bluuebunny/crossref_metadata_2025 huggingface dataset:
Increased serum reverse triiodothyronine levels at diagnosis of hepatocellular carcinoma in patients with compensated HCV‐related liver cirrhosis
Authors: Sorvillo Francesca , Mazziotti Gherardo , Carbone Antonella , Morisco Filomena , Cioffi Michele , Rotondi Mario , Stornaiuolo Gianfranca , Amato Giovanni , Gaeta Giovanni B. , Caporaso Nicola , Carella Carlo
Published: March 2003

objective The aim of this study was to investigate changes in thyroid hormone metabolism in relation to the development of hepatocellular carcinoma (HCC) in patients with HCV‐related liver cirrhosis.

materials and methods The study group (Group A) comprised 31 patients (25 M, 6 F; median age 62·1 years, range 54·0–81·5 years) affected by HCV‐related liver cirrhosis with superimposed HCC. Acute and chronic systemic disease, other than cirrhosis, inducing ‘euthyroid sick syndrome’ was excluded in all patients. Serum TSH, FT4, FT3, rT3, and thyroxine‐binding globulin (TBG) levels were retrospectively evaluated in frozen aliquots drawn at the time of tumour diagnosis and every 6 months for 3–7 years before HCC diagnosis. The control group (Group B) comprised 29 patients affected by HCV‐related liver cirrhosis without HCC, matched for sex, age and grade of liver dysfunction.

results At the time of HCC diagnosis, all patients in Group A were euthyroid with serum TSH, FT4, FT3 and TBG values not significantly different from those of cirrhotic patients of Group B. However, at diagnosis Group A patients had serum rT3 values that were significantly higher than those in Group B (35·0 ng/dl, range 12·0–162·0 vs. 19·0 ng/dl, range 10·0–51·0; Group A vs. Group B; P < 0·001). Serum rT3 values above the normal range were found in 12 patients in Group A (38·7%) but in only one of the patients from Group B (3·4%) (χ2 10·2; P = 0·001). The serum rT3 levels were not significantly correlated to the Child grade of liver cirrhosis (rho 0·1; P = 0·5). The intrasubject analysis demonstrated that a significant increase in serum rT3 levels occurred at the time of HCC diagnosis but serum FT4, FT3 and TSH values did not change significantly. A receiver operating curve (ROC) demonstrated that a 6‐monthly increase in serum rT3 levels of at least +22·5% identified patients with HCC with a diagnostic accuracy of 81·7%.

conclusions Our study has demonstrated that development of hepatocellular carcinoma is accompanied by a significant increase in serum rT3 levels in patients with low‐grade HCV‐related liver cirrhosis who had no other illness causing the ‘euthyroid sick syndrome’.
Selectivity of superficial vein occlusion at the ankle and calf level: a methodological study in healthy volunteers
Authors: Zachrisson  , Volkmann  , Bergerheim  , Holm
Published: March 2003

Judgement of deep venous function may be necessary before surgery for superficial vein incompetence is performed. Assessment of deep venous function needs selective entrapment of superficial venous compartments between the ankle and knee, which may not be guaranteed if conventional tourniquets are used. This study was, therefore, aimed at modifying the technique of selective compression of superficial vein compartments. Twenty apparently normal legs of 10 volunteers were investigated on two study days. The subjects were in a supine position with the feet resting 30 cm above heart level. Ankle cuffs (3 cm wide) were placed just above the malleoli and stepwise inflated with air. The steady‐state venous volume of the forefoot as a function of the pressure within the ankle cuff was measured with a mercury‐in‐rubber strain gauge. The maximum venous outflow velocity from the foot was also measured at each cuff pressure step after the addition of conventional thigh vein occlusion. The same protocol was used on the second study day: calf cuffs (3 cm wide) were then used instead of the ankle cuffs. In the forefoot, venous volume increased and the maximum venous outflow velocity decreased significantly either at ankle cuff pressures >30 mmHg or at calf cuff pressures of >60 mmHg. By using small cuffs, selective superficial vein occlusion seems to occur at cuff pressures ranging between 10 and 30 mmHg (ankle) and between 30 and 60 mmHg (calf), provided the feet are 30 cm above heart level. Higher cuff pressures seem to interact with deep venous function.
Detection of patent foramen ovale by transcranial Doppler and carotid duplex ultrasonography: a comparison with transoesophageal echocardiography
Authors: Nygren Anders T. , Jogestrand Tomas
Published: March 2003

Patients who have suffered a transient ischaemic attack or minor stroke are examined thoroughly to determine the aetiology of the cerebrovascular incident. An examination of the carotid arteries is compulsory to detect significant stenosis. In some patients, cardiogenic sources of emboli may be suspected. This study examined the possibilities of screening for patent foramen ovale (PFO) using i.v. injection of a microbubble solution with Doppler monitoring of the internal carotid artery (ICA) and the middle cerebral artery (MCA). Transoesophageal echocardiography (TEE) served as the gold standard. Twenty‐three patients with a recent episode of cerebral ischaemia were examined: 12 patients with and 11 without PFO documented by TEE. After i.v. injection, microbubbles were monitored visually in the right and left atria and using Doppler sonography in the right ICA and in the right MCA. In the group with a PFO (n = 12), microbubbles were detected in the ICA in seven patients (7 of 12) and in the MCA in 10 patients (10 of 10). In the group without a PFO, microbubbles were detected in the ICA in one patient and in the MCA in two. This corresponds to a sensitivity and specificity, respectively, of 58% and 91% for the ICA/duplex technique and 100% and 82% for the MCA/transcranial Doppler technique. From this limited sample, it is shown that transcranial Doppler monitoring of the middle cerebral artery, but not ultrasound duplex monitoring of the internal carotid artery, can be used as screening for patent foramen ovale.
Glucose metabolism in chronic diabetic foot ulcers measured in vivo using microdialysis
Authors: Simonsen Lene , Holstein Per , Larsen Kirsten , Bülow Jens
Published: March 2003

