Baseline inaccuracy rates for the comparison of cervical biopsy to loop electrosurgical excision histopathologic diagnoses

OBJECTIVE: The purpose of this study was to quantify the baseline inaccuracies in histopathologic diagnosis between colposcopically directed cervical biopsies and loop electrosurgical excision procedure specimens. STUDY DESIGN: A retrospective review was made of cervical biopsies and loop electrosurgical excision procedure pairs (n = 448) that were performed at the University of Arizona between 1992 and 2000. Agreement was assessed by kappa statistics and Spearman rho coefficients. Subgroup analysis was performed (n = 139) to assess pairs with significant inaccuracy between biopsy and loop electrosurgical excision procedure, when these were performed within 28 days of each other. RESULTS: Eighty-one percent agreement was found between cervical biopsy and loop electrosurgical excision procedure histopathologic diagnoses, when compared to within 1 degree (kappa, 0.73; P <.0001). A discrepancy that would be attributed to regression or progression was found: mild biopsy (regression, none by definition; progression, 4%), moderate biopsy (regression, 9%; progression, 0%), and severe biopsy (regression, 26%; progression, 0%). CONCLUSION: Even when colposcopically directed cervical biopsy correlates strongly with loop electrosurgical excision procedure histopathologic diagnosis, there is a definable percentage of patients for whom there is a discrepancy between these 2 diagnoses. This discrepancy represents an inherent inaccuracy of the diagnostic testing modality and should not be interpreted as progression or regression of disease.     

Proton magnetic resonance spectroscopy: normal findings in the cerebellar hemisphere in childhood

BACKGROUND: The cerebellar hemispheres (CER) are different from the supratentorial white and gray matter embryologically, in cytoarchitecture, and probably in metabolic activity. Proton magnetic resonance spectroscopy ((1)H MRS) can provide a noninvasive biochemical analysis of this region. OBJECTIVE: To study, with (1)H MRS, metabolite concentrations in CER as a function of age and compare these metabolic data with those of parietoccipital white matter (PO WM) in healthy children. MATERIALS AND METHODS: Using single-voxel (1)H MRS, we studied 37 volunteers (3-18 years) with normal MRI scans of the brain. (1)H MRS was performed using the PRESS technique in CER and PO WM. The NAA/Cr, Cho/Cr, NAA/H(2)O, Cr/H(2)O, and Cho/H(2)O ratios were analyzed as a function of age. Metabolic data from these regions were compared. RESULTS: The NAA/Cr ratio tended to increase with age in CER. Mean NAA/Cr and Cho/Cr ratios were found to be lower in CER than in PO WM. Mean NAA/H(2)O, Cr/H(2)O, and Cho/H(2)O ratios in CER were higher than in the PO WM. CONCLUSION: Our data confirm the regional variations between CER and PO WM metabolite ratios, and demonstrate a tendency of age-dependent change of the NAA/Cr ratio in CER. The creatine concentration was significantly higher in the cerebellum than in the PO WM.     

Kinetics and equilibrium in the immunoradiometric assay (IRMA) of thyroglobuline

This paper studies the kinetics of the thyroglobuline reaction with its specific antibody immobilised on the inner wall of the reaction tube, and the subsequent binding of the immunocomplex formed with a second 125I-labelled antibody. These reactions are used in the immunoradiometric determination of thyroglobuline. Independent variables were analyte and labelled antibody, temperature, viscosity, and the medium's ionic strength. For the global process, mono-exponential kinetics were found to be dependent on the concentrations, such dependence fitting with the models discussed in the paper. Viscosity results clearly indicate its negative influence on the direct reaction rate. Ionic strength shows noticeable, but not too relevant, effects, which suggests that the variation caused by the glycerol addition is not due to the influence of the dielectric constant of the solutions used. The effect of temperature shows activation parameters similar to the viscous flow energy of water, which suggests diffusion control for the global process.     

Impairment of immunological memory in the absence of MHC despite survival of memory T cells

The mechanisms by which immunological memory is maintained after infection or vaccination are still a matter of debate. Long-term survival of memory T cells does not require major histocompatibility complex (MHC) contact. We show here that compared with memory CD4+ T cells that maintain contact with MHC class II, memory CD4+ T cells deprived of MHC class II contact show distinct functional defects upon antigen re-encounter. Thus, in contrast to their survival, maintenance of the typical quality of memory T cells crucially depends on MHC-derived signals.     

