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J Weintraub

Publications and source records attributed to J Weintraub.

At least 19 recordsLinked to original sources

Efficacy of a liquid-based thin layer method for cervical cancer screening in a population with a low incidence of cervical cancer.

The performance of the ThinPrep(R) Pap Testtrade mark (TP) (Cytyc Corp., Boxborough, MA) for detection of cervical cancer precursors in a population with a low incidence of disease was evaluated. This prospective trial compared results obtained with TP to those obtained with the standard cytologic smear in women from the general community who were being screened for cervical cancer from January 1, 1995-December 31, 1997 by physicians in private practice (n x 130, 381 conventional examinations and 39,864 TP examinations). In the TP series there was a significant increase in the proportion of "satisfactory" examinations (91.9% TP vs. 72.2% conventional) and positive diagnoses (5.5% TP vs 2.4% conventional, odds ratio x 2.21; 95% confidence interval (CI), 2.08-2.34). The likelihood of detecting a high-grade squamous intraepithelial lesion (HSIL) by TP was significantly greater than in controls (odds ratio x 1.86; 95% CI, 1.68-2.06). Detection of low-grade squamous intraepithelial lesions (LSIL), or atypical squamous cells of undetermined significance (ASCUS), was significantly greater in the TP series than in controls (LSIL odds ratio x 3.41; 95% CI, 3.07-3.79; ASCUS odds ratio x 1.68; 95% CI, 1.56-1.82). A histologic lesion was confirmed in 141 (93%) of the biopsies for HSIL (130 HSIL or greater, 10 LSIL, 1 SIL not otherwise specified). In conclusion, both diagnostic sensitivity and sample adequacy were significantly improved using the ThinPrep(R) Pap test under routine conditions in an outpatient population with a low incidence of cervical cancer.

Adult↗

Contrast-enhanced breath-hold three-dimensional magnetic resonance angiography in the evaluation of renal arteries: optimization of technique and pitfalls.

The authors describe the optimization of a contrast-enhanced, breath-held, three-dimensional magnetic resonance angiography (CE-BH-3DMRA) technique in the assessment of the renal arteries and compare its utility with conventional x-ray angiography (XRA). Signal optimization using specific pulse sequence parameters was based on the patient's circulatory conditions, injection rate, and pulse sequence timing. Fifty-one patients (27 M, 24 F; mean age 69.7 years) were evaluated with CE-BH-3DMRA and XRA. All patients had an MR angiogram 3 months either before or after XRA. A test bolus study was performed for accurate assessment of transit time in each patient. A total of 51 patients (115 vessels) were studied in which the sensitivity and specificity for all renal artery stenoses including the proximal and mid-renal arterial segments were 96% and 92%, respectively. In-stent stenosis could only be diagnosed by quantifying flow beyond the stent using an additional triggered phase contrast cine pulse sequence. A total of 11 accessory renal arteries were correctly identified. In addition, fibromuscular dysplasia in two patients and stents in three patients were correctly identified on MRA. J. Magn. Reson. Imaging 2000;12:912-923.

Adult↗

A large-scale investigator-sponsored field study of the test performance of the ThinPrep papanicolaou test in a low-risk routine outpatient setting.

The performance of the ThinPrep Papanicolaou test (TP)(CYTYC Corp., Boxborough, MA) was evaluated in a low- risk outpatient population in order to assess its efficacy in routine clinical use. A total of 18,246 cervical cytology samples were prepared using TP during a 6-month evaluation period from January through June 1997. Results of TP interpretation, assessed for specimen quality and diagnostic information as reported according to the Bethesda system terminology, were reviewed and compared with corresponding results from 2 historical control series of 35,347 and 35,409 conventional cervical smears (Papanicolaou smears). Archived conventional smears obtained during the first 6 months of 1995 and 1996 from the same general patient population by the same group of gynecologists and general practitioners were selected for analysis. Positive cytologic diagnoses in the TP series were reviewed and cytologic-histologic correlations were analyzed when biopsy material was available. The results demonstrated that the proportion of cytologic examinations classified as "satisfactory" was significantly greater in the TP series as compared to conventional controls (88.8% vs 71.1%, P <.0001). There was a significant increase in the number of TP examinations with an adequate endocervical component as compared to conventional controls (90.2% vs 86.9%, P <.005) and a significant decrease in the number of TP examinations that were classified as "satisfactory but limited by" either poor fixation or obscuring factors, such as blood, neutrophils, and contaminants (1.1% TP vs 14.1% nonTP, P <.0001). The overall sensitivity of detection for abnormal cells as indicated by the number of positive diagnoses was increased in the TP series (5.7% vs 2.4%, P <.01). The cytologic diagnoses of ASCUS, LSIL, and HSIL were respectively 1.6, 3.6, and 3 times more frequent in the TP series than in controls. Cytologic-histologic correlations were available for 110 (27%) of the 403 cytologic diagnoses of LSIL and for 90 (83%) of the 121 cytologic diagnoses of HSIL. The presence of a histologic lesion (LSIL or HSIL) was confirmed in 71 (65%) biopsies for LSIL and in 81 (90%) biopsies for HSIL. In conclusion, both sample quality and diagnostic sensitivity were significantly improved using the ThinPrep Papanicolaou test under routine conditions in a low-risk population.