Ten subjects with diabetes mellitus and unilateral chronic foot ulcer were investigated. Local tissue concentrations of glucose and lactate were measured using the microdialysis method at a distance of 0·5–1 cm from the edge of the ulcer and in normal skin in the contralateral foot. Subcutaneous blood flow in the area investigated was measured using the 133Xe‐washout technique. The interstitial glucose concentration in the ulcer was found to be lower than in intact skin (8·0 ± 1·0 mmol l−1 vs. 8·5 ± 1·1 mmol l−1) (P<0·02), and the interstitial lactate concentration was higher in the ulcer than in intact skin (3·2 ± 0·2 mmol l−1 vs. 2·1 ± 0·3 mmol l−1) (P<0·01). The subcutaneous blood flow was on average 40% higher in the ulcer than in the intact skin. The calculated local glucose uptake and lactate outputs were twofold higher in the ulcer than in the intact skin. However, the molar ratio between lactate output and glucose uptake was approximately two, both in the ulcer and in the intact skin, indicating that the glucose metabolism was qualitatively the same in the two regions.
Distribution of ventilation‐to‐perfusion ratios analysed in planar scintigrams of emphysematous patients
Authors: Xu  , Moonen  , Johansson  , Bake
Published: March 2003

The aim of the present study was to develop and evaluate a method for semi‐quantification of ventilation‐to‐perfusion ratios in small regions in planar pulmonary scintigrams using 99mTc‐Technegas (Tetley Manufacturing Ltd, Sydney, Australia) and 99mTc‐macro‐aggregated human albumin. Eight emphysematous patients and eight healthy volunteers were investigated in the supine position. Anterio‐posterior and posterio‐anterior images of ventilation and ventilation‐and‐perfusion were acquired consecutively. Perfusion images were obtained by subtracting the corrected ventilation images from ventilation‐and‐perfusion images. Lung regions of interest were divided into 2·03 × 2·03 cm regions. The ratio of normalized counts of ventilation‐to‐perfusion (V/Q) was calculated in each square region. The log (V/Q)s of healthy volunteers were distributed symmetrically and similarly around 0, whereas the corresponding ratios in patients distributed unevenly. The standard deviations of log (V/Q)s were significantly higher in patients than in healthy volunteers. Parametric images of V/Q distribution were constructed to visualize the magnitude and location of ‘waste ventilation’ and ‘shunt’ effects. In conclusion, the present semi‐quantitative method is validated by confirming the expected dispersed V/Q distribution in emphysematous patients compared to healthy volunteers.
Can stroke volume and cardiac output be determined reliably in a tilt‐table test using the pulse contour method?
Authors: Nieminen T. , Kööbi T. , Turjanmaa V.
Published: March 2003

The applicability of the finger pressure‐derived pulse contour (PC) technique was evaluated in the measurement of stroke volume (SV), cardiac output (CO) and their changes in different phases of the tilt‐table test. The reference method was whole‐body impedance cardiography (ICG). A total number of 40 physically active patients, aged 41 ± 19 years, were randomly chosen from a pool of 230. Specifically speaking, 20 of the patients experienced (pre)syncope (tilt+ patients) during the head‐up tilt (HUT), and 20 did not (tilt–). A total number of three measurement periods, 30–60 s each, were analysed: supine position, 5 min after the commencement of HUT, and 1 min before set down. SV and CO values measured by PC underestimated significantly those measured by ICG (biases ± SD 19 ± 14 ml and 1·55 ± 1·14 l min–1, respectively) in agreement with earlier reports. The bias between the methods was almost the same in the different phases of the test. However, the SD of the bias was bigger for tilt+ (P<0·05). When the bias between the methods was eliminated by scaling the first measurement to 100%, the agreement between the methods in the second and third measurements was clearly better than without scaling. Both methods showed a physiological drop in SV after the commencement of HUT. These results indicate that PC suffices in tracking the changes in CO and SV, but for absolute values it is not reliable.
Coronary flow reserve: measurement with transthoracic Doppler echocardiography is reproducible and comparable with positron emission tomography
Authors: Saraste M. , Koskenvuo J. W. , Knuuti J. , Toikka J. O. , Laine H. , Niemi P. , Sakuma H. , Hartiala J. J.
Published: March 2003

