Effect of eight weeks of endurance exercise training on right and left ventricular volume and mass in untrained obese subjects: a longitudinal MRI study.

The aim of the present investigation was to examine how 8 weeks of intense endurance training influenced right and left ventricular volumes and mass in obese untrained subjects. Ten overweight subjects (19-47 years; body mass index of 34+/-5 kg/m(2)) underwent intensive endurance training (rowing) three times 30 min/week for 8 weeks at a relative intensity of 72+/-8% of their maximal heart rate response (mean+/-SD). Before and after 8 weeks of endurance training, the left and the right end-diastolic volume (EDV), end-systolic volume (ESV), ejection fraction (EF), stroke volume (SV) and ventricular mass (VM) were measured by Magnetic resonance imaging (MRI). Submaximal heart rate decreased from 126+/-5 to 113+/-3 b.p.m. (10%; P<0.01), and from 155+/-5 to 141+/-4 b.p.m. (9%; P<0.001) at submaximal workloads of 70 and 140 W (110 W for women), respectively (mean+/-SEM). Resting ventricular parameters increased significantly: left ventricular SV, EDV and VM increased by 6%, 7% and 13%, respectively (P<0.01). The right side of the heart showed significant changes in SV, EDV and VM with increase of 4%, 4% and 12%, respectively (P<0.05). Eight weeks of endurance training significantly increased left ventricular SV and right ventricular SV, due to an increase in left ventricular EDV and right ventricular EDV. Furthermore, left VM and right VM increased. We conclude that using MRI and a longitudinal design it was possible to demonstrate similar and balanced changes in the right and left ventricle in response to training.

Revisiting the effect of the Pap test on cervical cancer.

OBJECTIVES: This report documents the effect of not having had a Papanicolaou (Pap) test on survival with uterine cervical squamous carcinoma. METHODS: Data were derived from Charity Hospital of Louisiana at New Orleans Tumor Registry reports for 1984-1987 and 1996. RESULTS: During the 5 study years, 101 of 213 women (47%) with invasive carcinoma had not undergone a previous Pap test. From 1984 to 1987, the observed 5-year survival rate for 171 patients with invasive carcinoma was 43%. The observed 5-year rate for 107 patients with carcinoma in situ from 1984 to 1986 was 99%. CONCLUSIONS: The goal of a yearly Pap test for all women can be approached by a number of different routes, with the use of all health facilities augmented with collection of specimens by trained nonphysician personnel.

Alteration of Wilms' tumor staging by cytologic detection of malignant cells in chylous ascites.

Accurate staging as per National Wilms' Tumor Study (NWTS) criteria is essential for therapy of Wilms' tumor. We report a unique case of a 9-mo-old white male in whom the diagnosis based upon clinical, radiological, surgical, and initial histopathologic findings was Stage I Wilms' tumor without regard to a positive cytologic examination of a small amount (5 ml) of chylous ascitic fluid obtained intraoperatively. This problem was clarified later at the NWTS panel review when the deeper recuts of a renal hilar lymph node revealed a single cluster of Wilms' tumor cells in capsular sinus, resulting in upstaging of tumor to Stage III. The significance of these findings in relation to staging will be discussed.

Medulloblastoma metastatic to breast, diagnosed by fine-needle aspiration biopsy.

The extracranial spread of a primary intracranial tumor is an infrequent occurrence. The most common metastatic sites in order of frequency are bone, lymph nodes, and soft tissue. Analysis of the literature uncovered only two case reports of medulloblastoma that had metastasized to the breast. Both of these cases were diagnosed by open surgical biopsies. We present a case of medulloblastoma metastatic to the breast which was diagnosed by fine-needle aspiration biopsy. This diagnosis was subsequently confirmed by a tru-cut surgical biopsy and was further supported by immunohistochemical studies.

The delayed diagnosis of invasive carcinoma of the uterine cervix.

While an effective method of screening for uterine cervical cancer is available, utilization of that method has been less than satisfactory in the high-risk indigent population of Louisiana. From 1984 through 1987, 171 new cases of invasive squamous cell carcinoma and 149 new cases of squamous carcinoma in situ of the uterine cervix were examined and/or treated at the Charity Hospital of Louisiana in New Orleans. In the 1984 group, 23 patients of the invasive and no patients of the in situ group died, giving a 5-year survival of 43% and 100% respectively. During the 4 years in question, 84 (49%) patients in the invasive group and 2 (1.3%) in the in situ group had no record of having had a previous cervical cytologic examination. Participation by nongynecology staff physicians, nurses, and nurse's aides in the charity hospitals and clinics in New Orleans and throughout the state could possibly remedy this problem.

Fine-needle aspiration by vacuum tubes.

Fine-needle aspiration of subcutaneous masses, accepted in many parts of Europe and the Americas as a routine diagnostic technique, employs a syringe holder to facilitate the creation of a vacuum to withdraw cells. This investigation demonstrates that a vacuum tube used in venipuncture can be used to supply the negative pressure to suck cells into the needle. This apparatus is more readily available than a syringe holder in hospitals and clinics, and particularly provides the operator with a more dexterous approach to the mass because the fingers holding the needle can be much closer to the mass being immobilized by the other hand.

