A multicenter investigation with D-FISH BCR/ABL1 probes.

Twenty-eight laboratories evaluated a new fluorescence in situ hybridization (FISH) strategy for chronic myeloid leukemia. In a three-part study, bcr/abl1 D-FISH probes were used to study bone marrow specimens. First, laboratories familiarized themselves with the strategy by applying it to known normal and abnormal specimens. Then, collectively the laboratories studied 20 normal and 20 abnormal specimens blindly and measured workload. Finally, each laboratory and two experts studied six serial dilutions with 98-0% abnormal nuclei. Using the reported normal cutoff of < 1% abnormal nuclei, participants reported no false-negative cases and 15 false-positive cases (1-6.6% abnormal nuclei). Results provided by participants for serial dilutions approximated the expected percentages of abnormal nuclei, but those from the experts exhibited greater precision. The clinical sensitivity, precision, nomenclature, workload, recommendations for training, and quality assurance in methods using D-FISH in clinical practice are discussed.

Intra-oral temperatures in man with special reference to involvement of the central incisors and premaxillary alveolar process in lepromatous leprosy.

The predilection of lepromatous leprosy for body sites substantially below core temperature is well known, and within the oral cavity the premaxillary alveolar process and upper central incisor teeth are especially affected. In this study, intra-oral temperatures were recorded by means of a series of thermistor probes applied to the teeth and labial surfaces of the gums of normal subjects. The temperature distribution established showed a close correlation with the known pattern of involvement of teeth and supporting structures derived from clinical, pathological and archeological data. Relatively low temperature of the premaxillary alveolar process was demonstrated, a factor which may be of prime importance for the localization of disease in this region, as it is for other tissues in the lepromatous patient.

Disability: a model and measurement technique.

Current methods of ranking or scoring disability tend to be arbitrary. A new method is put forward on the hypothesis that disability progresses in regular, cumulative patterns. A model of disability is defined and tested with the use of Guttman scale analysis. Its validity is indicated on data from a survey in the community and from postsurgical patients, and some factors involved in scale variation are identified. The model provides a simple measurement technique and has implications for the assessment of individual disadvantage, for the prediction of progress in recovery or deterioration, and for evaluation of the outcome of treatment regimes.

A radiological assessment of osteoarthrosis of the knee: experiments in observer error.

In a trial to determine the best palliative physiotherapy for the painful osteoarthrosic knee, radiological assessment was suggested as a measure for testing homogeneity of treatment groups. Preliminary observer error experiments showed that an accepted standard grading scheme was unsatisfactory. A different system was designed in which all three knee compartments were graded separately (medial, lateral and patello femoral), based on a comparison of supine and erect films. The two systems have been compared in use on the same set of radiographs, and the observer error results are presented. The advantages of grading each compartment separately are discussed.

Preliminary studies in measuring range of motion in normal and painful stiff shoulders.

This study has been prompted by the need to provide basic data for prospective studies in the management of the painful stiff shoulder. We have used a hydrogoniometric technique of proven accuracy to measure passive movement at the gleno-humeral joint in a normal population, patients currently attending with a painful stiff shoulder, and a retrospective group. We have shown that there are significant age and sex differences in the range of motion of normal and affected groups. A significant number (42 per cent) of patients had persisting limitation of range of the gleno-humeral joint six years after the onset of the disability. The study indicates the importance of matching patients for age and sex, and the need for long-term follow-up for meaningful results.