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PubMedDate not supplied

Cytohistologic correlation of peritoneal washing cytology in gynecologic disease.

The peritoneal washings and cul de sac aspirates from 204 patients undergoing 217 procedures for the evaluation of gynecologic disease were examined retrospectively and correlated with the histologic diagnoses. Of the 73 washings from patients with histologically benign genital disease, cytology diagnosed 64 (87.7%) as negative, 6 (8.2%) as inconclusive and 3 as malignant. One malignant washing was a true positive from a nongenital primary. False positives thus occurred in 2.7% of the benign cases on blind review. Of 144 cytologic examinations of washings from patients with histologically confirmed malignant disease of the female genital tract, 38 (26.4%) were considered positive after cytohistologic correlation. Four malignant cases (2.1%) were undercalled on blind review while 3 (2.0%) were considered overcalls. Eleven of 47 cases (23.4%) with biopsy-proven peritoneal disease had negative cytology after histologic correlation. Recurring problems in interpreting peritoneal washings included: (1) the differential diagnosis of the spectrum encompassed by reactive mesothelium, endosalpingiosis, borderline serous tumors and well-differentiated serous cystadenocarcinoma; (2) morphologic similarities between some tumor cells and mesothelial cells associated with treatment effects; and (3) a paucity of malignant cells in some washings, resulting in false-negative interpretations. Ineffective cytopreparation, particularly of bloody specimens, hampered interpretation of some specimens. Correlation with previous histology and cytology enhanced the accuracy of peritoneal washing cytology in this study.

Adult↗

PubMed1987

Evaluation of the EDTA-washed diet for use in the experimental production of zinc deficiency in human subjects.

Ethylenediaminetetraacetate (EDTA) is known to bind zinc (Zn) and other metals. EDTA-washed soy protein-based diet has been extensively used as a dietary model for the production of Zn-deficiency in human subjects as well as in experimental animals. The present study was conducted to test this diet for possible contamination with EDTA (inhereted by washing procedure) and also to evaluate it for its acceptability and palatibility by human subjects. In the first experiment, EDTA-washed soy protein-based diets were prepared as previously described (repeated washing with EDTA-sodium salt followed by washing with deionized water and filteration), but 14C-EDTA was used. Scintillation counter analysis showed no traces of 14C in the prepared diet (100% of the 14C activity was recovered in the filtrate). In the second experiment, the diets were prepared using inactive EDTA, then fed to 10 volunteers for sensory evaluation. Results of this trial showed that the palatibility and acceptability of these diets are generally very poor. In conclusion, the use of EDTA-washing procedure did not result in any contamination of the soy assay protein with the EDTA. However, the present dietary model may not be used to induce zinc deficiency in human volunteers on a long term basis since the palatibility of the washed product is poor.

Diet↗

PubMed1988

Effects of source and washing of erythrocytes on growth of bacterial pathogens from the bovine mammary gland.

Effects of source and washing of RBC on quantitative growth and hemolytic zone sizes of common bacterial pathogens of the bovine mammary gland were evaluated. Blood samples used to prepare the blood agar media were obtained from 10 adult dairy cows, 10 dairy calves, and 10 sheep. Hemolytic zone sizes produced by Staphylococcus aureus were significantly (P less than 0.01) larger on blood agar prepared with washed RBC than on blood agar prepared with nonwashed RBC, regardless of RBC source. With the exception of Corynebacterium bovis, growth of all bacteria was equivalent or significantly higher on medium prepared with washed RBC, compared with that on medium prepared with nonwashed RBC, regardless of RBC source. Significantly higher numbers of C bovis (P less than 0.01) and Streptococcus agalactiae (P less than 0.01) were isolated on medium prepared with washed cow RBC. Significantly higher numbers of Str uberis (P less than 0.01) and S aureus (P less than 0.05) were isolated on medium prepared with washed sheep RBC and washed calf RBC, respectively. Growth of Escherichia coli was not affected by the RBC source. Seemingly, RBC used in the preparation of medium should be washed. The source of RBC, as well as inter-animal variation, also should be considered in the quality control of medium.

Animals↗

PubMed1982

Microbiological aspects of washing hands in slaughter-houses.

