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NUCLEAR TUBULOFDLAMENTOUS INCLUSIONS IN VIPOMAS
610 We thank Prof. J. E. Banatvala and members of his staff at St Thomas’ Hospital and Medical School, London, who kindly demonstrated their technique to us. of Microbiology, Bedford General Hospital, (North Wing) Bedford MK40 2NU
Department
L. M. DE SILVA J. MARSHALL
HLA-B27 IN BLACK PATIENTS WITH ANKYLOSING
SPONDYLITIS
SIR,—The strong association between ankylosing spondylitis (A.s.) and HLA-B27’-3 is commonly used in clinical diagnosis and family counselling,4 but its usefulness in American Blacks has been questioned.’ To evaluate this issue, we tested sera from 89 patients with "rheumatoid-type" complaints for HLA-B27. Diagnostic categories were assigned in accordance INCIDENCE OF
HLA-B27 ANTIGEN
IN BLACK AND WHITE PATIENTS WITH POSSIBLE A.S.
Intranuclear rod in Dl-like tumour cell.
(Reduced to about half of x 13 500.) Their maximum length 5900 nm. The same nuclear rods have been seen in sympathetic neurons of cats,’ and Bryant et al. have demonstrated v.Lp. secretion by sympathetic tumours (ganglioneuroblastomas). Our findings accord with a neural origin for endocrine pancreatic cells.
larly spaced electron-dense material.
was
with standard criteriaand independently of HLA typing. HLA antigens were determined by a standard microcytotoxi-
city technique.? The data are presented in the table. All Whites, both male and female, with A.S. were B27 positive, but only half the Black patients with A.S. were B27 positive (P<0.001). No other HLA/A or B antigen was common to the B27-negative patients. These data confirm the findings of Khan et al. Caution must be exercised in utilising HLA typing as a diagnostic aid in Black patients, particularly when counselling B27-negative relatives. Divisions of Orthopedic Surgery and Immunology, Duke University Medical Center, Durham, North Carolina 27710, U.S.A.
SIR,—We have studied by electron microscopy three cases of Verner-Morrison syndrome with vasoactive intestinal peptide (v.i.p.) secreting tumours of the pancreatic islets. The hormone was identified by extraction or immunofluorescence methods. At the ultrastructural level, the cellular proliferation could be classified as Dl-cells. The small (150-250 nm) secretory granules appeared round with a dense core and a tightly fitting limiting membrane. Some nuclei lodged tubulofilamentous inclusions, formed by parallel microfilaments crossed by reguBrewerton, D. A., Caffrey, M., Hart, F. D., Nicholls, A., Sturrock, R. D. Lancet, 1973, i, 904. 2. Schlosstein, L., Terasaki, P. I., Bluestone, R., Pearson, C. M. New Engl. J. 1.
4. 5. 6. 7.
Med. 1973, 288, 704. L. P., Svejgaard, A. Associations Between HLA and Disease: report from the HLA and Disease Registry. Copenhagen, 1976. Ritzmann, S. E. J. Am. med. Ass. 1976, 236, 2305. Khan, M. A., Braun, W. D., Kushner, I., Steinberg, A. G. in HLA and Disease; abstr. p. 40. INSERM, Paris, 1976. Bennett, P. H., Wood, P. H. N. (editors). Population Studies of the Rheumatic Diseases (Excerpta med. int. Congr. Ser. 1976, no. 148). Amos, B., Cabrera, G., Bias, W. B., MacQueen, J. M., Lancaster, S. L., Southworth, J. G., Ward, F. E. in Histocompatibility Testing 1970 (edited by P. I. Terasaki); p. 259. Copenhagen, 1970.
Ryder,
U. 56
1. 2.
INSERM, Bicêtre
J. P. LECLERC J. M. SCOTTO
Seite, R., Escaig, J., Couineau, S. J. ultrastruct. Res. 1971, 37, 449. Bryant, M. G., Bloom, S. R., Polak, J. M., Albuquerque, R. M., Modlin, I., Pearse, A. G. E. Lancet, 1976, i, 991.
Commentary from Westminster FROM A CORRESPONDENT
Clause 49 of the Patent Bill ROBERT J. RUDERMAN FRANCES E. WARD
NUCLEAR TUBULOFDLAMENTOUS INCLUSIONS IN VIPOMAS
3.
Department of Pathology, Hôpital Lariboisière, Paris 75010, France
RELATIONS between the Government and the phamaceutical industry seem a little strained at the moment because of a fierce tussle which has been going on behind the scenes over price control. The Government is seeking to re-enact the controversial provision allowing licences for new drugs to be made available to competing firms who took no part in the original research. The aim is to stimulate price competition and restrain high prices. But it is a provision which has been universally hated by the industry since it first became law in thePatent Act 1949. Last week Conservative peers rode to the industry’s rescue when they removed from the new Patent Bill clause 49 re-enacting section 41 of the old legislation. Against the advice of the Lord Chancellor the House decided by 78 votes to 45 to throw out the clause. Lord Elwyn Jones had warned peers that by deleting this provision they could be prejudicing talks going on between the Government and the industry to try and reach a voluntary agreement. The Government now has to decide whether to try and put clause 49 back into the Bill when the legislation comes to the Commons. Without an overall majority this could be difficult. Much will depend on whether the industry agrees to the voluntary arrangements which have been put to it.
