Cytologic examination of the breast: a safe, simple, and accurate technique

Aspiration cytology of the breast is a rapid, accurate diagnostic technique which can be easily and safely performed in the physician's office in conjunction with clinical examination of the breast. When evaluated by an experienced pathologist, cytologic preparations are useful in assessing solid masses in the breast or abnormal secretions of the nipple. The procedure has few complications, and spread of tumor cells along the needle track is not likely.     

Diagnostic cytology for detection of early cancer

Cytologic methods for detection of early cancers of the uterine cervix, lung and various other organs are discussed. The scraping smear method using a spatula is more effective than the cotton swab or vaginal pool smear method for detection of preinvasive intraepithelial lesions, such as, carcinoma in situ and dysplasias of various degrees of the uterine cervix. The use of sputum specimens pooled for three to five days is recommended for cytologic examination in population screening of lung cancer. Good cytopreparatory techniques, suitable screening and cytodiagnostic classifications of malignancy are also described and emphasized, especially, the importance of properly fixed cytologic material for correct cytopathological diagnosis.     

Nuclear medicine approach for the detection and characterization of liver metastasis

Nuclear Medicine procedures include in vitro techniques able to detect and characterize liver metastases. Among the in vitro applications, circulating tumour markers level determination provides information about the response to therapy and the presence of active disease. While after a successful antineoplastic treatment the serum biological marker level usually falls, a progressive increase represents an alarm signal of occult/residual tumour or metastatic dissemination. However, this method is not able to identify the site of the lesion, therefore complementary imaging techniques are needed to confirm or exclude the diagnostic suspicion. The main advantages of the in vitro methods are the low cost and, consequently, the possibility of periodically checking of tumour activity. The in vivo nuclear medicine techniques are usually performed as second level test. In fact, they can play a role in detecting and characterizing hepatic metastases when radiological methods are inconclusive or when selected tumour seeking agents (i.e. radiolabelled antibodies, radioiodinated mIBG, Octreotide, etc.) can be used. Moreover, the introduction of PET procedures has provided physicians with a useful tool for the evaluation of tumour behaviour (glucose consumption, proteic, synthesis, receptor expression). A further significant diagnostic improvement is represented by the recent introduction of the multimodality co-registration of images (including CT scan, MRI, SPET, PET). The fusion imaging allows a superimposition of the functional and metabolic information to the morphological one.     

Nuclear medicine approaches for detection of axillary lymph node metastases

Rhopalosiphum padi virus (RhPV) is an aphid virus that has been considered a member of the Picornaviridae based on physicochemical properties. The 10,011-nt polyadenylated RNA genome of RhPV was completely sequenced. Analysis of the sequence revealed the presence of two open reading frames (ORFs). The predicted amino acid sequence of ORF1, representing the first 6600 nt of the RhPV genome, showed significant similarity to the nonstructural proteins of several plant and animal RNA viruses. Direct sequence analysis of the RhPV capsid proteins showed that ORF2, which represents the last 2900 nt, encodes the three structural proteins (28, 29, and 30 kDa). The predicted amino acid sequence of ORF2 is very similar to the corresponding regions of Drosophila C virus, Plautia stali intestine virus, and to a partial sequence from the 3' end of the cricket paralysis virus genome. The site of initiation of protein synthesis for ORF2 could not be determined from the amino acid and nucleotide sequences. ORF1 is preceded by 579 nt of noncoding RNA and the two ORFs are separated by more than 500 nt of noncoding RNA. Like picornaviruses, these regions may function to facilitate the cap-independent initiation of translation of the two ORFs. These data suggest that RhPV, Drosophila C virus, Plautia stali intestine virus, and probably cricket paralysis virus are members of a unique group of small RNA viruses that infect primarily insects.     

Bone scintigraphy in the detection of chronic recurrent multifocal osteomyelitis

In this study, we describe the importance of the whole-body bone scan in diagnosing the multifocality of chronic recurrent multifocal osteomyelitis (CRMO) and in distinguishing it from unifocal acute hematogenous osteomyelitis. MATERIALS: The medical records and two-phase, whole-body bone scans of 14 patients (mean age 10.5 yr) with the diagnosis of CRMO, were retrospectively reviewed. The diagnosis of CRMO was based on bone biopsy in 9 patients and clinical course/laboratory findings in 5. Bone scans were evaluated for geographic and anatomic locations of their lesions. Correlative radiographs of areas of abnormal uptake were performed to assess the radiographic appearance of the lesions. RESULTS: The presentation of the disease was localized to one painful, tender and swollen periarticular site 86% of the time. The number of lesions detected by bone scan varied from 1-18 (mean 6). Most lesions were metaphyseal, proximal or distal tibial lesions. Purely sclerotic or mixed (sclerosis and lysis) lesions were found on radiographs. Bilateral lesions were seen in 64% of patients. Biopsies were negative for organisms in all patients and exhibited subacute or chronic histologic changes in most instances. Complications of chronic hyperemia included marked overgrowth (5), diffuse demineralization (1), angular deformity (1) and length discrepancy (1). CONCLUSION: The identification of the multifocal configuration of the disease process by two-phase (soft-tissue and delayed) whole-body bone scintigraphy results in appropriate diagnosis and therapy of CRMO. Additional sites for possible bone biopsy become apparent for exclusion of other diagnoses. Supportive (nonsteroidal, anti-inflammatory medication) instead of antimicrobial therapy can be initiated with significant cost savings.     

