The myocardium in ankylosing spondylitis. A clinical, echocardiographic, and histopathological study.

Cardiac function was investigated in men with ankylosing spondylitis (AS) age 21-65 years who had no cardiorespiratory symptoms or known abnormalities of heart or lungs. Chest radiographs and standard electrocardiograms were normal in 73 of 74 subjects. In echocardiographs of 30 men, left atrial size and left ventricular cavity size and wall thickness were normal. Minor abnormalities in the valve roots were present in 3 older men. Early diastolic abnormalities of the left ventricle were demonstrated in 16 of 30 subjects. This finding was confirmed by repetition of the echocardiography a year later in 15 subjects and by comparison of 11 probands with their healthy brothers. Myocardial tissue obtained at necropsy from 28 AS patients without ischaemic or valvular heart disease or hypertension was studied. A mild, diffuse increase of interstitial connective tissue was seen but there was no inflammatory change or amyloid. Computerised image analysis showed 30.7% interstitial reticulin compared with 17.7% in age/sex matched controls (p less than 0.0001).

Focal loss of anterior horn cells in the cervical cord in motor neuron disease.

In a three-dimensional study of the distribution of anterior horn cells in the C8 segment of the human spinal cord we have recognized lateral and medial zones of motor neuron groupings, but have not been able to recognize subgroups of neurons within these groupings resembling the anatomical columns described by earlier investigators. This observation does not invalidate the concept of functional groupings within these anterior horn cell pools. In studies of the same segment in cords obtained at autopsy from patients with motor neuron disease, zones of focal loss of motor neurons were identified, without consistent severity or distribution at different sectional levels. These findings imply varying resistance to the disease in different pools of motor neurons.

Transplacental carcinogenesis with radioactive phosphorus: the effects of promoting agents.

In a previous experiment, using 32P as a potential transplacental carcinogen in rats, we found that the isotope caused life-span shortening, reduced growth and caused ante-dating of the time of the tumour occurrence. Liver cell changes (nuclear atypia, variation in cell size) were noted and suggested liver cell damage, possible 'initiation'. A phorbol ester (TPA) and a high fat/high protein diet were used as promoting agents on further transplacentally irradiated rats. The results were identical to the previous experiment; no evidence of promotion was found.

Computer programs in cytology reporting and record keeping.

Large numbers of specimens are handled by cytology laboratories. There is great variation in their origin, a need for a name and disease index and for statistical data about the source and nature of the specimens. A computer program was devised to reduce this workload and to improve the accuracy of record keeping. Much of the tedium of this important aspect of laboratory function can thus be removed.

Transplacental carcinogenesis with radioactive phosphorus.

1 An attempt was made to produce a model of osteogenic sarcoma using 32P transplacentally. 2 Fetal tissues appeared to be resistant to irradiation as no tumour was induced at an increased frequency in treated animals. 3 Tumours that normally occur in our strain (Sprague-Dawley rats) showed a clear tendancy to occur earlier in post-natal life in treated animals compared with controls.

Measurement of polymorphonuclear leucocyte motility under agarose by computer-linked image analysis.

We have applied computer-linked image analysis to the measurement of polymorphonuclear leucocyte motility under agarose. A high degree of correlation was found between manual and machine values of cell numbers migrating and leading front measurements. This method permits a more complete analysis of cell motility than current methods. It is quick and reliable and allows cell distribution profiles to be studied.

Computer programs in histopathology record keeping.

Increasing work loads, changes in the nature of data obtained from biopsies, and the use of laboratory statistics in determining financial provision for pathological services combine to enhance the value of computer generated results and indexing in histopathology. The system described here depends on an indexed file system using the Basic Plus-2 language with a PDP-11 computer and SNOP. Error traps are included. The system is designed for secretarial use, SNOP coding being carried out by medical staff.

A histoquantitative study of the striate cortex and lateral geniculate body in normal, blind and demented subjects.

The amount of myelin in the outer band of Baillarger in the human visual cortex stained by Luxol Fast Blue MBS, has been measured in normal individuals of wide age range, in a group of blind and severely visually impaired but otherwise normal individuals and in a series of demented patients of the Alzheimer and multi-infarct type who were apparently visually normal. The amount of myelin is found to be significantly reduced in the blind and demented groups. Examination of the lateral geniculate body in the blind cases demonstrated slight reduction in neuron numbers and marked reduction in mean neuron diameter. Neuronal cytoplasmic ribonucleic acid, nucleolar volume and numbers of tetraploid glial nuclei in the blind or visually impaired cases were significantly reduced when compared with controls, indicating reduced function in these neurons. Similar results were obtained on examining this nucleus in Alzheimer and multi-infarct cases, suggesting that the visual pathways may be involved in these conditions. It is concluded that loss of myelin from the outer band of Baillarger occurs in association with reduced function of neurons in the lateral geniculate body.