Detection of urinary tract cancer in urinalysis specimens in an outpatient population.

This investigation was undertaken to determine the effectiveness of detecting urinary tract cancer in an outpatient population utilizing the urinalysis sediment. A total of 9870 urinalysis wet preparations was examined on patients from various clinics serviced by the clinical microscopy laboratories. One hundred forty-eight of these examinations were considered to be abnormal (1.5%). Follow-up urine specimens from the patients with atypical wet preparations examined in the cytology laboratory by the permanent procedure were obtained from 100 patients (68% return rate). Histopathologic follow-up studies revealed 12 of the original abnormal wet preparations had histologic evidence of cancer. Such a high pick up rate (1.2 per 1000) suggests that this examination for cancer is a valuable additional part of urinalysis.

Malignant melanoma of the cervix. Report of a case.

A malignant melanoma of the cervix, a rare neoplasm, was found to have an unusual cytologic pattern, similar to that of a leiomyosarcoma. A biopsy sample was diagnosed as cervical malignant melanoma of the spindle cell type. Some neoplastic cells in the tissue contained melanin pigment, whereas none of the abnormal cells in the cervical scrapes, except for an abnormal giant cell, had visible cytoplasmic pigment. The abnormal cells in the cervical scrape specimen were spindle-shaped, as were their nuclei, which is why the cytologic pattern was interpreted as that of a leiomyosarcoma. Evidence from this and previously reported cases shows that malignant melanoma must be considered as a possible source of exfoliated abnormal nonpigmented spindle-shaped cells in a cervicovaginal cell sample.

Linear and nonlinear effect of the argon laser on a fallopian tube animal model.

Rabbit fallopian tubes were used as models to demonstrate the delayed effects of the argon laser wavelength on tissue. Power density, energy density, and velocity were all variables in the experiment. Three groups of ten rabbits were sacrificed two at a time, on days 0, 5, 10, 15, and 20. The results clearly showed delayed tissue changes associated with fibrosis. Mathematical and theoretical comparisons of the argon laser to the carbon dioxide laser help express the advantages and disadvantages of the use of the argon laser in fallopian tube surgery. The return of organ function with respect to time has possible significance to studies of human fallopian tube surgeries.

Herpes simplex virus type 2 and human cervical cancer: relationship between cellular and immune assays for the detection of previous infection.

Women with invasive carcinoma of the cervix were examined for evidence of previous infection with herpes simplex virus (HSV) type 2 (HSV-2) by three assays: Assay 1 measured the ratio of lymphocyte blastogenesis to herpes simplex virus type 1 (HSV-1) and HSV-2 antigens; assay 2 measured the ratio of antibody titer to surface antigens of HSV-1-infected and HSV-2-infected cells; assay 3 measured the titer of type-specific antibody to HSV-1 and HSV-2, including the percentage of HSV-2 type-specific to total HSV antibody. The ability of assays to detect previous infection was evaluated with the use of groups with histories of infection with HSV-1, HSV-2, or both. Women with invasive cervical cancer were matched to control women by age (+/- 3 yr), race (black), and socioeconomic class (low). All assays detected similar patterns of previous HSV-2 infection, and all indicated a higher frequency of previous HSV-2 infection in women having cervical cancer. Results from assays 1 and 2 suggest that many of the cancer patients and controls also had been infected with HSV-1. The more definitive type-specific antibody assay confirmed those results and showed that sera from 85% of women having cervical cancer and from 100% of the matched controls contained antibody type-specific for HSV-1.

Detection of urinary cancer with urinalysis sediment.

Examination of urinalysis sediments stained with toluidine blue from 1,208 men and women more than 40 years old revealed 58 abnormal specimens. Of these specimens 5 were positive with a routine cytologic examination and histopathologic confirmation. This detection rate of 1 bladder cancer in 1,000 examinations makes this simple examination worthwhile, the preparation of which has been done mainly in clinical microscopy.

Cytologic diagnosis of amniotic fluid embolus. Report of a case.

This paper reports a case of a primigravid woman with the presumptive diagnosis of amniotic fluid embolus who had a blood sample aspirated from the right heart. The blood specimen was sent to the cytology laboratory, processed and then examined for squames and lanugo. The laboratory procedure and results are described.

Association of Herpes simplex virus (HSV) with cervical cancer by lymphocyte reactivity with HSV-1 and HSV-2 antigens.

Twenty-six women with invasive cervical cancer were examined for lymphocyte responsiveness to phytohemagglutinin (PHA) herpes simplex virus (HSV). Blood specimens were obtained from each patient before radiation therapy and separated into subpopulations by Ficoll-Hypaque centrifugation. Lymphocytes were cultured in RPMI-1640 containing autologous plasma and exposed to PHA, HSV-1, HSV-2, and control antigens. The results compared with those of women having negative Papanicolaou smears and matched to the cancer patients by age, race, and socioeconomic class revealed significant differences in blastogenic response (3H-thymidine) to HSV-2 antigens. Results from groups with known HSV-1 and HSV-2 infections indicated that differences were associated with the cancer patients having a higher frequency of HSV-2 infection. Results generally agreed with the findings of previous studies in which serologic test procedures were used.