bluuebunny/crossref_metadata_2025 huggingface dataset:
A study of the effect of introducing a restrictive cervical screening policy on laboratory workload and cervical cancer detection rates
Authors: CHANNER J. L. , MACKENZIE E. F. D.
Published: May 2007

This study examines the effect of a change in screening policy on the detection rate of severe dyskaryosis. During 1987 a total of 423 cases of severe dyskaryosis were identified by the Avon Screening Programme. Eleven per cent of these abnormal smears were repeat smears taken without clinical indication within the recommended 5 year recall period (interval smears). In a comparable control group of negative smears 31% were interval smears. Twenty‐five per cent of the dyskaryotic interval smears (3% of the total severely dyskaryotic smears) were taken within 3 years of the previous negative smear, compared with 50% of the control group. By discouraging opportunistic smears within 5 years of the previous smear, the laboratory workload could be reduced by 30%, or within 3 years of the previous smear by 15%. There is, however, a risk of 11% and 3% respectively of missing a significant lesion (severe dyskaryosis).
Immunogold labelling of tumour cells during NK/target cell interactions
Authors: ZANYK M. J. , BANERJEE D. , HEARN S. A.
Published: May 2007

Using a system of immunocolloidal gold labelling, we have monitored the expression and distribution of transferrin receptors (TfRs) within the K562 cell line, during NK/target cell interactions. An indirect method of immunolabelling was used to effectively immunolabel tumour cells without disrupting the natural effectontarget interactions. Successful localization of TfRs demonstrates the potential of the described technique for discerning antigenic distribution of other cell:cell interactions.

Immunolabelling has also provided a useful method for demonstrating receptor down‐regulation within NK target cells, as a proposed cause of reduced receptor expression by TPA‐treated cells. Following 30 and 60 min incubation periods with TPA, approximately 15 and 30%, respectively, of the gold/antibody complexes were relocated from the surface membrane to an intracellular location within endocytotic vesicles. The demonstration of receptor down‐regulation is important as a proposed cause of TPA‐induced tumour cell resistance to NK‐mediated cytolysis.
Functional immunocytopathology and the diagnosis of bone marrow micrometastases
Authors: NEVILLE A. MUNRO
Published: May 2007

Immunocytochemical methods offer a new dimension for cytopathology in the diagnosis, prognosis and biology of neoplastic diseases. This concept is illustrated with particular respect to the immunodetection of bone marrow micrometastases and the role of cytologically demonstrable functional parameters in prognosis and therapy planning. A future role for the polymerase chain reaction (PCR) in this diagnostic sphere is proposed.
The effect of tamoxifen on cervical squamous maturation in Papanicolaou stained cervical smears of post‐menopausal women
Authors: EELLS T. P. , ALPERN H. D. , GRZYWACZ C. , MacMILLAN R. W. , OLSON J. E.
Published: May 2007

Using cervical smears obtained as part of routine gynaecological examinations, a retrospective study of the effects of the drug tamoxifen on squamous epithelial maturation of the cervix of post‐menopausal women being treated for advanced breast cancer was made. The degree of squamous epithelial maturation was quantitated by using the Maturation Index and the Maturation Value. Although tamoxifen is a synthetic, non‐steroidal compound classified as anti‐oestrogenic, the findings indicate that this drug commonly produces a level of squamous maturation indicative of oestrogenic stimulation in Papanicolaou stained cervical smears from post‐menopausal patients receiving this drug. Knowledge of the oestrogenic effect of tamoxifen in the cervix can obviate clinical concern about endometrial carcinoma.
Cytological grading of breast carcinoma—a feasible proposition?
Authors: HUNT C. M. , ELLIS I. O. , ELSTON C. W. , LOCKER A. , PEARSON D. , BLAMEY R. W.
Published: May 2007

Fine needle aspiration cytology (FNAC) of the breast is widely used in the diagnosis of breast carcinoma. In some centres this is sometimes the only diagnostic procedure performed prior to definitive treatment. A grading system based on cytology would be helpful in the selection of patients for appropriate therapy. The aim of this study, therefore, was to devise such a system for grading breast carcinoma based on cytological features alone.

The features assessed were the degree of cell clustering, nuclear pleomorphism, nuclear diameter, the presence of multiple, easily visible nucleoli and necrosis. Cytological features were compared to the histological grade of the tumours following excision. Discriminant analysis showed that the features with the closest correlation with histological grade were nuclear diameter, nuclear pleomorphism and the presence of nucleoli. A scoring system based on these three parameters enabled the classification of tumours into high and low cytological grades which showed a close correlation with histological grade.
Cytology of Ki‐1 (CD‐30) positive large cell lymphoma
Authors: NOORDUYN L. A. , VAN HEERDE P. , MEYER C. J. L. M.
Published: May 2007

To study the cytomorphology of Ki‐1 (CD‐30) positive anaplastic large cell lymphoma, imprints and fine needle aspirates from a total of 20 of these tumours were collected. The results show that these tumours have a highly pleomorphic and variable picture, which can be easily confused with other poorly differentiated large cell tumours. Typical morphological differences between the B‐cell and T‐cell variety were found. B‐cell tumours more often showed nuclear multilobation, a fine, hypochromatic chromatin pattern, and many lymphoglandular bodies. T‐cell tumours more often displayed multinucleation, window nuclei, and a hyperchromatic coarse chromatin pattern. The diagnosis of anaplastic large cell Ki‐1 positive lymphoma, B‐cell type or T‐cell type, should be included in the differential diagnosis of any large cell tumour of uncertain origin with mainly dissociated tumour cells. Immunocytochemistry is recommended to establish the correct diagnosis.
Demonstration of oestrogen receptor in symptomatic breast carcinoma, using fine needle aspiration cytology
Authors: CUTHBERT A. , HERBERT A. , CODDINGTON R. , THEAKER J. , TAYLOR I. , ROYLE G. T.
Published: May 2007

Oestrogen receptor immunocytochemical assay (ER‐ICA) was used to determine oestrogen receptor (ER) content of cells in fine needle aspirate (FNA) specimens from 88 breast carcinomas. In 49 of these the radioligand binding assay for oestradiol was available for comparison. The predictive value of ER‐ICA staining for a positive radioligand binding assay (greater than 10 fmol/mg protein) was 95%. Although the predictive value of negative staining was only 66%, 34 out of 37 ER‐ICA negative tumours had radioligand binding assays below 60 fmol/mg protein.

