Sub-ppt detection limits for copper ions with Gly-Gly-His modified electrodes.

An electrochemical metal ion sensor has been developed with a detection limit of less than 0.2 ppt by the covalent attachment of the tripeptide Gly-Gly-His as a recognition element to a 3-mercaptopropionic acid modified gold electrode.

Villoglandular adenocarcinoma of the cervix: a report of three cases and review of the literature.

Villoglandular adenocarcinoma of the cervix is a distinct histologic type of cervical cancer. Fewer than 60 cases have been reported in the literature. Previous reports suggest that, due to the highly favorable prognosis of this rare histologic type of cervical cancer, conservative surgical therapy with cervical conization or extrafascial hysterectomy alone may be undertaken. In this series, three cases of villoglandular adenocarcinoma of the cervix are described. Preoperatively in each case, the cancer was confined to the cervix and histologic well-differentiated villoglandular adenocarcinoma of the cervix was confirmed. Extended hysterectomy was performed in all cases. In one case, residual invasive endocervical adenocarcinoma was noted. Careful review of the histologic characteristics of these tumors is needed when deciding if these patients can be managed with conservative therapy.

Physical properties and use of pertechnegas as a ventilation agent.

UNLABELLED: Pertechnegas, a variant of technegas, produces similar ventilation images with a much increased clearance rate. This work aims to determine the properties of pertechnegas and its use as a ventilatory agent. METHODS: Fourteen men and 11 women were scanned for PE, after pertechnegas ventilation. Six were reimaged with technegas within 1 wk. Studies were reported according to PIOPED criteria. Pertechnegas samples were analyzed by transmission electron microscopy (TEM), cascade impaction (CI), aerosol mobility analysis (AMA), Fourier transform mass spectrometry (FTMS), x-ray photoelectron spectroscopy (XPS), paper strip (PC) and gas chromatography (GC). RESULTS: Post-test probabilities were normal in 5, low in 8, high in 5 and indeterminate in 7. There were 15 Grade 1, 6 Grade 2 and 4 Grade 3 studies. All Grade 3 patients had FEV1 < 1.5 liters, 3 with rates < 1.0 liter. Patients with high probability had proven deep venous thrombosis in three by venography and in one by doppler. TEM identified 0.3 micron salt particles. CI demonstrated a 7-min time to half clearance from the chamber for particles in the < 0.1 micron range. AMA indicated all particles were < 0.032 micron when salt was excluded. Pertechnegas behaves in PC as pertechnetate, GC demonstrated CO levels below 516 ppm. CO2 concentrations were 0.146 +/- 0.0009%. FTMS found molecular pertechnetate species including 99TcO3(OH)+, Na99TcO3(OH)3+ and Na99TcO3(OH)3+. XPS confirmed that these Tc species exist in oxidation state +7. CONCLUSION: Comparison with technegas images in the follow-up group proved equivalent in the first five views, but indistinct lung boundaries and a high background activity characterized the final anterior images. The active component of pertechnegas is molecular pertechnetate.

A study of Technegas employing X-ray photoelectron spectroscopy, scanning transmission electron microscopy and wet-chemical methods.

Scanning transmission electron microscopy (STEM), coupled with energy dispersive X-ray analysis (EDS), X-ray photoelectron spectroscopy (XPS) or radionuclear chemical methods, indicates that the active agent in Technegas is either polymeric TcO2[i.e. (TcO2)n] or (TcO2)n bound to a carbon nanoparticle. The particle size observed using STEM is in good agreement with other published results. XPS has also been used to investigate technetium residues remaining on spent crucibles. The chemical form of technetium in this residue is quite different to the form detected in the aerosol particles. We conclude that the small fraction that migrates into the crucible framework upon resistive heating is reduced to either metallic technetium or carbidic forms, with the remaining nuclide evaporating as (TcO2)n with or without carbon before complete reduction can occur.

The observation of fullerenes in a Technegas lung ventilation unit.

Evidence is provided to show that Technegas has structure compatible with the Buckminsterfullerene model C60 in which 99Tcm atoms are trapped.

Preservation of multiple oncogenic human papillomavirus types in recurrences of early-stage cervical cancers.

OBJECTIVES: Our purpose was to determine the relationship between human papillomavirus genotypes contained in primary early stage cervical cancers and those contained in the respective recurrences. STUDY DESIGN: Six early-stage cervical cancers that were considered cured by surgical extirpation subsequently recurred within 21 months of the original surgery. The primary tumors and the recurrences underwent polymerase chain reaction for human papillomavirus typing with confirmation of types performed by means of diagnostic restriction fragments. RESULTS: All primary tumors and recurrences contained human papillomavirus, with all primary tumors positive for multiple types. The concordance rate between the primary tumors and recurrences for specific types was 73% (11/15). Among the highly oncogenic types 16 and 18 there was 100% concordance between primary and recurrent tumors. CONCLUSIONS: Highly oncogenic types of human papillomavirus are preserved between primary tumors and their recurrences in cervical cancers. This further supports the role of oncogenic types in the maintenance of the malignant state and supports the clonogenic nature of cervical cancer recurrence.

