exposed workers, and although not conclusive this finding correlates with a positive Be MIF test. Although the detection of hypersensitivity is not diagnostic of disease, the Be MIF test can be used as an additional method for monitoring the health of beryllium workers. The full significance of our results should be assessed by a long-term study.
Complementary use of aesculin hydrolysis and inositol fermentation in the characterisation of Klebsielleae.
Authors: Barr J G , Mahood R J
Published: June 2007

Rates of aesculin hydrolysis and inositol fermentation adequately differentiate Klebsielleae from other Enterobacteriaceae. In combination with tests for motility and growth in potassium cyanide medium, presumptive differentiation between Klebsielleae, and confirmation of Klebsiella pneumoniae, is obtained.
Twice weekly prophylactic therapy in haemophilia A.
Authors: Aronstam A , Kirk P J , McHardy J , Culver-James J W , McLellan D S , Turk P , Rainsford S G , Slattery M
Published: June 2007

Factor VIII-containing materials were administered to four severely affected haemophiliacs twice weekly in doses calculated to raise the factor VIII level to either 15% or 30% of average normal. The pooled results from those patients with statistically similar baseline bleeding frequencies showed a significant reduction in bleeding frequency on both doses in the first 48 hours. The 30% dose produced a more significant reduction than the 15% dose in the first 24 hours, but there was no significant difference between the two doses in the second 24 hours. It appears that to reduce the bleeding frequency of severely affected haemophiliacs by 60% would require a two-and-a-half-fold increase in therapeutic materials. A 90% reduction would need nine times the amount of material currently in use.
Reduced oxidase activity in the caeruloplasmin of two families with Wilson's disease.
Authors: Gollan J L , Stocks J , Dormandy T L , Sherlock S
Published: June 2007

Caeruloplasmin has been determined immunologically and by coper oxidase activity in 25 normal subjects, 20 patients with Wilson's disease, and 80 patients with chronic liver disease. Repeated estimation in four patients with Wilson's disease and two heterozygous mothers from two families revealed a consistent reduction in the copper oxidase activity of caeruloplasmin (12-32 units copper oxidase activity/mg caeruloplasmin) relative to the values obtained in normal subjects, patients with chronic liver disease, and other Wilson's disease patients (mean 65-79 units/mg). It is suggested that the functional abnormality in caeruloplasmin observed in these two families is an inherited variant, which does not appear to be due to the presence of a serum inhibitor of copper oxidase.
A sensitive urine-test method for monitoring the ingestion of isoniazid.
Authors: Ellard G A , Greenfield
Published: June 2007

A method is described for monitoring the ingestion of isoniazid based on detecting its metabolites, isonicotinic acid, and isonicotinylglycine in the urine. The sensitivity of the method is high so that reliably positive results were obtained up to about 24 hours after the ingestion of 100 mg isoniazid. The method should facilitate monitoring the taking of isoniazid by tuberculosis patients and the use of isoniazid as a marker for assessing the regularity with which other drugs prescribed for self-administration are actually ingested.
Incidence of K1 antigen in Escherichia coli isolated from blood and cerebrospinal fluid of patients in the United Kingdom.
Authors: Cheasty T , Gross R J , Rowe B
Published: June 2007

Altogether 411 cultures of Escherichia coli isolated from blood and 60 from cerebrospinal fluid (CSF) of patients in the United Kingdom were identified biochemically and serologically. They were tested for the presence of K1 antigen by an antiserum-agar method using horse meningococcus group B antiserum and by slide agglutination using E. coli 07.K1.H-antiserum. In total 71 cultures from blood (17%) and 29 from CSF (48%) gave positive results by both methods and were considered to possess the K1 antigen. Among the cultures from patients less than 3 years of age the K1 antigen was found significantly more often in those isolated from CSF (53%) than in those from blood (29%). The K1 antigen was found significantly more frequently in cultures isolated from the blood of patients less than 3 years old (29%) than in those from the blood of older patients (13%). Cultures which gave negative results in the slide agglutination test also gave negative results by the antiserum-agar method but positive results obtained by slide agglutination were not always confirmed using the antiserum-agar technique. Slide agglutination was considered to be valuable for the elimination of K1 negative cultures, but positive results required confirmation using the antiserum-agar method.
A comparative study for the enumeration of peripheral blood white cell counts below 2.0 x 10(9)/1 using counting chambers and the Coulter Counter model "S".
Authors: Hurd K E , Palmer M K , Hull S
Published: June 2007

Low white cell counts are performed in many laboratories by a visual method as the method of choice. In this study, the visual count has been compared to that obtained by the Coulter Model "S". The results obtained by the two methods show very close correlation, thus allowing the Coulter Model "S" to be used with confidence for all low white cell counts provided certain precautions are taken.
Evaluation of a new test system for rubella haemagglutination inhibiting antibodies.
Authors: Roberts P C , Hobbs S J
Published: June 2007