ER‐ICA staining showed a strong positive correlation with age of the patient, positivity being rare before the menopause. There was a weak inverse correlation with tumour grade but none with tumour size or lymph node status.

The assessment of ER by immunocytochemistry using FNA cytology is a rapid technique, which may easily be repeated and provides a pre‐operative assessment of ER status. It allows confirmation that tumour cells are present in the sample and an assessment of tumour heterogeneity.
Morphometric analysis of fine needle aspirates from breast lesions
Authors: MAPSTONE N. P. , ZAKHOUR H. D.
Published: May 2007

In an attempt to discover the morphometric variables with the most diagnostic power in the differentiation of benign from malignant breast disease, 20 unequivocally benign and 20 unequivocally malignant and histologically confirmed breast aspirates were examined on an image analyser. It was found that standard deviation of nuclear area was the most discriminant variable. Then 23 aspirates initially diagnosed as ‘suspicious of malignancy’ were measured by the same technique, and standard deviation of nuclear area correctly differentiated all but three cases.
Immunophenotyping of Mesothelial Cells and Carcinoma Cells With Monoclonal Antibodies to Cytokeratins, Vimentin, Cea and Ema Improves the Cytodiagnosis of Serous Effusions
Authors: DASTE G. , SERRE G. , MAUDUYT M‐A. , VINCENT C. , CAVERIVIERE P. , SOLEILHAVOUP J‐P.
Published: May 2007

This paper presents an immunocytochemical study performed on cytocentrifuged deposits from 109 peritoneal and pleural effusions including 20 transudates, 43 malignant metastatic effusions and 46 effusions containing atypical cells, unidentifiable as reactive mesothelial or malignant epithelial cells on the classical morphological criteria. A panel of four monoclonal antibodies (MAb) was used, including KL1 directed to cytokeratins (KER), V9 to vimentin (VIM), NEO 723 to carcinoembryonic antigen (CEA) and E29 to epithelial membrane antigen (EMA). In most transudates the reactive mesothelial cells coexpressed VIM and KER with a ring‐like pattern for the latter proteins. In contrast, they were unreactive to anti‐CEA and weakly and inconsistently reactive to anti‐EMA. In malignant effusions, most carcinoma cells coexpressed EMA, CEA and KER with a predominant diffuse cytoplasmic pattern for the latter. Only a few malignant epithelial cells from five metastatic adenocarcinomas weakly expressed VIM. When used on the 46 effusions with unidentifiable cells, the panel of MAb allowed reactive mesothelial cells and malignant epithelial cells to be distinguished from each other in 39 of 46 cases (85%).
The Significance of Nuclear Grooves and Phagocytosis In the Diagnosis of Metastatic Papillary Carcinoma of the Thyroid
Authors: CHETTY R. , LEARMONTH G. M. , KALAN M. R.
Published: May 2007

A 57‐year‐old patient presented with a lesion of the iliac bone. Cytological smears prepared from material aspirated from the lesion revealed cells with longitudinal nuclear grooves and haemosiderin within their cytoplasm. These observations led to a diagnosis of metastatic thyroid papillary carcinoma which was confirmed by histological examination.
The Cytological Diagnosis of Pneumocystis Carinii By Fluorescence Microscopy of Papanicolaou Stained Bronchoalveolar Lavage Specimens
Authors: WEHLE K. , BLANKE M. , KOENIG G. , PFITZER P.
Published: May 2007

In a retrospective and prospective analysis fluorescence microscopy of Papanicolaou stained bronchoalveolar lavage specimens has been applied to the diagnosis of Pneumocystis carinii (PC) in routine cytology. the pneumocysts presented as circular structures of 5 μm in diameter and of brilliant green‐yellow fluorescence surrounding two mirror image reniform structures. Fluorescent inclusions of 1–3 μm diameter within the alveolar macrophages could be identified as remnants of pneumocysts by a follow‐up of all steps of degradation ending in very small irregular granules. By applying both criteria, i.e. pneumocysts with reniform bodies and degradation inclusions within macrophages, Pneumocystis carinii pneumonitis (PCP) could be detected in 100% of cases. Transbronchial biopsy permitted the correct diagnosis in only 65.2% of cases. Retrospective analysis of slides is possible after a long period as no significant loss of fluorescence occurs after 4 years. Thus fluorescence microscopy permits the diagnosis of Pneumocystis carinii without any additional staining or loss of time.
Cytopathology of Follicular Tumours of the Thyroid With Clear Cell Change
Authors: HARACH H. R. , VIRGILI E. , SOLER G. , ZUSMAN S. B. , DAY E. SARAVIA
Published: May 2007

A retrospective cytological study of nine follicular tumours of the thyroid with clear cell change was undertaken. In five clear cell adenomas and one moderately differentiated clear cell follicular carcinoma the epithelial cells occurred singly or in sheets and clusters; they sometimes assumed a trabecular or follicular pattern. the cells usually had pale diffusely vacuolated cytoplasm with ill‐defined boundaries, a variable degree of anisonucleosis, nucleolar enlargement, and nuclear overlapping. Smears from a signet‐ring cell adenoma contained in addition a few cells with large cytoplasmic vacuoles and compressed eccentric nuclei.

