RESUMO
OBJECTIVE: To assess the efficacy of a new fluid-based, automated, thin-layer system for cervical screening, in routine use in our clinical laboratory. STUDY DESIGN: Data from 39,408 conventional cervical cytologic smears and 10,694 ThinPrep slides collected concurrently were analyzed to compare diagnostic detection rates, specimen adequacy, sensitivity and specificity. RESULTS: The ThinPrep slides yielded a significantly higher proportion of low grade squamous intraepithelial lesions (LSILs) and high grade squamous intraepithelial lesion (HSIL) diagnoses when compared to the conventional smear. This increase was greater than twofold. The ASCUS:LSIL ratio was reduced by 55% in the ThinPrep group. Specimen adequacy was also improved: the ThinPrep method reduced the "satisfactory but limited by" (SBLB) rate by 35% and the "unsatisfactory" category by 73%. Limited biopsy results confirmed the increased sensitivity of ThinPrep. CONCLUSION: In routine use in our laboratory, the ThinPrep method demonstrated a significant increase in the detection of LSIL and HSIL diagnoses. Specimen adequacy was also dramatically improved. The ThinPrep method significantly reduced the number of SBLB and unsatisfactory specimens.
Assuntos
Colo do Útero/citologia , Esfregaço Vaginal/métodos , Adolescente , Adulto , Idoso , Automação , Biópsia , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/patologia , Centrifugação com Gradiente de Concentração , Células Epiteliais/patologia , Estudos de Avaliação como Assunto , Feminino , Humanos , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Sensibilidade e Especificidade , Manejo de Espécimes/instrumentação , Manejo de Espécimes/métodos , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/patologia , Esfregaço Vaginal/instrumentação , Displasia do Colo do Útero/diagnóstico , Displasia do Colo do Útero/patologiaRESUMO
To study whether myocardial infarction differs in patients with and without ventricular tachycardia, the hearts of 22 deceased patients with ventricular tachycardia and 21 deceased control patients were analyzed quantitatively. The hearts from the ventricular tachycardia group were heavier and more dilated than those from the control group. Histologic analysis of a representative cross section from each heart showed that the ventricular tachycardia group had larger, more solid infarcts than did the control group. The ventricular tachycardia group also had a greater area of spared subendocardium, more hydropic change of the spared subendocardium, and more "ribbon type" spared subendocardium, which was defined as spared subendocardium of uniform contour 1 mm thick or less. The ventricular tachycardia group was divided into a subacute subgroup (n = 14, dying less than or equal to 10 weeks after infarction) and a chronic subgroup (n = 8, dying greater than 10 weeks after infarction). The infarcts of the subacute ventricular tachycardia group were more solid and had a greater amount of ribbon type spared subendocardium than those of the chronic ventricular tachycardia group. This information can serve as a baseline for the evaluation of animal preparations of tachycardia and, when combined with knowledge of the location of the arrhythmogenic region furnished by intraoperative mapping, should lead to better understanding of the anatomic substrate for ventricular tachycardia.