The hand hygiene of workers in a number of chicken-, pig-, calf- and cattle slaughter-houses was investigated. The number of E. coli and salmonellae on hands was determined before and after washing hands in order to measure the washing effect on the number of these faecal bacteria. All workers examined carried E. coli on their hands during work. The average logarithmic E. coli count on hands before washing was about 5.0 in chicken-and calf-slaughter-houses, about 3.5 in pig-and 3.0 in cattle-slaughter-houses. Hand washing decreased the E. coli count per hand by about 1.5 log cycle. Salmonellae were isolated from the hands in chicken- (59 pos./145 samples), pig-(42 pos./116 samples) and calf-slaughter-houses (11 pos./68 samples). Even after washing salmonellae were found to be present. Generally 'normal' washing causes a considerable reduction in the number of transient bacteria on hands. The presence of E. coli and Salmonella after washing, however, indicates that the effectiveness of the procedure needs to be improved.

Abattoirs↗

PubMed1981

[Washed erythrocyte concentrate, degree of purity and cell vitality].

The reduction of leukocytes of packed red cells amounted to 70 +/- 8% (n = 29) by single removing of buffy coat and to 86 +/- 9% (n = 12) by additional washing in isotonic NaCl-solution with a loss of 23% of red cells. The ratio of granulocytes to lymphocytes increased The ratio of granulocytes to lymphocytes increased slightly by washing. Storage of washed red cells damaged their function in dependence on temperature and storage medium more than the washing procedure. The ATP content of washed red cells maintained at the normal level during 24 hr at 277 K (4 degrees C), but the 2.3-P2G level decreased to 1/3 of the normal value. The survival rate of washed red cells amounted to 86 +/- 7% (n = 7). The preparation of red cells poor in leukocytes in recommended by removing buffy coat and the upper 50 ml of red cells after single centrifugation of blood and adding 100 ml CDS-AG (citrate-glucose-sucrose-adenine-guanosine) preservation solution of packed red cells. A storage of 6 weeks is possible. Thus washing the red cells in isotonic NaCl-solution for the purpose of leukocyte reduction can be omitted.

Blood Preservation↗

PubMed1996

Value of rigid bronchoscopy and cytodiagnosis of bronchial washings in detecting bronchial carcinoma in the presence of a carcinoma of the upper aerodigestive tract.

OBJECTIVE: To assess the usefulness of rigid bronchoscopy and bronchial washings in detecting primary lung carcinomas. SETTING: Department of Otolaryngology, University Hospital of Ghent, Belgium. DESIGN: Prospective analysis of patient investigations. METHOD: The results of 127 rigid bronchoscopies with bronchial washings in patients with a new, untreated head and neck tumour and a normal chest radiograph were analyzed for their usefulness in detecting simultaneous primary lung carcinomas. All patients were followed for a minimum of 2 years or till death. RESULTS: We found positive bronchial washings in 19 cases (21%). Unilateral positive bronchial washings were found in 8 patients (9%). In only one patient was a simultaneous primary lung tumour found. One patient was found to have a pulmonary metastasis. The remaining 6 patients with positive unilateral cytology (6/8) had normal chest roentgenograms and/or CT scans, and did not develop a lung tumour in the course of follow up. Of the 19 positive bronchial washings, 10 patients had a carcinoma of the larynx and two had a large hypopharyngeal carcinoma. CONCLUSIONS: Contamination of bronchial washings with tumour cells from head and neck neoplasms limited seriously the usefulness of positive bronchial cytology. The sensitivity and specificity of the rigid bronchoscopy with bronchial washing is too low to justify its cost.

Adult↗

PubMed1998

Telomerase: a potential marker of bladder transitional cell carcinoma in bladder washes.