Evaluation of two commercially available in situ hybridization kits for detection of human papillomavirus DNA in cervical biopsies: comparison to Southern blot hybridization.

In order to determine the distribution of human papillomavirus (HPV) types and to compare in situ hybridization (ISH) with Southern blot hybridization (SBH), paired colposcopically directed cervical biopsies and cervical-vaginal lavages were obtained from 92 women referred for abnormal Pap smears. The lavages and one of the biopsies were snap-frozen and subsequently tested by SBH for HPV DNA. The other biopsy was formalin-fixed and paraffin-embedded for conventional light microscopy and for ISH using two commercially available kits from Digene Diagnostics Inc.: ViraType In Situ containing probe mixtures to HPVs 6 and 11, 16 and 18, and 31, 33, and 35; and Omniprobe containing a single probe mixture to 14 different anogenital HPVs. In addition to the aforementioned types Omniprobe contains probes for types 42, 43, 44, 45, 51, 52, and 56. HPV DNA was detected by SBH in 27% of specimens showing no specific pathological change and in 92% of cases of cervical intraepithelial neoplasia (CIN). The HPVs by SBH in CIN were type 16 in 25%, types 31 or 35 in 23%, types 52 or 56 in 17%, uncharacterized types in 13%, mixed types in 8%, and type 18 in 6%. None of the specimens was positive for the low-risk HPV types 6, 11, 42, 43, or 44. The proportion of cases of CIN containing HPV 16 increased as the grade of CIN increased. Otherwise there were no striking differences detected in the HPV types in the different grades of CIN. ISH using ViraType In Situ was positive in only 50% of cases of CIN that were HPV positive by SBH.(ABSTRACT TRUNCATED AT 250 WORDS)

Idiopathic hydropericardium as a cause of death of a preterm neonate.

We report a case of a very premature infant who died on day 17 of life because of clinically unsuspected cardiac tamponade due to a pericardial effusion with no gross or microscopic features of myocardial inflammation or perforation. The pericardial effusion probably accumulated for 8 days prior to his death, as evidenced by chest X-ray films. The only relevant microscopic finding was a prominent pericardial and myocardial interstitial edema. Although Staphylococcus epidermidis line sepsis, central venous catheter trauma, hypoalbuminemia, anemia, and heart failure could be possible contributory factors, no definitive cause of the pericardial effusion was found and the etiology of this condition remains obscure.

Prognostic significance of polymerase chain reaction detected human papillomavirus of tumors and lymph nodes in surgically treated stage IB cervical cancer.

This study describes the prognostic role of polymerase chain reaction detected human papillomavirus (HPV) in Stage IB cervical cancer patients treated with radical hysterectomy and pelvic and paraaortic node dissection. All tumors were confined to the cervix and all margins and nodes were disease free. Twenty-one patients were analyzed: 6 patients recurred within 20 months of initial therapy, while 15 had no evidence of disease with a minimum follow-up of 36 months. Polymerase chain reaction (PCR) was performed on paraffin-block tissue of the hysterectomy specimen cervical tumor and lymph nodes. Oligonucleotide probes for HPV types 6, 11, 16, 18, 31, 33, and 35 were used with consensus primers for uncharacterized HPV types created from an L1 constant region. Control tissues were run with each tumor sample to assure against contamination. HPV type confirmation was performed using diagnostic restriction sites. HPV was detected in all cervical tumors. Recurring tumors were infected with multiple types of HPV in all 6 tumors versus only 5 of 15 nonrecurring tumors being multiply infected (P = 0.023). No tumor had HPV 6 or 11, and the incidence of HPV 16, 31, 33, and 35 was not significantly different for recurrent versus nonrecurrent groups. HPV 18 was found in 5 of 6 recurring cancers versus 1 of 15 nonrecurring tumors (P = 0.0029). PCR typing of the histologically negative nodes that had been obtained at radical hysterectomy was done in all 6 recurring patients and in 6 nonrecurring patients. The recurrent patients had a significantly higher incidence of lymph nodes positive for HPV DNA (71%) than the nonrecurring patients (35%) (P = 0.0047). These observations suggest that HPV 18 cervical cancer patients, those with infections of multiple types, and those with HPV DNA in histologically negative lymph nodes may be at increased risk for recurrence.

Epidermal growth factor receptor expression and the presence of human papillomavirus in cervical squamous intraepithelial lesions.