Myocardial contrast echocardiography: reliable, safe, and efficacious myocardial perfusion assessment after intravenous injections of a new echocardiographic contrast agent

Reliable and reproducible myocardial opacification after intravenous administration of echocardiographic contrast agents has remained elusive. This study was performed to determine whether a new agent, FS069, a suspension of perfluoropropane-filled albumin microspheres (3.6 microns average microbubble size, concentration 8 x 8(8)/ml), could achieve safe and successful myocardial opacification in open-chest dogs. Seventeen dogs (group 1, n = 7, group 2, n = 10) underwent two-dimensional echocardiography before, during, and after the administration of intravenous FS069. Safety was evaluated by measuring arterial and pulmonary artery pressures, heart rate, blood gases, systolic function, myocardial blood flow, and postmortem analysis of myocardial viability by triphenyl-tetrazolium chloride staining. Efficacy to detect changes in regional myocardial perfusion was assessed by injecting FS069 at baseline, after sequential coronary occlusions and reperfusion, and during intravenous vasodilators with and without coronary occlusions. Results were compared with radiolabeled microspheres. FS069 was found to be safe and effective. In the absence of coronary occlusions, uniform myocardial opacification was observed in all dogs. A perfusion defect was observed in all dogs during coronary occlusions. Background-subtracted peak contrast intensity in the myocardium correctly identified regional myocardial blood flow changes and showed a significant correlation with radiolabeled microspheres (r = 0.65, p = 0.0001).     

Inhaled nitric oxide in primary pulmonary hypertension: a safe and effective agent for predicting response to nifedipine

OBJECTIVES: The purpose of this study was to assess the utility of inhaled nitric oxide (NO), a selective pulmonary vasodilator, for predicting the safety and acute hemodynamic response to high-dose oral nifedipine in primary pulmonary hypertension (PPH). BACKGROUND: A significant decrease in pulmonary vascular resistance with an oral nifedipine challenge is predictive of an improved prognosis, and potential clinical efficacy in PPH. However, the required nifedipine trial carries significant first-dose risk of hypotension. While inhaled NO has been recommended for assessing pulmonary vasodilator reserve in PPH, it is not known whether it predicts the response to nifedipine. METHODS: Seventeen patients with PPH undergoing a nifedipine trial were assessed for hemodynamic response to inhaled NO at 80 parts per million for 5 minutes. The nifedipine trial consisted of 20 mg of nifedipine hourly for 8 hours unless limited by hypotension or intolerable side effects. Patients were classified as responders and nonresponders with positive response defined as > or =20% reduction in mean pulmonary artery pressure (mPA) or pulmonary vascular resistance (PVR) with the vasodilator administration. RESULTS: NO was safely administered to all participants. Seven of 17 (41.2%) responded to NO, and 8 of the 17 to nifedipine (47.1%). Nifedipine was safely administered in 14 of the 17. Three suffered either mild or severe hypotension, including one death. All NO responders also responded to nifedipine, and 9 of the 10 NO nonresponders were nifedipine nonresponders, representing a sensitivity of 87.5%, specificity of 100%, and overall predictive accuracy of 94%. All NO responders tolerated a full nifedipine trial without hypotension. There was a highly significant correlation between the effects of NO and nifedipine on PVR (r=0.67, p=0.003). CONCLUSIONS: The pulmonary vascular response to inhaled NO accurately predicts the acute hemodynamic response to nifedipine in PPH, and a positive response to NO is associated with a safe nifedipine trial. In patients comparable with those evaluated, a trial of nifedipine in NO nonresponders appears unwarranted and potentially dangerous.     

4-iodotamoxifen aziridine, a new affinity labeling agent for the rapid detection of estrogen receptor isoforms

During the past few years significant progress has been made in the treatment of cutaneous melanoma. These developments often involve the use of interferon-alpha (IFNalpha). Promising results have been reported in high risk patients using adjuvant treatment with high dose IFNalpha. A confirmatory trial of high dose IFNalpha and several adjuvant trials using low or intermediate dose IFNalpha are ongoing, and currently a standard regimen cannot be defined. High response rates have been reported in patients with metastatic disease with combination chemoimmunotherapy schedules. Randomized trials have to be performed in order to demonstrate a survival benefit over less toxic regimens. In this paper the current status of IFNalpha in the treatment of cutaneous melanoma is reviewed.     