Telomerase is an enzyme that immortalizes cells by maintaining a constant telomere length. Here, telomerase activity in bladder washes was analyzed and compared with the final pathological diagnosis in 23 patients with bladder transitional cell carcinoma (TCC). Bladder washes and normal tissues were obtained from each patient prior to transurethral resection of bladder tumor. Telomerase activity was detected using telomeric repeat amplification protocol assay based on PCR. Cytological diagnosis of centrifuged cells from bladder washes was made using Papanicolau's stain. Results demonstrated that telomerase activity was detected in 95.7% of both cancer tissues and bladder washes. In normal tissues, telomerase activity was not detected in 22 of 23 samples. Regarding cytological diagnosis, only 69.6% of bladder wash samples had positive cytology. Moreover, in five cases of grade 1 TCC, only 20% of the cytological specimens were positive for malignancy, whereas 80% showed positive telomerase activity. These results demonstrate that telomerase activity is detectable in a majority of human bladder cancer tissues and bladder washes obtained from patients with TCC. In addition, results of this study suggest that the presence of telomerase in bladder washes may be a specific marker of bladder cancer, especially in low-grade tumors.

Aged↗

PubMed1991

Hand washing in pediatric ambulatory settings. An inconsistent practice.

The first phase of this study was performed to determine the rate of breaks in hand washing technique by physicians in two pediatric ambulatory settings and to determine whether this technique was influenced by the physician's level of training. The second phase was performed to determine if reminding physicians to wash their hands would decrease the rate of breaks. A hand washing break in technique was defined as not washing hands before patient contact. The observations were made by medical students accompanying the providers. In the 496 encounters during the first phase, 254 breaks (51.2%) occurred. In the 293 encounters during the second phase, 150 (51.2%) breaks occurred. During both phases, the rates of hand washing breaks among the four groups of providers (residents in postgraduate years 1 through 3 and faculty) were similar. Breaks in hand washing technique occur at an unacceptably high rate in outpatient settings.

Ambulatory Care↗

PubMed1999

Peritoneal washing cytology is unnecessary in gynecologic surgery for benign diseases.

BACKGROUND: The presence of tumor cells in peritoneal washing cytology specimens taken during surgery affects the staging of many gynecologic malignancies. Peritoneal washings are often collected routinely, even in cases of presumed benign disease. This study was designed to address whether evaluation of these specimens is justified. METHODS: We reviewed diagnostic reports from all peritoneal washings and the corresponding surgical pathology specimens from patients undergoing gynecologic surgery during a 1-year period in one institution and a 20-month period in the other. Cases were divided into benign and malignant categories based on the surgical pathology diagnosis. RESULTS: Three hundred forty-six patients had peritoneal washings collected during the study period. The proportion of cases with malignancy was 30% in one institution and 49% in the other. Of these, 119 had an endometrial or ovarian malignancy, including 16 ovarian tumors of low malignant potential. Malignant cells were detected in 19 cases. In 10 of these 19, grossly apparent peritoneal tumor implants were present at the time of surgery. The remaining 227 were found to have benign disease, and the peritoneal washing cytology diagnosis was negative in all cases. Potential savings of $13,000 to $17,000 based on current insurance reimbursement could have been realized for these 227 patients without compromising patient care. CONCLUSIONS: These data suggest that peritoneal washing cytology specimens collected at the time of gynecologic surgery for presumed benign disease can be held and processed later if an unsuspected malignancy is discovered. This practice can result in cost savings without compromising patient care. Cancer (Cancer Cytopathol)

Cytodiagnosis↗

PubMed2004

The histologic subtype of ovarian tumors affects the detection rate by pelvic washings.

