Influence of age and human papillomavirus-infection on reliability of cervical cytopathology

The aim of the present study was to evaluate the effect of age and human papillomavirus (HPV) infection associated cellular changes on the predictive value of cervical cytology. In a group of 671 women with Papanicolaou smears suggesting low grade squamous intraepithelial lesion (LSIL), high grade squamous intraepithelial lesion (HSIL) or invasive cervical cancer, cervical cytology was correlated with the histological finding. Predictive values were calculated and related to severity of the lesion, age and HPV associated changes. The predictive values of Papanicolaou (cervical) smears suggesting LSIL, HSIL and invasive carcinoma were 40%, 86%, and 78%, respectively. A poor predictive value of smears suggesting LSIL was found among older women. HPV associated changes were diagnosed in 80% of women 25 years of age, 66% in the age group 26 to 35 years, 51% in the age group 36 to 45 years and 38% in women aged 46 years (P = 0.03). The presence of HPV associated cellular changes led to a significantly higher number of overdiagnoses (9% with HPV infection compared to 4% without HPV infection) and HPV negative cases were more frequently associated with underdiagnosis (15% without HPV infection compared to 8% with HPV infection,P = 0.0011). This result remained significant after adjustment for age (P = 0.004). Cellular changes associated with HPV infection most frequently occurred in young women. HPV infection should therefore be acknowledged as source of overdiagnosis in the cytological evaluation of SIL especially in woung women.Supported by the Research Grant of the Mayor of Vienna (no. 1045 [to Dr. Kainz])     

Evaluation of delta-aminolaevulinic acid excretion in random urine samples of children

Urinary delta-aminolaevulinic acid (-ALA) excretion was evaluated in random urine samples of 191 healthy children, aged 2–14 years, with blood lead levels <0.8 mol/l (mean ± SD: 0.34±0.13), erythrocyte zinc-protoporphyrin <70 mol/mol haem (mean ± SD: 50.4±8.0) and blood haemoglobin >6.8 mmol/l (mean ± SD: 8.2±0.5). It was found that uncorrected -ALA concentration and -ALA/creatinine ratio are age-dependent, whereas the ratio of -ALA/logarithm of creatinine concentration (mean ± SD: 55.3±13.5 mol/log mmol) is independent of age and sex. The authors recommend the use of this parameter for the assessment of -ALA excretion in random urine samples in children     

Retrospective prediction of birth weight by growth velocity curves during neonatal period

In this prospective study, birth weight of 304 babies born at Kamla Nehru Hospital Pune during study period was recorded. From these 304 babies, babies with birth weight above 2000 grams were selected (260 babies) to prepare growth velocity curves. Daily weight of these 260 babies was recorded for 30 days. The mean birth weight of study population was 2742.5 grams. Among the daily weight recorded babies, all the babies lost weight ranging from 92 to 218 grams (mean 121 grams) after birth. The weight loss continued upto 5 days. Days required to gain weight equal to birth weight ranged from 5 to 13 days. Total weight gain observed in 30 days was 734.7 grams. Predictive value of these curves was tested in 49 infants. Deviation upto 50 grams of predicted birth weight from actual birth weight was observed in 90% of babies on day-2, 79% on day-4, 65% on day-8 and 39% on day-30.     

Incidence of analgesic nephropathy among patients undergoing renal replacement therapy in Czech republic and Slovak republic

BACKGROUND.: The occurrence of analgesic nephropathy (AN) among renal replacementtherapy patients in former Czechoslovakia is not known. Previoussurveys were not based on representative samples and lackeduniform criteria for diagnosing the disease. METHODS.: Incidence of AN in former Czechoslovakia was investigated inpatients commencing renal replacement therapy in 24 (1/3 ofall) dialysis centres from 1 January to 31 December 1992. Patientsshowing an unclear renal diagnosis (n=149) were investigatedwith an interview and renal imaging techniques. The diagnosisof AN was withheld or rejected on the base of recently publisheddiagnostic criteria demonstrating that a decreased renal massof both kidneys combined with bumpy contours and/or papillarycalcifications had a high performance for diagnosing AN (NephrolDial Transplant 1992; 7: 479–486). RESULTS.: Based on the renal imaging criteria, AN was diagnosed in 30of 328 registered patients, resulting in an AN incidence of9.1% while the EDTA data only mentioned an incidence of 4.8%(period 1986–1989). The products most commonly abusedwere analgesic mixtures containing two analgesic substancescombined with caffeine and/or codeine. CONCLUSIONS.: AN was found to be a common disease in the Czech and SlovakRepublics. The disease was diagnosed using reliable renal imagingcriteria.     

