ABSTRACT
An estimated third of rheumatologists send aspirated synovial fluid samples for culture routinely during the course of management of their patients irrespective of the underlying diagnosis. This is done apparently even when sepsis is not suspected. This audit of 507 synovial fluid culture requests revealed that positive bacterial growth was rare even when sepsis was queried on the request forms but none was positive in any of the routine samples. Our findings throw doubt on the value of routine synovial fluid culture. We recommend that such cultures are undertaken when infection is a possibility and in immuno-compromised patients. An average health district would save pounds 3000 per annum if such a policy was adopted, but across the National Health Service as a whole the total expenditure saved on this unnecessary investigation would be considerable.
Subject(s)
Arthritis, Infectious/diagnosis , Diagnostic Tests, Routine/standards , Financial Audit/standards , Synovial Fluid/microbiology , Adolescent , Adult , Aged , Aged, 80 and over , Arthritis, Infectious/economics , Arthritis, Infectious/epidemiology , Cells, Cultured , Child , Cost Savings , Diagnostic Tests, Routine/economics , Female , Humans , Male , Middle Aged , State Medicine/economics , Synovial Fluid/cytology , United Kingdom/epidemiologyABSTRACT
Fine-needle aspiration biopsy (FNAB) smears from 16 cases of neuroblastoma are reviewed, and various cytomorphologic features helpful in diagnosing this tumor are described. Cytoplasmic processes were present in ten cases, and pseudorosettes in three cases. Electron microscopic study of FNAB samples revealed that all diagnostically important features, such as cell processes, neurosecretory granules, and synaptic cell junctions, could be recognized. These findings indicate that FNAB studied by light and electron microscopy is an effective method for diagnosing neuroblastoma.
Subject(s)
Neuroblastoma/pathology , Biopsy, Needle , Child , Child, Preschool , Cytoplasm/ultrastructure , Female , Humans , Infant , Male , Microscopy, Electron , Neuroblastoma/ultrastructureABSTRACT
This article describes a technic for processing aspiration biopsy samples for electron microscopy. Red blood cells present in these samples were separated from the tissue fragments with the use of a nylon sieve. The tissue fragments were pelleted and processed for electron microscopy in a routine manner. An analysis of 19 cases processed in this manner revealed that this separation technic is highly effective and results in a significant improvement in cellular yield.
Subject(s)
Biopsy, Needle/methods , Humans , Microscopy, Electron , Neoplasms/pathology , Neoplasms/ultrastructure , Specimen Handling/methodsSubject(s)
Marriage , Physicians, Women , Career Choice , Family , Social Support , Socioeconomic FactorsABSTRACT
A nonlethal dose of Staphylococcus aureus was inoculated into the mainstem bronchus of mice in order to study the influx of polymorphonuclear leukocytes (PMN). The goal was to determine the routes of entry of PMN into the lung following bacterial challenge, the relative importance of PMN as compared to alveolar macrophages (AM) in the uptake of S aureus, and the role of lymphatics in clearance of intact microorganisms. Resident AM took up S aureus within minutes of inoculation, but PMN were subsequently recruited to the lung and were the predominant cell containing S aureus by 4 hours following inoculation. PMN were recruited from arteries, capillaries, and venules. Emigration of PMN into alveolar spaces occurred between type I epithelial cells as well as between type I and type II epithelial cells. Lymphatics played only a minor role in the clearance of S aureus.