Detection of early vascular changes indicated by lowered coronary flow reserve (CFR) would allow early treatment and prevention of atherosclerosis. The purpose of this study was to test whether it is possible to reproducibly measure CFR with transthoracic Doppler echocardiography (TTE) in healthy volunteers. We measured CFR using dipyridamole infusion in ten healthy male volunteers with two methods: TTE and positron emission tomography (PET) with oxygen‐15‐labelled water (group A). However, CFR was assessed twice with TTE in eight healthy male volunteers (group B) to study the reproducibility of this method. We compared CFRs obtained using TTE flow measurements in the left anterior descending coronary artery (LAD) and PET flow measurements in the corresponding myocardial area. Coronary flow in LAD could be measured in all subjects using TTE. By TTE, an average CFR based on peak diastolic flow velocity (PDV) was 2·72 ± 1·16, mean diastolic flow velocity (MDV) 2·56 ± 1·06 and velocity time integral (VTI) 1·87 ± 0·49. The results were reproducible in two repeated TTE studies (coefficient of variation in MDV 6·1 ± 4·3%,n=8). By PET, CFR was 2·52 ± 0·84. CFR assessed by TTE correlated closely with that measured by PET (MDVr=0·942,P<0·001; PDVr=0·912,P<0·002 and VTIr=0·888,P<0·006) and intraclass correlation was 0·929 (MDV) and tolerance limits for differences of CFRs was −0·78 to 0·72. We show that CFR measured by TTE has an excellent correlation with CFR measured by PET. We also found that TTE measurements of CFR were highly reproducible.
Evaluation of various electrocardiographic criteria for left ventricular hypertrophy in patients with stable angina pectoris: influence of using modified limb electrodes
Authors: Malmqvist Karin , Kahan Thomas , Eriksson Sven , Björkander Inge , Held Claes , Forslund Lennart , Rehnqvist Nina , Hjemdahl Paul
Published: March 2003

Background: Left ventricular hypertrophy (LVH) in coronary heart disease is associated with poor prognosis. Electrocardiography (ECG) criteria for LVH, when using ECG with modified limb electrode positions, has not been validated in patients with angina pectoris. Methods: Echocardiography and resting ECGs with modified limb electrode positions, i.e. with the limb leads placed on the abdomen instead of the extremities, were registered from 468 patients (295 men) with stable angina pectoris. To evaluate the influence of using modified limb electrode positions, ECGs with standard and modified limb electrode positions were compared in a control group consisting of 50 other patients. Results: The ECG criteria for LVH according to the Perugia score, the Minnesota code and Romhilt & Estes reached the highest sensitivity values, 27–31% in men and 24–38% in women, while the sensitivities of different Cornell criteria were as low as 6–10% in men and 19–29% in women. In the control group, the R‐ and S‐wave amplitudes of the precordial leads were only slightly changed, as expected, whereas those of the limb leads changed considerably. Based on these results, we corrected aVL in the main study, which increased the sensitivity of the Cornell voltage criteria from 15 to 30%, while the specificity was maintained at 95%. Conclusions: ECGs registered with modified limb electrode positions can be used to detect LVH with traditional ECG criteria, but changes in the limb leads are considerable and influence the sensitivities.
Temporal age‐related changes in spectral, fractal and complexity characteristics of heart rate variability
Authors: Jokinen Vesa , Syvänne Mikko , Mäkikallio Timo H. , Airaksinen K. E. Juhani , Huikuri Heikki V.
Published: March 2003

Cross‐sectional studies have suggested that heart rate (HR) variability, analysed using traditional time and frequency domain methods, is related to ageing, but no longitudinal studies have estimated the age dependence of HR fluctuation. This study evaluated temporal age‐related changes in 12‐h measures of HR variability among 109 patients with coronary artery disease (CAD), who underwent repeat Holter recordings at 32‐month intervals. Time and frequency domain measures, along with fractal and complexity measures of HR variability, were determined at the baseline and after 32 months. Changes in HR dynamics were compared with various laboratory variables, exercise data and angiographic progression of CAD. Traditional time and frequency domain measures of HR variability did not change significantly during the follow‐up, but the power‐law scaling slope decreased from −1·29 ± 0·20 to −1·36 ± 0·23 (P<0·01) and the short‐term fractal exponent (α1) of HR dynamics from 1·29 ± 0·14–1·22 ± 0·18 (P<0·001). The approximate entropy value also decreased from 1·00 ± 0·19 to 0·95 ± 0·18 (P<0·05). The changes in HR behaviour were not related to demographic data, laboratory values or angiographic progression of CAD. Only a weak correlation was observed between the change in the power‐law slope and the baseline glucose value (P<0·05). This longitudinal study shows that the fractal characteristics of HR dynamics and the complexity properties of R‐R intervals undergo rapid changes along with ageing, and that fractal and complexity analysis techniques are more sensitive than traditional analysis methods in documenting temporal age‐related changes in HR behaviour.
Intracellular pH, intrauterine growth and the insulin resistance syndrome
Authors: Pinkney Jonathan H. , Vernon Paul , Carstensen Elin , Gillies Sheona , Phillips David I. W. , Yudkin John S.
Published: March 2003

Defects of both sodium–hydrogen exchange (NHE) and sodium–lithium countertransport (SLC) have been described in subjects at increased risk of coronary heart disease (CHD). Sodium transport is linked to the regulation of cell volume, intracellular pH and cell growth, which may explain aspects of this association. However, impaired growth in early life is also linked to adult CHD, and ‘programmed’ alterations of cell behaviour are postulated to be responsible for this. In this study, therefore, we examined whether NHE or SLC in adults are predicted by anthropometric measures at birth, as well as being associated with insulin resistance syndrome (IRS) variables in adulthood. Red cell SLC was measured in 26 adults, and NHE in dermal fibroblasts from another 15 subjects characterized anthropometrically at birth. SLC activity correlated with LDL cholesterol, triglycerides and urate (r=0·42 – 0·49; 0·05 > P>0·01), but not birth anthropometry. NHE Vmax correlated with plasma insulin (r=0·80; P<0·001), but birth weight was unrelated to Vmax, Km or Hill coefficient for H+i. However, pHi correlated with birth weight (r=0·74; P=0·002), insulin sensitivity (r=0·52; P<0·05), fasting glucose (r=–0·52; P<0·05) 2 h insulin (r=0·51; P<0·05) 2 h glucose (r=–0·54; P<0·05). In conclusion, red cell SLC is related to IRS variables, but not with birth weight measures. In contrast, low intracellular pHi is related to both low birth weight and adult insulin resistance, suggesting it might be a ‘programmed’ cell phenotype, although this is not apparently explained by altered NHE kinetics.
Heart rate dynamics and cardiorespiratory coordination in diabetic and breast cancer patients
Authors: Bettermann H. , Kröz M. , Girke M. , Heckmann C.
Published: March 2003

