Journal of Clinical Pathology

Manual and automated methods for the determination of blood glucose have been devised using an oxidase/peroxidase system, with dl adrenaline, a non-carcinogen, as oxygen acceptor. The manual technique employs a stable single solution protein precipitant and the other reagents used are also stable. The automated methods are operated at 40/hr sample speed and washover between samples, over a very wide concentration range, is negligible.

The pathological features of 20 cases dying in status asthmaticus have been studied. In gross sections the lungs showed no emphysema, but mucus plugs in the air passages and focal areas of collapse were outstanding features. Five cases showed cystic bronchiectasis which was of a similar distribution to the focal areas of collapse, occurring in the upper lobes as commonly as in the lower lobes.

Histologically, shedding of the ciliated bronchial mucosal cells was prominent and this is attributed to a transudation of oedema fluid from the submucosa. Areas of regeneration of the mucosa, with the presence of simple stratified epithelium, were seen frequently. The loss of the ciliated respiratory epithelium and the transudation of oedema fluid into the bronchial lumen, with interference with the action of the remaining ciliated cells, are considered to be the essential factors in the failure of clearance of the bronchial secretions in asthma. It is postulated that bronchospasm plays little or no part in the shedding of the bronchial mucosa or in the pathogenesis of the asthmatic attack.

Eighteen strains ofStaph. pyogenes(nine penicillin-sensitive and nine penicillin-destroying) were passaged 40 to 50 times on Celbenin¹ditch plates.

All strains developed an increase in resistance to Celbenin and eight strains (four penicillin-sensitive and four penicillin-destroying) were able to grow in 100 μg/ml. or more Celbenin. Resistance was of the drug-tolerant type and none of the cultures inactivated Celbenin. There was an associated increase in tolerance to benzyl penicillin.

The highly Celbenin-resistant cultures isolated from penicillin-destroying staphylococci were in sharp contrast to those from penicillin-sensitive strains, as well as to penicillin G-tolerant staphylococci isolatedin vitro, because they retained the cultural characteristics, coagulase and haemolytic activity, and mouse virulence of the parent strains, and the degree of resistance remained stable after repeated passage in the absence of Celbenin.

Three naturally occurring Celbenin-resistant strains ofStaph. pyogenesisolated from infective processes were also studied. All three strains grew luxuriantly in concentrations of Celbenin up to 12·5 μg/ml. but very poorly in higher concentrations.

The possible significance of these findings is discussed.

The severe acute respiratory syndrome (SARS)-coronavirus-2 (CoV-2) outbreak in Wuhan, China has now spread to many countries across the world including the UK with an increasing death toll. This will inevitably lead to an increase in the number of suspected coronavirus disease 2019 (COVID-19)-related deaths at autopsy. The Royal College of Pathologists has responded to this concern with the release of a briefing on autopsy practice relating to COVID-19. The following article is a summary and interpretation of these guidelines. It includes a description of hazard group 3 organisms, the category to which SARS-CoV-2 has been assigned, a brief description of what is currently known about the pathological and autopsy findings in COVID-19, a summary of the recommendations for conducting autopsies in suspected COVID-19 cases and the techniques for making the diagnosis at autopsy. It concludes by considering the clinicopathological correlation and notification of such cases.