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J Jones

Publications and source records attributed to J Jones.

At least 397 records · Page 22Linked to original sources

Monoclonal anti-D specificity and Rh D structure: criteria for selection of monoclonal anti-D reagents for routine typing of patients and donors.

The Rh blood group system is the next most important to the ABO system in terms of its clinical significance in blood transfusion. It is vital to the safe, efficient practice of transfusion medicine that Rh D phenotyping tests are selected, executed and interpreted correctly. However, the Rh D blood group antigen has been shown to be subject to many phenotypic variations, and different reagents and typing techniques vary in their ability to detect these variants. The range of D-positive phenotypes are reviewed in terms of their reactivity with monoclonal antibody reagents and their clinical significance. In view of the available evidence, it is suggested that patient typing can be safely achieved by the duplicate use of one high-avidity or two very similar IgM monoclonal anti-D reagents that detect most variants except category DVI in simple tube or microplate saline tests. Antiglobulin testing for weak D should not be carried out on patient samples. Donor typing can be safely achieved by the use of the same monoclonal, used in parallel with a polyclonal anti-D reagent that detects DVI on sensitive automated equipment.

Antibodies, Monoclonal↗

A novel common Kell antigen, TOU, and its spatial relationship to other Kell antigens.

A 47-year-old native American (TOU) was admitted to hospital for hip surgery. His serum agglutinated all red blood cells (RBCs) tested except Ko and DTT-treated RBCs and was weakly reactive with RBCs known to have a weak expression of Kell antigens, namely Kmod, McLeod, Kp(a+b-) (KEL:3,-4) and K:-13 (KEL:-13) phenotypes. RBCs from three siblings, a son and a daughter were incompatible with TOU's antibody. TOU's RBCs had the common Kell phenotype: K-k+Kp(a-b+c-)Ku+Js(a-b+)Ul(a-)K:11,-17K:14,-24K:12,13,18,19, 22,-23(KEL:-1,2,-3,4,5,-6,7,-10,11,12,13,14,-17,18,19,-21,22,-23,-24). Since TOU's RBCs were not agglutinated by an unidentified Kell-related antibody (IAN), tests were performed to show that TOU and IAN were mutually compatible. IAN is a Latino female hospitalised for a hysterectomy. The TOU antigen was shown to be located on the Kell glycoprotein by a monoclonal antibody immobilisation of erythrocyte antigen (MAIEA) assay. The unique pattern of reactivity obtained with TOU and IAN antibodies using this assay indicated the TOU epitope to be in an area remote from other Kell antigens, namely K, k, Kpa, Kpb, Kpc, Ku, Jsa, Jsb, U1a, K11, K12, K13, K14, Wka, K18, K19, K22 and K24 (KEL1, KEL2, KEL3, KEL4, KEL5, KEL6, KEL7, KEL11, KEL12, KEL13, KEL14, KEL17, KEL18, KEL4, KEL5, KEL6, KEL7, KEL11, KEL12, KEL13, KEL14, KEL17, KEL18, KEL19, KEL21, KEL22 and KEL24) but close to the low-incidence antigen K23 (KEL23).(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗

K12 is located on the Kell blood group protein in proximity to K/k and Jsa/Jsb.

K12 is a high-prevalence antigen, with no known antithetical partner, that is associated with the Kell blood group system. We report studies on the 5th propositus (MS) with the K:-12 phenotype and the second case to show that the K12 is inherited. The anti-K12 in his serum did not destroy antigen-positive incompatible red cells transfused on at least 3 occasions over 6 years. Red cell membranes from MS possessed the Kell protein that was indistinguishable from control membranes. K12 antigen was shown by immunoprecipitation to be on a protein with an apparent molecular mass of 93,000 and by monoclonal antibody immobilization of erythrocyte antigens (MAIEA) assay to be on the Kell protein in proximity to K/k and Jsa/Jsb antigens. These data remove the K:-12 phenotype from its current Kell-related (or para Kell) status and elevates the K12 antigen to a bona fide member of the Kell blood group system.

Antibodies, Monoclonal↗

Identification of two new D variants, DHMi and DHMii using monoclonal anti-D.