A recently available kit for the determination of rubella haemagglutination inhibiting antibodies (Rubindex, Ortho diagnostics) was was compared with the method used routinely in this laboratory. Rubindex compared favourably in that no significant difference in titre was found in 95.1% of 287 sera tested. Difficulty occurred with some sera from cases of Mycoplasma pneumoniae infection, rheumatoid arthritis, and a small number of normal sera containing human "O" cell agglutinins. This was overcome by treatment of the sera with 2-mercaptoethanol. Rubindex had the advantage that all reagents were provided in kit form and the trypsinised human "O" cells provided had a longer shelf life than chick erythrocytes.
Aminopyrine breath test in alcoholic liver disease and in patients on enzyme-inducing drugs.
Authors: Lewis K O , Nicholson G , Lance P , Paton A
Published: June 2007

The 14C-aminopyrine breath test was used to measure liver function in 14 normal subjects, 16 patients with alcoholic cirrhosis, 14 alcoholics without cirrhosis, and 29 patients taking a variety of drugs. The normal value for the breath test was 8.6 +/- 1.5%, whereas it was significantly lower (5.1 +/- 3.8%) in patients with alcoholic cirrhosis. Higher than normal values were found in some alcoholic patients without cirrhosis and in patients receiving enzyme-inducing drugs, such as phenobarbitone. There was a significant correlation between serum gamma-glutamyltransferase and breath test in these groups. Some patients with alcoholic cirrhosis may also be capable of enzyme induction.
Multiple myeloma and oat cell carcinoma.
Authors: Smith A G , Cumming R L
Published: June 2007

An association linking multiple myeloma with a higher incidence of carcinomatous tumours has been reported. The following case report describes a man diagnosed as having bronchogenic carcinoma found also to have myelomatosis. Aspects of this association are discussed.
Report filing in histopathology.
Authors: Blenkinsopp W K
Published: June 2007

An assessment of alternative methods of filing histopathology report forms in alphabetical order showed that orthodox card index filing is satisfactory up to about 100000 reports but, because of the need for long-term retrieval, when the reports filed exceed this number they should be copied on jacketed microfilm and a new card index file begun.
An on-line computer system for histopathology reporting.
Authors: Codling B W , Macartney J C , Curran R C
Published: June 2007

An on-line computer system was developed for issuing histopathology reports as part of an integrated hospital information system. Input is through a Cossor visual display unit with a typewriter keyboard to a Univac 418 III computer. Stored information is available to authorised hospital staff via similar visual display units located in the wards and laboratories. Existing programs and computer staff were used to provide the new service. It has resulted in better method, speedier communication, and saving of laboratory staff time. The system has yet to be fully tested but initial reactions are favourable and indicate that the investment in computer staff time and extra laboratory equipment will be cost effective.
Alpha1-fetoprotein in the diagnosis of hepatoma: statistical and cost benefit aspects.
Authors: Phillips P J , Rowland R , Reid D P , Coles M E
Published: June 2007

A rational comparison of different serum concentrations of alpha1-fetoprotein (S-AFP) in the diagnosis of hepatoma must be made. We took data on the sensitivity and specificity of different diagnostic S-AFP concentrations from the literature and evaluated them statistically and by Bayesian analysis. In our patients (hepatoma prevalence 0.028) a sensitive diagnostic concentration (30-50 ng/ml) will misdiagnose hepatoma so often that a positive test will indicate hepatoma in only 10% of cases. A positive test at a specific diagnostic concentration (500 ng/ml) indicates hepatoma in 100% of cases and is preferable in terms of cost benefit. Although the lower concentration will diagnose a larger proportion of patients with hepatoma (74% compared with 59%) the 'costs' of excluding false positives are considerable (A$2545 per extra case with 2.5% of patients suffering significant morbidity). In western societies, where the prevalence of hepatoma is low, a higher, less sensitive but more specific diagnostic S-AFP concentration is appropriate.
Rapid screening for significant bacteriuria using a Coulter Counter.
Authors: Smither R
Published: June 2007

A Coulter Counter was evaluated for detecting significant bacteriuria. Simple urinary particle counts showed agreement in 883 of the 956 (92.4%) urine specimens examined compared to a standard culture procedure. They also provided a semiquantitative estimate of bacterial numbers in specimens diagnosed as infected by culture. Sample preparation before counting was minimal, and results were obtained within two to four minutes.
Continuous-flow automation of the Lactobacillus casei serum folate assay.
Authors: Tennant G B
Published: June 2007