In these cases a cytological diagnosis of ‘follicular lesion’ (or follicular neoplasia), clear cell type or signet‐ring cell type, was given. A cytodiagnosis of ‘carcinoma’ was made only in the poorly differentiated follicular carcinoma‐clear cell variant studied which showed unequivocal features of malignancy. Features suggestive of thyroid cyst, nodular goitre, Hashimoto's thyroiditis, and cell hyperactivity (marginal vacuoles, ‘fire flare’) were also found in the aspirated specimens of these cases of clear cell tumour of the thyroid.
Breast Carcinoma With Osteoclast‐Like Giant Cells
Authors: STEWART C. J. R. , MUTCH A. F.
Published: May 2007

The cytological and histological findings of a case of breast carcinoma with osteoclast‐like giant cells are presented. A fine needle aspiration specimen demonstrated the characteristic combination of malignant epithelium and reactive multinucleated cells and enabled identification of this rare variant of breast cancer. Immunocytochemical studies using the monoclonal antibody KP1[CD68] support a histiocytic origin for the osteoclast‐like cells.
Bronchoalveolar Lavage In the Diagnosis of Bronchiolo‐Alveolar Carcinoma. A Case Report
Authors: MILMAN N. , JACOBSEN G. K.
Published: May 2007

Bronchiole‐alveolar carcinoma is usually localized to the terminal bronchioles and alveoli, and may present on chest X‐ray as interstitial pulmonary disease with diffuse reticulonodular infiltrates. the cytological diagnosis is often difficult to obtain. This case demonstrates that bronchoalveolar lavage can be useful in the diagnostic evaluation of this type of malignancy, in conjunction with transbronchial lung biopsy.
Significance of Borderline Nuclear Abnormality In Cervical Smears
Authors: PARHAM D. M. , WIREDU E. K. , HUSSEIN K. A.
Published: May 2007

Women with cervical smears showing borderline nuclear abnormality (BNA), or reactive changes in the form of squamous metaplasia (SM) or endocervical cell hyperplasia (ECH), were age‐matched with healthy controls to determine the outcome of these conditions. No significant difference in the risk of dyskaryosis was observed in cases showing reactive changes and the controls. In contrast, there was a 23% excess of cases showing dyskaryosis in the repeat smears of cases of BNA over the controls. an odds ratio of 8.3 was obtained, showing dyskaryosis in subsequent smears after a diagnosis of BNA.
Renal Transplant Aspiration Cytology. Role For Simple Morphological Criteria
Authors: GOULDESBROUGH D. R. , McLIGEYO S. O. , ANDERTON J. L.
Published: May 2007

Fine‐needle aspiration (FNA) is a well‐recognized technique for sampling solid organs. It is used in renal transplantation to clarify the cause of a poorly functioning graft. Differential scoring techniques with respect to peripheral blood cell populations, and immunocyto‐chemistry have been employed in this context. We describe the use of simple morphological criteria alone in renal transplant FNA. We compare these with needle biopsy and clinical parameters and show their value in the detection of active cellular rejection. Their limitations are discussed within the framework of other patterns of transplant pathology.
Coexpression of Vimentin, Cytokeratin and S‐100 In Monomorphic Adenoma of Salivary Gland; Value of Marker Studies In the Differential Diagnosis of Salivary Gland Tumours
Authors: GUPTA R. K. , NARAN S. , DOWLE C. , SIMPSON J. S.
Published: May 2007

An unusual Coexpression of glial fibrillary acid protein (GFAP), keratin and vimentin occurs in pleomorphic adenoma of salivary gland. We designed this study to see if Coexpression of the markers was also present in monomorphic adenoma of the salivary gland and whether monomorphic adenoma could be distinguished from other salivary gland tumours by marker studies. Immunocytochemical markers were used on fine needle aspiration samples from four cases of monomorphic adenoma, two cases of oncocytic adenoma, three cases of adenoid cystic carcinoma and four cases of pleomorphic adenoma. While positivity for cytokeratin, vimentin and S‐100 was consistently found in all cases of monomorphic adenoma, only cytokeratin was expressed in adenoid cystic carcinoma. In pleomorphic adenoma, GFAP, cytokeratin and vimentin were coexpressed while in cases of oncocytic adenoma none of the markers was localized. Thus, it appears that by using a combination of GFAP, cytokeratin, vimentin and S‐100 a distinction between these neoplasms may be possible. However, a larger study is needed to establish the usefulness of this approach.
Ciliary Ultrastructure In Nasal Brushings
Authors: ROBSON A. M. , SMALLMAN L. A. , GREGORY J. , DRAKE‐LEE A. B.
Published: May 2007

Normal ciliary ultrastructure is thought to be necessary for effective function. There has been little or no attempt to quantify ultrastructural abnormalities in nasal disease and assess their significance. In this study we measured nasal ciliary function and examined ciliary ultrastructure in nasal brushings from 35 patients with perennial nasal symptoms refractory to treatment. Ultrastructural defects included microtubular abnormalities, compound cilia and ciliary ‘blebs’. the incidence of abnormal cilia was 16.7%, compared with 9% in controls, but there was only a poor correlation between ultrastructural defects and ciliary beat frequency. One patient had primary ciliary dyskinesia (PCD) with a typical clinical history and immotile cilia. However, only secondary ultrastructural abnormalities were seen. We have been unable to show that ciliary ultrastructural defects form the basis of impaired function. In patients with suspected PCD, nasal brushings should be taken for functional and ultrastructural studies; ideally, a further sample should be obtained for examination of possible primary ultrastructural abnormalities.
Cytomegalovirus Infection of the Cervix Detected By Cytology and Histology: A Report of Five Cases
Authors: HUANG J. C. , NAYLOR B.
Published: May 2007

