A prospective study of colposcopy in women with mild dyskaryosis or koilocytosis

Summary. Colposcopy was performed in 91 women who had cervical cytology suggesting mild dyskaryosis or showing koilocytosis, all previous cytology having been normal. The final histological diagnosis was C1N III in 22%, CINII in 18%, CINI in 31%, koilocytosis alone in 14% and no abnormality in 15%. These results indicate that even with mild cytological atypia, a high proportion of patients will have more advanced disease when colposcopy-directed punch biopsy is performed.     

Tympanosclerosis of the stapes: hearing results for various surgical treatments.

When tympanosclerosis involves the tympanic membrane or the lateral ossicles, treatment is usually straightforward and uncomplicated. When the stapes is involved, therapy is more controversial and may be more difficult. We report our results in 154 patients who underwent different surgical procedures for tympanosclerosis of the stapes. Followup was up to 10 years. Pure-tone average threshold was significantly improved (p < 0.05) in patients who underwent mobilization procedures or stapedectomy for definitive treatment. The air-bone gap was less than 20 dB at 6 months postoperative in 72% of patients and less than 30 dB in 90%. At 6 months, 2 years, and 5 years there were no statistically significant differences in hearing results between stapedectomy and mobilization patients, some of whom were followed for up to 10 years. No patient had a profound hearing loss after surgery. Surgical treatment for tympanosclerosis of the stapes is a safe procedure, with hearing results similar to those of surgery for other chronic ear diseases involving the ossicular chain.     

Control of intraocular pressure after cataract extraction

We carried out a prospective randomized study in 172 patients undergoing cataract extraction and lens implantation to compare the effects of pilocarpine gel, 1% acetylcholine chloride and 0.01% carbachol on early postoperative intraocular pressure (IOP), to determine the effect of sodium hyaluronate on IOP and to compare the effects of 0.01% carbachol (full-strength) and 0.005% carbachol (half-strength) on IOP, pupil size and brow ache. IOP was measured 3, 6, 9 and 24 hours after surgery, and in the full- and half-strength carbachol groups pupil size and subjective complaints of brow ache were recorded. The mean IOP 3 and 6 hours after surgery was significantly lower in all the treatment groups than in the control groups. At 9 and 24 hours it was significantly lower only in the carbachol groups. The use of sodium hyaluronate was not found to affect the postoperative IOP. There was no difference in postoperative IOP or miosis between the full- and half-strength carbachol groups, but fewer patients in the half-strength group than in the full-strength group reported brow ache at 9 and 24 hours. The results suggest that carbachol is the most effective agent currently available for the management of IOP after cataract extraction.     

A novel 37-Kd adhesive membrane protein from cloned murine bone marrow stromal cells and cloned murine hematopoietic progenitor cells

The adhesion of hematopoietic progenitor cells to bone marrow stromal cells is critical to hematopoiesis and involves multiple effector molecules. Stromal cell molecules that participate in this interaction were sought by analyzing the detergent-soluble membrane proteins of GBI/6 stromal cells that could be adsorbed by intact FDCP-1 progenitor cells. A single-chain protein from GBI/6 cells having an apparent molecular weight of 37 Kd was selectively adsorbed by FDCP-1 cells. This protein, designated p37, could be surface-radiolabeled and thus appeared to be exposed on the cell membrane. An apparently identical 37- Kd protein was expressed by three stromal cell lines, by Swiss 3T3 fibroblastic cells, and by FDCP-1 and FDCP-2 progenitor cells. p37 was selectively adsorbed from membrane lysates by a variety of murine hematopoietic cells, including erythrocytes, but not by human erythrocytes. Binding of p37 to cells was calcium-dependent, and was not affected by inhibitors of the hematopoietic homing receptor or the cell-binding or heparin-binding functions of fibronectin. It is proposed that p37 may be a novel adhesive molecule expressed on the surface of a variety of hematopoietic cells that could participate in both homotypic and heterotypic interactions of stromal and progenitor cells.     

The value of technetium-99M renography for the detection of renal artery stenosis in patients with aortic and lower limb vascular disease.

The results of technetium renography were compared with arteriography to determine whether this is a satisfactory screening test for renal artery stenosis (RAS). Sixty-three patients were studied before aortic surgery. All were investigated by aortography and isotope renography. These tests were assessed blind and all arteriograms were graded by a single independent radiologist. Renal artery stenosis was detected by arteriography in 34 (54%) patients. Twenty-three (37%) had mild (less than 50%) stenosis, seven (11%) had moderate (50-80%) stenosis and four (6%) had severe (greater than 80%) stenosis. Of these 34 patients, only 6 (18%) were correctly diagnosed by isotope renography. None of the four with severe stenosis were identified. Isotope renography resulted in six true positives, six false positives, 23 true negatives and 28 false negatives. It was concluded that isotope renography did not fulfil the criteria for a screening test for the detection of RAS and appeared to be of no value in those patients undergoing aortic surgery in whom arteriography was not indicated.     

Development of dental plaque on the incisor teeth of monkeys (Macaca fascicularis).

Bacterial plaque which had accumulated for 0.5, 1, 2, 4, 7, 14 and 28 days was cultured from the labial surface of one of the central incisor teeth in 15 monkeys (Macaca fascicularis). Each sampling area was defined by a metal well contained within a custom-made removable acrylic block. The number (log10) of the total colony forming units (c.f.u.) increased significantly from 3.40 to 6.02 between 0.5 and 28 days. Similarly the number of streptococci increased from 2.80 to 4.79 during the same period, although when expressed as a percentage of the total c.f.u., the proportions decreased from 34.9 per cent at 1 day to 6.9 per cent at 7 days and then remained at that level. The number of micro-aerophilic actinomyces increased throughout the period of plaque accumulation and comprised 15.3 per cent of the total c.f.u. at 28 days. Neisseriae were infrequently isolated from 0.5- and 1-day-old plaque and were not recovered at more than 1 per cent of the total c.f.u. during any period of plaque accumulation. The fastest doubling time (median) of the total c.f.u. was 1.9 h (range 1.3-18.5 h). The rapid development of dental plaque after tooth cleaning emphasizes the importance of regular and meticulous oral hygiene to control the accumulation of potentially periodontopathic and cariogenic bacteria.     

A technique to obtain and process surgical specimens of the human vestibular aqueduct for histopathological studies of the endolymphatic duct and sac.

The endolymphatic sac (ES) may play a crucial role in the pathophysiology of Ménière's disease. This paper presents a technique to obtain and process fresh human specimens of the endolymphatic duct (ED) and the presumably more active intraosseous portion of the ES obtained at surgery. The specimens are preserved with an intact bony shell around the ED and the intraosseous ES. This allows ultrastructural histopathological evaluation of the intraluminal contents, the epithelium and the subepithelial tissue as well as the mutual relationships of these structures. Various factors influencing ES ultrastructure are discussed. The results obtained from this method may increase our understanding of the possible role of the ES in the etiology of different inner ear disorders.