A method is described for the continuous-flow automation of the serum folate assay using Lactobacillus casei. The total incubation period is approximately four hours. The growth response of the organism to folate is estimated by measuring the rate of reduction of 2,3,5-triphenyl tetrazolium chloride (TTC). A simple continuous culture apparatus is used to grow the inoculum. Supplementation of the assay medium is necessary to obtain parallel results. A statistical assessment shows a favourable comparison with the whole-serum tube assay using a chloramphenicol resistant strain of L. casei. The method is less sensitive to inhibitory substances than the tube assay.
Alpha-1-antitrypsin bodies in the liver.
Authors: Blenkinsopp W K , Haffenden G P
Published: June 2007

The cytoplasmic bodies in hepatocytes thought to indicate possession of the Z allele for alpha 1-antitrypsin deficiency were found in necropsy in 10 of 64 adults with cirrhosis, four of nine with hepatic fibrosis, and four of 15 with hepatocellular carcinoma. They were also found in six of 76 adults with severe panacinar emphysema, and in four of a control series of 110 adults with neither emphysema nor liver disease. The association of the bodies with each of the three liver diseases was statistically significant, but the association of the bodies with emphysema was not. It is considered probable that heterozygous (PiMZ) alpha 1-antitrypsin deficiency is associated with an increased incidence of cirrhosis, hepatic fibrosis, and hepatocellular carcinoma.
Use of umbelliferone derivatives in the study of enzyme activities of mycobacteria.
Authors: Grange J M , Clark K
Published: June 2007

A spectrophotometric method using umbelliferone derivatives has been developed for the study of enzymic activites of mycobacteria. Arylsulphatase activity can be estimated in six hours rather than in 10 days as in the conventional method. The technique may be applied to a study of whole cells or to cell-free extracts.
Screening of blood donors for the detection of antitetanus antibodies suitable for the production of human antitetanus immunoglobulin.
Authors: Wiseman I C , Gascoigne M E
Published: June 2007

During a 12-month period, 40 146 blood donors were tested for the presence of high titre antitetanus antibodies. An attempt has been made to define the most suitable donors, those with antitetanus antibody titres of 4 IU/ml or above, by virtue of titre, sex, location, and length of time since most recent immunisation. Particular note is made of those donors from university sessions. Towards the end of the series, donors who had an initially acceptable level of antitetanus antibody were being tested a second time.
Congenital dyserythropoietic anaemia: response to splenectomy and quantitation of ineffective erythropoiesis.
Authors: Samson D , Halliday D , Chanarin I
Published: June 2007

The clinical and haematological features of an unusual case of congenital dyserythropoietic anaemia are described. There was a pronounced haemolytic component to the anaemia, with a mean cell life of five days, and a remarkable response to splenectomy. Measurement of the incorporation of 15N glycine into the haem of circulating red cells and into bilirubin showed that haem turnover due to ineffective erythropoiesis was increased 45 times compared with a control group (11.63 mg/kg/day, NR = 0.26 + 0-10) and represented 51% of total erythroid haem turnover.
Does preoperative iodide treatment for thyrotoxicosis bring about involution?
Authors: Wilkin T J , Beck J S , Michie W
Published: June 2007

It is generally believed that preoperative iodide decreases the hyperplasia of the toxic thyroid gland. Histometric studies of glands from thyrotoxic patients pretreated with propranolol alone compared with those from patients pretreated with propranolol and iodide failed to confirm this. Although histological appearances and volume percentage measurement of component tissues suggested that the glandular epithelium had involuted after iodine treatment, measurement of their absolute mass indicated that the mean mass of epithelium was the same in both groups and that involution had not occurred. We conclude that considerable confusion in the thyroid literature has arisen through incorrect use of the term involution.
Morphology and the natural history of cribriform adenocarcinoma (adenoid cystic carcinoma).
Authors: Osborn D A
Published: June 2007

Forty-three examples of cribriform adenocarcinoma (adenoid cystic carcinoma) of mixed glandular origin are reported. Structural studies emphasise the classical cribriform pattern which indicates the capacity of this neoplasm to behave as both an epithelial and a connective tissue type tumour. In terms of survival, it does not appear to be an malignant as other forms of carcinoma arising in similar anatomical locations. The five-year crude survival rate (56%) compares favourably with that of other carcinomas of the palate and paranasal sinuses. A recurrence rate of the order of 20% may persist up to 10 years after primary treatment, and while this is not inimical to longer survival there is clearly a high morbidity.
Fucosidosis in a native-born Briton.
Authors: Dos Santos P P , Logan R W
Published: June 2007