We present four cases of cytomegalovirus (CMV) infection detected by cervical cytology of asymptomatic young women. One patient who had undergone bone marrow transplantation was immunosuppressed, but no factors predisposing to CMV infection were identified in the other three patients. A cervical biopsy specimen from a fifth patient, who was also asymptomatic, demonstrated the locus of CMV infection to be in endocervical gland cells. Immunocytochemical and polymerase chain reaction studies on this biopsy specimen confirmed that the histological changes were caused by CMV. the finding of CMV‐infected cells in cervical cytological or biopsy specimens is a rarity. Our observations in asymptomatic, non‐immunocompromised women suggest their presence is an incidental finding, unlikely to have any clinical significance.
Determination of Ki67 Growth Fraction and Oestrogen Receptors In Screen‐Detected Breast Cancer Using Cytological Preparations
Authors: CODDINGTON R. , CUTHBERT A. , CAMPBELL I. D. , HERBERT A. , THEAKER J. M. , ROYLE G. T. , TAYLOR I.
Published: May 2007

Oestrogen receptor (ER) status of 77 cases of screen‐detected breast cancer has been determined using cytological preparations. In 48% ER status was positive, which was the same proportion as that formed in a control group of age‐matched patients with symptomatic breast carcinoma. Since the screen‐detected group contained more low grade tumours, the percentage of ER‐positive cases would be expected to be higher. the reasons for the discrepancy are discussed. Ki67 score has been determined for 41 cases of screen‐detected cancer. Ki67 score showed a positive correlation with histological tumour grade and a negative correlation with ER status. However, there was no correlation with tumour size or lymph node status. the Ki67 scores in the screen‐detected cancers were essentially similar to those found in an age‐matched symptomatic group, but the very low scores were only found in the screened group.
Comparison of Fine Needle Sampling By Capillary Action and Fine Needle Aspiration
Authors: DEY P. , RAY R.
Published: May 2007

Fine needle aspiration (FNA) and non‐suction fine needle sampling (FNS) were performed consecutively in 107 lesions from 100 patients. the quality of diagnostic material was assessed using a scoring system based on the cellularity and amount of blood in the smear. the total score in the FNS group was significantly higher (P < 0.05) than that of FNA technique. the FNS procedure is less traumatic and equally cost effective and can be safely undertaken in liver, orbital and thyroid lesions. In lymph nodes, especially in children, FNS gives an excellent cellular yield. However, this procedure can not be advocated in cystic, bony and fibrous lesions.
A Retrospective Analysis of 94 Patients With Cin and False Negative Cervical Smears Taken At Colposcopy
Authors: BEEBY A. R. , WADEHRA V. , KEATING P. J. , WAGSTAFF T. I.
Published: May 2007

This report investigates the reasons for false negative cervical cytology in 94 out of 630 patients (15%) in whom cervical intraepithelial neoplasia (CIN) was diagnosed on colposcopically directed biopsy. Cervical smears were taken immediately before biopsy and the cases with false negative cytology were compared with those whose cytology was abnormal. Patients with false negative cytology were more likely to have been younger (P < 0.01), to have had fewer pregnancies (P < 0.001), to have had a less severe grade of dyskaryosis on their referral smear (P < 0.001), to have had no endocervical cells on the smear (P < 0.05), to have had a less severe grade of CIN on biopsy (P < 0.001), to have had no punctation visible at colposcopy (P < 0.01), and to have had no mosaic pattern seen at colposcopy (P < 0.05). We found no effect attributable to the patient's menstrual history, the interval between referral smear and colposcopy clinic visit, the smear taker or the type of spatula used to take the smear.
Fine Needle Aspiration Cytology of Breast In Invasive Carcinoma of Tubular Type and In Radial Scar/Complex Sclerosing Lesions
Authors: LAMB J. , McGOOGAN E.
Published: May 2007

Fine needle aspirates (FNA) from 31 invasive carcinomas of tubular type and 22 radial scar/complex sclerosing lesions (RS/CSL), diagnosed in Edinburgh between 1986 and 1991, were reviewed. the lesions in this study varied in size and palpability at presentation, but are of increasing interest in the differential diagnosis of non‐palpable areas of increased mammographic density. In agreement with previously published information1′5′8, it was found that the tubular cancers were usually selected for biopsy following aspiration, but less often definitively diagnosed as malignant. Nearly 50% of the RS/CSL group were correctly reported benign on cytology, but in 40%, biopsy was recommended to exclude malignancy. In addition, cytological features helpful in suggesting malignancy in aspirates from tubular cancers, also raised suspicion in aspirates from the RS/CSL group, with a risk of overdiagnosis of cancer.
Pleural Fluid Adenosine Deaminase and Lymphocyte Proportion: Clinical Usefulness In the Diagnosis of Tuberculosis
Authors: DE OLIVEIRA H. GOULART. , ROSSATTO E. R. , PROLLA J. C.
Published: May 2007

Adenosine deaminase (ADA) and lymphocyte proportion are known to be independently elevated in tuberculous effusions, but are non‐specific, and false positive results are frequent. to overcome this problem the combined use of both parameters was prospectively studied in 276 patients with pleural effusion seen at Porto Alegre, Brazil. Using a cut‐off level of 40 U/l at 37°C (method of Giusti19) for ADA activity and lymphocyte proportion of more than 50%, the correct diagnosis of tuberculosis (sensitivity) was made in 90.7% (CI 87.3–94.1%) of 54 patients. A specificity of 97.7% (CI 95.9–99.5%) was recorded. Five false positive diagnoses of tuberculous effusion were made. Five false negative diagnoses were made: three cases with haematogenous tuberculous dissemination with low ADA levels, and two other patients with low lymphocyte proportion. the combined use of ADA activity determination and lymphocyte proportion is a highly efficient diagnostic strategy of low cost, that merits wider use.
Cell Lysis Due to Ultrasound Gel In Fine Needle Aspirates; an Important New Artefact In Cytology
Authors: MOLYNEUX A. J. , COGHILL S. B.
Published: May 2007

