Roll-out of an educational workshop to improve knowledge and self-confidence of healthcare professionals engaged in mainstreaming of breast cancer genetics.

Background: There are calls worldwide for the mainstreaming of genetic testing in breast cancer (BC) clinics, but health care professionals (HCPs) are not always familiar with nor confident about genetic counselling. TRUSTING (Talking about Risk & uncertainties of Testing in Genetics is an educational programme shown to significantly improve HCPs' knowledge, communication, self-confidence, and self-awareness. We rolled out TRUSTING workshops across the UK and probed their influence on mainstreaming within BC clinics.

The straight to test endoscopy service for suspected colorectal cancer: meeting national targets but are we meeting our patients' expectations?

Aim: The NHS Cancer Plan describes initiatives to improve patient care in the UK, including the two-week rule cancer referral pathway. To meet this target a straight to test (STT) endoscopy service was devised to expedite diagnosis of suspected colorectal cancer. Our novel study aimed to determine patient satisfaction with this new approach to rapid access investigation.

Lymph node ratio can further stratify prognosis in subpopulations of breast cancer patients with axillary nodal metastases.

Breast cancer (BC) is the most common cancer in women worldwide and affects one in eight women in the UK at some point in their lifetime. Advances in treatment have led to greatly improved survival rates. Management of axillary lymph node (LN) metastases has been a controversial but evolving area of BC therapy.

Exocrine pancreatic insufficiency following esophagectomy.

Weight loss following esophagectomy is a management challenge for all patients. It is multifactorial with contributing factors including loss of gastric reservoir, rapid small bowel transit, malabsorption, and adjuvant chemotherapy. The development of a postoperative malabsorption syndrome, as a result of exocrine pancreatic insufficiency (EPI), is recognized in a subgroup of patients following gastrectomy.

Necrotising soft tissue infection following mastectomy.

Necrotising fasciitis is a rare but rapidly progressive soft tissue disease which can lead to extensive necrosis, systemic sepsis and death. Including this case, only 7 other cases have been reported in the world literature with only 2 others affecting the patient post mastectomy. This 59 year old Caucasian lady presented with severe soft tissue infection soon after mastectomy, which was successfully treated with a combination of debridement, triangulation, VAC© dressing and skin grafting.

Defects in the Drosophila myosin rod permit sarcomere assembly but cause flight muscle degeneration.

We have determined the molecular and ultrastructural defects associated with three homozygous-viable myosin heavy chain mutations of Drosophila melanogaster. These mutations cause a dominant flightless phenotype but allow relatively normal assembly of indirect flight muscle myofibrils. As adults age, the contents of the indirect flight muscle myofibers are pulled to one end of the thorax.

Recovery of dominant, autosomal flightless mutants of Drosophila melanogaster and identification of a new gene required for normal muscle structure and function.

To identify further mutations affecting muscle function and development in Drosophila melanogaster we recovered 22 autosomal dominant flightless mutations. From these we have isolated eight viable and lethal alleles of the muscle myosin heavy chain gene, and seven viable alleles of the indirect flight muscle (IFM)-specific Act88F actin gene. The Mhc mutations display a variety of phenotypic effects, ranging from reductions in myosin heavy chain content in the indirect flight muscles only, to reductions in the levels of this protein in other muscles.

Lymphocytes of the intestinal mucosa of chickens.

Examination, by light and electron microscopy, of the morphology and the staining properties of intraepithelial lymphocytes from the intestine of the chicken revealed a population of lymphoid cells, of which a proportion (up to 20%) is granulated. The majority of cells were immunoreactive with anti-T cell serum and can therefore be considered to be related to T-lymphocytes, but they did not proliferate when cultured with phytohaemagglutinin. The granulated cells were identical to those previously designated globule-containing leukocytes, but were distinct from mast cells in their morphology, staining reactions and the stability of the granules in different fixatives and buffers.

Marek's disease in turkeys: the induction of lesions and the establishment of lymphoid cell lines.

The inoculation of turkeys with large doses of a virulent strain of Marek's disease virus (GA strain), but not of two other virulent strains (HPRS-16 and JM), was found to induce a disease resembling Marek's disease of the chicken. The most prominent lesions were lymphocytic leukaemia and lymphoid and reticular hyperplasia in the spleen and the liver. These developed after a prolonged latent period and the early histological changes (lymphoid cell destruction and reticuloendothelial cell hyperplasia) reported in chickens were not observed.

The effect of immunity on the early events in the life-cycle of Eimeria tenella in the caecal mucosa of the chicken.

A comparison was made between the early events (asexual stages) in the life-cycle of Eimeria tenella in specifically immunized and control chickens. Particular attention was paid to the quantitative aspects and to the transport of sporozoites within intra-epithelial lymphocytes (IEL) from the enterocytes of the surface epithelium to the enterocytes of the crypts. There was a moderate decrease in the number of parasites initially seen in the mucosa of the immune birds, suggesting that some of the effects of immunity are exerted before penetration of the surface enterocytes, but the reduction in the numbers of developing parasites was more marked.