This investigation reports the biochemical findings in a native-born Briton suffering from the adult form of fucosidosis. Alpha-L-fucosidase, alpha-L-iduronidase, and beta-D-galactosidase were studied in cultured fibroblast and leucocytes from the patient with fucosidosis, her maternal grandfather, and several normal controls. A complete lack of alpha-L-fucosidase activity was found in the patient's fibroblasts and leucocytes while the grandfather exhibited a heterozygous level of alpha-L-fucosidase activity in his leucocytes. Excessive excretion of what is very likely to be a fucose-containing sphingolipid was demonstrated in the patient's urine by thin-layer chromatography. Compared with five isoenzyme forms of alpha-L-fucosidase activity in normal leucocytes, cellulose acetate electrophoresis of the patient's leucocytes produced evidence of a single band of slight activity associated with one of the isoenzymes. This residual activity probably accounts for the survival of such patients into adolescence and beyond.
Circulating immune complexes in subacute infective endocarditis and post-streptococcal glomerulonephritis.
Authors: Mohammed I , Ansell B M , Holborow E J , Bryceson A D
Published: June 2007

Two out of five patients with subacute infective endocarditis and two patients with post-streptococcal glomerulonephritis had large amounts of soluble circulating immune complexes in their sera. The three others with endocarditis had less severe disease and minimal evidence of circulating immune complexes. Low serum complement was also found in two of the cases.
Halothane macrophage migration inhibtiion factor test in halothane-associated hepatitis.
Authors: Price C D , Gibbs A R , Williams W J
Published: June 2007

As an index of delayed hypersensitivity in vitro halothane macrophage migration inhibition factor tests (halothane-MIF tests) were performed on peripheral blood lymphocytes from five patients with halothane hepatitis. Twenty-two subjects exposed to halothane, but with no evidence of jaundice, five 'healthy' hospital anaesthetists, nine jaundiced subjects without halothane exposure, and 10 healthy subjects with no history of exposure to halothane were also tested. The halothane-MIF test was positive in four of the five patients with halothane-induced hepatitis; the negative result was in a patient on steroid treatment. The test was negative in all other subjects. Our findings suggest that the halothane-MIF test may be of value in the diagnosis of halothane-induced hepatitis and as a screeening procedure for the identification of susceptible subjects.
Hypophosphataemic osteomalacia associated with a malignant tumour of the tibia: report of a case.
Authors: Wyman A L , Paradinas F J , Daly J R
Published: June 2007

A case of vitamin D resistant hypophosphataemic osteomalacia with glycosuria and aminoaciduria is reported. The course of the disease was dramatically altered by the removal of a bone sarcoma which probably had been growing slowly since the onset of the patient's symptoms five years previously. The histology and electron microscopy of the tumour are described. Three years after the operation the patient remains free of symptoms.
Erythrocyturia, smoking, and occupation.
Authors: Freni S C , Dalderup L M , Oudegeest J J , Wensveen N
Published: June 2007

In a population of 432 apparently healthy men aged 50 years and over 19-2% had one or more erythrocytes per high-power field in the urine while 8-1% had more than 10. Erythrocyturia seemed to be strongly correlated with tobacco consumption. No significant association with occupation could be demonstrated but the data were insufficient to refute the possibility of such an association. Raised levels of orthoaminophenols as a result of abnormal tryptophan metabolism induced by smoking might cause microhaematuria in smokers. As these metabolites are carcinogens microhaematuria might be a valuable sign of cancer of the urinary bladder.
Automated red cell indices and marrow iron reserves in geriatric patients.
Authors: Raper C G , Rosen C , Choudhury M
Published: June 2007

The marrow iron reserves, automated red cell indices, serum iron, and total iron binding capacity of 69 geriatric patients were recorded. A fall in the mean red cell volume (MCV) to between 71 and 82 fl failed to distinguish between iron deficiency and the 'anaemia of chronic disorders'. However, there was no reserve of marrow iron in the eight patients with an MCV of 70 fl or less.
A regional quality control trial of folate assays.
Authors: Dawson D W , Newsome D A
Published: June 2007

A regional quality control trial of folate assays is described. It is concluded that the trial is practical and useful in allowing inter-laboratory comparison of results, promoting discussion, and improving precision but it is impossible to assess accuracy. It was of no use in the comparison of assay methods, probably on account of the small number of laboratories participating.
Rubella virus serology:detection of residual lipoprotein inhibitors of haemagglutination using sensitive indicator arboviruses.
Authors: Shortridge K F
Published: June 2007

Immune and non-immune rubella sera were examined in the haemagglutination inhibition (HAI) test to evaluate the removal of lipoprotein non-specific inhibitors (NSI) of haemagglutination after kaolin and manganous chloride/heparin treatments. The sera were titrated fresh or after lipoprotein deterioration brought about by ageing the samples at 4 degrees C for various periods of time and by freezing at -20 degrees C with subsequent thawing. Deterioration was seen as altered electrophoretic mobility while the lipoproteins in treated sera were detected by indicator arboviruses whose haemagglutination is known to be strongly inhibited by the native macromolecules. After both treatments, notably manganous chloride/heparin, residual NSI activity was detected in deteriorated samples, particularly with group B arboviruses such as Japanese encephalitis and west Nile viruses but generally less so or not at all with the group A arboviruses employed. Absolutely fresh sera are considered highly desirable for rubella virus HAI assay, and it is suggested that the efficiency of lipoprotein NSI removal regardless of treatment protocol could be monitored in parallel HAI tests using carefully chosen indicator arboviruses. This could be done in conjunction with density gradient centrifugation of doubtful sera should ultracentrifuging facilities be available. The suitability of the monitoring procedure would be dependent to some extent on whether certain arboviruses are known to be endemic in a particular area.
Aminoglycoside antibiotics and renal function: changes in urinary gamma-glutamyltransferase excretion.
Authors: Beck P R , Thomson R B , Chaudhuri A K
Published: June 2007