An important new artefact in cytopathology is described. the initial observation of the artefact followed contamination of a breast fine needle aspiration (FNA) sample by ultrasound gel which was used to localize the lesion. the changes proved reproducible ex vivo. the changes varied depending on the conditions and degree of contamination, and ranged from cell swelling to leakage of nuclear chromatin and cell lysis. This artefact is discussed in the context of other major sources of cytology artefact. Pathologists and radiologists should beware of the detrimental effects of ultrasound gel on cytology specimens.
Diagnostic associations of p53 immunostaining in fine needle aspiration cytology of the breast
Authors: STEPHENSON T. J. , ROYDS J. A. , SILCOCKS P. B. , BRAMMER H. J. , SHORTHOUSE A. J. , UNDERWOOD J. C. E.
Published: May 2007

Duplicate cytospin preparations were made from 46 symptomatic breast fine needle aspirates. One of each pair was assigned to benign or malignant categories by one experienced observer as part of the ‘triple approach’patient assessment. the other was immunostained with DO7, a monoclonal antibody to recombinant p53 protein, and rated by another observer as positive or negative for nuclear staining, unaware of the cytodiagnosis. Positive controls included carcinomas known to have mutant p53, while negative controls were of the reagent substitution type. of the 26 aspirates with a benign cytodiagnosis (verified by the triple approach), 23 were p53 protein‐negative and three positive. of the 20 with a malignant cytodiagnosis (histologically confirmed), six were p53 protein‐negative and 14 positive (exact P<0.0001). As a diagnostic test this would give 70% sensitivity and 88% specificity.
Prostatic carcinoma cells in urine specimens
Authors: RUPP M. , O'HARA B. , McCULLOUGH L. , SAXENA S. , OLCHIEWSKI J.
Published: May 2007

Between January 1985 and March 1990, the Cytology Laboratory of Hanover General Hospital examined cytologic preparations from four patients which revealed cells consistent with prostatic adenocarcinoma. In three of these cases, malignant cells were positive for prostatic‐specific antigen. A fifth patient's specimen contained prostatic‐specific antigen positive cells compatible with prostatic origin, but without overtly malignant features. All five patients had high grade prostatic adenocarcinoma (Gleason's Grade 8–10), and urinary tract symptoms. the most useful cytologic features indicating prostatic origin were large and often multiple nucleoli.
Hodgkin's disease: diagnostic accuracy of fine needle aspiration; a report based on 62 consecutive cases
Authors: FULCINITI F. , VETRANI A. , ZEPPA P. , GIORDANO G. , MARINO M. , de ROSA G. , PALOMBINI L.
Published: May 2007

We report on our series of 62 cases occurring between January 1977 and December 1990, which were diagnosed as Hodgkin's disease by fine needle aspiration (FNA) samples. the overall accuracy of the cytological diagnosis was high, with only four incorrect diagnoses and a positive predictive value of 93.5%. the value of FNA as a first level diagnostic technique in the screening of lymphadenopathies is discussed, as well as the limitations and pitfalls of the cytological diagnosis.
Comparison of two methods of storing breast fine needle aspirates (FNAs) using oestrogen receptor immunocytochemical assay as a method of evaluating the storage methods
Authors: BURTON S. A. , DOWSETT M. , TROTT P. A.
Published: May 2007

Two methods of storing fine needle aspirates were compared in 14 patients with breast cancer. the methods of storage were: (1) as a Cytospin slide prepared immediately from the aspirated material and stored at −80°C; (2) as a suspension of cells in tissue culture medium, stored at −80°C. the effect of storage on the cells was assessed by means of an oestrogen receptor immunocytochemical assay (ER‐ICA). an ER positivity of 100% was obtained by ER‐ICA staining of cells after storage method 1, whilst all of the specimens stored by method 2 were ER‐negative. the data demonstrate that cells stored in tissue culture medium at −80°C are not suitable for ER measurement. the storage method of choice for specimens intended for ERICA is as a Cytospin slide. the ER status of cells deposited on Cytospin slides prepared immediately and stored at −80°C for 2 years could be demonstrated despite the delay in processing the specimen.
Immunocytochemical Staining of Serous Effusions: an Additional Method In the Routine Cytology Practice?
Authors: JENSEN M. LIDANG , JOHANSEN P.
Published: May 2007

In a consecutive and prospective cytomorphologic and immunocytochemical study we have examined 100 serous fluids with a panel of antibodies. Three different immunocytochemical patterns of staining were recognized: (i) a benign profile showing no Ber‐EP4 or CEA‐positive cells; (ii) a malignant profile with Ber‐EP4 and strongly EMA‐positive epithelial cells; and (iii) a malignant profile in which mesothelial cells were strongly positive for EMA. By applying these profiles the number of malignant cases recognized increased from 19 to 38. All cytomorphologic malignant fluids showed a malignant profile, but in two cases a malignant epithelial profile was found in patients without otherwise proven malignant disease (false positive staining). Immunocytochemistry with anti‐Ber‐EP4 and anti‐EMA can be recommended as a routine procedure, but the marker result should always be correlated with cytomorphology, eventual histologic data and clinical records.

