Search PubMed⌕ Search

Biomedical subjects

I Lauder

Publications and source records attributed to I Lauder.

At least 73 records · Page 4Linked to original sources

Use of immunochemistry in Britain: EQA forum antibody usage questionnaire.

A questionnaire was prepared under the auspices of the Department of Health with the aim of defining the extent and nature of immunocytochemistry use within pathology departments. The questionnaire was circulated to 320 pathology laboratories within the United Kingdom, and a total of 178 replies were received, representing a response rate of 56%. One hundred and thirty eight (78%) of the respondents used immunocytochemical techniques: 64 used immunocytochemical kits, including 35 district general hospital and 29 teaching hospital laboratories. An extensive range of antibodies was being used on a variety of tissues, epithelial and lymphoid markers far exceeding all other antibodies. Several differences in the numbers of cases and the types of tissues studied were identified among laboratories. The techniques used, the problems encountered, and the procedures followed with unsatisfactory reagents were also analysed. Finally, an assessment of the resources allocated to immunocytochemistry, both in terms of staff and reagent costs was made. Taking into account the response rate of 56% and the uncertainty that all pathology departments in the United Kingdom had been circulated, the estimated annual total costs for immunocytochemistry for all pathology laboratories in the United Kingdom was 5.4 million pounds.

Antibodies↗

Comparative quality assessment in immunocytochemistry: pilot study of CD15 staining in paraffin wax embedded tissue in Hodgkin's disease.

The feasibility of comparative quality assessment studies in immunocytochemistry was examined. The reactions of three CD15 antibodies--anti-Leu M1, DM1, and Tü9--were examined in paraffin wax sections in Hodgkin's disease under a variety of different fixation and pre-treatment conditions, using four immunochemical detection techniques. All three antibodies stained Reed-Sternberg cells, but DM1 could be used at slightly higher dilutions to achieve comparable results. Tissue fixed in formol sublimate showed the most intense staining reactions, and formol saline and neutral buffered formalin gave relatively poor results. Although neuraminidase pre-treatment improved staining, its routine use is probably contraindicated by its high cost. Trypsinisation has some value for sections of tissue fixed in formol saline and neutral buffered formalin. The avidin-biotin complex technique produced the best results, but indirect immunoperoxidase produced acceptable results, is technically easier to perform, and is less expensive. It is concluded that information regarding variations in techniques and commercially available reagents, which may be of use in routine diagnostic histopathology, can be obtained by comparative quality assessment studies of this type.

Adult↗

Angiofollicular lymph node hyperplasia with amyloidosis.

Two cases of angiofollicular lymph node hyperplasia are described, one of the solitary plasma cell type the other of the multicentric hyaline vascular type. Both cases illustrate the wide ranging clinical and pathological findings associated with this condition but both also have unusual features. The solitary plasma cell lesion had an exceptional 32 year clinical history and was associated with systemic amyloidosis of AL type. The multicentric hyaline vascular case was associated with coexistent multiple myeloma and amyloid deposition also of AL type. These cases are presented with a review of the relevant literature.

Amyloidosis↗

An assessment of drug information sheets for diabetic patients: only active involvement by patients is helpful.

Insulin/sulphonylurea-treated diabetics attending a busy university diabetic clinic were studied to determine whether issuing drug information sheets and/or age influenced understanding and behaviour regarding their disease and its treatment, especially with respect to avoiding hypoglycaemia. Patients were each asked 10 basic questions (each correct answer scoring 1), stratified by age (20 were less than or equal to 45 years and 91 greater than 45 years). According to a single-blind randomised protocol, they were issued or not issued with drug information sheets (providing information to correctly answer all 10 questions). After 2-3 months, 107 (88 aged greater than 45 years) were retested and asked whether they recalled an information sheet, read it themselves or had it read to them. Whether or not patients received sheets, corresponding mean aggregate scores were very similar in both age groups and there was no correlation with age. Second test scores yielded clinically and statistically significant increments in both the sheet and no sheet groups, respective mean aggregate scores increasing from 4.48 to 5.80 and 5.14 to 6.27 (P less than 0.001). Among patients issued with sheets, 32 who recalled reading them achieved the greatest improvement in mean scores (4.53 to 6.16, P less than 0.001). Active interaction/communication (participation in first test, recall and reading of information sheet) had a favourable educational impact irrespective of age, but merely issuing drug information sheets had no benefit.

