RESUMO
AIM: Anal intraepithelial neoplasia precedes the development of anal squamous cell carcinoma. Detection of the lesion is essential to management. This paper describes a prospective study to detect and ablate anal squamous intraepithelial lesions (SILs) using white light narrow band imaging (NBI) and NBI with acetic acid (NBIA). METHOD: Sixty patients with abnormal anal cytology and risk factors for anal dysplasia underwent examination of the anoderm with a high definition gastroscope and NBIA. Targeted biopsies were taken and the lesions were ablated and characterized histopathologically. Visualization of the anal transitional zone was facilitated by retroflexion and examination through a disposable anoscope. RESULTS: Targeted biopsies were taken from lesions in 58 patients. No lesion was seen in two patients. Histopathology showed SIL in 48 (80.0%) of 60 biopsies. One biopsy showed lymphoid aggregates. Biopsies in nine (15%) of the 60 patients showed normal mucosa. Lesions were seen in white light in 27 (45%) of the 60 cases, NBI in 39 (65%) and NBIA in 57 (95%). There was no major morbidity. Sensitivity analysis showed that all methods were significantly different from each other. CONCLUSION: Anal SIL in the anal transitional zone and anal canal can be identified by NBIA. Patient selection influences findings. Limitations include small sample size and non-randomization.
Assuntos
Ácido Acético , Canal Anal/patologia , Neoplasias do Ânus/diagnóstico , Células Escamosas Atípicas do Colo do Útero/patologia , Indicadores e Reagentes , Imagem de Banda Estreita , Lesões Intraepiteliais Escamosas Cervicais/diagnóstico , Adulto , Idoso , Neoplasias do Ânus/complicações , Biópsia , Carcinoma in Situ/complicações , Carcinoma in Situ/diagnóstico , Feminino , Infecções por HIV/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Infecções por Papillomavirus/complicações , Lesões Pré-Cancerosas , Estudos Prospectivos , Lesões Intraepiteliais Escamosas Cervicais/complicações , Adulto JovemRESUMO
We determined the deduced amino acid sequences of two H1 duck influenza A virus hemagglutinins (HAs) and found that the consensus sequence of the HA, determined directly from virus recovered from the intestinal tract, remains unchanged through many generations of growth in MDCK cells and chicken embryos. These two duck viruses differ from each other by 5 amino acids and from A/Dk/Alberta/35/1976 (F. J. Austin, Y. Kawaoka, and R. G. Webster, J. Gen. Virol. 71:2471-2474, 1990) by 9 and 12 amino acids, most of which are in the HA1 subunit. They are antigenically similar to each other but different from the Alberta virus. We compared these H1 duck HAs with the HAs of human isolates to identify structural properties of this viral glycoprotein that are associated with host range. By comparison to the human H1 HAs, the duck virus HA sequences are highly conserved as judged by the small fraction of nucleotide differences between strains which result in amino acid substitutions. However, the most striking difference between these duck and human HAs is in the number and distribution of glycosylation sites. Whereas duck and swine viruses have four and five conserved glycosylation sites per HA1 subunit, none of which are on the tip of the HA, all human viruses have at least four additional sites, two or more of which are on the tip of the HA. These findings stress the role of glycosylation in the control of host range and suggest that oligosaccharides on the tip of the HA are important to the survival of H1 viruses in humans but not in ducks or swine.
Assuntos
Sequência Consenso/genética , Patos/microbiologia , Hemaglutininas Virais/genética , Vírus da Influenza A/genética , Sequência de Aminoácidos , Animais , Antígenos Virais/genética , Antígenos Virais/imunologia , Células Cultivadas , Sequência Consenso/imunologia , Fezes/microbiologia , Variação Genética , Glicosilação , Glicoproteínas de Hemaglutininação de Vírus da Influenza , Hemaglutininas Virais/imunologia , Vírus da Influenza A/imunologia , Modelos Moleculares , Dados de Sequência Molecular , Processamento de Proteína Pós-Traducional , Sequências Reguladoras de Ácido Nucleico/genética , Seleção Genética , Homologia de Sequência de AminoácidosRESUMO
A patient with sickle cell disease and multiple alloantibodies required frozen storage of autologous red cells (RBC) to provide the RBC volume equivalent of 6 units of normal donor blood for an orthopedic surgical procedure. Eleven 600-ml donations were made at 4-week intervals, without significant change in hemoglobin concentration, hematocrit, or reticulocyte count, and with only small decreases in serum iron and ferritin concentrations. Minor modifications of a glycerolization and deglycerolization procedure described recently were used. We report in vitro recoveries of deglycerolized RBC from the 11 units following frozen storage for 27 to 391 days. Despite use of a single donor and adherence to a standardized processing protocol, considerable variation in the percent in vitro RBC recovery was observed (51-81%). In vivo survival of an aliquot following frozen storage for 27 days was identical with fresh autologous RBC (100% at 1 hr, 88% at 24 hr, one-half disappearance of 7.5 days). Autologous transfusion of RBC recovered from 7 units after storage for as long as 126 days was uneventful.