Objective of this study was to evaluate cardiac autonomic function in female breast cancer patients on the basis of linear and non‐linear heart rate variability (HRV) as well as on musical heart rate rhythmicity. The latter method has been recently developed and enables particularly the quantification of cardiorespiratory coordination solely on the basis of ECG recordings. To provide a broad basis of comparability, 37 breast cancer patients were compared with 37 age‐matched healthy women and 40 age‐matched female diabetic patients who serve as pathological controls. During night sleep, all parameters showed a tendency towards lower variability, complexity or rhythmicity of HRV in cancer patients. The most prominent alterations were found for the binary pattern predominance (PP) and for the ratio of heart rate and respiration. In particular, when comparing metastasized and non‐metastasized cancer patients, the discriminatory power of binary heart rate rhythmicity emerges: the histograms of 1‐h intervals during night sleep with a predominance of cyclically recurrent phase locking patterns unveiled a clear transition from higher to lower cardiorespiratory coordination ratios and to a loss of coordination capability in metastasized patients.
Effect of flow and vascular heterogeneity on glucose metabolism in isolated dog hearts
Authors: Kuikka J. T.
Published: March 2003

In non‐ischaemic myocardium glucose uptake is assumed to be proportional to blood flow. We investigated the effect of regional vascular heterogeneity on glucose metabolism at various flow rates in the isolated blood‐perfused dog hearts. Aortic bolus injections contained an intravascular reference tracer (albumin) and two of three glucoses: L‐glucose (an extracellular tracer), D‐glucose and 2‐deoxy‐D‐glucose. Flow ranged from 0·5 to 2·4 ml min–1 g–1. Vascular heterogeneity was calculated from the albumin outflow dilution curve. A three‐region, convection‐diffusion model was fitted to outflow dilution curves to estimate glucose metabolic rate (consumption). The results of 2‐deoxy‐D‐glucose experiments showed that the lumped constant was dependent on flow, glucose metabolic rate was proportional to flow and dependent on the heterogeneity of the myocardial vasculature. The results support the views that without accounting the regional flow heterogeneity, glucose metabolic rate will be underestimated.
Fine needle aspiration biopsy of the spleen in pyrexia of unknown origin
Authors: Rajwanshi A. , Gupta D. , Kapoor S. , Kochhar R. , Gupta† S. , Varma† S. , Gupta S.
Published: March 2003

Fine needle aspiration biopsy of the spleen in pyrexia of unknown origin

To evaluate the diagnostic utility, value and potential risk of fine needle aspiration biopsy of spleen (sFNAB) in patients with splenomegaly in pyrexia of unknown origin (PUO), a retrospective analysis of medical records and cytological material of 31 patients on whom FNAB was performed between April 1994 and October 1997 was done. The patients were HIV− and presented with PUO. All other relevant investigations were negative. The spleen was either palpable or detected to have space‐occupying lesions on ultrasonography (USG). The splenic aspirates showed tuberculosis in 11 patients (35.4%) and inconclusive or reactive changes in nine patients (25.8%). One case out of this group proved to be Kaposi's sarcoma on autopsy. The other diseases encountered were leishmaniasis (n = 3), non‐Hodgkin's lymphoma (n = 4), fungal infections (n = 2), Hodgkin's lymphoma (n = 1). The patients who were diagnosed as having tuberculosis had epithelioid cells, giant cells, necrosis and inflammatory cells in various combinations. AFB positivity was 63.6%. The other cases which showed granulomas but no AFB were diagnosed on empirical grounds and all responded to the anti‐tuberculosis therapy. No complications were encountered with the procedure. Therefore the authors conclude that sFNAB is rewarding in patients where all other non‐invasive modalities of diagnosis have failed.
Improved fine needle aspiration (FNA) cytology results with a near patient diagnosis service for breast lesions
Authors: Dray M. , Mayall F. , Darlington A.
Published: March 2003

Improved fine needle aspiration (FNA) cytology results with a near patient diagnosis service for breast lesions

This study is a review of the quality of FNA cytology results for breast lesions approximately 18 months before and 10 months after a change from a rapid diagnosis FNA service with consultant pathologist aspirators to a conventional FNA service with clinician aspirators of varied experience. The setting was symptomatic breast clinic in a large hospital in rural New Zealand acting as a tertiary referral centre for a population of 550000. The results were collected retrospectively and prospectively. The quality of results for pathologist aspirators (total 810) and clinician aspirators (total 403) was compared using the definitions of the NHS Breast Screening Program Guidelines for Cytology Procedures and Reporting in Breast Cancer Screening. There were statistically significant differences in specificity (biopsy cases only) with 73% for pathologists and 49% for clinicians, specificity (full) with 74% and 56%, inadequate rate with 23% and 37%, and complete sensitivity with 76% and 67%. The use of pathologist aspirators allowed the specimens to be reported in a few minutes. Specimens taken by clinicians took at least 30 min to report. The financial aspects of the two approaches are discussed. When compared with clinician aspirators, pathologist aspirators obtained better quality results and these were reported more quickly.
Exact Touch: a new device for cervical cytology. Comparison with Ayre spatula plus Cytobrush
Authors: De Palo G. , Stefanon B. , Alasio L. , Polotti S.
Published: March 2003