Adult↗

Southern blot analysis of DNA extracted from formal-saline fixed and paraffin wax embedded tissue.

Model experiments were designed to assess whether DNA could be recovered from formol-saline fixed peripheral blood lymphocytes and tonsil tissue for use in Southern blot gene analysis. Lymphocytes were fixed for 30 min and tonsil for 6 and 24 h, then paraffin embedded. High molecular weight DNA was extracted by prolonged digestion (2-7 days) with proteinase K or protease XXIV in the presence of 1 per cent sodium dodecyl sulphate. Restriction, transfer and hydridization were possible without modification of standard procedures. Multiple copy sequences were demonstrated using Mspl and Bst Nl restriction and hybridization for the Y chromosome (pHY 2.1 probe), single copy genes using EcoRI and BamHl restriction for the T-cell receptor beta chain (T beta probe), and Bgl II and Hind III for the immunoglobulin heavy chain (JH probe). Identical banding to unfixed tissue was achieved except when 24 h fixed extracts were used. With these, demonstration of the 24 KB Bam Hl/T beta and 9.2 KB Hind III/JH bands was not obtained. These findings suggest that as the fixation time is extended, alterations to DNA will limit the available range of restriction enzyme/probe combinations. However, with careful choice of these the extraction of DNA from formalin fixed and paraffin embedded pathological tissue for Southern blotting should be profitable.

DNA↗

How do we teach pathology? The laser videodisc and computer-assisted learning.

A laser videodisc, holding 54,000 still frames per side, can be used to provide visual material of excellent quality for pathology teaching. In a collaborative project between ten pathology departments, the first pathology videodisc has recently been completed and the production of the disc is described. When used as illustrative material for computer-assisted learning programs, the videodisc offers accurate random access of still frames and allows the overlay of computer-generated graphics onto the video picture. This can be used to pre-identify every individual feature of a particular frame, and an example tutorial program is described to show how this may be used to improve the students' understanding of what they see. Details and costs are given for a workstation suitable for this application and potential future developments for this teaching method are discussed. Although objective assessment of the cost-effectiveness of interactive video in teaching pathology has yet to be undertaken, one suitably designed program can give individual tuition to many students, making this a most efficient use of teaching time.

Computer-Assisted Instruction↗

Non-Hodgkin's lymphoma: case control epidemiological study in Yorkshire.

This paper reports the results of a case control study of non-Hodgkin's lymphoma in the Yorkshire Health Region. In all, 437 cases and 724 controls were interviewed. Risk factors associated with past skin conditions, family history of cancer and infectious mononucleosis, aspects of social life and contact with wood dust and epoxy glues all emerge. A comparison of high and low grade morphological forms of disease reveal contrasting risks and suggest separate aetiologies for these conditions.

England↗

The immunohistology of Hodgkin's disease--Reed-Sternberg cells and their variants.

Thirty-three cases of Hodgkin's disease were analysed by immunoalkaline phosphatase and immunoperoxidase techniques, using a monoclonal antibody panel, including markers of B-cells, T-cells, macrophages, granulocytes, and the antibody Ki-1. Hodgkin's cells were found to express markers generally regarded as T-cell, B-cell, myeloid, or monocyte associated. Furthermore, heterogeneity of marker expression was also seen within the Hodgkin's cell population in any single case. Morphological and immunohistological analogies between cells involved in antigen presentation and Hodgkin's cells are described, suggesting possible relationships between these cell types. Anti-Leu M1 was not found to be a particularly sensitive marker of Hodgkin's disease under the conditions used in this study.

Antibodies, Monoclonal↗

In situ hybridization: alkaline phosphatase visualization of biotinylated probes in cryostat and paraffin sections.