Kraepelin-oriented research-diagnosable schizophrenia,mania, and depression in schneider-negative schizophrenics

Summary The rigorous neo-Kraepelinean research criteria of the St. Louis/ Iowa and Taylor groups were applied to case record data of 116 first admissions of Schneider-negative schizophrenics—that is, those without first-rank symptoms (FRSs)—hospitalized in a strongly Schneider-oriented German University Psychiatric Clinic from 1962 to 1971. This sample had a total of 45.7% (53 cases) of psychiatric illness diagnosable by research methods. Indeed, only 31% (36 cases) of Schneider-negative schizophrenics turned out to have research-positive Kraepelin-oriented schizophrenia; and of these, 21 fulfilled both sets of research criteria for schizophrenia. It is important that 14.6% (17 cases) of Schneider-negative schizophrenia consisted of research-diagnosable affective disorder, with mania making up 5.2% and depression 9.4% of this figure. The findings suggest that a sample of Schneider-oriented schizophrenia without FRSs as routinely diagnosed in Germany does not seem to represent a clear-cut homogeneous and uncontaminated group of schizophrenics.     

SPECT脑血流显像在难治性癫癎灶定位诊断中的价值

目的 :探讨单光子发射计算机断层(SPECT)脑血流显像在癫灶定位诊断 ,指导癫外科治疗的价值。方法 :对88例难治性癫患者进行了脑电图(EEG) ,磁共振成像(MRI)和SPECT脑血流显像检查 ,其中42例患者进行了外科(开颅手术或γ刀放射)治疗。结果 :SPECT脑血流显像的阳性率最高 ,为90.9 % ,EEG和MRI的阳性率分别为76.1 %和40.9 %。外科治疗患者SPECT与EEG定位结果的一致及相对一致率为83.3 % ,SPECT与MRI定位结果的一致及相对一致率为81.3 %。3者定位结果的一致及相对一致率为75.0 %。外科治疗的有效率为83.3 %。结论 :SPECT脑血流显像是诊断癫灶灵敏而有效的方法 ,对正确选择癫手术或γ刀治疗方案并取得较好的治疗效果具有重要意义     

Nuclear Pedigree Criteria for the Identification of Individuals Suspected to Be at Risk of an Inherited Predisposition to Gastric Cancer

Gastric cancer is the second most frequently diagnosed malignancy worldwide and therefore represents a significant healthcare burden. Environmental and genetic factors are involved in the development of gastric cancer. To date only one clear genetic predisposition has been identified involving mutations in the E-cadherin gene. The disease phenotype in patients harbouring E-cadherin mutations appears to be specifically related to diffuse gastric cancer. Little is known genetically about the other forms of gastric cancer. Since there is a growing awareness about the necessity of early intervention criteria have been developed that aid the identification of hereditary forms of gastric cancer. The aim of the current study was to identify minimal inclusion criteria so that nuclear pedigree families can be provided with risk assessment and/or genetic testing.The results reveal that inclusion features described herein such as (a) gastric cancer diagnosed before 46 years of age; (b) two gastric cancers among first degree relatives diagnosed over the age of 50 are useful in identifying suspected hereditary gastric cancer patients.     

国人（195例）重心动摇计检查正常值的测定

目的：为测得正常中国人重心动摇检查各项正常值。方法：１９５例无晕与平衡障碍的人行重心动摇检查，得到各项测试值，结果：与日本学会标准比较，睁眼与闭眼外周面积值各年龄组无益氏于日本学会标准，其余各项数值相仿。结论；国人重心动摇应参照中国人的正常值。     

小鼠四诊采集项目标准的建议

辨证论治机理实验研究主要采用的是小鼠.通过我们长期的研究和观察,初步建立了小鼠四诊采集项目标准.该标准主要有四部分内容:(1)类似于问诊采集的内容,包括一般情况、始病和治疗经过、饮食情况、脏腑病位;(2)闻诊采集的内容;(3)望诊采集的内容,包括自然望诊、胖瘦、小鼠旷场自主活动计数、爪和尾显微拍照后计算机图像处理等内容,涉及类似望形体状况、望形体虚实、望形体神、望形体寒热、望运动步态、望精力、望毛色虚实、望呼吸状况、望眼神、望耳、望鼻、望唇、望腹、望二阴、望大便、望小便、望爪、望尾、望睡眠、爪和尾显微观察等;(4)切诊采集的内容,包括体温、肿块检测、脉的至数与节律、肤之温凉、肌力等.同时,还对是否可以实现小鼠的四诊以及如何开展四诊进行了理论分析.     

老年性黄斑变性脉络膜新生血管的组织病理学特征

目的 观察老年性黄斑变性（AMD）脉络膜新生血管(CNV) 吲哚青绿血管造影(ICGA) 表现与其组织病理学变化的关系。 方法 ICGA检查确诊的AMD患者21 例21只眼，根据ICGA检查结果将CNV分成活动期、消退期、静止期，通过玻璃体切割手术取出CNV，光学显微镜、透射电子显微镜观察不同期CNV的组织病理学特征。 结果 活动期CNV9只眼，组织病理学特征为大量CNV，无色素性细胞和纤维组织或有少量色素性细胞将其部分包裹；消退期CNV9只眼，组织病理学特征为CNV较活动期减少，有较多色素性细胞、少量的纤维组织；静止期CNV3只眼，组织病理学特征为大量的纤维组织，无CNV或有极少CNV，无色素性细胞。 结论 渗出型AMD患者CNV的组织病理学特征与ICGA表现具有一定的相关性。 （中华眼底病杂志，2004，20：71-74）