Exact Touch: a new device for cervical cytology. Comparison with Ayre spatula plus Cytobrush

Exact Touch® is a new plastic device for the collection of cells from the ectocervix and endocervix. A total of 189 consecutive women were evaluated, 94 with the Ayre/cytobrush and 95 with Exact Touch®. Sampling was performed by only one clinician, and the slides were analysed by only one cytotechnologist, who had no information about the sampling method. Our results showed that more endocervical and metaplastic cells were collected by Exact Touch® than by Ayre/cytobrush.
Educational Case Report Cervical cytology through the looking glass
Authors: Smith J. H. F.
Published: March 2003

Educational Case Report—Self‐Assessment

A 25‐year‐old woman underwent a routine cervical smear that was reported as showing borderline change. Six months later when 6 months pregnant she had a repeat smear. This is shown in Figure 1 (Pap., original mag. × 600.)

What is your opinion?

 For the correct answer please read the Educational Case Report (page 54).
Cervical screening: how often should women be screened?
Authors: Herbert A.
Published: March 2003

Introduction

As a result of major improvements that have been made to cervical screening during the last 15 years, and implementation of call and recall to invite all women aged 20–64 for screening, the incidence of cervical carcinoma has fallen by 42% since 19901. Cervical cancer is now a rare disease, largely thanks to the widespread uptake of screening by the women at risk. Despite the manifest success of the NHS Cervical Screening Programme (NHSCSP), there is pressure on one hand to improve its sensitivity by the introduction of new technology, including human papillomavirus (HPV) testing2, and on the other hand to reduce the cost of the programme, which is more than £130m per year. The main method suggested to reduce costs is the restriction of routine screening to an interval of 5 years3–5.
Scrape cell‐block technique for fine needle aspiration cytology smears
Authors: Kulkarni M. B. , Prabhudesai N. M. , Desai S. B. , Borges A. M.
Published: March 2003

Scrape cell block technique for fine needle aspiration cytology smears

An inconclusive diagnosis on fine needle aspiration cytology (FNAC) may be due to poor spreading and presence of thick tissue fragments despite aspiration of adequate material. Repeat aspiration may not be possible especially when aspirates of deep seated organs have been obtained by image guided techniques. We have resorted to a ‘scrape cell‐block’ (SCB) technique in such cases. In this technique the cellular material on the slides which had already been fixed and stained, was carefully removed by scraping following destaining and then processed as a cell block. SCB interpretation was then compared with the smear diagnosis and histological diagnosis, wherever available. A total of 27 cases were studied. In 12 cases SCB slides added information to the FNAC smears. In 14 cases SCB did not offer any additional information. SCB was inconclusive in one case. Final histological correlation was available in eight cases and the SCB diagnosis was confirmed in six cases, whereas in two cases SCB failed to identify the tumour. Immunocytochemistry (ICC) was done in one case. SCB is a useful technique to make the best use of the available material when reaspiration is difficult.
Fine needle aspiration cytodiagnosis of secretory carcinoma of the breast
Authors: Gupta R. K. , Kenwright D. , Naran S. , Lallu S. , Fauck R.
Published: March 2003

Fine needle aspiration cytodiagnosis of secretory carcinoma of the breast

Secretory carcinoma (SC) of the breast is a rare variant of breast malignancy and its cytological features in fine needle aspirates have only recently been described. In this communication, our experience with four cases of SC of the breast is presented in which the diagnosis was established on fine needle aspiration cytology (FNAC). In all cases, the samples were cellular and featured diffuse, prominent, intracytoplasmic vacuoles and secretion in malignant cells and occasional signet‐ring like forms. The cytodiagnosis of SC in all the cases correlated with subsequent examination of cell blocks of the aspirate and tissue. Cytochemical stains showed diffuse positivity for mucin by alcian blue stain in the vacuolated cells which was periodic acid–Schiff positive and resistant to diastase digestion. Oil‐red O staining was negative. Immunopositivity to carcinoembryonic antigen, cytokeratin (CAM 5.2), B72.3 and epithelial membrane antigen was found in malignant cells. The cytodiagnostic criteria for SC of the breast, characteristic cytological features which are useful in a correct FNAC diagnosis and differentiation from other pertinent breast carcinomas, are discussed.
Survey of smear taking practice in the former North Thames region
Authors: Al Awadhi R. , Coleman D. V.
Published: March 2003

Survey of smear taking practice in the former North Thames region

One hundred and seventy‐seven doctors and 161 nurses from 230 clinics responded to a questionnaire on smear taking practice. The responses show that 66% of smear takers use the Aylesbury spatula and 30% use the Ayre spatula. A total of 53% use a cytobrush for selected cases. Training of smear takers and preparation of smears was satisfactory. Most (but not all) smear takers routinely record clinical information on the request form. Only 20 cytology laboratories in the North Thames region (70%) provide additional feedback to the smear takers about the quality of their smears apart from the information on the request form. Our study shows that feedback is an area where interaction between the laboratory and smear taker could be encouraged.
Cytological evaluation of angiogenesis in endometrial aspirates
Authors: Ono M. , Shiina Y.
Published: March 2003

