PAPNET testing for HSILs. The few cell/small cell challenge.

OBJECTIVE: To define and evaluate the effectiveness of the PAPNET Testing System for high grade squamous cervical intraepithelial lesions (HSIL). STUDY DESIGN: The literature was reviewed, defining the "few cell/small cell challenge" associated with HSIL. Several recently published investigations demonstrate the effectiveness of PAPNET testing, especially the effectiveness of PAPNET testing in reducing false negatives for these lesions. RESULTS: The results of several independent investigations demonstrate that the PAPNET Testing System is sensitive to the types of abnormalities typically not detected by conventional screening (e.g., abnormal cells that are small and few in number). In clinical practice, the PAPNET Testing System is effective in reducing false negatives. CONCLUSION: The PAPNET Testing System helps solve the "unfortunate paradox of Pap smear diagnosis," as noted by DeMay, that high grade serious lesions may be more difficult to detect and diagnose by cytology than low grade lesions, which are clinically less significant and often regress without therapy. The accuracy of detection of HSIL is improved with the PAPNET Testing System.

Expression of PAI-1, t-PA and u-PA in cultured human umbilical vein endothelial cells derived from racial groups.

To determine whether inherent fibrinolytic differences may exist in racial groups (black americans, BA vs. white americans, WA), 55 different individual racially-derived human umbilical vein endothelial cell (HUVEC) cultures (35 BA and 20 WA) were analyzed in terms of their fibrinolytic protein (t-PA, u-PA and PAI-1) antigen and mRNA levels. Values (mean +/- SD) for measured fibrinolytic component levels include: cell-associated t-PA antigen (ELISA), 1.14 +/- 0.82 ng/ml/8.6 x 10(5) cells/24 hr in BA and 0.70 +/- 0.85 ng/ml in WA (p = 0.0624); secreted t-PA antigen, 18.65 +/- 17.06 ng/ml in BA and 10.37 +/- 6.38 ng/ml in WA (p = 0.0422); t-PA/cyclophilin mRNA ratios (Northern blot analysis), 1.90 +/- 1.34 in BA and 1.32 +/- 0.70 in WA (p = 0.0776); cell-associated PAI-1 antigen, 71.10 +/- 30.16 ng/ml/8.6 x 10(5) cells/24 hr in BA and 108.85 +/- 56.89 ng/ml in WA (p = 0.0022); secreted PAI-1 antigen, 1,582.13 +/- 612.67 ng/ml in BA and 1,992.17 +/- 711.50 ng/ml in WA (p = 0.0285); 2.4 kb PAI-1/cyclophilin mRNA ratios, 0.59 +/- 0.39 in BA and 0.79 +/- 0.31 in WA (p = 0.1085); 3.4 kb PAI-1/cyclophilin mRNA ratios, 0.70 +/- 0.47 in BA and 0.77 +/- 0.54 in WA (p = 0.6322). These combined data suggest that cultured HUVECs from BA express significantly higher levels of t-PA, lower levels of PAI-1 and approximately 1.72-fold lower molar ratio of PAI-1/t-PA antigen (183.99 +/- 168.81 vs. 315.92 +/- 164.99) (p < 0.05) than cultured HUVECs from WA, presumably reflecting an apparent inherent increased fibrinolytic potential in cultured HUVEC derived from BA.

Eluate analysis of anti-Bg a associated renal allograft rejection.

Renal allograft rejection, following development of a positive indirect antiglobulin reaction, occurred in a multiply transfused recipient. Panel techniques confirmed both anti-Bga and anti-Kell antibodies. Recognition of the concordant antigenic specificity of the Bga and HL-A7 antigens led to an investigation of the potential role of this antibody in the rejection phenomenon. In the absence of serological cytotoxicity, a modified elution technique was used to directly obtain immunoglobulin from the rejected allograft. The eluate obtained displayed specificity for the Bga red blood cell antigen. The described technique affords an additional approach to the documentation of immunologically mediated graft rejection and obviates the limitations imposed by the absence of serological cytotoxicity. Emphasis is placed on the need for recognition of the relationship between red blood cell and HL-A antigens.