Alkaline phosphatase immunochemical systems were evaluated for use in the demonstration of in situ hybridized biotin-labelled probes in frozen and fixed sections of tonsil. Three probes were used: total genomic DNA, pHY2.1, a human repetitive sequence which hybridizes to a 2.12 KB sequence on the Y chromosome (2000 repeats) and a 2.0 KB sequence on the autosomes (100-200 repeats), and human papilloma virus type II. Indirect, three- and five-stage detection methods were compared on cryostat sections. The indirect method involved the application of a streptavidin, biotinylated alkaline phosphatase sequence. The three-stage procedure comprised a mouse monoclonal anti-biotin, rabbit anti-(mouse immunoglobulin), mouse APAAP system. In the five-stage method the indirect and three-stage reagents were sequentially applied. Alkaline phosphatase was demonstrated using a Fast Red naphthol-capture method. The total genomic DNA probe was used initially to investigate hybridization conditions including the optimum temperature of denaturation, which was found to be higher than previously reported. The five-stage detection method gave the most sensitive results for the Y sequence probe, with intense demonstration of the Y body in male nuclei and autosomal sequences in female nuclei. This method was then applied to fixed tissue sections and gave Y body signals on Bouin's and Carnoy's fixed tissue. On the other hand tissue fixed using formalin-based solutions required proteolytic digestion as a pretreatment to hybridization for a Y body signal. The application of this methodology to viral diagnosis in routine fixed anogenital tissue and cytological preparations was also demonstrated.

Alkaline Phosphatase↗

Chemoprophylaxis with oral amoxycillin against bacterial endocarditis: when should second doses be administered after dentistry?

The adequacy of serum bactericidal activity after oral amoxycillin given as prophylaxis against infective endocarditis was studied using a double blind randomised protocol in healthy volunteers having dentistry. One hour before their procedure 38 patients received 3 g amoxycillin syrup and 12 received matching placebo. Venous blood samples were drawn before and one and nine hours after dosing and serum amoxycillin concentrations determined using a standard bioassay. Samples containing amoxycillin had inhibitory titres measured against two reference isolates of viridans streptococci known to have caused infective endocarditis. The susceptibility to amoxycillin of one strain was high and the other low, respective minimal bactericidal and inhibitory concentrations being 0.08 and 0.04 mumol/l (0.03 and 0.015 microgram/ml) and 2.74 and 1.37 mumol/l (1 and 0.5 microgram/ml). Amoxycillin was detected in only post-treatment samples of patients given the active drug. There were no significant correlations between one or nine hour drug concentrations and age or physical characteristics, nor was there any relation to preceding food consumption. Correlations between drug concentrations at one and nine hours were weak (r = 0.34; p less than 0.05), but between corresponding drug concentrations and serum inhibitory titres there were consistent correlations (r = 0.46-0.48; p less than 0.005). Against the low susceptibility reference isolate bactericidal amoxycillin concentrations were encountered in only 20 of the 38 nine hour samples (95% confidence limits 34% and 66%). When repeat doses of amoxycillin are indicated after dentistry they should be given about four hours later, not eight hours later as commonly practised.

Administration, Oral↗

The demonstration of B-cell, T-cell and myeloid antigens in paraffin sections.

The monoclonal antibodies MB1 and MT1, which detect B cells and T cells respectively, have been applied to human lymphoid tissues. The distribution of staining within paraffin sections was compared with that observed using frozen sections and was found to be identical. The antibodies were then applied to paraffin sections of 19 B-cell lymphomas and 10 T-cell lesions in which full immunophenotyping had been performed. The B lymphomas all consisted of a large majority of MB1 positive cells with a variable infiltrate of small MT1 positive lymphocytes. The T cell lesions consisted of MT1 positive cells with few MB1 positive cells except in residual B cell areas of lymph nodes. In paraffin sections from cases of Hodgkin's disease anti-Leu M1 identified Reed-Sternberg cells and their variants and MB1 and MT1 showed a similar distribution of B cells and T cells to that demonstrated in previous studies using frozen sections. The results show that MB1 and MT1 are useful markers for B and T cells in routinely fixed paraffin embedded tissue. In conjunction with anti-Leu M1 they provide a valuable panel of antisera for the examination of lymph nodes and other biopsies when frozen tissue is not available.

Antibodies, Monoclonal↗

Surface membrane phenotypic expression and treatment response of malignant lymphomas.

Cryopreserved lymphoid tissue has been used from 113 patients for an analysis of cell surface membrane phenotypes using a panel of monoclonal antibodies. Dual heavy chain expression was common in many B-cell malignant lymphomas and in the B-cell lymphomas as a whole there was a predominance of lambda light chains. The expression of lambda light chain was associated with a poorer response to treatment and there was a tendency for such tumours to fall into the high grade lymphoma category. Surface membrane heavy chain expression, as assessed by staining intensity, was greatest in the lymphomas composed mostly of centrocytes and IgD expression was reduced in high grade lymphomas. The ratio of helper to suppressor T-cells was reduced in centroblastic and immunoblastic lymphomas. In Hodgkin's disease a predominance of T-cells was found in most instances although the series included a large proportion of nodular sclerosis cases.