Fifteen examples of red cells are described which showed discrepant reactivity on routine grouping with two monoclonal anti-D typing reagents, HAM-A being negative and MAD-2 strongly positive. The reaction profile of these cells with a number of monoclonal anti-D characterised the samples into two new variant groups, DHMi and DHMii. DHMi was characterised by a negative reaction with BRAD-8 and DHMii by a negative reaction with BRAD-5. DHMi cells were found to have a papain-sensitive site, identified by Mab 21 G6, which was not detectable in DHMii. The presence of allo-anti-D in one case of DHMi suggests a partial D in these individuals. The positive reaction of HAM-A with sialidase- and endo-F-treated DHMii cells suggests that sialic acid and/or N-glycans could possibly be involved in blocking the reaction with untreated cells. All samples typed as C-E+. One was e negative while the rest had variable depression of the e and f antigens. Marginal depression of E was seen with those DHMi cells tested, but not with DHMii cells. Data from family studies suggest that the variant D in both DHMi and DHMii is inherited as a cDE gene complex and is controlled by the RH locus.

Amidohydrolases↗

Bedside fluoroscopy for the detection of foreign bodies.

OBJECTIVE: To determine the sensitivity and specificity of portable fluoroscopy for foreign-body detection using an ex-vivo experimental model. METHODS: A prospective, randomized masked investigation was performed to characterize foreign-body detection in cubes of beef. Three emergency physicians (EPs) independently used a portable fluoroscope to determine the presence or absence of various foreign bodies in ten cubes of beef (approximately 6 cm on each side). Six different groups of foreign bodies were examined: glass, wood, graphite (pencil lead), metal (needle), plastic, and gravel. An independent observer placed the six objects randomly into each set of ten beef cubes. One hundred observations were made by each physician using sets of ten beef cubes at a time. RESULTS: Fluoroscopy detected 117 of 180 foreign bodies (sensitivity 65%; 95% CI 58-72%), including all cubes of beef embedded with gravel, metal, and glass. Graphite was detected 27 of 30 times (sensitivity 90%; 95% CI 74-98%). None of the plastic or wooden foreign bodies was identified despite magnification techniques and real-time imaging (sensitivity 0%; 95% CI0-12%, each). Of the 120 cubes of meat with no foreign body, two false-positives were recorded (specificity 98%; 95% CI 94-100%). The overall positive predictive value and negative predictive value of fluoroscopy were 98% and 65%, with 95% CIs of 94-100% and 58-72%, respectively. Interobserver agreement between the three EPs was considered excellent (kappa = 0.75). CONCLUSION: Bedside fluoroscopy lacks sufficient sensitivity to rule out many foreign bodies in the ED. Its use should be limited to suspected gravel, glass, pencil lead, and metallic objects, which are known to be radiopaque.

Emergency Medicine↗

Changes in the expression of integrins and basement membrane proteins in benign mucous membrane pemphigoid.

OBJECTIVE: To determine the location of the subepithelial split in benign mucous membrane pemphigoid (BMMP) and its relationship to the anchoring filaments and their receptors. MATERIALS AND METHODS: Frozen sections of lesional and perilesional oral mucosa from 10 cases of BMMP were stained, using an immunofluorescence method, for the beta-1, beta-4, alpha-3 and alpha-6 integrin subunits and for their ligands, laminin I and laminin V (kalinin). In all cases the diagnosis was confirmed by the demonstration of linear staining for IgG at the basement membrane zone. Six specimens of normal mucosa were stained for comparison. RESULTS: Staining for integrins, laminin and kalinin in perilesional mucosa was similar to normals, although one case showed loss of alpha-6 and beta-4 . In lesional mucosa, laminin and kalinin showed strong linear staining localised to the floor of the bullae. The alpha-6 and beta-4 subunits were expressed only on the roof of the bullae but staining was weak and patchy with areas of loss. In some sections alpha-6 showed a punctate intracellular distribution similar to IgG. The distribution of alpha-3 and beta-1 was similar to that seen in normals. CONCLUSIONS: In all cases kalinin was found on the connective tissue side of the lesions and alpha-6 beta-4 localised to the epithelial side. This shows that the split occurs at a location which separates anchoring filaments from the hemidesmosomes. Loss of the alpha-6 beta-4 integrin in the lesions and the similar intracellular staining of alpha-6 and IgG, suggest that disruption of hemidesmosomes may be a key event in the immunopathogenesis of the lesions and that the alpha-6 integrin subunit is a potential antigen in oral mucosal BMMP.