Cytological evaluation of angiogenesis in endometrial aspirates

We conducted a comparative study of angiogenesis observed in endometrial aspirates according to histological type. Cytological specimens from 14 cases of proliferative phase endometrium, 21 cases of endometrial hyperplasia and 18 cases of well‐differentiated endometrial adenocarcinoma were used in the investigation. Immunohistochemical staining was performed according to standard methods using CD34 monoclonal antibody, and new vessels were examined. New vessels were identified in all of the histological types, but no morphological differences were seen. New vessels were observed in more cases of adenocarcinoma than in cases of normal tissue or hyperplasia, and the differences were significant. The difference between the maximum and minimum rates of occurrence of cell clusters possessing new vessels tended to be greater in adenocarcinoma than in the other tissue types (P < 0.05). Based on the above findings, examination of new vessels appearing in aspirated endometrial specimens appeared to be of help in differential diagnosis, but it also seemed necessary to take changes due to the menstrual cycle etc. into consideration.
The Lepidoptera fauna associated with Calluna vulgaris: effects of plant architecture on abundance and diversity
Authors: Haysom K. A. , Coulson J. C.
Published: March 2003

Abstract.1. The effects of plant architecture on the Lepidoptera assemblage associated with heather Calluna vulgaris were studied at four locations in northern England and southern Scotland in 1992 and 1993. The study areas were Calluna vulgaris–Vaccinium myrtillus heaths, where management by rotational burning had created a mosaic of stands of different‐aged Calluna. Lepidoptera were sampled in the larval stage.

2. Larval abundance was considered in relation to Calluna age, height, cover, green shoot density, and flower density. For most study areas and species, multiple regression selected Calluna height as the variable that explained most variation in larval density, although the explanatory variables were intercorrelated.

3. After compensating for the effects of different study locations, the slope of the regression between the logarithm of larval density and the logarithm of Calluna height was common to the macrolepidoptera, microlepidoptera, geometrid, and noctuid larval groups.

4. There was a significant progressive increase in larval diversity with increase in Calluna height, due to the presence of uncommon moth species in the samples from taller Calluna, and a change in the contribution of common species to the community in different height zones.

5. The significance of these results is discussed in relation to other heathland invertebrate studies and management practices.
Parasitoid–host relationships when host size varies: the case of Pseudacteon flies and Solenopsis fire ants
Authors: Morrison Lloyd W. , Gilbert Lawrence E.
Published: March 2003

Abstract.1. Phorid flies in the genus Pseudacteon are parasitoids of ants. Variation in host size preferences of four South American and two North American Pseudacteon species on monogyne and polygyne forms of their host Solenopsis species [S. invicta Buren and S. geminata (F.), respectively] was documented.

2. Monogyne Solenopsis workers were, on average, significantly larger than polygyne workers, and the average size monogyne worker attacked was significantly larger than the average size polygyne worker attacked in four of the six Pseudacteon species.

3. Three South American Pseudacteon species attacked larger than average size workers, whereas one attacked smaller than average size workers, in both monogyne and polygyne forms. Both North American Pseudacteon species attacked larger than average size polygyne workers and smaller than average size monogyne workers.

4. Three Pseudacteon species were reared from eggs to adults in infected ants in the laboratory. The size of the emergent phorid fly was related positively to the size of the host worker ant, with females emerging from larger hosts. Similar patterns were documented for both monogyne and polygyne forms.

5. The mean size of worker host from which phorids emerged did not differ significantly between the monogyne and polygyne forms in the subsample of phorids reared to adults.

6. The observed patterns elucidate factors that may cause variation in Pseudacteon sex ratios, and have implications for biological control efforts of pest Solenopsis species.
Differences between understorey and canopy in herbivore community composition and leaf quality for two oak species in Missouri
Authors: Corff Josiane LE. , Marquis Robert J.
Published: March 2003

1. From July 1994 to September 1995, at six censuses, the herbivore community associated with understorey (< 2.5 m height) and canopy (15–20 m) leaves of Quercus alba and Q. velutina was sampled in south‐eastern Missouri, U.S.A.

2. Across all censuses, herbivore densities were not significantly different between canopy and understorey for Q. alba and Q. velutina, except in August 1994 when herbivore densities were 60% higher in the canopy on Q. alba. Little significant spatial variation in herbivore densities or community composition was found during the study years.

3. The herbivore community was diverse, consisting of 138 species of leaf‐chewing insects. Species richness was significantly greater (by 5–20%) in the understorey than in the canopy for both tree species, and the relative abundance of the main families, different feeding guilds, and most common species differed significantly between understorey and canopy.

4. To determine the extent to which leaf quality explained the observed patterns, percentage nitrogen and protein binding capacity were measured in canopy and understorey leaves of Q. alba and Q. velutina. Per cent nitrogen was higher in canopy leaves for Q. velutina while protein binding capacity was higher in canopy leaves for Q. alba.

