M30 expression demonstrates apoptotic cells, correlates with in situ end-labeling, and is associated with Ki-67 expression in large intestinal neoplasms.

Context: The monoclonal antibody M30 recognizes a neoepitope of cytokeratin 18 produced during apoptosis. It is reactive in formalin-fixed, paraffin-embedded tissue and has great potential in the study of apoptosis in clinical and experimental material.

Objectives: To compare the results of M30 immunoexpression with a more established technique of demonstrating apoptosis in tissue sections, in situ end-labeling.

The effects of orthognathic surgery on pharyngeal airway dimensions and quality of sleep.

Orthognathic surgery has been associated with airway narrowing and induction of sleep-related breathing disorders. Therefore, the pharyngeal airway dimensions of 32 orthognathic surgery cases were prospectively investigated, and the relationship between the surgery and sleep quality assessed. Digitized lateral cephalometric radiographs were used to compare oropharyngeal airway morphologies before and after surgery.

Mitotic and in situ end-labeling apoptotic indices as prognostic markers in malignant mesothelioma.

The prognostic role of mitotic and apoptotic indices in 60 patients with malignant mesothelioma was examined on hematoxylin-eosin-stained sections. The findings were compared with apoptotic indices determined by in situ end labeling (ISEL) in 35 of the cases. There was a significant survival advantage associated with lower mitotic counts and a lower apoptotic index defined by ISEL (P < .

Risk management of asymmetrical hearing impairment in an armed forces population.

The prevalence of asymmetrical hearing impairment in the entire service population (1490 individuals) of a Royal Air Force flying station was estimated from routine audiometric testing recorded in individuals' medical records. Criteria for magnetic resonance imaging (MRI) scanning to exclude the possibility of vestibular schwannoma were determined in accordance with the risk management principle that the cost of the screening should not exceed the value of the likely benefit. MRI scanning should be carried out in the presence of an asymmetrical sensorineural hearing impairment of (a) 15 dB or more at two adjacent frequencies, or (b) 15 dB or more averaged over 0.

Initial use of a computer system for assisting dermatological diagnosis in general practice.

The accuracy of skin lesion description by 24 general practitioners was assessed as they used a computer diagnosis assistance system (DERMIS). Descriptive accuracy determines the quality of advice. Only four doctors showed a trend to accurate description over 25 hospital referrals.

Methicillin-resistant Staphylococcus aureus: evaluation of detection techniques on laboratory-passaged organisms.

Strains of methicillin-resistant Staphylococcus aureus (MRSA) are a major cause of nosocomial infection. This has led to the widespread introduction of screening techniques to identify patients or staff colonised with the organism and prevent the spread of MRSA in the hospital environment. The aim of laboratory techniques for the detection of MRSA screening is the rapid isolation and identification of MRSA, enabling timely implementation of appropriate infection control measures.

Acinar morphology in colorectal cancer is associated with survival but is not an independent prognostic variable.

Aims: Microacinar morphology has been reported as a stage-independent prognostic variable for colorectal cancer. We have undertaken a retrospective analysis to test this observation in patients with colonic as well as rectal adenocarcinoma, and to assess interobserver agreement for identifying microacinar morphology.

Methods And Results: One hundred and eighty patients with colorectal cancer, 144 colonic and 36 rectal, were assigned to either macroacinar (144) or microacinar (36) groups.

Telemedicine kept simple.

Telemedicine ("medicine from a distance") is about bringing specialist knowledge to a patient from afar, by the use of communication technology. This article is based on personal experience in helping set up a simple, versatile, cheap and effective store-and-forward telemedicine system for the British Defence Medical Services. This system uses readily available still digital cameras to record clinical, radiographic and microscopic images, which are then sent by electronic mail to an organised network of specialists for secondary or tertiary opinion.

Mature bone metaplasia in abdominal wall scar.

A 58-year-old man who had had three laparotomies for gastric surgery, developed a painful mass in the abdominal wall scar. Radiology confirmed bone formation in the scar. The bone was excised and the wound repaired.

QARNNS at sea--HMS Roebuck.

Despite an initial problem of seasickness I thoroughly enjoyed my five weeks at sea on board HMS Roebuck. Having to make medical decisions can be somewhat daunting. However, you always have back up radio support if required.

Operational telemedicine.

A simple, effective digital camera and E-mail-based telemedicine system has been developed using commercially available equipment. Initial trials were successful and this system is now deployed in several operational units. A retrospective audit has shown it to be of value in 50% of referrals.

The pathology of acute appendicitis.

Although acute appendicitis is frequent, it is subject to common misconceptions. Furthermore, there is little good evidence to support some of our beliefs. This report reviews the role of the anatomic pathologist in diagnosis when acute appendicitis is suspected clinically and discusses what is known of its pathology.

Early experience of intra-ureteric capsaicin infusion in loin pain haematuria syndrome.

Objectives: To evaluate early results of the intra-ureteric instillation of capsaicin for the treatment of loin pain haematuria syndrome (LPHS).

Patients And Methods: Ten patients with LPHS were treated using intra-ureteric capsaicin instillation. A solution of capsaicin was infused into the affected ureter through an embolectomy catheter, under anaesthesia.

Teleradiology--practical aspects and lessons learnt.

Teleradiology is the most widely practised form of telemedicine and the necessary equipment is readily available. The limiting technical factor is often the communication links between the two sites. A balance must be struck between the degree of image compression and the transmission time.

Initial plastic surgery experience with the first telemedicine links for the British Forces.

In January 1998, the first telemedicine link for the British Defence Medical Services was established between the British military hospital in Sipovo, Bosnia and the Royal Hospital Haslar, the main triservice hospital in the UK. Further links were established later in the year. These simple links use a high-resolution digital camera, the Olympus C1400L and the C1400XL, to capture still images.

Trans-axillary first rib excision for thoracic outlet syndrome.

Aim: Thoracic outlet syndrome (TOS) is a clinical diagnosis treatable by excision of the first rib. This study was undertaken to assess the alleviation of symptoms following trans-axillary rib excision in patients with a diagnosis of TOS suggested by a positive Elevated Arm Stress Test and, by inference, to estimate the prevalence of the syndrome.

Method: A retrospective review of trans-axillary first rib excision was performed.

Reactivation of cutaneous leishmaniasis after surgery.

Cutaneous leishmaniasis (CL) is caused by a parasite from the genus Leishmania. Infection is transmitted to humans from the bite of sandflies. We describe an 85-year-old man who developed CL on his face after recent cutaneous surgery in that site.

Ganglion of the hip joint--we present a logical approach to the exploration of a mass in the femoral triangle.

Hip joint ganglion is a rare cause of a mass in the femoral triangle. Our patient presented with a swelling in the groin and a history of femoral hernia repair 5 years previously. Pre-operative assessment with ultrasound suggested a possible femoral artery aneurysm.

The pathophysiology of primary blast injury and its implications for treatment. Part II: The auditory structures and abdomen.

The authors have previously considered the mechanisms by which primary blast injury affects the respiratory and cardiovascular systems and what deductions may be made about management of the resulting injuries. This article considers the somatic effects of primary blast on abdominal and auditory structures. These injuries are usually of less immediate concern but require accurate management in order to avoid late mortality and morbidity and to return the casualty to full function.

Proximal patellar tendinosis and abnormalities of patellar tracking.

Objective: To assess whether an association exists between patellar tendinosis and abnormal patellar tracking.

Design And Patients: The MRI examinations of 630 patients (i.e.