Fine needle aspiration cytology as part of a three stage diagnostic approach to breast lumps in a District general hospital.

Recent studies from specialist breast centres have suggested that fine needle aspiration cytology in conjunction with mammography and clinical examination can provide a prompt and accurate diagnosis of breast lumps. These three methods of diagnosis have been assessed in the context of a district general hospital by analysing 104 consecutive breast lesions with known histology, of which 75 were benign and 29 malignant. The results are presented in terms of the sensitivity and specificity for each method. Fine needle aspiration cytology had a sensitivity for malignancy of 88% (n = 26) and a specificity of 97% (n = 58). Similarly, sensitivity for mammography was 95% (n = 20) and clinical examination 90% (n = 29). Respective specificities were 96% (n = 45) and 83% (n = 75). In none of the 29 patients with breast cancer were all three modalities negative. It is concluded that without specialist breast clinicians and cytologists, a combination of fine needle aspiration cytology, clinical examination and mammography can still provide a degree of preoperative diagnostic accuracy comparable with specialist centres, allowing prompt counselling with all the subsequent benefits.

Purification, characterization and immunological properties of the serotype-specific capsular polysaccharide of Pasteurella haemolytica serotype A7 organisms.

The serotype-specific capsular polysaccharide from two strains of Pasteurella haemolytica serotype A7 organisms was purified and characterized by chemical analysis and by 1H and 13C NMR spectroscopy using one- and two-dimensional methods. The polymer has the repeating unit----3)-beta-2-acetamido-2-deoxygalactopyranose-(1----3)-alpha- 2-acetamido- 2-deoxy-6-O-acetyl-glucopyranose-(1-phosphate----. It was immunogenic (capable of eliciting antibodies) for sheep. Chemical removal of O-acetyl groups destroyed both the ability of the polymer to adhere to sheep erythrocytes at neutral pH and the ability to form immune precipitates with specific antisera. Studies using the protein A-gold technique in the electron microscope showed the polysaccharide to be peripherally localized on the bacterial surface.

Purification, characterization and immunological properties of the capsular polysaccharide of Pasteurella haemolytica serotype T15: its identity with the K62 (K2ab) capsular polysaccharide of Escherichia coli and the capsular polysaccharide of Neisseria meningitidis serogroup H.

Capsular polysaccharide from two strains of Pasteurella haemolytica serotype T15 was purified and characterized by chemical analysis and NMR spectroscopy. The polymer, a teichoic acid, proved to be very similar in structure to the capsular polysaccharide of P. haemolytica serotype T4 and identical to the previously described K62 (K2ab) capsular polysaccharide of Escherichia coli, and the capsular polysaccharide of Neisseria meningitidis serotype H, i.e. ----(2-glycerol-3)----(phosphate)----(4-alpha-D-galactopyranose -1)---- with partial O-acetylation on the galactose residues. Electron microscopy with Protein A-gold labelled antisera showed that the polysaccharide was peripherally located on the surface of all three organisms. Chemical removal of O-acetyl groups from the polysaccharide yielded a structure identical to that previously described for E. coli K2 (K2a). Both O-acetylated and de-O-acetylated P. haemolytica T15 polymers, when absorbed on to sheep erythrocytes in passive haemagglutination assays, yielded identical antibody titres with sera raised against P. haemolytica T15, E. coli K2 or N. meningitidis H whole cells. De-O-acetylation of the Pasteurella polysaccharide influenced its precipitability with immune sera, but this could not be related to the absence of O-acetyl groups because the non-acetylated E. coli K2 polymer readily precipitated with a line of 'identity' with the acetylated P. haemolytica T15 polymer.

Purification, characterization and immunological properties of the serotype-specific capsular polysaccharide of Pasteurella haemolytica (serotype T4) organisms.

The serotype-specific capsular polysaccharide from two strains of Pasteurella haemolytica serotype T4 organisms was purified and characterized by chemical analysis and NMR spectroscopy. The polymer, a teichoic acid, has the backbone structure ----(2-glycerol-l)----(phosphate)----(6-alpha-D-galactose-1)---- and is partially O-acetylated on the C2 and C3 galactose residues. Chemical removal of O-acetyl groups from the polysaccharide destroyed both its ability to precipitate with antiserum raised against killed whole serotype T4 organisms and its ability to adhere to sheep erythrocytes in passive haemagglutination experiments. Attempts to elicit antisera using the purified polymer were unsuccessful but a partially purified material was immunogenic.

Purification, characterization and immunological properties of the serotype-specific capsular polysaccharide of Pasteurella haemolytica (serotype A1) organisms.

The serotype-specific capsular polysaccharide from two strains of Pasteurella haemolytica serotype A1 organisms was purified and characterized by chemical analysis and NMR spectroscopy. The polymer has the structure----3)-O-(2-acetamido-2-deoxy-4-O-acetyl-beta-D-mannopyranos yluronic acid)-(1----4)-O-(2-acetamido-2-deoxy-beta-D-mannopyranose)-(1----. The polysaccharide was immunogenic (able to evoke production of antibodies) for sheep but not for rabbits. Immuno electron-microscopy studies using the Protein A-gold technique showed the polysaccharide to be peripherally located on the bacterial surface. Reduction, oxidation and de-O-acetylation of the polymer did not appear to alter its immunological precipitability with specific antiserum, but all three treatments destroyed its ability to adhere to sheep erythrocytes at neutral pH. De-N-acetylation of the polymer destroyed both immunological precipitability and erythrocyte adherence.