BACKGROUND: Since its introduction more than 45 years ago, the pelvic wash has gained widespread acceptance and is used routinely use at most centers. However, widely varying figures have been reported regarding its sensitivity for peritoneal involvement in ovarian tumors. In the current study, the authors evaluated a consecutive group of pelvic (peritoneal or abdominopelvic) washings performed in the evaluation of adnexal masses to determine whether histologic subtype significantly affects the tumor detection rate using this procedure. METHODS: Reports from all washes performed over a 5-year period in the evaluation of adnexal masses were evaluated and correlated with those of the synchronously obtained histologic specimens. The sensitivity for each histologic subtype was calculated, with ovarian surface involvement and/or tumoral involvement of any peritoneal surface defined as the criterion standard. Cases with cytologic and histologic concordance were defined as true-positive or true-negative. Statistical significance was determined using the Fisher exact test. RESULTS: In the current study, 185 of 846 (21.9%) total washes were associated with malignant (n = 161) or borderline (n = 24) tumors involving the ovary. For the malignancies, the overall cytology detection rate was 25%. A comparison of the cytology detection rates for the individual histologic subtypes with the overall rate demonstrated that the serous carcinomas were more likely (P = 0.0144) and the clear cell carcinomas were less likely (P = 0.0452) to be detected in pelvic washings. Cytology detection rates for mucinous, endometrioid, and undifferentiated carcinomas did not appear to differ significantly (P > 0.05) from the average detection rate. The cytohistologic correlation rate (efficiency), sensitivity, and specificity for the 5 most common histologic subtypes (n = 130) were 79.23%, 50.77%, and 93.33%, respectively. Differences also were observed in the calculated sensitivity for each subtype: serous (n = 57), 71.4%; endometrioid (n = 30), 58.33%; clear cell (n = 19), 20%; mucinous (n = 13), 50%; and undifferentiated (n = 11), 50%. Borderline tumors demonstrated a sensitivity and specificity of 80% and 100%, respectively. CONCLUSIONS: In the current study, the pelvic wash was found to be a specific, but only moderately sensitive, technique for detecting peritoneal involvement in ovarian tumors. The histologic subtype of the underlying ovarian tumor was found to have an effect on the likelihood of detection of peritoneal involvement using this diagnostic assay.

Adenocarcinoma, Clear Cell↗

PubMed2006

Comparison of ureteral washing and biopsy specimens in the community setting.

BACKGROUND: Ureteral lesions can be difficult to diagnose. The value of ureteral biopsy in addition to ureteral washings has not been defined clearly. METHODS: All ureteral washings and biopsies with follow-up that were performed at a single institution were reviewed. RESULTS: In total, 39 patients underwent ureteral washing, ureteral biopsy, or both and had follow-up: Eighteen patients had urothelial tumors at follow-up (14 high-grade carcinomas, 3 low-grade carcinomas, and 1 papillary urothelial neoplasm of low malignant potential). The sensitivity was 79% for washings and 71% for biopsies (P = 1.0), for a combined sensitivity of 100%. Biopsies often were scant, and cell blocks from biopsies and washings often were of value. CONCLUSIONS: Ureteral washings and biopsies had similar sensitivity and appeared to be complementary. Cell blocks often are useful for both specimen types.

Biopsy↗

PubMed2004

Carcinoid tumors of the lung: a diagnostic challenge in bronchial washings.

Bronchial washings are used routinely in the diagnosis of lung tumors. However, unlike other tumors, the diagnosis of bronchial carcinoids on bronchial washings is difficult. We reviewed 17 cases of histologically proven bronchial carcinoids from the files of the cytology laboratory over a period of 15 yr (1986-2001). The bronchial washings and histology sections of all the cases were reviewed separately by two independent observers and the results tabulated. Two cases had inadequate bronchial washings for evaluation and were excluded from the study. A growth was identified on bronchoscopy in 13 of 15 cases. Initial cytologic diagnoses were ?adenocarcinoma/?carcinoid and suspicious of carcinoid in one case each. However, on review, tumor was identified in 10 of 13 cases initially considered to be negative. The possible reasons for a false-negative report on initial cytology include the paucity of tumor cell fragments in the bronchial washings (5 of 12 cases showing only one to two tumor fragments) and their bland appearance, often being mistaken for benign columnar cells. This study highlights the potential pitfalls in the diagnosis of bronchial carcinoids on bronchial washings and underlines the importance of a diligent search in cases with high clinical suspicion and positive bronchoscopic findings.

Adolescent↗

PubMed2004

Pelvic washing cytology in serous borderline tumors of the ovary using ThinPrep: are there cytologic clues to detecting tumor cells?