Department
L. M. DE SILVA J. MARSHALL
HLA-B27 IN BLACK PATIENTS WITH ANKYLOSING
SPONDYLITIS
SIR,—The strong association between ankylosing spondylitis (A.s.) and HLA-B27’-3 is commonly used in clinical diagnosis and family counselling,4 but its usefulness in American Blacks has been questioned.’ To evaluate this issue, we tested sera from 89 patients with "rheumatoid-type" complaints for HLA-B27. Diagnostic categories were assigned in accordance INCIDENCE OF
HLA-B27 ANTIGEN
IN BLACK AND WHITE PATIENTS WITH POSSIBLE A.S.
Intranuclear rod in Dl-like tumour cell.
(Reduced to about half of x 13 500.) Their maximum length 5900 nm. The same nuclear rods have been seen in sympathetic neurons of cats,’ and Bryant et al. have demonstrated v.Lp. secretion by sympathetic tumours (ganglioneuroblastomas). Our findings accord with a neural origin for endocrine pancreatic cells.
larly spaced electron-dense material.
was
with standard criteriaand independently of HLA typing. HLA antigens were determined by a standard microcytotoxi-
city technique.? The data are presented in the table. All Whites, both male and female, with A.S. were B27 positive, but only half the Black patients with A.S. were B27 positive (P<0.001). No other HLA/A or B antigen was common to the B27-negative patients. These data confirm the findings of Khan et al. Caution must be exercised in utilising HLA typing as a diagnostic aid in Black patients, particularly when counselling B27-negative relatives. Divisions of Orthopedic Surgery and Immunology, Duke University Medical Center, Durham, North Carolina 27710, U.S.A.
SIR,—We have studied by electron microscopy three cases of Verner-Morrison syndrome with vasoactive intestinal peptide (v.i.p.) secreting tumours of the pancreatic islets. The hormone was identified by extraction or immunofluorescence methods. At the ultrastructural level, the cellular proliferation could be classified as Dl-cells. The small (150-250 nm) secretory granules appeared round with a dense core and a tightly fitting limiting membrane. Some nuclei lodged tubulofilamentous inclusions, formed by parallel microfilaments crossed by reguBrewerton, D. A., Caffrey, M., Hart, F. D., Nicholls, A., Sturrock, R. D. Lancet, 1973, i, 904. 2. Schlosstein, L., Terasaki, P. I., Bluestone, R., Pearson, C. M. New Engl. J. 1.
4. 5. 6. 7.
Med. 1973, 288, 704. L. P., Svejgaard, A. Associations Between HLA and Disease: report from the HLA and Disease Registry. Copenhagen, 1976. Ritzmann, S. E. J. Am. med. Ass. 1976, 236, 2305. Khan, M. A., Braun, W. D., Kushner, I., Steinberg, A. G. in HLA and Disease; abstr. p. 40. INSERM, Paris, 1976. Bennett, P. H., Wood, P. H. N. (editors). Population Studies of the Rheumatic Diseases (Excerpta med. int. Congr. Ser. 1976, no. 148). Amos, B., Cabrera, G., Bias, W. B., MacQueen, J. M., Lancaster, S. L., Southworth, J. G., Ward, F. E. in Histocompatibility Testing 1970 (edited by P. I. Terasaki); p. 259. Copenhagen, 1970.
Ryder,
U. 56
1. 2.
INSERM, Bicêtre
J. P. LECLERC J. M. SCOTTO
Seite, R., Escaig, J., Couineau, S. J. ultrastruct. Res. 1971, 37, 449. Bryant, M. G., Bloom, S. R., Polak, J. M., Albuquerque, R. M., Modlin, I., Pearse, A. G. E. Lancet, 1976, i, 991.
Commentary from Westminster FROM A CORRESPONDENT
Clause 49 of the Patent Bill ROBERT J. RUDERMAN FRANCES E. WARD
NUCLEAR TUBULOFDLAMENTOUS INCLUSIONS IN VIPOMAS
3.
Department of Pathology, Hôpital Lariboisière, Paris 75010, France
RELATIONS between the Government and the phamaceutical industry seem a little strained at the moment because of a fierce tussle which has been going on behind the scenes over price control. The Government is seeking to re-enact the controversial provision allowing licences for new drugs to be made available to competing firms who took no part in the original research. The aim is to stimulate price competition and restrain high prices. But it is a provision which has been universally hated by the industry since it first became law in thePatent Act 1949. Last week Conservative peers rode to the industry’s rescue when they removed from the new Patent Bill clause 49 re-enacting section 41 of the old legislation. Against the advice of the Lord Chancellor the House decided by 78 votes to 45 to throw out the clause. Lord Elwyn Jones had warned peers that by deleting this provision they could be prejudicing talks going on between the Government and the industry to try and reach a voluntary agreement. The Government now has to decide whether to try and put clause 49 back into the Bill when the legislation comes to the Commons. Without an overall majority this could be difficult. Much will depend on whether the industry agrees to the voluntary arrangements which have been put to it.