The urinary excretion of the renal proximal tubular enzyme, gamma-glutamyltransferase (gamma-GT), has been studied in 41 patients receiving tobramycin, gentamicin or streptomycin for a variety of infections. All patients receiving tobramycin or gentamicin have shown increased excretion of gamma-GT in the urine. Only 46% of those receiving streptomycin have shown an increase in gamma-GT excretion and this is of a lesser degree. A change in creatinine clearance which could only be explained by antibiotic administration was detected in three patients (2 on gentamicin, 1 on streptomycin). The degree of elevation of urinary gamma-GT activity was greater when the initial creatinine clearance was lower, and it is therefore suggested that those patients with pre-existing renal dysfunction should be monitored particularly carefully for signs of nephrotoxicity from these antibiotics. Urinary gamma-GT is a useful enzyme in the investigation of renal drug effects.
A simple discriminant function for hepatic disease.
Authors: Hamilton M
Published: June 2007

Tests of hepatic function do not correlate highly and this, together with their skew distribution, makes the information provided by them difficult to interpret. By means of an appropriate transformation it is possible to normalise their distributions so that the information from them can be combined in the form of a discriminant function which is not only easy to interpret but gives an index of severity of disease which is more reliable than any one single test. In this study nine tests were examined, and after normalisation it was found that only four tests were required to present almost all the information available in the nine. A formula is given for calculating the index in T-score form, which is particularly easy to interpret. A discriminant function of the type described retains the maximum information with the minimum number of biochemical tests. It therefore contributes to the solution of a problem which is causing increasing concern--the exponential increase in the number of investigations which the hospital services will soon find it impossible to bear.
Methods for detection of hepatitis B surface antigen in paraffin sections of liver: a guideline for their use.
Authors: Sumithran E
Published: June 2007

Methods for the localisation of hepatitis B surface antigen (HBsAg) in paraffin sections of the liver include the detection of ground-glass hepatocytes and the use of Shikata's orcein stain, and of immunoperoxidase and immunofluorescent techniques. A comparative study of the different methods on 20 livers shows the orcein stain to be the method of choice for routine use. The Shikata stain is not only specific but is relatively inexpensive, easily performed, and stains out distinct cytoplasmic inclusions even in stored formalin-fixed livers, old paraffin blocks, and autolysed livers. Since HBsAg is irregularly distributed in the liver, adequate sampling is necessary to prevent false negative; when sufficient tissue is available at least five blocks should be examined before a case is labelled as HBsAg-negative.
Apparent hypoxic changes in pulmonary arterioles and small arteries in infancy.
Authors: Kendeel S R , Ferris J A
Published: June 2007

The pulmonary arterioles and small arteries were studied and their musculature and its nuclei were quantified in 90 neonates, infants, and young children who had suffered from a variety of clinical and hypoxic conditions immediately before death. Among the 90 cases investigated in this study, 30 were of sudden infant death syndrome (SIDS). No evidence was found to support the view that cases of SIDS are subjected to chronic hypoxia before death as significantly more medial muscle tissue in the pulmonary arterioles and small arteries was found in the chronic hypoxic group compared to the SIDS, non-hypoxic, and acute hypoxic groups. Furthermore, there was no statistically significant difference in the amount of medial muscle tissue of the pulmonary vessels as between the SIDS, non-hypoxic, and acute hypoxic groups. With other signs of acute hypoxia found at the necropsy of SIDS, the results of this study could be considered to support the view that cases of SIDS succumb as a result of an acute episode of hypoxia, or possibly repeated short-duration episodes of acute hypoxia which do not produce pulmonary vascular changes.
Modification of the microimmunofluorescence test to provide a routine serodiagnostic test for chlamydial infection.
Authors: Treharne J D , Darougar S , Jones B R
Published: June 2007