Dans cette étude cytomorphologique prospective, nous avons analysé 100 liquides d'épanchement des séreuses, consécutifs, à l'aide d'une batterie d'anticorps. Trois profils immunocytochimiques différents ont été individualisés: (i) un profil bénin dans lequel aucune cellule n'est positive avec Ber‐EP4 ou l'ACE, (ii) un profil malin avec des cellules épithéliales fortement positives aves Ber‐EP4 et avec l'EMA et (iii) un profil malin dans lequel les cellules mésothéliales sont fortement positives avec l'EMA. En appliquant ces notions de profils, le nombre de cas malins reconnus passe de 19 à 38. Tous les cas cytologiquement malins avaient un profil malin, mais 2 cas de profil immunocytochimique épithélial malin correspondaient à des patients chez lesquels aucune pathologie maligne n'a été trouvée (faux positif). L'immunocytochimie avec l'anti Ber‐EP4 et l'anti EMA doit être recommandée en pratique de routine, mais les résultats de ces immunomarquages doivent toujours être corrélés avec l'étude morphologique et les éventuelles données histologiques et cliniques.

In einer prospektiven cytomorphologischen und immuncytochemischen Studie wurden 100 seröse Ergüsse mit einer Gruppe von Antikörpern überprüft. Es fanden sich 3 unterschiedliche Reaktionsmuster: (i) eine gutartige Gruppe ohne positive Reaktion auf Ber‐EP4 oder CEA, (ii) eine maligne Gruppe mit Ber‐EP4 positiven und stark positiven EMA‐Zellen und (iii) eine maligne Gruppe mit stark positiven mesothelialen Zellen auf EMA. Unter Anwendung dieser Einteilung konnte die Zahl der diagnostizierten malignen Fälle von 19 auf 38 vergrößert werden. Alle cytologisch malignen Fälle entsprachen den malignen Gruppen, während 2 Patienten mit immuncytochemisch positiven Befund keinerlei Malignitätszeichen aufwiesen. Der immuncytochemische Einsatz von Anti Ber‐EP4 und Anti EMA kann als Routineverfahren empfohlen werden, wobei jedoch immer eine Korrelation mit der Cytomorphologie oder histologischen und klinischen Daten berücksichtigt werden sollte.
Rapid rescreening of cervical smears: an improved method of quality control
Authors: DUDDING N.
Published: May 2007

Rapid rescreening of approximately 30% of all negative and inadequate consecutive smears was carried out over a 26‐month period. Smears (n = 24012) were rescreened using a × 6.3 objective only. Two minutes were allowed for each slide. Thirty‐nine smears were found to have been incorrectly diagnosed as negative, a rate of 0.16%. This can be compared with the previous 26 months during which the traditional 1 in 10 random rescreening of unsatisfactory and negative smears had been carried out at a routine pace and with an objective of × 10. A total of 6866 smears were rescreened. Eleven were found to have been incorrectly diagnosed as negative, a rate of 0.16%. Rapid rescreening is as sensitive as 1 in 10 rescreening, and allows a greater proportion of smears to be rescreened. We propose rapid rescreening should replace the traditional 1 in 10 rescreening methods.
Morphological study of bacteria of the respiratory system using fluorescence microscopy of Papanicolaou‐stained smears with special regard to the identification of Mycobacteria sp.
Authors: KÜPPER TH. , STEFFEN U. , WEHLE K. , RICHARTZ G. , PFITZER P.
Published: May 2007

In Papanicolaou‐stained smears certain structures such as nucleoli, Pneumocystis carinii, Charcot‐Leyden crystals, bacteria and fungi show a brilliant fluorescence. the morphological characteristics of microorganisms which can be detected by this system, especially mycobacteria, are described. This screening method offers the possibility of providing the clinician with a provisional diagnosis within hours. Proof of the nature of the organisms should be obtained by culture.
Papanicolaou staining of air‐dried smears: value in rapid diagnosis
Authors: JONES C. A.
Published: May 2007

Air‐dried material normally submitted for Diff‐Quik (modified Romanowsky stain) was rehydrated in normal saline, then fixed for a short period in formol alcohol, before staining by a modified Papanicolaou technique. Staining was performed by a rapid manual technique (<2 min) if urgent or routinely on an automatic stainer. Comparisons were made between wet‐fixed Papanicolaou‐stained specimens and air‐dried Papanicolaou‐stained material. Air‐dried material stained after rehydration showed superior nuclear definition compared with wet‐fixed material; the removal of erythrocytes enhanced the staining of the remaining epithelial cells.
Expression of p21waf1/cip1, mdm2 and p53 in vivo: analysis of cytological preparations
Authors: DOWELL S. P. , McGOOGAN E. , PICKSLEY S. M. , EL‐DEIRY W. S. , VOGELSTEIN B. , HALL P. A.
Published: May 2007

The aim of this study was to test the hypothesis that expression of p21 Wafl/CiPl and MDM2 could be used as indicators of the activity of wild‐type p53 which can transcriptionally activate the p21wafl/Cipl and mdm2 genes. In cytological preparations of serous fluids, the expression of p53, p21wafl/cipl and MDM2 protein was assessed by immunohistochemistry. A series of 50 cases was assessed for both p53 and p21wafl/Cipl expression and a subset of 37 cases had sufficient material for analysis of MDM2. In samples in which there were reactive mesothelial cells (n= 48) there was general concordance between p53 and P21wafl/Cipl expression, but in nine cases p21wafl/Cipl was expressed in the absence of detectable p53. Similarly, MDM2 expression was not correlated with p53 in 15 of 31 cases. P21wafl/Cipl was correlated with MDM2 in 24 of 31 cases, while in the remaining seven, MDM2 was expressed without detectable p21wafl/Cipl immunoreactivity. In samples with neoplastic cells (n=18) the presence of p21wafl/Cipl and MDM2 expression was always associated with p53 expression. Polymorphonuclear leucocytes frequently showed p21wafl/Cipl mmunoreactivity, and this was confirmed by immunoblotting of peripheral blood polymorphonuclear leucocytes. These data indicate that in general p21wafl/Cipl expression correlates with p53 expression in reactive mesothelial cells, consistent with a known mechanism of regulation. However, in reactive mesothelial cells, MDM2 expression is perhaps dissociated from p53 expression, contrary to current models of MDM2 regulation. Finally, in addition to many normal tissues, it is likely that in reactive mesothelial cells and some tumours p21wafl/Cipl expression is not dependent on the presence of wild‐type p53 protein. In conclusion, p53 status cannot be reliably predicted based only on p21wafl/Cipl or MDM2 expression.
Ringlike structures in fine needle aspirates from the breast
Authors: GUPTA R. K.
Published: May 2007