Actin Cytoskeleton↗

Third trimester fetal growth and umbilical venous blood concentrations of IGF-1, IGFBP-1, and growth hormone at term.

Insulin-like growth factor-1 (IGF-1), insulin-like growth factor binding protein-1 (IGFBP-1) and growth hormone (GH) concentrations were measured in umbilical venous blood after delivery of 78 term newborn infants. Three groups of pregnancies were prospectively identified during the third trimester, according to fetal size and subsequent fetal growth, assessed by repeated ultrasound scans. Fetal size was considered either appropriate for gestational age (AGA) or small for gestational age (SGA), according to whether the first ultrasound measurement of abdominal circumference was equal to or above, or below the tenth centile for gestational age, respectively. Subsequent fetal growth was quantified by the change in the standard deviation score of abdominal circumference measurements between the first and last scans before delivery. Fetal growth retardation (FGR) was defined as a (negative) change in SD score of greater than -1.5. Eighteen SGA fetuses with evidence of FGR had significantly lower IGF-1 (median 0.05 (range 0.0-0.24) U/ml) at delivery than 35 SGA fetuses with normal growth (median 0.13 (range 0.0-0.94) U/ml; P < 0.05) and 25 AGA fetuses with normal growth (median 0.31 (range 0.0-0.84) U/ml; P < 0.05). The median concentration in the SGA group with normal growth was also significantly lower than that of the AGA group with normal growth. There were no significant differences in IGFBP-1 or GH concentrations between the three groups. These observations indicate that umbilical blood concentrations at birth of IGF-1, but not IGFBP-1 or GH, relate to both fetal size and fetal growth during the third trimester of pregnancies reaching term.

Embryonic and Fetal Development↗

Anticomplementary activity in serum samples from patients with acute parvovirus B19 infection.

Of 65 serum samples submitted for diagnostic purposes which proved to be anti-complementary by complement fixation test, 49 were parvovirus B19 IgM positive. Forty four of the 49 serum samples were from patients with arthropathy. Acute parvovirus B19 infection should be suspected when a patient has symptoms of disease of the joints and the serum is anticomplementary.

Acute Disease↗

Association of postprandial triglyceride and retinyl palmitate responses with newly diagnosed exercise-induced myocardial ischemia in middle-aged men and women.

Although strong evidence exists linking fasting plasma levels of LDL cholesterol (LDL-C) and HDL cholesterol (HDL-C) to risk for development of coronary artery disease (CAD), the data in support of an independent role for fasting triglyceride (TG) concentrations are weak. Humans are in the postprandial state most of the day, however, and results from both basic and clinical studies suggest that postprandial TG levels may be atherogenic. Previous studies have not, however, attempted to determine if postprandial TG levels are associated with CAD independent of other traditional risk factors or plasma lipid levels, particularly fasting plasma concentrations of TG and HDL-C. Ninety-two men and 113 women (mean age, 51.6 and 53.6 years, respectively) were recruited from populations undergoing diagnostic exercise electrocardiographic or thallium stress tests at our medical centers. Twenty-six men and 24 women had positive tests. We chose exercise-induced myocardial ischemia (EIM) as the criterion for defining case and control subjects because we wanted participants who did not have a prior diagnosis of CAD. Blood samples were obtained for measurement of plasma TG, TG-rich lipoprotein TG, and retinyl palmitate (RP) levels 2, 3.5, 5, and 8 hours after the subjects had consumed a fatty test meal. Logistic regression models were developed to test for associations between each variable and case-control status. Among men but not women postprandial TG and RP responses were associated with EIMI independent of age, race, and smoking status. In the male group, the odds ratio (OR) for an increase in postprandial TG response of approximately 1 SD was 1.69 (P = .007); the OR for an increase in RP response of 1 SD was 2.47 (P = .011). However, when fasting TG was added to the model, the OR for postprandial TG area in the men was reduced to 1.44 (P = .17); the OR postprandial RP area in the men was reduced to 1.88 (P = .12). There was no effect of adding other risk factors, including LDL-C and HDL-C, to the model. Significant effect modification by body mass index (BMI) on the relationship between postprandial responses and case-control status was observed. In men with BMI < 30, the OR was 1.83 for postprandial TG (P = .041) and 2.77 for postprandial RP (P = .032) in models that included fasting TG, LDL-C, and hypertension.