5. These results suggest that the herbivore community associated with these two species of Quercus comprises species that appear to respond individually to environmental and biological conditions encountered in the understorey and the canopy.
Colour‐coded sampling: the pan trap colour preferences of oligolectic and nonoligolectic bees associated with a vernal pool plant
Authors: Leong JoaN. M. , Thorp Robbin W.
Published: March 2003

1. Pan traps or water traps have been used widely to sample agricultural insect pests, but no formal studies have assessed the utility of these traps as sampling devices for bees.

2. Coloured pan traps, used as flower models, can efficiently and selectively sample an oligolectic bee, Andrena (Hesperandrena) limnanthis, and other bees associated with white‐flowered Limnanthes douglasii rosea.

3. Females and males of A. limnanthis unexpectedly exhibit different colour preferences. Females are strongly attracted to white and blue traps, but discriminate against yellow traps. Males prefer white traps over blue and yellow traps. Consequently, blue traps are selective for females only, while white traps are selective for both sexes.

4. Non‐A. limnanthis bees were caught in significantly greater numbers in yellow than in blue or white traps. These bees included generalists, as well as specialists that are oligolectic on mostly yellow‐flowered species.

5. Colour of traps had a significant effect on the numbers of A. limnanthis females and males, and non‐A. limnanthis bees caught in traps. These results indicate that quantitative sampling of bees by pan trap methods can be highly sensitive to trap colour.
Interaction between the solitary bee Chelostoma florisomne and its nest parasite Sapyga clavicornis − empty cells reduce the impact of parasites
Authors: Münster‐Swendsen Mikael , Calabuig Isabel
Published: March 2003

1. Nesting behaviour and interactions between the bee Chelostoma florisomne (L.) (Megachilidae) and its nest parasite Sapyga clavicornis (L.) (Sapygidae) were studied through continual observations of individuals and dissections of bee nests. Protection of bee offspring is based on (1) the bee’s discovery and removal of parasite eggs deposited prior to the construction of a cell closure, (2) minimising the time when fully provisioned cells might be parasitised successfully, and (3) the construction of empty cells in front of brood cells.

2. An empty cell was found in front of 64.4% of all brood cells and, if the outermost brood cell in a nest was excluded, in front of 74.3% of inner brood cells. A vestibule closure is most often constructed in front of the outermost brood cell.

3. Following oviposition, the bee made only five flights, which together lasted 6–13 min, to construct a cell closure. A cell closure does not prevent the nest parasite from oviposition inside the brood cell, however, and parasite eggs deposited through the cell closure are not detected and removed by the bee. Only an additional cell closure, i.e. the formation of an empty cell, may protect a brood cell when the bee is not in the nest. The nest parasite often oviposited through the additional cell closure but its offspring were then trapped in the empty cell and starved to death.

4. Only 5.4% of the inner brood cells that were protected by an empty cell were parasitised, compared with 28.9% of those without an anterior, empty cell; 27.4% of the empty cells contained dead parasite offspring (eggs and larvae). Thus, the empty cells provided significant protection and, combined with additional means of protection of brood cells, led to a low degree of parasitism. More than 77% of the wasp offspring died at an early stage due to intraspecific interference competition within brood cells and as result of the wasps’ oviposition into empty cells.
Winter foraging patterns and voluntary hypothermia in the social caterpillar Eucheira socialis
Authors: Fitzgerald Terrence D. , Underwood Dessie L. A.
Published: March 2003

1. Analysis of 28 years of weather data for the Sierra Madre Occidentals of Mexico showed that while flight, mating, and oviposition of the social caterpillar Eucheira socialis (Lepidoptera: Pieridae) occurred in the warmest and wettest months, much of the caterpillar’s feeding and growth occurred in the winter when nocturnal temperatures often fell below 0 °C.

2. Although daytime temperatures at the study site in midwinter were markedly warmer than overnight temperatures, colonies remained sequestered in their bolsas by day. Caterpillars initiated activity shortly after the onset of darkness and foraged overnight at temperatures as low as − 2 °C. The remarkably low chill‐coma temperature recorded for this species has been reported previously only for a sub‐Antarctic caterpillar.

3. Temperature measurements on sunny days showed the interiors of bolsas to be thermally heterogeneous, with an average differential of 12 °C between the warmest and coolest regions of the structure. Although caterpillars clustered within the bolsas had body temperatures significantly greater than ambient, they exhibited voluntary hypothermia by day, seeking out and resting in the coolest pockets of the bolsas.

4. Voluntary hypothermia may influence growth rate adaptively and prevent acclimatisation to daytime temperatures that would have a negative effect on the caterpillar’s ability to locomote at low overnight temperatures.
The distribution and decline of a widespread butterflyLycaena phlaeasin a pastoral landscape
Authors: León‐Cortés Jorge L. , Cowley Matthew J. R. , Thomas Chris D.
Published: March 2003

1. Ecological specialists are often regarded as most likely to be threatened by anthropogenic habitat changes but few relevant data are available on changes in the status of widespread species.

2. Grid square distribution maps have been used widely to measure rates of decline and target conservation resources but it is known that coarse grain mapping is not appropriate to identify declines in widespread species that initially contain numerous local populations per grid cell. Changes in the status of widespread species need to be quantified.

3. Present‐day habitat associations, determined from over 2000 transect counts, combined with data on historical and present‐day habitat distributions, reveal that the area of occupancy and population‐level rate of decline of the Small Copper butterflyLycaena phlaeasis likely to have been of the order of 92 and 89% respectively, in 35 km2of North Wales. Similar data on the species' major host plantsRumex acetosaandR. acetosellaindicate possible declines in area occupied of 48 and 91%. If a 1‐km2grid was applied to the landscape, and ifL. phlaeas,R. acetosa, andR. acetosellahad occupied all 1‐km2cells in the study area in 1901 (non‐limestone cells forR. acetosellaonly), their declines would only have been recorded as 15, 9, and 35% respectively.