The detection of tumor cells in pelvic washings of patients with serous borderline tumors of the ovary (SBT) remains a diagnostic challenge. Accurate diagnosis of pelvic washings is important in determining therapeutic regimens and assessing patient prognosis. No study has exclusively examined pelvic washing cytology of patients with SBT using only ThinPrep methodology. The purpose of this study is to examine whether cytologic clues exist in detecting tumor cells of SBT in pelvic washings processed with ThinPrep. Using previously established criteria, we reviewed the pelvic washes of 37 patients with SBT and correlated them with the histologic findings in the omentum. We also compared their cytoarchitectural features with pelvic washes in patients with benign ovarian disease and serous carcinoma. Cytoarchitectural features that achieved statistical significance in distinguishing cells of a SBT from reactive mesothelial cells include the following findings: presence of a two-cell population (P = 0.001), psammoma bodies (P = 0.001), cytoplasmic vacuolization (P = 0.001), smooth group contours (P = 0.004), nuclear size >2x neutrophils (P = 0.004), high nuclear-to-cytoplasmic (N/C) ratio (P = 0.004), absent intercellular windows (P = 0.007), and course nuclear chromatin (P = 0.032). Psammoma bodies were the only statistically significant feature distinguishing SBT from serous carcinoma, being more common in SBT than serous carcinoma (P = 0.035). The prominent number of associated psammoma bodies seen in the SBT group was a notable finding that may aid as a valuable cytologic clue in detecting tumor cells. Overall cellularity remains a source of false-negative diagnosis. Correlation with histologic findings remains crucial given our inability to reliably distinguish tumor cells of SBT from endosalpingiosis or serous adenocarcinoma.

Adult↗

PubMedDate not supplied

Effect of repeated washing on sperm-bound immunoglobulin G.

The effect of sperm washing on the stability of sperm-bound immunoglobulin G (IgG) antibody derived from plasma from four patients and also IgG bound in vivo on the spermatozoa of four other men was quantitatively evaluated. In the first series of experiments, human spermatozoa were incubated with an IgG antibody-containing plasma and subjected to 18 cycles of sperm washing. In the second set of experiments, spermatozoa from men positive for sperm-bound IgG were subjected to four cycles of sperm washing. The amount of residual antibody bound to a constant number of spermatozoa was quantitated by a radiolabeled antiglobulin assay during and following the washing procedures. There was no significant loss of sperm-bound antibody due to the washing procedures. The results of these studies undermine the utility of sperm washing as an effective treatment of antibody-mediated infertility in men.

Fluorescent Antibody Technique↗

PubMed1993

The relationship between inert gas wash-out and radioactive tracer microspheres in measurement of bone blood flow: effect of decreased arterial supply and venous congestion on bone blood flow in an animal model.

Several methods have been employed in the study of bone perfusion. We used a method of determining inert gas wash-out by mass spectrometry in the study of blood flow rates in pigs. The method was validated by comparison of the result obtained with inert gas wash-out to that with measurement by microspheres. Furthermore, the effect of decreased inlet flow and venous congestion on the bone perfusion data was tested. The undisturbed bone blood flow was not significantly different when measured with wash-out of inert gas (7 +/- 0.7 ml/min/100 g) or with microspheres (9 +/- 2.9 ml/min/100 g), and the methods were correlated. Perfusion was reduced significantly, to 20% of the original value, after arterial occlusion. The changes in wash-out curves and accumulation of radioactive tracer provided substantial evidence for impaired intraosseous circulation following venous obstruction also. In conclusion, the study showed that this method of determining inert gas wash-out is feasible for studies of local perfusion rates in bone. The flow rates obtained by wash-out correlated well with the results of microsphere studies. In this animal model, both methods detected a fivefold reduction in flow rate after clamping of the arterial inflow. Obstruction of the venous outflow also impaired blood flow and lowered the cellular supply.

Animals↗

PubMed1993

Reperfusion arrhythmias and purine wash-out in isolated rat and rabbit heart. Effect of allopurinol, dimethylthiourea and calcium reduction.