Age Factors↗

Surgical management of congenital saccular cysts of the larynx.

Congenital saccular cysts of the larynx are unusual lesions that commonly present with respiratory obstruction in infants and children. The saccular cyst may result from an atresia of the laryngeal saccule orifice or may represent the retention of mucus in the collecting ducts of submucosal glands located around the ventricle. Traditionally, the treatment of the lesions has been endoscopic unroofing or marsupialization. Frequently, this modality requires multiple procedures as well as concomitant tracheotomy. There also have been reports of acquired subglottic stenosis. We have found that removal of the recurrent saccular cyst can be achieved relatively safely and effectively via a lateral cervical approach to the thyrohyoid membrane. We review our experience with four patients with congenital saccular cysts and detail the evaluation and surgical management of these lesions.

Cysts↗

The influence of vascular pressure and different primes on the fluid balance of, and oxygen supply to, the patient during CABG.

Detrimental changes of blood and erythrocyte rheology, and fluid exchange between the vascular and interstitial spaces, which influence the rate that oxygen is supplied to the patient, occur during cardiac bypass surgery. Venous flow is subject to a pulsatile and uncertain variation, because the vena cava is more than 30 mmHg below atmospheric pressure. This occurs because the patient is about 1 m above the air-blood surface of the bypass reservoir. Before any reliable study of fluid exchange can be undertaken this effect must be controlled. It was then established that optimum oxygen exchange occurs when equilibration of the plasma oncotic pressure and the capillary hydrostatic pressure is achieved without alteration of the interstitial fluid volume. At the lower arterial blood pressures used during bypass, it is necessary to reduce the plasma oncotic pressure by using an appropriate volume of crystalloid prime.

Coronary Artery Bypass↗

Serum insulin-like growth factor-binding protein-3 (IGFBP-3) levels and IGFBP-3 protease activity in normal, abnormal, and multiple human pregnancy.

Proteolytic activity directed against insulin-like growth factor (IGF)-binding protein-3 (IGFBP-3) is found in human pregnancy serum. We have investigated changes in this protease activity in pregnancies in which the fetus is small for gestational age and in multiple pregnancies. Maternal serum was obtained from 18 singleton pregnancies at 27 weeks gestational age (GA), and matched fetal serum was collected by cordocentesis. Fetuses were appropriate for GA (AGA; n = 6), small for gestational age (SGA) with evidence of uteroplacental insufficiency (UPI; starved SGA; n = 6), or SGA without UPI (nonstarved SGA; n = 6). In a second study, serum was obtained from women with singleton (n = 10), twin (n = 10), and higher multiple pregnancies (n = 10) at 9 weeks GA. All women with more than three fetuses underwent embryo reduction to 2 fetuses before 15 weeks gestation, when a second serum sample was obtained. Circulating IGF-I and IGF-II were measured by RIA, and IGFBP-3 was measured by both RIA and immunoradiometric assay. IGFBP-3 protease activity was assessed by Western ligand blotting after incubation with a normal nonpregnancy sera pool, immunoblotting, and specific protease assay. In the growth study, circulating maternal IGF-I and IGFBP-3 levels were not different in the three groups, but fetal IGF-I and IGFBP-3 levels were significantly lower in the UPI fetuses (IGF-I, 6.9 +/- 0.5 micrograms/L; IGFBP-3, 547 +/- 70 micrograms/L) than in either the nonstarved SGA fetuses (IGF-I, 27.8 +/- 6.3; IGFBP-3, 769 +/- 41 micrograms/L; P < 0.01) or the AGA fetuses (IGF-I, 39.4 +/- 3.4; IGFBP-3, 872 +/- 91 micrograms/L; P < 0.01). Maternal serum IGFBP-3 protease activity, measured by protease using [125I]IGFBP-3 as substrate, was increased in pregnancies complicated by UPI compared with GA-matched pregnancies in which the fetus was AGA or nonstarved SGA. No significant fetal serum protease activity was demonstrated. In the multiple pregnancies, IGFBP-3 rose significantly from 9-15 weeks GA in singleton (P = 0.005), twin (P = 0.004), and multiple (P = 0.007) pregnancies, and levels were higher in mothers of multiple pregnancies than in those of twin (P < 0.05) or singleton (P < 0.01) pregnancies at both 9 and 15 weeks GA. IGF-I levels were not different in the three groups and did not significantly increase between 9-15 weeks GA.(ABSTRACT TRUNCATED AT 400 WORDS)

Carrier Proteins↗

Growth hormone hypersecretion in a girl with McCune-Albright syndrome: comparison with controls and response to a dose of long-acting somatostatin analog.

