Endocervical sampling by kevorkian curette or pipelle aspiration device: A randomized comparison

Objective: Our purpose was to compare two means of endocervical sampling—the Kevorkian curette and the Pipeline aspiration device (Unimar Co., Wilton, Conn.)—with respect to patient discomfort, tissue volume, and specimen adequacy for diagnosis.Study design: Fifty-two women undergoing investigation of abnormal cervical cytologic results were assigned randomly to endocervical sampling by Kevorkian or Pipeline instruments. Pain associated with the procedure was assessed by having east subject indicate her pain level on a visual analog scale. Tissue volume was graded by examination of the microscopic slides by two investigators blinded to assignment. Adequacy for diagnosis was evaluated by reviewing pathology reports.Results: Subjects having Pipeline endocervical aspiration (n = 24) had significantly lower mean (±SEM) pain scores (27 ± 5 vs 48.5 ± 7, p = 0.02) than those in whom the Kevorkian instrument was used (n = 28). However, there were no significant differences in tissue volume obtained or in proportions considered adequate for diagnosis.Conclusions: Use of the Pipelle instrument was associated with less patient discomfort that Kevorkian curettage for endocervical sampling while providing similar tissue volume and adequacy for diagnosis.     

Regulation of lewis lung carcinoma invasion and metastasis by protein kinase A

Metastatic Lewis lung carcinoma (LLC-LN7) cells have increased protein kinase A (PKA) activity and are more invasive in vitro than are non-metastatic (LLC-C8) cells. To determine whether PKA mediates the in vitro invasiveness and in vivo metastatic capabilities of these tumor cells, the LLC variants were stably transfected to over-express the C_α subunit of PKA, and thus to have increased PKA activity, or to express a mutant cAMP-resistant PKA R_lα subunit which blocks PKA activation. Wild-type LLC-LN7 tumor cells were invasive in vitro and in vivo, recurred after tumor excision and metastasized to the lungs. However, they lost these properties after transfection to express the mutant R_lα that blocks PKA activation. The non-invasive, non-recurring and non-metastatic LLC-C8 cells gained the capacity to invade, to recur following tumor excision and to metastasize when transfected to express the PKA C_α subunit. © 1995 Wiley-Liss, Inc.     

Absorptive properties of synovium harvested from the carpal tunnel

Ischemia-induced reperfusion injury seems to play an important role in the pathophysiology of "idiopathic" carpal tunnel syndrome (CTS). The common final pathway in this developmental sequence is thought to be an intermittent increase in interstitial pressure, leading to degenerative changes in the flexor tenosynovium and fibrotic changes in the perineural tissue. We hypothesize that this concurrently leads to alteration in the physical properties of the synovium, leading to its rapid and persistent swelling. A prospective study was conducted on synovial tissue obtained from 27 CTS patients. The in vitro synovial absorption rate of CTS patients was significantly higher in the first hour compared to controls (n = 7). This difference was maintained up to 5-6 h, albeit at a slower rate. Rapid absorption and retention of fluid by the synovium led to increased interstitial pressure and nerve compression, resulting in early and persistent manifestation of symptoms in sensitized patients.     

Renal diseases in children in Venezuela,South America

The present study reports epidemiological data on renal disorders in children in Venezuela. Information was obtained from 14 centers for the period January through December 1998. A total of 3,624 patients were evaluated as either a first outpatient consultation or as a first hospital admission. Nearly 70% of the patients could be grouped in one of the following categories: (1) urinary tract infections (32%), with detection of abnormalities of the urinary tract in 25%, (2) metabolic disorders (28%), mainly idiopathic hypercalciuria and hyperuricosuria, (3) glomerulonephritis (9.5%). The other 30% corresponded to urolithiasis 7%; renal tubular acidosis 5.6%; nephrotic syndrome 4.5%; primary hematuria 4.2%; acute renal failure 2.8% (43% were secondary to acute dehydration, 15% to birth asphyxia, 14% to septicemia, and 23% to multiple factors); chronic renal failure 1.6% (secondary to glomerulopathies, predominantly focal glomerulosclerosis, structural abnormalities of the urinary tract, hereditary disorders, and renal hypoplasia/dysplasia); miscellaneous diseases 4.8%. Hence, the spectrum of renal disorders in Venezuela is wide, sharing similarities with countries of both the developed and developing world. These data will hopefully contribute to the development of national healthcare policies appropriate to the epidemiology of the country.     

Laminin alpha5 chain adhesion and signaling in conjunctival epithelial cells

PURPOSE: To identify peptides of the LG4 module of the laminin alpha5 chain that mediate human conjunctival epithelial cell adhesion to the laminin-10 isoform. METHODS: A peptide corresponding to a major heparin- and cell-binding domain of the LG4 module of the laminin alpha5 chain was analyzed. The attachment of conjunctival epithelial cells to the peptide compared with laminin-10 was determined by colorimetric adhesion assay. The role of glycosaminoglycans in mediating adhesion to the peptide was determined by altering their function at the cell surface and by blocking adhesion with exogenous glycosaminoglycans. The role of syndecan-4 in cell adhesion to the peptide was examined by adhesion assay. The role of the peptide in cell signaling was examined by phosphotyrosine Western blot analysis. RESULTS: The peptide facilitated the adhesion of conjunctival epithelium, although not as efficiently as laminin-10. Heparinase had no effect on adhesion to the peptide. In contrast, adhesion to the peptide decreased in glycosaminoglycan-deficient cells, heparatinase-treated cells, cells blocked with exogenous heparan sulfate proteoglycan, and cells treated with antibodies to the ectodomain of syndecan-4. Cell adhesion to the peptide for 90 or 120 minutes resulted in a significant increase in focal adhesion kinase (FAK) tyrosine phosphorylation, compared with the nonadherent control. CONCLUSIONS: Human conjunctival epithelial cells use a heparin- and cell-binding peptide of the LG4 module of laminin alpha5 chain in adhesion to laminin-10. Syndecan-4 is one mechanism by which the peptide facilitates adhesion. In addition to adhesion, the peptide may function in cell-signaling events.     

Issues related to combining risk factor reduction and clinical treatment for eating disorders in defined populations

Population-based psychotherapy considers the provision of services to a population at risk for or already affected with a disease or disorder. Using existing data on prevalence, incidence, risk factors, and interventions (both preventive and clinical) for eating disorders (anorexia excluded), this article examines issues related to integrating and providing risk reduction and treatment to a population of female college students. Population-based psychotherapy models have important implications for the provision of services and for future directions in research on eating and other types of mental health disorders, but the assumptions need to be carefully examined. Studies that provide data combining population-based risk factor reduction and clinical treatment are needed to advance this field.