The effects of perfusate calcium reduction, allopurinol and dimethylthiourea on reperfusion-induced arrhythmias and purine wash-out in isolated rabbit and rat hearts were compared. The overall incidence of reperfusion-induced ventricular tachycardia (VT) was 88% and 94% and that of ventricular fibrillation (VF) was 44% and 88% in the control rabbit and rat hearts, respectively. VF was reduced to 10% and 0% in rat and rabbit hearts subjected to perfusate calcium reduction (0.4 mM for 1 min before ischemia and for 1 min before and throughout reperfusion), respectively. In allopurinol, 1 mM, perfused rat hearts the overall incidence of VF was not changed and only the incidence of a sustained VF (that lasting for at least 10 min) was reduced. VT and VF were prevented in allopurinol-perfused rabbit hearts. Dimethylthiourea, 10 mM, reduced the incidence of VF in rat hearts to 16% and did not significantly affect VT and VF in rabbit hearts. In untreated rat hearts, the major purine compounds washed out upon reperfusion were inosine, hypoxanthine, xanthine and urate. Allopurinol augmented the wash-out of adenosine and abolished that of xanthine and urate. In untreated rabbit hearts, the major purine washed out were inosine, adenosine and hypoxanthine. Allopurinol did not cause further increase in adenosine wash-out in rabbit hearts. We speculate that: (1) calcium mediated arrhythmogenic mechanism is operating both in reperfused rat and rabbit heart; (2) free radical mediated mechanism is of an importance only in rat heart; (3) neither a decreased free radical production secondary to xanthine oxidase inhibition nor the augmentation of adenosine wash-out is a likely explanation for the antiarrhythmic effect of allopurinol in reperfused hearts; and (4) high level of myocardial adenosine accumulation during ischemia, probably secondary to low xanthine oxidase activity, may play a role of a natural defence mechanism in ischemic/reperfused rabbit heart.

Adenosine↗

PubMed1994

Changes in alveolar lavage materials and lung microsomal xenobiotic metabolism following exposures to HCl-washed or unwashed crystalline silica.

Intratracheal exposures of rats to crystalline silica washed with HCl to remove iron contaminants have previously been shown to increase lung surfactant phospholipids (PL) and proteins and to alter the pulmonary microsomal cytochrome P450 system. We compared these effects of HCl-washed silica with those produced by exposures to unwashed silica and alumina. Both silica preparations produce increases in lung weights and alveolar lavage PL and proteins, but to different degrees. The increases produced by HCl-washed vs unwashed silica are lung weights, 2.2- vs 1.3-fold; lavage PL, 25.9- vs 3.7-fold; and lavage proteins, 11.1- vs 3.2-fold, respectively. Although the two silica particles increase lung microsomal protein concentrations (expressed per gram lung) by 50-60%, their effects on cytochrome P-450-mediated xenobiotic metabolism are quite different. Exposure to HCl-washed silica leads to a 2.3-fold increase in 7-ethoxyresorufin O-deethylation, a reaction catalyzed by cytochrome P4501A1, and a 0.5- to 0.6-fold reduction in 7-ethoxycoumarin O-deethylation, a reaction which may be catalyzed by cytochrome P-4502B1. Unwashed silica does not alter the metabolism of either xenobiotic when results are expressed per milligram microsomal protein. Administration of alumina produces only minor increases in lung weight and lavage PL and no effect on microsomal xenobiotic metabolism. These results show that the increases in alveolar lavage PL and proteins induced by administration of unwashed silica are exaggerated by 3- to 7-fold if the silica is treated with HCl. Furthermore, exposure to HCl-washed silica results in significant alterations of the lung microsomal cytochrome P450 system, but the unwashed silica has little effect. Although the reason(s) for these different effects is not known, measurements of iron levels and formation of hydroxyl radicals using ESR demonstrate that there is more iron associated with the unwashed than with the HCl-washed silica.

Animals↗

PubMed1985

Antibacterial perineal washing for prevention of recurrent urinary tract infections.

Antibacterial ointment applied to the urethral meatus in females with recurrent urinary tract infections (UTIs) has been reported to decrease the incidence of UTIs. The value of perineal washing with the antibacterial lotion, hexachlorophene, in preventing urinary tract infections was determined in 56 females with recurrent UTIs. Of three groups of females one group used hexachlorophene perineal washings morning and night, another group used hexachlorophene perineal washings and an oral antibacterial daily (nitrofurantoin or trimethoprim-sulfamethoxazole), and the third group used the oral antibacterials daily alone. The infections per patient were 3.4 with hexachlorophene washings, 0.5 with hexachlorophene washing and oral antibacterials daily, and 0.9 with oral antibacterials alone. These results suggest that hexachlorophene perineal washing was not effective in preventing UTI in females.

Adult↗