A modification of the microimmunofluorescence test to provide a practicable routine serodiagnostic test for detecting and characterising chlamydial infection is described which uses four antigen pools, one of which corresponds with each of the four main clinical and epidemiological types of chlamydial infection. The three subgroup A Chlamydia (Chlamydia trachomatis) pools are: pool 1, hyperendemic trachoma TRIC agent serotypes A, B, and C; pool 2, paratrachoma TRIC agent serotypes D, E, F, G, H, I, and K; pool 3, lymphogranuloma venereum (LGV) agent serotypes L1, L2, and L3. Pool 4 contained four representative isolates of subgroup B Chlamydia (Chlamydia psittaci). For routine purposes sera need be screened only against these four representative antigen pools. This will detect antibody and indicate which clinical and epidemiological type of chlamydial infection is implicated, thereby clearly distinguishing those infections that are due to C. psittaci. The pattern of the cross-reactions may indicate the individual serotype involved, and further titration requiring a maximum of four individual antigens is sufficient to determine the serotype. The slight loss in sensitivity (twofold) is more than compensated for by the reduction in cost and the tenfold increase in the total number of sera which can be examined.
Laboratory assessment of physical and chemical methods of preserving urine specimens.
Authors: Watson P G , Duerden B I
Published: June 2007

Three methods of preserving simulated specimens of urine were studied with six test strains of bacteria. Viable counts were measured by a surface viable count and by the filter-paper-strip method during a holding period of 72 hours. Refrigeration at approximately 4 degrees C was effective and reliable. Boric acid (1-8%) at room temperature was toxic for the strain of Escherichia coli at a density of 10(7) cfu/ml but this may not be significant at the higher concentration of bacterial cells often found in clinical specimens. NaCl-polyvinylpyrrolidone (PVP) solutions containing PVP of mol. wt 44 000 or 700 000 were not effective; they were toxic for the Gram-negative strains and did not retard the growth of Micrococcus subgroup 3. The two methods of measuring viable counts were compared for specimens held under different conditions; the specificity of the filter-paper-strip method was high but the sensitivity was low when many of the specimens contained approximately 10(5) cfu/ml.
Cerebral involvement with disseminated intravascular coagulation in intestinal disease.
Authors: Ryan F P , Timperley W R , Preston F E , Holdsworth C D
Published: June 2007

Over a two-and-a-half-year period at the Sheffield Royal Infirmary, six patients developed disseminated intravascular coagulation as a serious complication of intestinal disease. There was clinical evidence of cerebral involvement in all six patients, and small vessel thrombi were demonstrated in the brains of all three cases examined post mortem. Where the true significance of the cerebral disorder was not recognised, this led to delay in the diagnosis with serious risk to the patient. In the single case in which the diagnosis was made early, the intravascular coagulation was completely reversed with heparin therapy.
Light and electron microscopy study of capillaries in normal and inflammatory human synovial membrane.
Authors: Dryll A , Lansaman J , Cazalis P , Peltier A P , De Seze S
Published: June 2007

Synovium aspirated from the knee joint by trochar was studied by light and electron microscopy in 40 cases of inflammatory arthritis and in 10 controls. The morphology of synovial capillaries, extravascular plasma diffusion, interendothelial vascular gaps, extracapillary blood cell migration, vascular congestion, endothelial hyperplasia, and obliteration of the capillary lumen by endothelial cells were compared in normal and inflammatory synovia. Inflammatory synovitis was characterised by the number and diversity of blood cells migrating through the interendothelial pathway out of the capillary lumen. Polymorphonuclear leucocytes were the blood cells most often seen at interendothelial junctions. No other capillary changes that might be related to synovial inflammation were found.
Immunohistochemical study of lichen planus.
Authors: Shousha S , Svirbely J
Published: June 2007

The distribution of IgM and IgG in 20 cases of lichen planus and five cases of non-specific inflammation were studied by the unlabelled antibody-enzyme (PAP) technique. Routine paraffin sections were used. In lichen planus deposits of immunoglobulins were seen in and around epithelial cells, in colloid bodies, at epidermo-dermal junctions, and in some inflammatory cells. All cases examined for IgM and eight out of 13 cases examined for IgG were positive. The peripheral migrating epidermal cells were mostly negative. The application of the PAP technique to skin biopsy and the significance of the findings in lichen planus are discussed.
Evaluation of a teaching hospital necropsy service.
Authors: Fowler E F , Nicol A G , Reid I N
Published: June 2007

The information returned to the hospital clinician after a necropsy was investigated in a series of 1000 patients. It was found that specific clinical queries were answered in 83% of cases, that the necropsy corrected the major clinical diagnosis in 36% of cases, and that 29% of cases were used for undergraduate or postgraduate teaching. The results demonstrate the continuing value of the necropsy as an investigative and educative procedure.
Multiplication of contaminant bacteria in urine and interpretation of delayed culture.
Authors: Wheldon D B , Slack M
Published: June 2007