To determine the relationship between the expression of epidermal growth factor receptor (EGFR) and the presence or type of human papillomavirus (HPV) in cervical squamous intraepithelial lesions (SIL), paired colposcopically directed cervical biopsies were obtained from 88 patients referred for abnormal Papanicolaou smears. One biopsy was formalin-fixed and processed for conventional light microscopy, and the other was immediately frozen. A portion of the frozen tissue was used for Southern blot HPV DNA hybridization and a portion for immunohistochemical studies for EGFR using a monoclonal antibody. Forty-seven cases were SIL and 41 were normal. In 41 (87%) of the cases of SIL and in eight (20%) of the normal cases, HPV DNA was detected. Of the SIL cases, HPV 16 was the most frequently detected type, being present in 12 (25%), followed by 10 (21%) types 31 or 35, nine (19%) types 52 or 56, five (11%) uncharacterized types, three (6%) type 18, and two (4%) multiple types. Regardless of histology, EGFR was detected in all cases. In normal cases, EGFR expression was detected in the basal cells only and in SIL in abnormal proliferating parabasal cells such that it correlated with the grade of SIL. When stratified by grade of SIL, no differential expression of EGFR was seen in cases where HPV was detected; in contrast, in cases where no HPV was detected, no differential expression was seen between cases of different HPV type. Thus, EGFR is expressed by all proliferating squamous epithelial cells and as such correlates with the grade of SIL.(ABSTRACT TRUNCATED AT 250 WORDS)

Periurethral colonic-type polyp simulating urethral caruncle. A case report.

A 50-year-old, black woman presented with a 1-cm, polypoid lesion on the posterior edge of the urethral meatus that had the gross appearance of a urethral caruncle. The histologic features, however, revealed a superficially ulcerated lesion composed of colonic-type mucosal glands with focal regenerative atypia in response to inflammation. A similar histologic pattern is also found in so-called solitary rectal ulcer syndrome and inflammatory cloacogenic polyps arising in the anorectal area. Based upon an English-language literature review, this case appears to be the second reported one of an intestinal-type polyp in this location. The patient had no further problems after excisional biopsy.

Correlation of the histologic appearance of intraepithelial neoplasia of the cervix with human papillomavirus types. Emphasis on low grade lesions including so-called flat condyloma.

Cervical condylomas and intraepithelial neoplasia (CIN) were correlated with human papillomavirus (HPV) types and analyzed for the presence of abnormal mitotic figures. Colposcopically directed cervical biopsies were divided in half and processed for routine microscopy and Southern blot hybridization. Of 83 specimens from 71 patients, 70 (84%) contained HPV-DNA sequences. The HPV distribution was as follows: HPV 16 in 6/25 flat condylomas (FC), 2/8 CIN I, 8/18 CIN II, 12/14 CIN III; HPV 18 in 1/25 FC; HPV 31 in 3/25 FC, 3/18 CIN II, and 1/14 CIN III; HPV 6/11 in 12/18 exophytic condylomas (EC), 5/25 FC, 2/8 CIN I, and 3/18 CIN II. Uncharacterized HPVs were identified in 4/18 EC, 5/25 FC, 2/8 CIN I, and 1/18 CIN II. A similar heterogeneous distribution of HPV types was found in flat condylomas and CIN I. A more homogeneous distribution was noted in the exophytic condylomas and high grade CIN lesions, with HPV 6/11 found in the former and predominantly HPV 16 in the latter. Abnormal mitotic figures were predominantly seen in the high grade CIN lesions. Based on our findings, we would recommend that the term flat condyloma be abandoned and that low grade flat lesions of the cervix be graded according to CIN criteria.

Prognostic value of cytologic peritoneal washings.

The following points summarize the important diagnostic and prognostic features of peritoneal cytology. Malignant cells in peritoneal fluid are most often indicative of secondary malignancies with short periods of patient survival except in some early-stage tumors of the female genital tract. Atypical reactive mesothelial cells can simulate malignant cells. Experienced cytologic evaluation is important. Peritoneal cytology is an integral part of the initial staging and follow-up of ovarian cancer. Many researchers feel that peritoneal cytology is important for prognosis in endometrial cancer, and cytologic evaluation is at present a part of some study protocols. There is a low yield of positive peritoneal cytologic findings in patients with early-stage cervical cancer, and cytologic assessment probably plays a small role when other poor prognostic factors are present. Thorough sampling of the peritoneal cavity and careful cytologic preparation are important for optimal diagnosis.

Primary cytodiagnosis of synchronous small-cell cancer and squamous-cell carcinoma of the respiratory tract.

Report is made of the first primary cytodiagnosis of a synchronous small-cell cancer of the lung and squamous-cell carcinoma of the larynx, which were histologically confirmed. Sputum cytology should be used in the detection and surveillance of multiple primary malignancies of the respiratory tract, which have been observed with increasing frequency.