Polymorphonuclear motility: measurement by computer-linked image analysis.

Most methods of measuring neutrophil motility provide information mainly about the performance of a small proportion of the fastest moving cells. Application of a computer-linked image analysis technique, using the "Quantimet," provides a convenient, automated method of measuring the motility of the whole cell population. This makes it possible to test whether changes in motility represent a homogeneous alteration affecting all cells or a change in the numbers or performance of a subset of cells. In this study the neutrophils from patients with uncomplicated rheumatoid arthritis were found to perform similarly to normals, while cells from patients with Felty's syndrome were markedly slower. This was an overall, homogeneous slowing of the whole cell population, not due to a loss of fast moving cells.

The variability of blood group antigens in gastric carcinoma as demonstrated by the immunoperoxidase technique.

In this study the immunoperoxidase technique was used to demonstrate the blood group antigens A, B and H in normal gastric mucosa and primary and metastatic gastric carcinomas. No clear relationship between tumour differentiation and preservation of blood group antigens was found. In some well differentiated tumours there was a marked loss of blood group substance, whereas in other poorly differentiated tumours, both primary and metastatic, it was easily detectable. In some tumours an inverse relationship between A or B and H activity was noted. This observation is consistent with the theory that in some malignant cells there is a blocking of the normal step-by-step elongation of the carbohydrate portion of blood group substances.

Comparison of the effects of alclofenac, flurbiprofen, and prednisolone on acute inflammatory response in the rat.

The fluid and cellular phases of the inflammatory response were measured using a technique employing subcutaneous implantation of polyurethane foam cubes impregnated with heat-killed Mycobacterium tuberculosis. Fluribiprofen and prednisolone were equipotent and were capable of almost completely suppressing fluid and cellular responses, while alclofenac was less potent at nontoxic dose levels. Study of the patterns of cellular exudation by image analysing computer showed that alcofenac appears unique in that it produces a well-defined cell-free zone between the edge of the implanted cubes and a band of neutrophil polymorphs within the cubes.

Prevalence of asbestos bodies in a necropsy series in East London: association with disease, occupation, and domiciliary address.

The prevalence of asbestos bodies was measured in lung sections in a necropsy series carried out at the London Hospital (1965-66) after exclusion of all known asbestos factory workers and cases of asbestosis and of mesothelioma. Associations were sought between the presence and number of asbestos bodies with the patients' sex, domiciliary address, occupation, industry, and diseases recorded at necropsy. Asbestos bodies were present in 42% of the 216 men in the series and in 30% of the 178 women. The number of bodies in the positive cases was small in comparison with the numbers seen typically in asbestosis; thus there were less than 6 asbestos bodies per 6-75 mm-3 lung tissue in 107 of the total 145 positive cases in contrast to 1 000 or more in asbestosis. In comparison with the overall series, an increased number of asbestos body positives was present in males with carcinoma of stomach and females with carcinoma of breast. In view of this finding lung sections were counted in further post-mortem examples of these carcinomas making a total of 50 males with carcinoma stomach and 82 females with carcinoma breast. Thirty-five positive cases were found in the carcinoma stomach group as against 22-7 expected and 38 in the carcinoma breast group against 26-35 expected. There was no excess of observed over expected asbestos body positives in 51 males with carcinoma of bronchus. There was an excess of asbestos body positives (60-9%) in heavy manual workers and in both heavy and light manual male workers in the shipping (61%), electrical and engineering (56%), and transport (54%) industries. The incidence in male clerical workers was 12-8%. The incidence of asbestos body positives according to home address was highest (53% in males, 45% in females) in patients living in the industrial and cockland area due east of the hospital. The incidence fell in the less industrial areas north-east of the hospital. Consideration of possible environmental sources of the inhaled asbestos suggests that in this survey occupation, industry, and comiciliary area all play a part. The comparatively minor intensity of asbestos pollution in our positive cases showed a positive association with carcinoma of stomach and breast, possibly playing a direct pathogenic role in carcinoma of stomach. No positive association was identified with any other neoplastic disease including carcinoma of bronchus.