Spherical ringlike structures of various sizes resembling Liesegang rings (LRs) are described in four fine needle aspirates (FNAs) from breast lesions over a period of 13 years. A characteristic finding in these structures was a distinct double layer outer wall with striations and an amorphous central nidus. Under polarized light they were non‐refractile and no birefringence was noted in Congo red. Immunohistochemical stains for calcium, iron, mucus, glycogen, amyloid, cytokeratin and epithelial membrane antigen in all the cases were found to be negative. Since LRs can be mistaken for ova or parasites, their presence in aspirates of breast should be kept in mind to avoid misdiagnosis.
Ectopic Darier's Disease of the Cervix: an Extraordinary Cause of an Abnormal Smear
Authors: ADAM A. E.
Published: May 2007

A small number of skin diseases may involve either extremity of the alimentary tract or the vulva. Fortunately for patients and cytoscreeners, they rarely involve the cervix or vagina. When they do, difficulty in diagnosis may arise if a full history is not provided. A case is described of cervicovaginal Darier's disease, which presented with an abnormal cervical smear and led to a dermatological referral.

Un petit nombre de pathologies cutanées peuvent concerner une extrémité du tractus digestif ou la vulve. Heureusement pour les maladies et pour les cytotechniciens, ces affections touchent rarement le col ou le vagin. Lorsqu'elles le font, des difficultés diagnostiques peuvent exister si l'histoire clinique compléte n'est pas transmise. Ce travail décruit un cas de localisation cervico‐vaginale de maladie de Darier, qui s'est présenté avec un frottis cervical anormal et qui à conduit a une consultation dermatologique.

Eine kleine Zahl von Hauterkrankungen befällt gelegentlich auch die Analregion und die Vulva. 1st dies der Fall kann bei Fehlen der Anamnese eine zytologische Beurteilung schwierig sein. Ein derartiger Fall, der ein dermatologisches Konzil crforderlich machte, wird vorgestellt.
Prophylactic treatment of haemophilia patients with inhibitors: clinical experience with recombinant factor VIIa in European Haemophilia Centres
Authors: MORFINI M. , AUERSWALD G. , KOBELT R. A. , RIVOLTA G. F. , RODRIGUEZ‐MARTORELL J. , SCARAGGI F. A. , ALTISENT C. , BLATNY J. , BOREL‐DERLON A. , ROSSI V.
Published: May 2007

Summary.  Many patients with haemophilia develop inhibitors to factor VIII and require bypassing agents to provide haemostatic cover for limb‐ or life‐threatening bleeding episodes. Due to the reduced risk of blood‐borne pathogen transmission with recombinant products, on‐demand recombinant factor VIIa (rFVIIa; NovoSeven®) is the treatment of choice for children with inhibitors. In haemophiliac patients without inhibitors, primary prophylaxis has been clinical practice for several years. This paper summarises 13 case histories of rFVIIa secondary prophylaxis for haemophilia patients with inhibitors. This was a retrospective survey of adult and paediatric severe haemophilia patients with inhibitors treated with rFVIIa from ten European Haemophilia Centres. There was a wide variation in administered rFVIIa dose, from 200–250 μg kg−1 per week to 220 μg kg−1 daily. In many cases, this was lower than the recommended on‐demand dose of rFVIIa. In 12/13 cases, prophylaxis with rFVIIa considerably reduced the number of bleeding episodes compared with previous treatment. Eight/nine patients were satisfied or very satisfied with rFVIIa treatment, and in cases reporting subjective quality of life (QoL), all were improved, much improved, or significantly improved. In haemophilia patients with inhibitors, prophylaxis with rFVIIa is highly effective in reducing the number of bleeding episodes and results in good patient compliance and improved QoL. Randomised controlled trials are needed to confirm these findings. Results of a recently completed clinical trial on secondary prophylaxis with rFVIIa in frequently bleeding haemophilia patients with inhibitors are expected in late 2006.
Saccharomyces cerevisiae SSD1 orthologues are essential for host infection by the ascomycete plant pathogens Colletotrichum lagenarium and Magnaporthe grisea
Authors: Tanaka Shigeyuki , Yamada Kaori , Yabumoto Kayo , Fujii Satoshi , Huser Aurélie , Tsuji Gento , Koga Hironori , Dohi Koji , Mori Masashi , Shiraishi Tomonori , O'Connell Richard , Kubo Yasuyuki
Published: May 2007