Invasion of chicken caecal and intestinal lamina propria by crypt epithelial cells infected with coccidia.

The development of second generation schizonts of Eimeria necatrix and E. tenella was studied with the electron microscope. Invasion of the crypt epithelial cells by merozoites of the first generation schizonts caused changes in the morphology of the infected cells and stimulated their migration into the lamina propria through breaks which appeared in the basement membrane of the crypts.

Mucosal transport of Eimeria tenella in the cecum of the chicken.

A study of the early life history of Eimeria tenella with the electron microscope confirmed that sporozoites do not directly enter the enterocytes of the crypts, in which they develop, but are carried there by host cells. However, these cells are not macrophages, as previously thought, but intraepithelial lymphocytes. The evidence presented demonstrates that sporozoites first penetrate surface enterocytes and then enter intraepithelial lymphocytes that leave the epithelium, pass through the lamina propria and enter the crypts.

Parasite-host relationships during the development of Eimeria dispersa Tyzzer 1929, in the turkey (Meleagris gallopavo gallopavo) with a description of intestinal intra-epithelial leucocytes.

An electron microscopical study was made on the development of Eimeria dispersa in the small intestine of the domestic turkey. Turkey poults, 10-14 days of age, were inoculated with oocysts and pieces of intestinal tissue were fixed at intervals between 3.5 and 114 h after inoculation.

Ultrastructure of the central nervous system in Marek's disease and the effect of route of infection on lesion incidence in the central nervous system.

The ultrastructure of the lesions of the central nervous system (CNS) of chickens was examined at intervals after intra-abdominal inoculation of Marek's disease virus (MDV). No transient paralysis occurred. Peri-vascular accumulations of lymphocytes and macrophages (cuffing) were accompanied by invasion of the CNS by these blood-borne leukocytes in the most severe lesions.

Idiopathic polyneuritis in SPF chickens.

Paralysis due to peripheral neuritis occurred sporadically in a flock of Rhode Island Red chickens over a period of 8 years and is named idiopathic neuritis (IP). The flock was housed in isolators and free from many common pathogens including all known neurotropic viruses of chickens. The pathology of the nerve lesions, including their ultrastructure, is described and comparisons made with the lesions of Marek's disease and experimental allergic neuritis in chickens.

Presence of a complete endothelial barrier between lymph and lymphoid tissue in the lumbar lymph nodes of the duck (Anas platyrhynchos).

The ultrastructure of the lumbar lymph nodes of the domestic duck is described and compared with published accounts of mammalian lymph nodes. The barrier to cell migration between lymphoid tissue and lymph is more formidable in the duck than in the mammal. In the duck the lymphatic endothelium lining the lymph spaces is continuous and bonded with desmosomes whereas in the mammal it is unbonded and fenestrated.

The effect of virus dose on the development of Marek's disease in two strains of chickens.

The effect of inoculating different doses of Marek's disease virus on the consequent lymphocyte-associated viraemia titres, survival time and mortality was studied in two strains of chickens, one highly susceptible (a strain of Rhode Island Red) and one moderately resistant (a strain of Light Sussex) to Marek's disease. In both strains an increase in the infecting dose of virus increased the ensuing viraemia, and there was an inverse relationship between virus dose and survival time. There was a negative correlation between viraemia titres and survival time.

Chronological study of ultrastructural changes in the peripheral nerves in Marek's disease.

A chronological study was made of the ultrastructural changes in peripheral nerves following inoculation of 1-day-old chicks with a neurogenic strain of Marek Disease virus. No virus particles were found in nerves. Cellular infiltration of nerves was detected as early as 5 days after inoculation and by 3 weeks some nerves contained proliferative lesions which possessed many of the ultrastructural features characteristic of normal, reactive lymphoid tissue.

Haemopoietic cells in peripheral nerves of SPF chickens.

Foci of haemopoiesis were found in the peripheral nerves of SPF Rhode Island Red chickens and conventionally reared Brown Leghorn chickens. They contained cells which closely resembled the development stages in the bone marrow of erythrocytes, heterophil leukocytes or thrombocytes, but did not include lymphocytes. When birds from these flocks are used to study neuropathological disease, ectopic haemopoiesis in nerves must be distinguished from pathological lesions.

Comparison of the flagellins from different flagellar morphotypes of Escherichia coli.

The molecular weights of the flagellins of 13 strains of Escherichia coli, each with a different H antigen, were estimated using polyacrylamide gel electrophoresis. In each case only one major polypeptide was demonstrated, although some strains possessed apparently sheathed flagella. Considerable differences in the molecular weight of flagellin accompanied the previously described structural differences between flagella from strains with different H antigens.