Should punch biopsies be used when high-grade disease is suspected at initial colposcopic assessment? A prospective study

The reliability and applicability of colposcopically directed cervical punch biopsy was assessed in a sample of 170 paired punch and large loop excision of cervical transformation zone (LLETZ) specimens obtained from previously untreated women who had been selected for treatment on the basis of cytology and/or colposcopic findings and in whom the entire cervical transformation zone was visible. A single punch biopsy was taken immediately before the LLETZ, and all the specimens were reviewed by a single pathologist. Nine (5.3%) punch biopsies were inadequate. In terms of whether or not there was cervical intraepithelial neoplasia (CIN), the chance-corrected kappa analysis rated overall agreement as poor (kappa = 0.21, 95% confidence limits 0.02-0.39), whereas in terms of histologic grade, it was fair to moderate (kappa = 0.32, 95% confidence limits 0.23-0.42). Punch biopsy tended to underestimate the disease. The sensitivity and specificity of colposcopically directed punch biopsy for the detection of high-grade CIN was 74% and 91%, respectively, with positive- and negative predictive values of 97% and 48%, respectively. Two microinvasive and two intraepithelial glandular lesions were missed on punch biopsy. Punch biopsy should be avoided when high-grade disease is suspected.     

Sexual Maturation in Male Rats after Centchroman and Naphthofuran Administration during Neonatal Period*

Geschlechtsreife bei männlichen Ratten nach Centchroman- und Naphthofuran-Anwendung während der neonatalen Periode Am 5. Tag ihres postnatalen Lebens erhielten männliche Ratten eine Einzeldosis von 250 μg Östradiolpropionat; um an den Hoden Veränderungen in der Reifung und um das Wachstum der akzessorischen Geschlechtsorgane zu studieren. Dabei wurde festgestellt, daß das Wachstum der akzessorischen Organe reduziert war und daß Reifeveränderungen an den Hoden zu beobachten waren. Eine ähnliche Behandlung mit zwei nichtsteroidalen ?östrogenen” Substanzen (Centchroman - 500 μg und Naphthofuran - 500 μg) führte zu einer Retardierung des Hodenwachstums und der akzessorischen Geschlechtsorgane, während die Spermatogenese unbeeinflußt blieb. Dieser Effekt hielt über einen Zeitraum von 90 Tagen an. Die Ergebnisse der vorgelegten Studie legen es nahe, daß die zwei nichtsteroidalen Substanzen einen geringeren Effekt auf die non-response-Zentren für Hormone im Gehirn haben, verglichen mit dem klassischen Östrogen Östradiol.     

Fixed drug eruption due to ciprofloxacin

Summary We describe seven patients with fixed drug eruption (FDE) due to ciprofloxacin, five confirmed by rechallenge. These cases make up 8.75% of all cases of FDE seen by us during 1992–93. Isolated, and striking involvement of the lips was seen in two patients. To our knowledge, only a single case of FDE to ciprofloxacin previously has been reported. Our experience suggests that, with widespread use, ciprofloxacin could become one of the common drugs causing FDE.