[The quality of susceptibility examinations of urine in general practice is generally good]. / Kvaliteten af resistensbestemmelser på urin i almen praksis er generelt god.

In Denmark, many microbiological tests (microscopy, culture and susceptibility examinations) are done in general practice for the diagnosis of urinary tract infections (UTI). In 2006, the costs of susceptibility examinations were 28 million DKK. Some regional health authorities have established a program for quality assessment. National quality requirements for susceptibility examinations have already been established. The clinical microbiological departments send simulated urines with bacteria of common UTI strains. The specimens are examined in general practice with routine methods. The results for a two-year period of susceptibility examinations are reported. Generally, the quality criteria were met.

Onconeural antibodies in sera from patients with various types of tumours.

PURPOSE: We assessed the frequency and levels of onconeural antibodies in 974 patients with various types of tumours, but without apparent paraneoplastic neurological syndromes (PNS). PATIENTS AND METHODS: We included patients with the following tumours: 200 small-cell lung cancer (SCLC) patients, 253 breast cancer patients, 182 ovarian cancer patients, 266 uterine cancer patients and 73 thymoma patients, as well as 52 patients with PNS and cancer and 300 healthy blood donors. Sera were screened for amphiphysin, CRMP5, Hu, Ma2, Ri and Yo antibodies using a multi-well immunoprecipitation technique. RESULTS: The most frequently detected antibodies were Hu followed by CRMP5. Ma2, Yo, amphiphysin and Ri antibodies were less common, but each was found at similar frequencies. Onconeural antibodies were present at similar levels in sera from the PNS control group and from cancer patients. Hu antibodies were rare in cancers other than SCLC. CRMP5 was the only antibody found in patients with thymoma and this antibody was more common among patients with thymoma than in other tumour patients. With one exception, coexisting antibodies were only found in patients with SCLC. The presence of onconeural antibodies in SCLC patients was not associated with prolonged survival. CONCLUSION: Onconeural antibodies are associated with various types of tumours suggesting that all antibodies should be included in the serological screening for possible PNS. The levels of onconeural antibody are not sufficiently sensitive to discriminate between cancer patients with PNS and those without.

[Mesenterial thrombangitis obliterans in a female]. / Mesenteriel thrombangitis obliterans hos en kvinde.

In this case report we describe a case of meseriental thrombangitis obliterans in a 39-year-old, previously healthy female smoker. She was referred to hospital because of abdominal pains, nausea and diarrhoea. All tests where normal. One year later the patient was admitted due to fever and acute abdominal pain. Initial diagnostic laparoscopy was normal. The patient deteriorated and laparotomy was performed. Inflammation and gangrene was found in the small intestine. The pathological examination of the resected specimen determined that the diagnosis was mesenterial thrombangitis obliterans.

Ri antibodies in patients with breast, ovarian or small cell lung cancer determined by a sensitive immunoprecipitation technique.

The presence of circulating antineuronal antibodies has been associated with paraneoplastic neurological syndromes (PNS). Ri antibodies are often associated with lung or breast cancer, but the prevalence of such antibodies in large cancer materials is largely unknown. We used a highly sensitive immunoprecipitation assay to study the level of Ri antibodies in blood samples from 200 patients with small cell lung cancer (SCLC), 253 patients with breast cancer and 557 patients with ovarian cancer. Two hundred blood donors and six Ri positive PNS patients served as controls. The recombinant antigen used in the immunoprecipitation assay was radiolabeled by a coupled in vitro transcription and translation (ITT) technique, enabling low levels of antibodies to be detected. None of the blood donors contained Ri antibodies, whereas all of the sera from the PNS patients were positive. Ri antibodies were present in 4.5% of the patients with SCLC, 0.8% of the patients with breast cancer and in 0.2% of the patients with ovarian cancer. Retesting of the Ri positive samples with immunofluorescense and immune blot showed that the immunoprecipitation technique was more sensitive than the other immune assays. Ri antibodies were not associated with PNS in the patients with breast or ovarian cancer. Neurological data were not available for the SCLC patients, but in these, Ri antibodies were not associated with survival.

Proteasome antibodies in paraneoplastic cerebellar degeneration.

Antibodies to proteasome have been detected in several autoimmune diseases, including multiple sclerosis. We have investigated the presence of such antibodies in patients with paraneoplastic neurological syndromes, by Western blotting and immunohistochemistry. Antibodies to 20S proteasome were detected in the majority of patients with paraneoplastic cerebellar degeneration (PCD), but in only one of nine sera from patients with paraneoplastic encephalomyelitis/sensory neuronopathy (PEM/SN), and were not found in cancer patients in general. The results suggest that the immune responses in PCD differ from those of PEM/SN, whereas the functional significance of proteasome antibodies in PCD is yet to be determined.

Heterogeneous expression of CD59 on human Purkinje cells.

The expression of CD59 and other complement regulators was studied in human cerebellum from 14 individuals with no cerebellar pathology, from one patient with multiple sclerosis (MS) and from two patients with paraneoplastic cerebellar degeneration (PCD). CD59 was present on the Purkinje cells at various levels in eight of the 14 cases with no cerebellar pathology. CD59 was also present on the Purkinje cells of the patient with MS, but not on the scarce remaining Purkinje cells of the two patients with PCD. Other complement regulators (CD35, CD46 and CD55) were not expressed on the Purkinje cells, whereas CD59, CD46 and CD55 were present on the molecular, granulosa and endothelial cells. The results suggest that Purkinje cells not expressing CD59 could be especially prone to complement-mediated damage.

[Peliosis hepatis as the cause of liver affection in a patient treated with immunosuppressive agents]. / Peliosis hepatis som årsag til leverpåvirkning hos en patient i behandling med immunosuppressiva.

A case of peliosis hepatis in a 64-year-old woman treated with azathioprine because of a lung transplantation is described. The patient was admitted owing to epigastric pain and jaundice. Sixteen months before admission the patient had had a lung transplantation because of pulmonary emphysema. A liver biopsy showed multiple, dilated, blood-filled liver sinusoids consistent with peliosis hepatis. Besides azathioprine, the patient was treated with cyclosporine and prednisolone, but none of these drugs are known to be responsible for the development of peliosis hepatis. This rare condition, which causes liver affection in patients treated with azathioprine, should be kept in mind.