Autonomic heart-rate control in response to standing in toxemic and normotensive primigravid pregnancies.

Heart-rate changes after transition from a supine to a standing posture were measured in 12 hypertensive and 12 normotensive primigravid women, in their last trimester of gestation. The subjects beat-to-beat heart-rate (HR) changes were recorded on both an ordinary cardiotocograph and on magnetic tape. The hypertensive patient group (1) reached an HR-maximum after standing up in a significantly shorter period of time and (2) had a significantly lower HR during 1 min erect posture. A population threatened by pregnancy-induced hypertension might be detected by using the non-invasive method of recording the maternal beat-to-beat heart-rate changes after transition to the standing posture, even before the onset of hypertension.

The association between precancerous-columnar and squamous lesions of the cervix: a morphometric study.

A histological study of 208 cases found a strong association between the occurrence of precancerous cervical columnar and squamous lesions. This was not, however, directly related to cellular abnormalities. The criteria for adenocarcinoma in situ (AIS) and its precursor lesions were defined morphometrically. With increasing abnormalities of the columnar cells, changes of the glandular and epithelial architecture were more frequently observed. Of the 20 cases morphometrically classified as AIS, only four were initially diagnosed as such, of which three were cases of 'pure' AIS lacking squamous cell abnormalities. Quantifying abnormalities of columnar epithelium is an important aid in the identification and classification of AIS.

Morphometric characterisation of 52 B cell non-Hodgkin's lymphomas.

Fifty-two B cell non-Hodgkin's lymphomas, in which the diagnosis was based on immunological, cytochemical, and ultrastructural studies, were characterised by morphometry on plastic-embedded tissue sections. Parameters studied were: nuclear size, cytoplasmic area, cytoplasm to nucleus ratio, nuclear contour index, nucleolar size, location of nucleoli within the nucleus, as expressed by relative nucleolar eccentricity, and the mean number of nucleoli per nuclear cross-section. The results of the measurements and subsequent statistical analysis show that the different types of lymphoma can be distinguished from each other, even though the differences were small. Small cell lymphomas (chronic lymphocytic leukaemia, lymphoplasmacytoid and polymorphic immunocytoma, centrocytic, centroblastic/centrocytic and intermediate lymphocytic lymphomas) could be separated from each other by the standard error of mean (SEM) of nuclear area, the cytoplasm to nucleus ratio, and nuclear contour index. Large cell lymphomas (centroblastic and B immunoblastic lymphomas) could be differentiated with cytoplasm to nucleus ratio and nucleolar parameters (relative nucleolar eccentricity and number of nucleoli per nuclear cross-section). The morphometric parameters of lymphoblastic lymphomas fell in the range of the large cell lymphomas, but lower SEM indicate these lymphomas were more monomorphic. These morphometric data underline the concept of the Kiel classification and establish the usefulness of morphometry as an additional technique in diagnosis.

Morphometrical analysis of urothelial cells in voided urine of patients with low grade and high grade bladder tumours.

The morphometric differences between the urothelial cells (wet-fixed Papanicolaoustained) in the voided urine of 2 patients with low grade and high grade bladder tumours were measured. The morphometrical data of this learning set resulted in a cytomorphometrical classification rule, which was applied to a test set of 21 cases with low grade and high grade bladder tumours. The results of the cytomorphometrical classification rule correspond very well with the histomorphometrical classification and the histological grade of the parent tumours. The results indicate that it is feasible to classify bladder tumours using the cytomorphometrical data of the exfoliated urothelial cells alone.

Computation of preoperative diagnosis probability for follicular adenoma and carcinoma of the thyroid on aspiration smears.

Morphometric analysis of 23 follicular tumors (13 adenomas and 10 carcinomas) and 10 metastatic lesions from follicular thyroid carcinomas resulted in the identification of five significant parameters between the carcinoma and adenoma groups. With a classification rule using these features, the probability of a histologic diagnosis of adenoma versus carcinoma was computed for each case. Using threshold values of probabilities of 0.25 and 0.75, only 1 of the 33 cases was not correctly classified on the cytologic smear alone; the remaining 32 cases were correctly classified. These results indicate that morphometric analysis in follicular tumors of the thyroid may be of great help in individual patient care if used as a selective method by a well-trained cytopathologist.

Morphometry and cytodiagnosis of breast lesions.

Cells aspirated from breast lesions and smeared on slides were subjected to computer assisted morphometric analysis. Three groups of cases were studied. The first were those collected from patients with known benign and malignant lesions. The second group were 143 unselected consecutive aspirates from breast lesions and the third, a group with a needle aspirate cytodiagnosis "suspicious of malignancy". The analysis showed the malignant cells to have larger nuclei with more anisokaryosis and more variation in the nuclear cytoplasmic ratios when compared with benign cells. When this form of semiautomatic analysis was applied to the "suspicious" group the accuracy of cytodiagnosis was improved.

Adenocarcinoma in situ of the cervix: an underdiagnosed lesion.

Although invasive adenocarcinoma of the cervix constitutes 5--15% of all cervical cancers, the in situ counterpart is underrepresented in the published series of percursor lesions of cervical cancer. Moreover, no cases are known to have been published in which in situ adenocarcinoma preceded invasive cancer. Partly, this can be explained by the fact that in situ adenocarcinoma is an underdiagnosed lesion. In a series of 52 cases of adenocarcinoma of the uterine cervix, 18 "negative" endocervical biopsies, taken 3--7 years prior to the clinical presentation of cancer, were available for study. In five of these cases, areas of adenocarcinoma in situ were found. The quantitative parameters of these "missed" adenocarcinomas in situ and adenocarcinomas in situ adjacent to invasive cancer were the same. The in situ lesions differed significantly from benign endocervical epithelium. This study strongly suggests that these lesions may progress to invasive cancer. With the acquired information on the quantitative features of adenocarcinoma in situ cells, the most significant criteria for routine diagnostic practice can be identified.