A prospective study of the bacterial populations of non-infected urine was mounted in an attempt to define the length of delay between voiding and analysis during which culture would not give false positive results due to the multiplication of contaminant bacteria present at the time of voiding. The findings suggest that culture of urine within four hours of voiding is likely to give a true indication of the presence or absence of infection. With further delay the interpretation of a heavy growth of bacteria in urine becomes progressively more unreliable, even if that growth is in pure culture.
Simplified method for the rubella haemagglutination inhibition screening test.
Authors: Mortimer P P , Jordan S M , Smith I V
Published: June 2007

A modification of the rubella haemagglutination inhibition (HAI) test in which both pretreatment and serum titration are carried out in wells of the same microtitre plate saves time, labour, and materials and gives results comparable to a conventional HAI procedure.
Two cases of alpha chain disease from Nigeria.
Authors: Whicher J T , Ajdukiewicz A , Davies J D
Published: June 2007

The first two cases of alpha chain disease from Central Africa are reported from Nigeria. Both patients show the classical features of the disease with diffuse involvement of the small bowel and malabsorption. The patients were lost to follow-up but died soon after diagnosis.
Application of a screening test for antibody the hepatitis B core antigen.
Authors: Cohen B J , Cossart Y E
Published: June 2007

Hepatitis B core antigen (HBcAg) was prepared from human liver tissue and used in an immunoelectro-osmophoresis screening test to detect antibody to HBcAg (anti-HBc) in patients with evidence of liver disease and in blood donors. With the exception of two immunosuppressed HBsAg carriers, anti-HBc was found in all cases of hepatitis B infection even when HBsAg was detectable only by radioimmunoassay. Non-specific reactions were observed in 'non-B' hepatitis but, in spite of this problem, antib-HBc screening was considered a useful addition to routine tests in the clinical hepatitis laboratory.
Serum IgM antibody and influenza A infection.
Authors: Buchner Y I , Heath R B , Collins J V , Pattison J R
Published: June 2007

Sucrose density gradient ultracentrifugation followed by haemagglutination inhibition for demonstrating specific influenza IgM was evaluated as a means of confirming recent infection with influenza A viruses. Specific IgM antibodies were found in at least one serum obtained from 83% of patients with proven recent infection with influenza A viruses but in none of the sera from 21 individuals without evidence of infection. Influenza IgM antibodies persisted for up to 112 days after infection. The relative merits of detecting specific IgM and complement fixing antibodies for diagnostic purposes are discussed.
Leprosy and the serodiagnostic test for tuberculosis.
Authors: Cruickshank J G , Ellis B P
Published: June 2007

Sera from patients with leprosy agglutinated killed H37Rv Mycobacterium tuberculosis to varying degrees. Higher titres were found in association with active disease but there was no difference between patients at the lepromatous or at the tuberculoid ends of the clinical scale. A sharp rise in titre occurred during the active phase of an episode of erythema nodosum leprosum.
Cross infection in a surgical ward caused by Pseudomonas aeruginosa with transferable resistance to gentamicin and tobramycin.
Authors: Falkiner F R , Keane C T , Dalton M , Clancy M T , Jacoby G A
Published: June 2007

An outbreak of gentamicin- and tobramycin-resistant Pseudomonas aeruginosa infection occurred in a surgical ward over a three-month period. Resistant Ps. aeruginosa strains with the same serological, phage, and pyocin type were cultured from the urine of six patients. Identical organisms were found on urine bottles, bedpans, and the hands of attendant staff. Inadequate disinfection played a major role in cross-infection. Isolates of the epidemic strain from each of the patients and of an unrelated but similarly resistant Ps. aeruginosa from one of them could transfer resistance to a recipient strain of Ps. aeruginosa. Resistance to gentamicin, kanamycin, tobramycin, sulphonamides, and mercuric chloride was determined by R factors belonging to Pseudomonas incompatibility group P-3. Aminoglycoside resistance was due to acetylation.
Comparison of anticoagulants for the preservation of prothrombin time specimens.
Authors: Ramsay D M , Robertson E P , MacArthur E
Published: June 2007

The value of different anticoagulants as preservatives of specimens for prothrombin time ratios is evaluated and discussed. An increase in the ratio was demonstrated with all anti-coagulants after 24 hours and this was significant when coagulometer error was taken into account. Both solid and liquid sodium citrate were superior to sodium oxalate as preservatives at 24 hours after taking off samples, but differences were slight and were not significant when coagulometer error was considered. It was concluded that for routine clinical practice, where a range of the prothrombin time ratio of 1.8/1 to 2.5/1 is allowable, there would be no significant advantage in any of the anticoagulants considered.
Lymphocyte tubular structures in rheumatoid arthritis.
Authors: Dryll A , Cazalis P , Ryckewaert A
Published: June 2007