Adult↗

Clinical and immunohistological characterization of cutaneous lesions in chronic lymphocytic leukaemia.

Twenty-five patients with immunologically classified B cell chronic lymphocytic leukaemia (CLL) were examined for skin lesions. Six showed evidence of cutaneous involvement, and histological examination of skin biopsies from these patients revealed perivascular lymphocytic infiltration with some diffuse involvement in three. Immunohistological analysis with a range of B and T cell specific monoclonal antibodies revealed that in all cases the infiltrate was predominantly T cell in origin and that epidermotropism in three cases was also associated with T cell components. Six control patients with macroscopically normal skin were also biopsied and these biopsies subjected to the same assessment. All were normal.

B-Lymphocytes↗

Concurrent T-cell lymphocytic lymphoma and malignant histiocytosis.

A case in which both malignant histiocytosis and T-cell lymphocytic lymphoma occurred together is presented. Examples of malignant histiocytosis-like syndromes associated with lymphoreticular malignancies have been previously reported. Many of these represent reactive haemophagocytic syndromes, probably virally induced. The considerable degree of cytological atypia and frequent mitotic figures seen in the histiocytes in this case were indicative of a true malignant histiocytosis.

Adult↗

Yorkshire Regional Lymphoma Histopathology panel: analysis of five years' experience.

Five years' experience of operating a Regional Lymphoma Histopathology Panel is described. During this period, approximately 1400 cases were registered of which nearly 1200 were confirmed as malignant lymphoma. Complete concordance of diagnosis was achieved between submitting pathologists and the Panel in two-thirds of cases of Hodgkin's disease and just over half of non-Hodgkin's lymphoma. Most discrepancies in diagnosis were found to be of clinical importance in terms of prognosis and/or therapeutic management of patients. In approximately two-thirds of such instances disagreement arose because of wrong assignment of tumour grade within the main lymphoma class but in one-third of cases the main class of lymphoma was wrongly designated. Panel members experienced similar diagnostic problems as submitting pathologists although to a lesser extent. The existence of the panel has not reduced the proportion of cases causing diagnostic difficulty for submitting pathologists or panel members during the 5 year study period. The principal cause of death was ascertained from death certificates and autopsy findings in nearly half the cases dying during the study period. In approximately half of these infection (largely pulmonary) played a major role while most of the remainder died of various cardiovascular, pulmonary or renal disorders. There was no specific pattern relating to the main lymphoma class. It is concluded that whilst the panel fulfils a useful function in resolving diagnostic difficulties and standardizing lymphoma diagnosis its role is restricted somewhat by the limitations imposed by conventional morphological assessments.

Adult↗

Aetiologic factors in lymphoid malignancies: a case-control epidemiological study.

A prospective case-control study of the aetiologic factors involved in the production of lymphoid malignancies has been conducted within a defined geographical area covering six health districts in the Yorkshire Region. Among the aspects investigated were past medical events, occupations and certain social factors. A number of possible causal relationships have been identified including Jewish religion, past solvent exposure and ingestion of amphetamines, although the latter did not achieve statistical significance in this study. In addition several new associations have been identified, most notably with the occurrence of adult eczema/dermatitis and with treatment by radiation or steroids. The feasibility of conducting such a broadly based epidemiological investigation has been established.

Adrenal Cortex Hormones↗

Identification of large cell undifferentiated tumours in lymph nodes using leucocyte common and keratin antibodies.

A total of 43 cases undifferentiated large cell tumours presenting in lymph nodes were stained by immunoperoxidase techniques using antibodies against keratin and a leucocyte-associated glycoprotein. In 26 cases diagnosed histologically as metastatic carcinoma, staining with the keratin antibody suggested a squamous cell origin in 11 cases. This was supported by microscopic observation of intracellular filaments in seven cases. In 15 patients in whom the original diagnosis was uncertain, a definite diagnosis was possible in all cases following immunoperoxidase staining with the two antibodies and most of these proved to be large cell lymphomas. In two cases a potentially major diagnostic error was detected. It is suggested that the staining of undifferentiated human neoplasms using combinations of antibodies reactive with epithelial and lymphoid cells should result in much greater diagnostic accuracy in the field of large cell tumours presenting in lymph nodes.

Adolescent↗