4. Many declining ecological specialists are threatened with extinction because of their initial rarity. At a population level, however, they may or may not be declining faster than less specialised species. The results presented here illustrate that some widespread species may have declined as much as many of Britain's rarities.
Contrasting patch choice behaviour by immature ambush predators, a spider (Misumena vatia) and an insect (Phymata americana)
Authors: Kevan Peter G. , Greco Carlos F.
Published: March 2003

1. Spiderlings of the crab spider Misumena vatia and nymphs of the ambush bug Phymata americana normally ambush prey in flowers, as do the adults. The immatures of M. vatia are more mobile, by ballooning, than the ambulatory but largely sedentary adult female spiders, but the apterous immatures of P. americana are less mobile than the alate adults. The aim of the work reported here was to investigate how immatures, as compared with adults, select sites from which to ambush their prey.

2. Individual immatures of both species were released in experimental arenas with variously manipulated natural stems: normal, with and without leaves, and with and without flowers of three species of plants.

3. The spiderlings and nymphs showed discriminatory behaviour but not in accordance with optimal foraging in either case. The spiderlings chose more leafy stems than any other kind of stem. For the nymphs, the importance of leaves was less marked, food apparently being more important than shelter.

4. Neither of the predators discriminated among flowering stems of Solidago canadensis, Daucus carota, and Cirsium arvense.

5. In other experiments, in which flowered and deflowered stems were located in two separated groups in the arena and the individual was released in a bare area between the two groups, the spiderlings chose either group as predicted by chance but the nymphs showed a slight preference for the flowered sector. Nevertheless, once in either of the groups, the predators showed similar behaviour in choosing leafy stems more often than other stems.

6. Nymphs of P. americana are much more selective than adults but spiderlings of M. vatia are less selective than adult females. These results appear to accord with the time and energy costs of changing hunting sites, walking being slower than flying or ballooning.

7. The results indicate the need to include other parameters, such as enemy‐free space and time spent in not being able to forage, in the analysis of foraging behaviour.
The role of nutrition, crowding and interspecific interactions in the development of winged aphids
Authors: Müller Christine B. , Williams Iain S. , Hardie Jim
Published: March 2003

1. Winged morph production in aphids is a phenotypic trait that has traditionally been seen as a response to unfavourable environmental conditions. The evidence to support this theory is reviewed and the ecological and evolutionary significance of the findings is discussed.

2. The common assertion of poor host‐plant nutritional quality leading to increased production of winged morphs does not always apply, particularly when the host‐plant quality is exceptionally poor. The available data are skewed heavily towards Myzus persicae, and for this species the dynamical change in plant quality appears to be important with respect to wing induction.

3. Crowding may be a less influential stimulus for wing induction as study methods approach natural conditions experienced by aphids on their host plant.

4. The growing evidence that interactions with other organisms can induce the production of winged morphs by aphid colonies is reviewed. In the case of natural enemies, such a response by an aphid colony may be regarded as induced defence. Wing induction may also act as a means of transmission for a virus or fungal pathogen.
Increased reproduction by pea aphids in the presence of secondary parasitoids
Authors: Van Veen F. J. F. , Rajkumar A. , Müller C. B. , Godfray H. C. J.
Published: March 2003

1. The influence of the presence of secondary parasitoids on aphid reproduction was tested in a field experiment.

2. Single pea aphids Acyrthosiphon pisum in clip cages on potted bean plants were exposed to a collection of secondary parasitoids enclosed within a small perforated bag. The aphids were exposed to volatile chemicals released by the secondary parasitoids but there was no physical contact.

3. The production of nymphs was recorded over an 11‐day period. Aphids produced significantly more offspring in the presence of secondary parasitoids than in the absence of secondary parasitoids (36.9 vs. 31.2).

4. This is the second reported occurrence of this phenomenon, and the reasons for its occurrence and its consequences for aphid population and community ecology are discussed.
Influence of chorion ingestion on the performance of Ascia monuste and its association with cannibalism
Authors: Barros‐Bellanda Helen C. H. , Zucoloto Fernando S.
Published: March 2003

1. In some lepidopterans, the newly hatched caterpillars feed on chorion (animal protein) as their first food. This is also a frequent behaviour of newly hatched caterpillars of Ascia monuste.

2. According to some parameters tested (time for pupation, number of adults, male imago weight, and fifth‐instar ingestion), chorion ingestion by first‐instar larvae affects adult performance positively. The ingestion of ultraviolet‐sterilised chorion provided the same positive effect on performance. It is thus suggested that young caterpillars may be benefiting from chorion nutritionally, and that chorion ingestion is a chain of events that leads to positive effects on insect performance.

3. Cannibalism in A. monuste was observed in newly hatched caterpillars and is related to the chorion ingestion behaviour. A condition for this to occur was the interval of time of hatching, which means that, if a group of caterpillars hatches very much before another group, once the caterpillars have ingested the chorion of their own eggs, there is a tendency for them to ingest the chorion of other eggs (including unhatched eggs) and, consequently, practice cannibalism.

4. Ascia monuste immatures are considered to be herbivorous, however it is important to know that they eat animal tissue (chorion and conspecific eggs).