GH every 20 min for 24 h, insulin-like growth factor I (IGF-I), IGF-binding protein 3, and estradiol (E2) were measured in a 7.3-yr-old girl with precocious puberty due to McCune-Albright syndrome (MAS) who developed stigmata of early acromegaly and in 9 other MAS patients who had no signs of acromegaly. To determine whether the MAS patients had subtle abnormalities in GH secretion, a computerized pulse analysis program was used to compare the MAS data with those from 27 control girls with central precocious puberty who had a similar rate of bone age advance, E2, and body mass index. We found no differences in mean GH, GH pulse frequency, pulse height, or pulse area between MAS patients and controls except in patient 1, who had an elevated mean +/- SD GH compared with controls (15.4 +/- 2 vs. 4.8 +/- 2.3 micrograms/L; P < 0.01) and an elevated IGF-I (908 micrograms/L) and IGF-binding protein 3 (5.6 mg/L). None of the GH parameters correlated with body mass index, age, bone age, or E2 levels in either group. The serum GH in patient 1 fell to near-undetectable levels from 60-180 min after a 100-micrograms sc dose of long-acting somatostatin, confirming that this form of therapy can be effective in cases of GH hypersecretion due to MAS.

Child↗

IgE-dependent reactions to urologic catheter extracts by skin testing in latex-allergic patients.

BACKGROUND: Latex allergy is mediated by residual IgE-binding proteins found on latex products. While most reported reactions involve latex gloves, the allergenic potential of other latex containing devices is unknown. OBJECTIVE: To assess the allergenic potential of latex urologic catheters. METHODS: Two identical lots of urologic catheters were extracted in sterile saline and analyzed for latex protein content using sensitive ELISA and Western blot assays. The extracts were tested by skin prick testing in a population of 47 latex-allergic patients. RESULTS: Latex proteins were detected by ELISA assay, however, the Western Blot method was not sensitive enough to measure latex proteins in these catheter extracts. Skin prick testing using a standard latex reagent (Bencard) demonstrated the test population to be extremely sensitive to latex as 68% of the population reacted to a 1/100,000 dilution. Using undiluted catheter extracts, only 11% of these latex-allergic patients reacted to catheter lot A and 2% to catheter lot C, by prick skin test. Eight percent of the control patients had a positive latex prick skin test and none reacted to the catheter extract. CONCLUSIONS: The data suggest that processing and leaching of these specific latex urologic catheters resulted in a very low latex allergen content. The low prevalence of skin test reactivity in a population of latex-allergic patients suggests that these catheters would be an unusual cause of allergic reactions. It is not possible, however, to determine whether latex-allergic patients could safely use latex urologic catheters.

Adolescent↗

The influence of a diastasis screw on the outcome of Weber type-C ankle fractures.

We performed a retrospective study of the factors affecting the outcome of Weber type-C ankle fractures in 43 patients reviewed at two to nine years after injury. We determined the functional result in relation to the use of a diastasis screw, the accuracy of reduction, the presence of tibiotalar dislocation, and of injury to the medial side of the ankle by medial malleolar fracture or deltoid ligament rupture. We assessed the use of a diastasis screw as appropriate or inappropriate on the basis of an anatomical study performed by Boden et al (1989). The diastasis screw was used unnecessarily in 19 of the 31 patients so treated, but this did not appear to affect the final functional result. The worse functional results were in ankles dislocated at the initial injury, and in those with medial malleolar fractures as opposed to those with deltoid ligament ruptures. The best results were after accurate reduction of the fibula and the syndesmosis, and greater increase in the width of the syndesmosis was associated with a worse result. Our results suggest that an increase of more than 1.5 mm in syndesmosis width is unacceptable. We recommend that when the deltoid ligament is ruptured, a diastasis screw should be used if the fibular fracture is more than 3.5 cm above the top of the syndesmosis. When a medial malleolar fracture has been rigidly repaired a diastasis screw is required if the fibular fracture is more than 15 cm above the syndesmosis.

Ankle Injuries↗

Urinary insulin-like-growth factor I in normal children: relationship to age, pubertal status and urinary growth hormone.

