Search

To determine the biological and prognostic significance of DNA ploidy, 492 consecutive and prospectively documented cases of colorectal cancer were retrieved from the archives of Concord Hospital. 35 cases were excluded due to poor preparations. Nuclei were extracted from paraffin blocks and analysed by DNA flow cytometry. A tumour was classified as diploid when only one G 0 -G 1 peak was detected and aneuploid when there were two or more G 0 -G 1 peaks. The DNA index (DI) was derived from the ratio between the mean fluorescence intensities of the second or aberrant G 0 -G 1 peak and the reference 2N peak. Anatomical Site Diploid Hyperdiploid DI DI ≥ 1.4 Proximal Colon 58 27 37 Distal Colon 56 25 81 Rectum 67 26 80 After a follow-up of 7 years DNA ploidy was of marginal importance as a prognostic indicator (p=0.055). Clinical staging (ACPS), extent of direct tumour spread and extent of lymph node involvement were the most relevant prognostic indicators, once other factors were taken into account. Aneuploidy was also significantly correlated with absence of contiguous adenoma, tumour ulceration and venous invasion. The degree of aneuploidy or DI was greater in distal colorectal (DCR) i.e. splenic flexure and beyond than proximal colon (PC) cancers (p

Properties which determine whether circulating immune complexes are nephritogenic in man could be influenced by immunological factors affecting antigen antibody ratios, size of complexes, and other characteristics of antibody production. There are conflicting reports on effects of antibody affinity on the development of glomerulonephritis in experimental situations and in human SLE. Our study examines whether the response to immunization with tetanus toxoid differs in patients with glomerulonephritis when compared with normal controls, and whether these differences could reflect the histological type of disease. In patients with glomerulonephritis the hemagglutinating antibody response to tetanus toxoid was reduced compared to normal controls. Mean antibody affinity before injection was higher in patients than in controls, and it rose after immunization in both groups. Six of eight patients with diffuse proliferative glomerulonephritis showed a fall in antibody affinity following injection, in contrast to 10 of 13 controls and 15 of 21 patients with other histological types of disease whose affinity increased. This rise was particularly marked in 3 of 4 patients with mesangiocapillary glomerulonephritis. These data suggest differences in antibody responses of patients with glomerulonephritis and could explain seemingly inconsistent results of previous studies where due regard has not been paid to histological categories. Pathogenesis may vary in different histological forms of the disease in man as in experimental models of the disease.

A tumour arising from the body of the eighth thoracic vertebra is believed to be the first recordedexample of a primary fibroxanthosarcoma of bone. Apart from the absence of a demonstrable storiform pattern, the histology conformed to that of fibroxanthosarcoma of the soft tissues. Ultrastructural studies showed that asteroid-like bodies seen in the cytoplasm of some tumour cells consisted of aggregated centrioles surrounded by cytoplasmic vacuoles. The finding of Langerhans cell granules in some tumour cells supported their identification as histiocytes. These granules have not previously been recorded in the fibrous histiocytoma group of tumours.

Many forms of human glomerulonephritis (gn) are considered to be caused by deposition of immune complexes in glomeruli resulting in an inflammatory response. The considerable variability in individual susceptibility to the disease suggests that differences in host immune responses are important in determining development of the glomerular lesion. Animal experiments have suggested that immune complex renal disease is associated with production of low affinity antibody inefficient in promoting antigen elimination. 1 In human SLE, however, it has been suggested that patients with gn have antibody with higher avidity for dsDNA than lupus patients without renal involvement. 2,3 If we assume that aberrations of immune response to antigens involved in gn may be reflected in the response to other antigens, we could obtain relevant information by comparing the effects of immunization in patients with normal controls. This paper reports such a study. Patients with gn and normal controls were immunized with 5Lf alum precipitated tetanus toxoid subcutaneously, and antibody was measured pre- and 14 d post-immunization. Glutaraldehyde fixed, tanned group 0 human red cells were used in passive haemagglutination. Tetanus toxoid was radio-labelled with 125 I by the chloramine T method, and used in determining avidity by modification of the Farr assay. Patients with gn had a suboptimal haemagglutinating antibody response in respect of numbers failing to respond (P These results suggest that the various histological appearances in gn may result from different pathogenetic mechanisms. Raised serum creatinine (>0.2mmol 1) did not affect avidity or haemagglutinating antibody response.

Immune complex deposition in glomeruli is believed to cause many forms of human glomerulonephritis (gn). One as yet unproven hypothesis suggests that relative immune deficiency prevents antigen elimination, thereby predisposing to immune complex formation and deposition. We sought in the present study to identify in such patients defective immune function. Forty-four sequential patients were studied who satisfied the following criteria: (1) serum creatinine levels ≤ 0.2 mM/L, (2) renal biopsy which allowed unequivocal histological classification and in which immune deposits were demonstrated by immunofluorescence or electron microscopy. (3) not receiving corticosteroids or immunosuppressives. We were able to demonstrate in patients with gn, compared with age and sex-matched normal controls, an increased incidence of immunological changes which included: 1. Elevated serum levels of several immunoglobulin classes in various forms of gn: a novel finding was of raised IgM in 4 of 9 patients with focal sclerosing gn and glomerular IgM deposition. 2. Patients with all forms of glomerulonephritis showed significant reduction in antibody response to tetanus toxoid compared with controls in their mean rise in litre (P (P 0.01). 3. Increase in total haemolytic complement (CH 50 ), and C-reactive protein, suggesting an acute phase inflammatory response. Isolated defects in functional C 2 were detected in 4/37 patients, but their disease was in no way unique. 4. No impairment in T cell function as measured by delayed hypersensitivity skin tests or DNCB sensitization. However, 8 patients (20%) had a reduced response to PHA stimulation, of whom only one (a patient with tuberculosis) had an inhibitory serum factor. Since uraemia and debility cannot be invoked to explain these findings, we suggest that they indicate immunological activity which may be important in genesis of the glomerular damage.