Characterization of T cell differentiation in the murine gut

Gut intraepithelial CD8 T lymphocytes (T-IEL) are distinct from thymus-derived cells and are thought to derive locally from cryptopatch (CP) precursors. The intermediate stages of differentiation between CP and mature T-IEL were not identified, and the local differentiation process was not characterized. We identified and characterized six phenotypically distinct lineage-negative populations in the CP and the gut epithelium: (a) we determined the kinetics of their generation from bone marrow precursors; (b) we quantified CD3-epsilon, recombination activating gene (Rag)-1, and pre-Talpha mRNAs expression at single cell level; (c) we characterized TCR-beta, -gamma, and -alpha locus rearrangements; and (d) we studied the impact of different mutations on the local differentiation. These data allowed us to establish a sequence of T cell precursor differentiation in the gut. We also observed that the gut differentiation varied from that of the thymus by a very low frequency of pre-Talpha chain mRNA expression, a different kinetics of Rag-1 mRNA expression, and a much higher impact of CD3 epsilon/delta and pre-Talpha deficiencies. Finally, only 3% of CP cells were clearly involved in T cell differentiation, suggesting that these structures may have additional physiological roles in the gut.     

From 'I Wish' to 'I Will': social-cognitive predictors of behavioral intentions

We tested the ability of several social-cognitive models to predict intentions to engage in two different health behaviors (resisting dieting and performing breast self-exam). All constructs from the health belief model (with and without self-efficacy), the theory of planned behavior (with and without perceived behavioral control) and the motivational process of the health action process approach were measured simultaneously in two subject samples. We hypothesized that models that include self-efficacy (or the related construct of perceived behavioral control) would be more effective than the models that do not include it. Our results supported this prediction. The health action process approach was the best predictor of intentions to engage in both behaviors. Implications for selecting appropriate models on which to base interventions are discussed.     

Study of phagocytosis of senescent erythrocytes in young and elderly individuals

There is a decrease in the percentage contribution of a heavy density fraction of red blood cells to whole blood with increasing age. The aim of this study was to investigate in the young and elderly the interaction between monocytes and different erythrocyte suspensions: senescent red blood cells, erythrocytes stored with or without serum, and desialylated red blood cells. The results obtained with senescent red blood cells and erythrocytes stored with serum show the involvement of autologous IgG in the selective removal of erythrocytes. These values were higher in elderly individuals, indicating that this process increases with age. Our observation suggest that desialylation is not involved in the increased removal of erythrocytes observed in elderly individuals. Received: 3 October 2002 / Accepted: 11 December 2002 Correspondence to C. Biondi     

Dedifferentiated chondrosarcomas of the larynx: a report of two cases and review of the literature

OBJECTIVE: To analyze the long-term clinical outcome of dedifferentiated chondrosarcoma or chondrosarcoma with additional malignant mesenchymal component (CAMMC) of the larynx and compare the results with those of axial chondrosarcomas. STUDY DESIGN/METHODS: Two patients with CAMMC of the larynx (0.03%) were retrospectively identified within the archives of the Armed Forces Institute of Pathology between 1970 and 2001. We compared the clinical and histologic features of these two cases with those reported in the English literature (Medline 1966-2001) (Table I). RESULTS: Patient no. 1 was a 67-year-old man who presented with a 12-month history of hoarseness and was found to have a 4-cm mass involving the cricoid cartilage. Enucleation was performed and histologically demonstrated a dedifferentiated chondrosarcoma. Without additional intervention, the patient died after 136 months without evidence of disease. Patient no. 2 was a 41-year-old man who also presented with a 12-month history of hoarseness and dysphagia and was found to have a 5-cm mass involving the cricoid cartilage. A total laryngectomy was performed for the dedifferentiated chondrosarcoma. He is alive without evidence of disease at last contact (91 mo). CONCLUSION: CAMMC of the larynx are rare tumors but have a better prognosis than their axial counterparts (mean, 6 mo). Initial voice-sparing surgery can be followed with more aggressive surgery if recurrences develop.     

Dynamic development of <Emphasis Type="Italic">Trypanosoma cruzi</Emphasis> in <Emphasis Type="Italic">Rhodnius prolixus</Emphasis>: role of decapitation and ecdysone therapy

Decapitation and ecdysone therapy on the population dynamics of the Trypanosoma cruzi Dm28c clone in the stomach, small intestine and rectum of fifth-instar larvae of Rhodnius prolixus were investigated. Parasites were not found in the small intestine and rectum of decapitated insects after 10 days post-infection (p.i.). Decapitated ecdysone-supplemented insects sustained the flagellate infection in both gut compartments. In the rectum, the population density of parasites increased 5-fold in ecdysone-treated decapitated larvae and 7-fold in control insects. Epimastigote forms dominated with 40-65%, intermediate stages and round forms varied over 10-35% in the stomach, small intestine and rectum in both insect groups. Low numbers of metacyclic trypomastigotes were observed in the stomach and small intestine of the control group and decapitated insects supplemented with ecdysone but, at 15 days p.i., this form of flagellate reached about 20% in the rectum of the control insects. In the entire gut, at 30 days p.i., 23% of parasites in the control group and 8% in the decapitated insects treated with ecdysone were found. These results indicate that a head factor, possibly the prothoracicotropic hormone from the brain which stimulates ecdysone production by the prothoracic glands, may act directly or indirectly to stimulate the development of epimastigotes and round forms of the parasite and that a single ecdysone treatment is not able to fully reverse metacyclogenesis in decapitated R. prolixus.