The Diagnostic Inventory for Screening Children: Psychometric, factor, and validity analyses.

Reviews normative data from 571 Ss for the Diagnostic Inventory for Screening Children (DISC) developed by J. A. Amdur et al (1988). Concurrent and construct validity of the DISC are also reported, based on data from 40 children who were referred to community agencies for assessment of developmental delays and workers from the agencies. Reliability data indicate substantial agreement and stability within the DISC. Validity data shows that the DISC was more likely to lead to a referral than the Denver Developmental Screening Test or the Stanford-Binet Intelligence Test—Third Edition. Factor analyses indicate that a common factor model with 1 factor was a good fit to most age groups, especially those under age 3 yrs. Limitations of the DISC are discussed. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The development of criteria of safe operation for groups.

Rejecting as inadequate accident rate data to describe the safe operation of military motor vehicle units, two evaluation devices were developed: a Safety Factors Rating calling for rating unit performance on 16 aspects of safety, and a Criterion Ranking Form requiring ranking units from "best" to "worst." Ratings and rankings were obtained for 93 units, the 16 high and 16 low units were identified, and the numbers and kinds of damages reported on Vehicle Damage Reports were compared. After adjustment for relative use, the percent damages were significantly different for all vehicle types combined, but for only one of the six vehicle categories considered. "… it is concluded that the subjective rating criterion has real validity." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Blinded, externally controlled multicenter evaluation of light microscopy and PCR for detection of microsporidia in stool specimens. The Diagnostic Multicenter Study Group on Microsporidia

The quality parameters for the detection of microsporidia in identical sets of 50 stool samples were determined for six laboratories where technicians used light microscopy and for six laboratories where technicians used PCR. The average overall sensitivities were 67% (89% for patient samples only) for the PCR laboratories and 54% (80% for patient samples only) for the light microscopy laboratories. Specificities were 98 and 95%, respectively. Differences in results were most apparent between the individual laboratories rather than between the two major methods used.     

Anatomically accurate, finite model eye for optical modeling

There is a need for a schematic eye that models vision accurately under various conditions such as refractive surgical procedures, contact lens and spectacle wear, and near vision. Here we propose a new model eye close to anatomical, biometric, and optical realities. This is a finite model with four aspheric refracting surfaces and a gradient-index lens. It has an equivalent power of 60.35 D and an axial length of 23.95 mm. The new model eye provides spherical aberration values within the limits of empirical results and predicts chromatic aberration for wavelengths between 380 and 750 nm. It provides a model for calculating optical transfer functions and predicting optical performance of the eye.     

Accuracy of accurate empathy ratings.

Studied the accuracy of accurate empathy ratings among 31 counseling graduate students by comparing 2 sets of ratings made under different experimental conditions with each other and with a predefined criterion of accuracy. 10 counselor-client exchanges representing excerpts from a single interview were deliberately constructed to represent 2 interactions at each level of the 5-point Accurate Empathy Scale. 2 groups of raters differing in amount of prior client information rated the exchanges. Data indicated that the 17 informed raters were significantly more accurate in their ratings than 14 noninformed raters and significant discrepancies in ratings occurred at the higher scale points of the Accurate Empathy Scale. Implications and suggestions for using this scale are discussed. (17 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Diagnostic procedure in cholecystolithiasis. Diagnostic approach, repeat examinations and (incidental) findings

If non-surgical methods are to be taken into account in the therapeutic decision-making process in cholecystolithiasis, an expanded diagnostic work-up including not only stone parameters but also gallbladder function, is needed. In 2270 patients (1649 women, 621 men; age: 47.2 +/- 14 years) with (suspected) "cholecystolithiasis" attending the special gallstone outpatient clinic at a university medical department within a period of 5 years the diagnostic procedures most commonly used in both the doctor's office and hospital were abdominal ultrasonography (52%/78%), laboratory investigations (28%/39%) and plain films of the biliary tract (27%/39%). In the doctor's office gallbladder function testing took the form of an cholecystogram (17% of the patients); in the hospital ultrasonography to determine gallbladder contractility (38%). With decreasing frequency, the following additional procedures were carried out (office/hospital): CT 3%/19%, esophagogastroduodenoscopy 7%/3%, intravenous cholegram 6%/0.6%, abdominal X-ray 1%/0.4%, ERCP 1%/0.4%, chest X-ray 0.8%/1.6%. Duplicated examinations showed a relevant frequency only for ultrasonography (39% of the cases), laboratory investigations (18%) and plain films of the gallbladder (4%). Pathologic secondary findings were established in 22% of the cases.