A retrospective study of transfusion-related non-A, non-B viral hepatitis was conducted in seven patients. Findings showed that six recipients had been exposed to at least one unit of blood possessing a putative serological marker for non-A, non-B hepatitis, the M2 antigen or anti-M2IgM. The M2 markers were associated with non-A, non-B hepatitis that developed 3–7 weeks after transfusion. It seems increasingly probable that M2 markers may be useful for diagnosis and/or prevention of post-transfusion hepatitis.

The delay in diagnosis of 106 patients with adult coeliac disease, diagnosed between 1976 and 1980, was studied. Overall, delay in diagnosis was 11 +/- 10.6 years, being considerably greater in females (12.8 +/- 7.8 years) than in males (3.5 +/- 9.8 years). Most of this delay occurred prior to hospital referral, although that following referral to hospital clinics was still significant (1.8 +/- 4.8 years). The most common presenting complaints were lassitude (75%) anaemia (65%) and flatulence (50%). Typical gastro-intestinal symptoms were relatively uncommon and mild, but when present led to a more speedy diagnosis. It is concluded that, despite advances in modern diagnostic procedures, little progress has been made in hastening the diagnosis of coeliac disease.

Mechanical, enzymatic and chelating methods for isolating rat intestinal epithelial cells were compared to determine the best technique for obtaining high yields of viable cells. The mechanical techniques resulted in consistently poor viability compared with the other methods. There was excellent agreement between viability determinations made by trypan blue exclusion and by cytofluorochromasia. Incubation with EDTA, citrate and dithiothreitol, combined with mechanical extrusion of dissociated cells provided the highest yields of viable cells in these studies.

In a prospective study, a comparison between immediate and next-day endoscopy has been made in 100 patients with acute upper gastrointestinal haemorrhage. Neither regime was statistically superior to the other. It is concluded that in the majority of patients immediate emergency endoscopy is unnecessary.

HLA A and B locus antigens were determined in 17 patients who had recovered from unexplained hepatitis following halothane anaesthesia. The greatest deviations from expected frequencies were observed with A1, A11 and BW22, but these differences were not statistically significant when the P values were corrected for the number of antigens tested. Although a larger series might show such deviations to be significantly different, HLA typing is of no predictive value in determining those at risk to hepatitis following repeated halothane exposure.

To look for possible HLA linkage in familial Crohn's disease, HLA haplotype segregation patterns were determined in 70 members of five kindreds, each having 2 or more patients with Crohn's disease (total number: 13 with Crohn's disease, 1 with ulcerative colitis). Concordant segregation of HLA haplotypes and disease was not observed. Study of HLA A and B locus phenotypes in 64 additional patients with documented Crohn's disease failed to show any significant disease association. We conclude that in these kindreds, HLA linkage does not account for the familial susceptibiltiy to Crohn's disease and that HLA A and B locus antigens are not associated with Crohn's disease.

Erosive gastritis and duodenitis resulting from chronic ischemia were seen at endoscopy in a 69-year-old woman with classical abdominal angina and severe atheromatous disease of all three splanchnic arteries.

Lymphocyte subpopulations in peripheral blood (PBL) and intestinal mucosa (IML) of 10 patients with inflammatory bowel disease (IBD) were compared with those of 11 non-IBD controls. PBL were separated on Ficoll/hypaque gradients, and IML were isolated by incubation in dithiothreitol, EDTA, and collagenase. These methods yielded cells of good viability and with intact HLA A and B-antigens. T-cells, identified by neuraminidase-treated sheep RBC rosettes and non-specific esterase staining, comprised approximately 91% of the IML from normal mucosa of all groups. B-cells, identified by erythrocyte-antibody-complement rosettes and surface immunoglobulins, were only 7% of these IML populations. Cell yields were two-fold or more greater from abnormal IBD mucosa, with T-cells ranging from 55 to 95% and B-cells from 2 to 36%. The percentage of Fc receptor bearing cells was low in all specimens. By these methods, T-lymphocytes predominated in intestinal mucosa of both IBD and non-IBD patients, but there is marked increase in the percentage of B-cells isolated from abnormal mucosa in IBD.

Foci of necrosis have been observed in the liver of 50% of enzyme-induced rats treated with halothane. The frequency of liver necrosis was significantly reduced by treatment with the free radical scavenger diethyldithiocarbamate. The severity of the lesion was not increased by repeated exposures to the anesthetic, and, although the frequency of liver necroses may be greater, the differences were not statistically significant.

Serum lysozyme levels were significantly raised in a group of eight patients with malabsorption associated with gastrointestinal lymphomas of a type recently characterised as malignant histiocytosis of the intestine. In four of the cases, levels were markedly raised. In contrast there was no significant difference between groups of patients with uncomplicated adult coeliac disease and healthy controls. The estimation of serum lysozyme is a simple test to perform and may be valuable in the diagnosis of malignant histiocytosis of the intestine, in particular differentiating it from uncomplicated adult coeliac disease.

We devised a sensitive and simple method for determination of bromide in whole blood and urine from humans using gas chromatography–mass spectrometry. Bromide was alkylated with pentafluorobenzyl p-toluenesulphonate in the mixture of acetone and phosphate buffer (pH 6.8). The derivative obtained was analyzed using gas chromatography–mass spectrometry with the positive-ion EI mode. The lower limit of detection for the compound was 1 mg/l. The calibration curve for bromide was linear over the concentration range from 2 to 100 mg/l. With use of this method, levels of bromide in whole blood and urine were determined in cases of poisoning by inhaled brominated hydrocarbons.

Endoscopic duodenal biopsies were taken from 27 patients with suspected coeliac disease and compared with intubation capsule jejunal biopsies. The specimens were reported without knowledge of the patients' names or symptoms. In 24 patients (89%), coeliac disease could either be diagnosed or excluded with 100% accuracy, despite the inability to orientate the biopsies correctly. Six biopsies were considered technically unsatisfactory, but only in three (11%) was it impossible to exclude coeliac disease. Duodenal biopsies were also taken from 118 consecutive patients attending for routine upper gastrointestinal endoscopy, and 1 patient with coeliac disease was discovered. We conclude that endoscopic duodenal biopsies are a reliable and worthwhile screening test for coeliac disease in certain patients attending for routine upper gastrointestinal endoscopy.

The case-histories of a husband and wife in whom Crohn's disease developed after more than 30 years of marriage are described.

To assess its value as a screen for avian antibodies, indirect immunofluorescence against avian intestinal tissue has been to test sera from thirty-nine patients with documented bird-fancier's lung disease, thirty-eight asymptomatic bird-fanciers and 257 controls without known avian contact. Immunofluorescent antibodies occurred more frequently than precipitins among patients with BFL and asymptomatic bird-fanicers. Globular fluorescence within the mucus occurred only in patients with avian contact, although other fluorescent antibodies were seen with control patients. No particular pattern was confined to patients with the lung disease. When included in an autoantibody profile, indirect immunofluorescence provides a sensitive and convenient alternative to precipitin methods in screening for avian antibodies.