Fungal plant pathogens have evolved diverse strategies to overcome the multilayered plant defence responses that confront them upon host invasion. Here we show that pathogenicity of the cucumber anthracnose fungus, Colletotrichum lagenarium, and the rice blast fungus, Magnaporthe grisea, requires a gene orthologous to Saccharomyces cerevisiae SSD1, a regulator of cell wall assembly. Screening for C. lagenarium insertional mutants deficient in pathogenicity led to the identification of ClaSSD1. Following targeted gene replacement, appressoria of classd1 mutants retained the potential for penetration but were unable to penetrate into host epidermal cells. Transmission electron microscopy suggested that appressorial penetration by classd1 mutants was restricted by plant cell wall‐associated defence responses, which were observed less frequently with the wild‐type strain. Interestingly, on non‐host onion epidermis classd1 mutants induced papilla formation faster and more abundantly than the wild type. Similarly, colonization of rice leaves by M. grisea was severely reduced after deletion of the orthologous MgSSD1 gene and attempted infection by the mutants was accompanied by the accumulation of reactive oxygen species within the host cell. These results suggest that appropriate assembly of the fungal cell wall as regulated by SSD1 allows these pathogens to establish infection by avoiding the induction of host defence responses.
YaeT‐independent multimerization and outer membrane association of secretin PulD
Authors: Collin Séverine , Guilvout Ingrid , Chami Mohamed , Pugsley Anthony P.
Published: May 2007

Previous studies demonstrated that targeting of the dodecameric secretin PulD to the Escherichia coli outer membrane is strictly dependent on the chaperone‐like pilotin PulS. Here, we report that PulD multimerization and membrane association in strains producing PulS were unaffected when the levels of the essential outer membrane assembly factor YaeT(Omp85) were reduced by controlled expression of a paraBAD–yaeT transcriptional fusion. This behaviour contrasted markedly to that of the trimeric porin LamB, which remained monomeric under these conditions. Furthermore, resistance to extraction by the detergent Sarkosyl and by urea, and susceptibility to trypsin digestion all suggested that PulD localized to the outer membrane in YaeT‐depleted cells. We conclude that, unlike classical β‐barrel outer membrane proteins such as LamB, multimerization of PulD is largely YaeT‐independent.
The critical role of the linear plasmid lp36 in the infectious cycle ofBorrelia burgdorferi
Authors: Jewett Mollie W. , Lawrence Kevin , Bestor Aaron C. , Tilly Kit , Grimm Dorothee , Shaw Pamela , VanRaden Mark , Gherardini Frank , Rosa Patricia A.
Published: May 2007

Borrelia burgdorferi, the aetiological agent of Lyme disease, follows a life cycle that involves passage between the tick vector and the mammalian host. To investigate the role of the 36 kb linear plasmid, lp36 (also designated theB. burgdorferiK plasmid), in the infectious cycle ofB. burgdorferi, we examined a clone lacking this plasmid, but containing all other plasmids known to be required for infectivity. Our results indicated that lp36 was not required for spirochete survival in the tick, but the clone lacking lp36 demonstrated low infectivity in the mammal. Restoration of lp36 to the mutant strain confirmed that the infectivity defect was due to loss of lp36. Moreover, spirochetes lacking lp36 exhibited a nearly 4‐log increase in ID50relative to the isogenic lp36+clone. The infectivity defect of lp36‐minus spirochetes was localized, in part, to loss of thebbk17(adeC) gene, which encodes an adenine deaminase. This work establishes a vital role for lp36 in the infectious cycle ofB. burgdorferiand identifies thebbk17gene as a component of this plasmid that contributes to mammalian infectivity.
Nifedipine in Scleroderma Ulcerations
Authors: Woo Thomas Y. , Wong Reynold C. , Campbell Janis P. , Goldearb Michael T. , Voorhees John J. , Callen Jeffrey P.
Published: May 2007

ABSTRACT: Cutaneous ulcerations may be due to a variety of causes, including vasculitis. infections, arterial insufficiency, and microvascular damage. The net effect is diminished blood flow to the skin. Nifedipine, a calcium antagonist, has been shown to improve cutaneous blood How and to alleviate reactive vasospastic ischemia (Raynaud's phenomenon). The authors report an ischemic ulcer of scleroderma showing visible improvement with nifedipine therapy.
Crotamiton Lotion in Pruritus
Authors: Smith Edgar B. , King Clinton A. , Baker Michael D.
Published: May 2007

ABSTRACT: The authors studied the antipruritic effects of 10% crotamiton lotion in 31 patients with bilaterally symmetrical pruritic dermatoses. In this double‐blind, paired‐comparison clinical trial, there was no significant difference in relief of pruritus between the crotamiton lotion and its vehicle. The study does not confirm the results of previous uncontrolled studies indicating that crotamiton has an antipruritic effect.
Fixed Drug Eruptions: A Study of 20 Occurrences in Singapore
Authors: Chan H. L.
Published: May 2007

ABSTRACT: Twenty occurrences of fixed drug eruptions (FDE) were studied. Of these, 12 were due to tetracyclines and 4 were due to analgesics (3 from pyrazolone derivatives and 1 from acetylsalicylic acid). Sixteen of the patients had less than 10 lesions each. The lips were affected in eight instances, and therefore seem preferentially involved. At presentation, seven patients were unaware of a drug relationship to their condition. A comparison of six reported series (including this one) revealed that the causative drugs varied over the years 1956‐1983 as well as by region.
Pediatric Skin Disease in Pakistan: A Study of Three Punjab Villages
Authors: Porter Michael J. , Mack Robert W. , Chaudhary Mushtaq A.
Published: May 2007

ABSTRACT: The population of children younger than 5 years old in three widely distributed villages in Punjab, Pakistan, was examined for skin disease in November 1980. Approximately 29% of the children had infectious skin disease, with pyoderma the predominant diagnostic category. There were significant differences in pyoderma prevalence rates between villages, with the suppressive effect of malathion spraying for malaria control on the insect population representing the most likely explanation for the observed differences. These data again emphasize the amount of skin disease, particularly in children, in rural areas of the lesser developed countries, and the desirability of focusing attention on the dermatologic needs of this vast sector of the world's population.