Journal Article↗

Bilateral secondary angle-closure glaucoma as a complication of anticoagulation in a nanophthalmic patient.

PURPOSE: To describe bilateral hemorrhage of the posterior segment and secondary angle-closure glaucoma as sequelae of anticoagulation therapy in a nanophthalmic patient. METHODS: An 80-year-old man who was nanophthalmic and was undergoing anticoagulation therapy presented with declining visual acuity in left eye. Six months later, he experienced declining visual acuity in his right eye. RESULTS: In the LE and six months later in the RE, ocular examination disclosed angle-closure glaucoma and a hemorrhagic retinal detachment. Peripheral iridoplasty successfully treated the initial attack. The subretinal hemorrhage was successfully drained by pars plana vitrectomy, retinotomy, and air-fluid exchange in the left eye. Anatomic success and intraocular pressure control were obtained, but visual recovery was limited. CONCLUSION: Intraocular hemorrhage and angle-closure glaucoma are potential complications of anticoagulation therapy in a patient with nanophthalmos.

Aged↗

Cholangiography.

Explore the source record for details and available documents.

Bile Ducts↗

Concurrent interfollicular Hodgkin's disease and metastatic breast carcinoma in lymph nodes.

The clinical and pathological findings are reported concerning a 73-year-old woman with progressive metastatic carcinoma of the left breast, who developed interfollicular Hodgkin's disease within the right cervical lymph nodes. Metastatic carcinoma and Hodgkin's disease were present concurrently as a "collision tumor' in the lymph nodes examined. To the best of the authors' knowledge, this is the first description of a collision tumor with these particular histologic components in this tissue. The factors influencing the coexistence and the order of appearance of the two pathologies in the present case remain unknown.

Aged↗

Compression sonography in patients with indeterminate or low-probability lung scans: lack of usefulness in the absence of both symptoms of deep-vein thrombosis and thromboembolic risk factors.

OBJECTIVE: We sought to determine whether compression sonography could be eliminated in the evaluation of patients who lacked both thromboembolic risk factors and symptoms of deep-vein thrombosis and who had an indeterminate or low-probability lung scan. MATERIALS AND METHODS: The medical records of 155 consecutive patients who underwent bilateral lower-extremity sonography after an indeterminate or low-probability lung scan were reviewed. The presence of thromboembolic risk factors and deep-vein thrombosis symptoms and the result of sonography were recorded. Patients were divided into two groups: group 1 consisted of patients with either thromboembolic risk factors or deep-vein thrombosis symptoms, and group 2 consisted of patients without thromboembolic risk factors and without deep-vein thrombosis symptoms. The incidences of deep-vein thrombosis in groups 1 and 2 were compared by use of a two-tailed Fisher's exact test. RESULTS: Thromboembolic risk factors or deep-vein thrombosis symptoms were found in 109 of 155 patients (70%) (group 1). Deep-vein thrombosis was found in nine of 108 patients (8%) in group 1. Both thromboembolic risk factors and deep-vein thrombosis symptoms were absent in 47 of 155 patients (30%) (group 2). Deep-vein thrombosis was found in none of 47 patients (95% confidence interval, 0-8%) in group 2. The difference in the incidences of deep-vein thrombosis in groups 1 and 2 approached statistical significance (p = .0579). The negative predictive value of the absence of both thromboembolic risk factors and deep-vein thrombosis symptoms in excluding deep-vein thrombosis was 100% (95% confidence interval, 93-100%). CONCLUSION: If both symptoms of deep-vein thrombosis and thromboembolic risk factors are absent, the usefulness of lower-extremity sonography in detecting deep-vein thrombosis in patients with an indeterminate or low-probability lung scan is low. The manner in which these findings may be used to modify individual practice patterns will undoubtedly depend on the rate of detection of deep-vein thrombosis at a given institution.

Algorithms↗

The comparative test performance of dot filter hybridization (Viratype) and conventional morphologic analysis to detect human papillomavirus.