Authentic insulin-like growth factor 1 (IGF-I) can be detected in human urine at one thousandth of the serum level, with which it correlates closely. The aim of this study was to establish the normal range of urinary IGF-I (uIGF-I) in relation to age, sex, and pubertal status, and to define the relationship between uIGF-I and urinary growth hormone (uGH). IGF-I was measured by RIA after acid extraction of IGF-I binding protein, and separation by gel chromatography in 302 healthy children (149 boys and 153 girls) in whom uGH had already been measured. The mean amount of uIGF-I excreted each night ranged from 17.5 ng (males) and 14.9 ng (females) at pubertal stage I (PS 1), to a peak of 66.8 ng (males) at PS 4, and 55.8 ng (females) at PS 3, coinciding with peak uGH excretion. Highly significant correlations were found between uGH and uIGF-I both before and during puberty (P < 0.01). These findings extend the range of non-invasive investigation available in growth disorders and physiological studies.

Adolescent↗

Apoptosis is associated with reduced expression of complement regulatory molecules, adhesion molecules and other receptors on polymorphonuclear leucocytes: functional relevance and role in inflammation.

Human polymorphonuclear leucocytes (PMN) express proteins that protect them from damage by homologous complement. Protection may be particularly important when these cells migrate to inflammatory sites where complement activation is taking place. Resolution of inflammation involves removal of these PMN. The major mechanism of removal is likely to involve PMN apoptosis followed by recognition and engulfment by macrophages. However, little attention has been paid to the possible relevance of apoptosis to PMN susceptibility to immune effectors. Here we describe a reduction in cell surface expression of two complement regulatory proteins, CD59, an inhibitor of the membrane attack complex and CD55 (decay accelerating factor), an inhibitor of the C3/C5 convertase, on a subpopulation of PMN aged in culture. Loss of these proteins, both attached to the membrane by glycosyl phosphatidylinositol (GPI) anchors, correlated closely with the appearance of apoptotic morphology. We also observed a marked reduction in expression of the GPI-anchored molecule CD16 on apoptotic PMN. Reduced expression of membrane proteins was not confined to those anchored through GPI--several transmembrane molecules including CD11a CD11b and CD18 were also reduced on apoptotic PMN, whilst other were little changed (CD35, CD46). The precipitous fall in CD16 surface expression on PMN was not specific for apoptosis--in vitro incubation of PMN with lipopolysaccharide-inhibited apoptosis but caused a reduction in CD16 expression to 'apoptotic' levels.

Antigens, Surface↗

Colocalization of human papillomavirus type 11 E1[symbol: see text]E4 and L1 proteins in human foreskin implants grown in athymic mice.

The most abundant viral mRNA species in tissues infected with HPV 11 consists of two exons, joining a short segment of open reading frame (ORF) E1 to ORF E4, potentially encoding an protein of 10 kDa. E4 gene products have previously been identified by immunohistochemistry in human tissues infected with HPV 1 and HPV 16, and in HPV 11-infected raft cultures. The E1[symbol: see text]E4 mRNA is produced in abundance in HPV 11-infected human foreskin implants grown in athymic mice. In contrast, the L1 mRNA is present at low levels and appears late in the course of infection. To characterize the relationship of these proteins, polyclonal rabbit antisera were produced against bacterially expressed HPV 11 trpE/E1[symbol: see text]E4 and trpE/L1 fusion proteins and tested in an immunohistochemical assay of paraffin-embedded sections of HPV 11-infected human foreskin tissue fixed with 10% buffered formalin phosphate or zinc formalin. In sections fixed with either fixative, the anti-L1 serum stained nuclei of cells in the upper spinous and granular layers. In contrast, the anti-E1[symbol: see text]E4 serum stained the cell membrane and, to a lesser degree, the cytoplasm of cells in the upper spinous and granular layers of tissue fixed with zinc formalin, but not 10% buffered formalin phosphate. In sections treated with both the E1[symbol: see text]E4 and L1 antisera, cell membrane staining occurred in the same cells that exhibited nuclear staining. The HPV 11 E1[symbol: see text]E4 protein appears to be a cell membrane-associated protein. Expression of the HPV 11 E1[symbol: see text]E4 and L1 proteins may be influenced by similar factors in differentiating cells.

Animals↗