Colposcopic evaluation after a repeat atypical squamous cells of undetermined significance (ASCUS) smear.

OBJECTIVES: Management of patients with atypical squamous cells of undetermined significance (ASCUS) remains controversial. We chose to repeat the Pap smear after four months. If ASCUS persisted in this second test, the patient was advised to undergo colposcopy. Our objective is to determine the clinical significance and the prediction of neoplasia among these patients through a colposcopic examination. METHODS: Of 29,827 patients who had a Pap smear, ASCUS were detected in 1387 (5%) and persisted in the repeat smear of 225 (16%). Colposcopy and an additional Pap smear were performed on 186 patients. RESULTS: Out of 186 colposcopic evaluations, 91 (49%) were normal and the patients had a negative Pap smear. Colposcopy was abnormal in 95/186 patients (51%) (Table 1). Histology of the directed biopsies revealed 38 (21%) low-grade squamous intraepithelial lesions (LSIL) and 17 (9%) high-grade squamous intraepithelial lesions (HSIL). Forty patients (21%) with normal biopsies had ASCUS for the third time in the Pap smear. CONCLUSIONS: Colposcopic evaluation after a repeated Pap smear with ASCUS is an appropriate cost-effective management. Finding 30% of LSIL or HSIL justifies this additional investigation.     

The nuclear concentration of kin17, a mouse protein that binds to curved DNA, increases during cell proliferation and after UV irradiation

UV-irradiation induces, in mammalian cells, the expression of a set of genes known as the 'UV-response', which may be reminiscent of the bacterial response, called SOS system. The multifunctional protein RecA controls the expression of the SOS genes. We report the expression profile of a mouse gene conserved among mammals, called Kin17, that codes a DNA-binding protein of undetermined biochemical activity and which shares epitopes with the bacterial RecA protein. We demonstrate that the level of Kin17 RNA was 5-fold higher in mid-S phase of serum- stimulated BALB/c 3T3 fibroblasts than in quiescent cells. Cells in S- phase displayed a high level of kin17 protein with a marked nuclear localisation. The maximal level of Kin17 RNA was observed 18 h after serum stimulation, indicating that Kin17 gene is a new member of the late growth-related genes. The accumulation of kin17 protein during cell proliferation follows the increase in Kin17 RNA and correlates with DNA synthesis, which suggests a possible role of kin17 protein in a transaction related to DNA-replication. In quiescent fibroblasts, a 3- fold increase in Kin17 RNA was seen 13 h after UV irradiation. In parallel, kin17 protein accumulated in the nucleus, which suggests that it might be required after the stress produced by UV irradiation.      

Chronic daily headache with migrainous features due to papilledema-negative idiopathic intracranial hypertension

Patients with the syndrome of chronic daily headache often report migrainous symptoms and consequently are diagnosed as having a primary headache syndrome. We report two cases of idiopathic intracranial hypertension causing chronic daily headache with migrainous features in the absence of associated papilledema.     

Évaluation clinique des chimioradiothérapies concomitantes et recommandations pratiques

The efficacy of concurrent radiochemotherapy should be evaluated in term of therapeutic ratio. The aims of treatment are increasing local control and possibly overall survival. Acute toxicity should be reported using the WHO recommendations, while late toxicity is reported using the scales recommended by the EORTC and RTOC Radiotherapy Groups. Moreover, functional, esthetic and quality of life considerations should be introduced. The application of these treatments needs a well-designed multidisciplinary staff.     

Prospective study of lung volumes in young asthmatic children

In a 9-y prospective study, the occurrence and duration of lung volume abnormalities in 21 young asthmatic children (median age at recruitment 4y, range 3–8 y) was determined. The median functional residual capacity (FRC) at recruitment was 135% of that predicted for height (range 79–187%) and 13 children were hyperinflated. The median FRC decreased significantly after 3 y of follow-up and by 9 y only one child remained hyperinflated. We conclude that persistent elevation of lung volume in young asthmatic children appears to be uncommon.     

Clinical studies of valproate for migraine prophylaxis

Within the last decade our understanding of the pathophysiologic mechanisms which generate migraine has expanded considerably. Accompanying these advances in basic science, new agents designed to treat migraine acutely have exhibited unprecedented pharmacologic selectivity and clinical efficacy. While these abortive agents clearly can provide many migraine patients with a degree of headache control they previously have not enjoyed, such treatment typically will not provide lasting benefit to individuals whose headaches are more pervasive and may require stabilization through effective prophylactic therapy. Unfortunately, our arsenal of agents for migraine prophylaxis has not grown as rapidly as that of the abortive medications, and for the most part clinicians and patients are left to rely upon a small handful of "traditional" drugs for that purpose. One notable exception to this is divalproex sodium; the safety and efficacy of this new agent for migraine prevention have been documented consistently in a series of recent clinical trials.     

吡唑烷酮类化合物的抗惊厥作用

对3类14种吡唑烷酮类化合物的抗惊厥作用进行了比较研究,它们对最大电休克惊厥均有对抗作用,作用出现快,但维持时间较短,其中II-f作用最强,对听源性发作和家兔海马注射硫酸锌形成的慢性癫痫模型也有效。此外,III-类尚能对抗戊四唑引起的阵挛性惊厥。