To investigate the test performance of a commercially available detection kit for human papillomavirus (HPV), the relationship between the detection of HPV by dot filter hybridization (DFH) and by standard morphologic methods was studied. Four hundred two cervical samples taken from 381 patients referred to a colposcopy clinic were examined. Human papillomavirus DNA sequences were identified and typed using commercially available anti-sense RNA probes. Simultaneous cytologic smears were obtained in 289 patients, directed biopsy samples in 284, and both smears and biopsy samples in 171 samples. Human papillomavirus DNA was detected in 164 specimens (41%), of which 24 (15%) were type 6/11, 74 (45%) were type 16/18, 39 (24%) were type 31/33/35, and 27 (16%) were untyped due to the presence of multiple positive signals. Viral types 16/18 and 31/33/35 were eight and six times more frequent in cervical intraepithelial neoplasia (CIN) II/CIN III lesions than in condyloma/CIN I, respectively. When the cytologic diagnosis was considered the standard of reference, the results of DFH for the detection of HPV were concordant in 167 (56%) paired samples. The sensitivity of DFH was 48% and the specificity was 77%. The distribution of the morphologic diagnoses in the group of false-negative results and true-positive results was similar. When the histologic diagnosis was considered the standard of reference, the efficiency of DFH was 62%, the sensitivity was 59%, and the specificity was 79%. In the subgroup of 118 samples with simultaneous smear and biopsy and at least one positive examination, 42 (36%) were positive by all three methods, 42 (36%) by two, and 34 (29%) by one, including 6 (5%) by DFH alone. Fifteen cases more were detected by the complementary use of DFH and cytology than with cytology alone. The results demonstrated that the sets of patients positive for HPV when detected by DFH or by morphologic methods were not identical but rather overlapped. The detection of HPV may be slightly improved by using DFH in addition to conventional examinations. A significant number of HPV-positive patients without a morphologic lesion and patients with low-grade lesions had HPV 16/18 or 31/33/35, suggesting a possible role for typing in establishing a risk profile. However, given uncertainties in understanding the biology of HPV-associated lesions, the role, if any, of clinical testing for HPV by DFH remains to be defined.

Adolescent↗

Loss of heterozygosity for the short arm of chromosome 11 (11p15) in human milk epithelial cells immortalized by microinjection of SV40 DNA.

We have developed, by microinjection of SV40 DNA into human milk epithelial cells, a new mammary cell line, Hu-MI, which exhibits the phenotype of luminal cells or so-called "breast cancer precursor cells." This cell line retains the phenotype of primary cells as demonstrated by the expression of keratins 18 and 19 and of polymorphic epithelial mucins. However, the cells do not grow in agar after more than 80 passages, nor do they form tumors in nude mice. Established cells contain 2 copies of SV40 DNA integrated into the cellular genome and up to 14 copies of free SV40 DNA. A deletion of the short arm of chromosome 11 (11p15) including the c-Ha-ras and the beta-globin genes was found in the immortalized cells when the DNA from these cells was compared to the DNA from peripheral blood mononuclear cells obtained from the same donor. In addition, this cell line showed a good transfection efficiency for other DNA sequences using classical transfection and selection techniques with a neomycin resistance gene (pKOneo). Selective microinjection of DNA into tumor precursor cells may prove useful for the study of the molecular mechanisms involved in breast carcinogenesis. The possible significance of the loss of 11p13-15 in malignant progression of breast cancer is discussed.

Aneuploidy↗

[The role of human papillomavirus in the pathogenesis of papillomas of the upper aero-digestive tract].

The term 'papilloma' is used to describe a highly diverse group of exophytic pathologic lesions in the upper aero-digestive tract. These lesions differ according to anatomic site, constituent epithelium and endoscopic appearance. The varying pathogenesis of papillomas is incompletely understood, but appears to be related both to host factors, e.g. regional differences in the susceptibility of epithelial cells, and to a number of cofactors. Among the cofactors already identified, the human papilloma virus is increasingly recognized as playing an important role in the pathogenesis of laryngeal papillomata and some specific oral proliferative lesions. The systematic identification and characterization of human papilloma viruses in tissues from papillomas will provide the basis for a better understanding of the potential pathogenetic role of these viruses in the development of benign and malignant proliferation in the upper aero-digestive tract.

Head and Neck Neoplasms↗

The application of immunocytochemical techniques to routinely-fixed and stained cytologic specimens. An aid in the differential diagnosis of undifferentiated malignant neoplasms.

Routinely-fixed and Papanicolaou stained smears with the cytologic diagnosis of undifferentiated malignant neoplasm that had been prepared with cells obtained by fine needle aspiration biopsy (n = 7), pulmonary lavage (n = 5), or thoracentesis (n = 3) from 15 unselected patients were stained by an immunocytochemical technique to evaluate the presence of keratin proteins and the leukocyte common antigen (LCA). Commercially available, well-characterized monoclonal antibodies with specificities for keratin proteins and the leukocyte common antigen, and a streptavidin-biotin-horseradish peroxidase labelling method were used. Evaluation of the stained smears revealed the presence of one of the two antigens in material obtained from each patient, thus indicating the probable cell-lineage of the neoplastic cells. The specificity of the monoclonal antibody reagents used was further evaluated in routinely-fixed and stained cytologic material from 24 histologically confirmed carcinomas and 12 lymphomas. In conclusion, immunocytochemical techniques may be successfully applied to routinely processed archival cytologic smears to determine the antigenic profile of morphologically undifferentiated cells and therefore aid in the differential diagnosis of undifferentiated malignant neoplasms.

Adult↗