Two types of lymphocyte tubular structures were studied by electron microscopy in 80 patients with classic or definite rheumatoid arthritis (RA). Fifteen patients with unequivocal systemic lupus erythematosus (SLE) and 10 healthy persons were studied as controls. Lymphocyte tubulo-reticular structures were found in 13 of the 80 patients with RA and in 10 of the 15 patients with SLE. No tubuloreticular structures were found in any of the healthy subjects. In the RA patients antinuclear antibodies, LE cell phenomenon, and chlorambucil treatment were associated significantly with these inclusions but disease activity was not related to their presence. In cases in which tubuloreticular structures were present the number of cells containing inclusions was on average much lower in patients with RA than in those with SLE. Lymphocyte tubular parallel arrays were found in all the patients with RA and SLE and in all the healthy persons. In all three groups the average number of cells containing parallel tubular arrays was similar.
Evaluation of a standardised assay for the measurement of antibodies to double-stranded (native) DNA.
Authors: Davis P , Burrington M , Morgan A R , Saetre A
Published: June 2007

A standardised commercially available radioimmunoassay kit for the detection of antibodies to native DNA (N-DNA) has been evaluated in clinical practice. This test system is shown to be a reliably reproducible method of detecting these antibodies. In addition, evaluation of the purity of the radiolabelled test antigen in this assay has shown it to be almost entirely double stranded (native) DNA with virtually no contamination with single stranded (denatured) DNA, and with few areas of single stranded breaks or ends in the duplex molecule. The inclusion of known standards and precise characterisation of the DNA has partially overcome variability in results and provides for interlaboratory standardisation which is lacking in the techniques used at present.
Direct immunofluorescence in the diagnosis of toxoplasmic lymphadenitis.
Authors: Matossian R M , Nassar V H , Basmadji A
Published: June 2007

The diagnosis of toxoplasmic lymphadenitis was established through the demonstration, by direct immunofluorescence, of toxoplasma cysts and trophozoites in a cervical lymph node biopsy which also had a characteristic histopathology. The patient had cervical lymphadenopathy and increased specific fluorescent antitoxoplasma IgG and IgM antibodies.
Carcinoembryonic antigen in thyroid disease.
Authors: Economidou J , Karacoulis P , Manousos O N , Manesis E , Kydonakis A , Koutras D A
Published: June 2007

Plasma carcinoembryonic antigen (CEA) levels were measured by the Z-Gel technique in 138 patients with benign thyroidopathies, 25 patients with thyroid cancer, and 141 normal persons. Levels were raised (above 5 ng/ml) in 2% of the normal subjects, in none of the patients with benign thyroidopathies, and in 20% of the patients with thyroid cancer. They were considerably raised in all cases of medullary carcinoma of the thyroid but they were also high in other histological types of thyroid cancer. Measurement of plasma CEA may be of value in the preoperative diagnosis and follow-up of patients with thyroid cancer.
Diagnosis of alpha-thalassemia trait from Coulter Counter 'S' indices.
Authors: Hegde U M , White J M , Hart G H , Marsh G W
Published: June 2007

A number of patients of Mediterranean and Asian origins were found to have unexplained microcytic hypochromic red blood cells. Iron deficiency and beta-thalassaemia trait were both satisfactorily excluded in all of them. The haematological indices of these patients, obtained on a Coulter Model 'S' Counter, were found to be very similar to those seen in obligatory heterozygotes for alpha-thalassaemia. It is postulated that these patients were also carriers for alpha-thalassaemia. Subsequent investigation of some of these patients showed the characteristically reduced rates of alpha-chain synthesis seen in this condition. The discriminant function of England and Fraser (1973) may be of help in diagnosing this state. alpha-Thalassaemia trait should be considered in all patients of 'high-risk' ethnic origins with a blood picture suggestive of beta-thalassaemia trait but in whom the levels of Hb A2 and Hb F are within normal limits.
Use of cell cultures as an indicator of pathogenicity of free-living amoebae.
Authors: Cursons R T , Brown T J
Published: June 2007

Results comparing the time needed for the development of cytopathic effects in cell cultures with that needed to cause death in mice using inocula of Naegleria and Acanthamoeba are presented. The significance of the source and concentration of the inocula is demonstrated. The use of cell cultures as an indicator of the pathogenicity of free-living amoebae is discussed.
Evaluation and application of an improved bacteriocin typing method for Klebsiella aerogenes.
Authors: Heddell G W , Mitchell A A
Published: June 2007

A bacteriocin typing method was evaluated using 200 strains of Klebsiella aerogenes, 93% of which fell into 11 distinct types. The typing technique was successfully applied to the monitoring and control of hospital cross-infection.
Detection of capsulated Haemophilus influenzae in chest infections by counter current immunoelectrophoresis.
Authors: McIntyre M
Published: June 2007

The application of counter current immunoelectrophoresis to the detection of Haemophilus influenzae capsular antigen in sputum is described. The method, technically simple, provided results within 30 minutes. H. influenzae capsular antigen was detected in 12% of patients and in 54.8% of the H. influenzae strains isolated. The test was not impaired by prior antibiotic therapy.