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The murine monoclonal antibody (A9), raised to the human squamous cell carcinoma (SCC) cell-line UM-SCC-1, defines a squamous cell antigen associated with aggressive biologic behavior of SCC cell lines in vivo and in vitro. In the present investigation, A9 antigen was detected in tissue sections from 37 consecutive, previously untreated patients with SCC of the head and nack. All tumors were positive for A9 binding, although three distinct patterns (reflecting different intensities of A9 expression) were identified. The intensity of A9 expression was independent of primary tumor site, tumor differentiation, keratinization, or growth pattern. The frequency of high expression (Pattern 1) grew with increasing T class, N class, and tumor stage, and was associated with loss of blood group expression in the tumor and with low levels of lymphocyte infiltration In the tumor. Strong A9 expression had a statistically signification association with low nuclear grade (i.e., tumors with more mature and fewer enlarged nuclei, P= 0.019), low vascular/stromal response (i.e., patchy response rather than continuous, P= 0.014), and impaired in vitro lymphokine production by peripheral blood leukocytes (P= 0.0011). Of greatest interest, however, was the strong association of high A9 expression with shortened disease-free interval (DFI) (P= 0.085) and survival (P= 0.081) relative to patients with weak A9 tumor staining (Patterns 2 and 3). Similarly, the loss of blood group antigen expression was strongly associated with decreased DFI (P= 0.038) and survival (P= 0.062). While neither Pattern 1 A 9 expression nor loss of blood group reach statistical significance in prediction of survival, the combination of Pattern 1 A 9 expression and loss of blood group expression in primary tumors was significantly associated, both with decreased disease-free interval (P= 0.017) and with decreased overall survival (P= 0.011) (median length of follow-up = 22 months). The length of follow-up (LFU) ranged from 2 to 38 months, with a median LFU of 22 months. While the number of patients (37) is small, the significant association between the expression of these cell-surface markers with relapse and survival indicates that immunohistologic staining of the primary tumor will be an important prognostic indicator useful in identification of individual patients at greatest risk of recurrence or early death from head and neck cancer, independent of tumor size, site, or stage at presentation. These markers may thus provide means of selecting patients who should receive adjuvant therapy and more intensive monitoring for the early detection of recurrent disease.

Frozen microtitration trays manufactured by Micro-Media Systems (MMS) for antimicrobial testing of anaerobic bacteria were evaluated and compared with the broth disk elution method of Virginia Polytechnic Institute (VPI) described by Wilkins and Thiel. A total of 224 clinical anaerobic isolates were tested. Susceptibility results were compared for carbenicillin, cefoxitin, chloramphenicol, clindamycin, penicillin, and tetracycline. Published procedures for the MMS and VPI methods were followed using aerobic inoculation. Growth performance in the MMS method was 74% compared with 89% in the VPI method. For each antibiotic, the MMS minimum inhibitory concentration was compared with the VPI test concentration. Of the 972 drug-organism combinations, 2.9% of the results were discrepant. Clindamycin and tetracycline accounted for 82% of the discrepancies. The MMS anaerobe susceptibility panels were easy to inoculate and interpret and compared well with the VPI broth disk susceptibility method.

A total of 100 random clinical urine specimens were divided and used to compare Becton, Dickinson & Co. B-D Urine Culture Kit-treated urine (BDU) with refrigerated urine (RU). Each RU-BDU pair was cultured with the standard calibrated loop-plate method and also screened with the Abbott Laboratories MS-2 system at 0, 5, and 24 h. An additional 158 positive urine specimens containing greater than 10(5) CFU/ml were tested by standard culturing and MS-2 at 0 and 24 h. In addition, growth curves were run for Escherichia coli containing RU-BDU pairs at 0 and 24 h, and MS-2 detection time frequencies were analyzed. Culture results showed few changes in colony counts at 0 and 5 h for RU and BDU specimens. At 24 h, there were decreased colony counts for 7.0% of RU and 17.7% of BDU specimens. MS-2 results showed detection rates at 0 h of 100% for RU and 82.9% for BDU specimens and at 24 h of 91.1% for RU and 63.3% for BDU specimens. The organisms most frequently missed at 24 h were E. coli, Pseudomonas aeruginosa, and Staphylococcus epidermidis. Growth curve analysis showed a 1-h delay of logarithmic growth in BDU specimens. MS-2 detection time analysis showed delayed positive reports owing to be extended detection time for BDU specimens. The B-D Urine Culture Kit is a convenient transport system; however, some difficulty in recovering organisms at 24 h with the standard culture method and increased difficulty with the MS-2 system were recognized.