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Coleman v. American Red Cross.
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Nurse's notes save the day. Case in point: Coleman v. Touro Infirmary of New Orleans (506 So. 2d 571-LA).
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Magnetic circular dichroism of Co (II) carbonic anhydrase.
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Complexities in ETS-domain transcription factor function and regulation: lessons from the TCF (ternary complex factor) subfamily. The Colworth Medal Lecture.
The ETS-domain transcription factor family can be divided into a series of subfamilies. Elk-1 represents the founding member of the ternary complex factor (TCF) subfamily. By focusing on the TCF subfamily, we can demonstrate the complexities that exist in the function and regulation of ETS-domain transcription factors. This article focuses on Elk-1 in detail and summarizes the functions of other TCFs. The key themes covered include the domain structure of the TCFs, the mechanisms of complex formation with serum response factor, regulation of TCFs by mitogen-activated protein kinase cascades, and transcriptional regulatory properties of the TCFs. Finally, the emerging role of the TCFs in vivo is discussed. A picture is developing indicating that, while these proteins exhibit significant sequence and functional conservation, key differences in their structure and regulation are being identified which may relate to unique functions of these proteins in vivo.
Perfusion chemotherapy in the primary treatment of melanoma of the extremities.
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Human polyomavirus in pregnancy. A model for the study of defence mechanisms to virus reactivation.
We have carried out a longitudinal study of human polyomavirus infection in 71 pregnant women and correlated the virological findings with changes in the defence system in the same patients. As reactivation of human polyomaviruses generally occurred late in the second trimester it was possible to distinguish between the immunological changes which preceded the onset of reactivation and those which were secondary to the infection. Evidence of reactivation was detected in 26 women; all had high or rising antibody titres against BK or JC virus, but only five of these developed viruria. A positive correlation was observed between a high monocyte count in early pregnancy and subsequent virus reactivation. The virus excretors had significantly lower neutrophil counts than the women who had no evidence of virus reactivation. In contrast, women with serological evidence of virus activity but no viruria has significantly higher neutrophil counts than the non-activators. They also had stronger lymphocyte responses to PHA than the virus excretors. Virus activators were found to have a significant lymphopenia in the third trimester compared to the non-activators. High antibody levels did not appear to inhibit virus excretion. These findings suggest that monocytosis may predispose to reactivation of human polyomaviruses in pregnancy. On the other hand, ability to contain the virus once it has been activated, was associated with neutrophilia, and relatively vigorous in vitro reactivity of lymphocytes to PHA. Persistent lymphopenia was probably secondary to virus reactivation. The model on which this study is based could be adapted to investigate the causes of reactivation of other viruses. It may also help to identify risk factors in patients who are particularly susceptible to infection with opportunistic viruses.
CD-ROM transnational training program in cervical cytology (CYTOTRAIN).
The Transnational Training Programme in Cervical Cytology (CYTOTRAIN) is a 3-yr project funded by the European Commission to harmonize training and quality standards in cervical screening across the European Union. The aim of the program is to develop new approaches in initial and continuing vocational training, particularly in the area of life-long learning with the aim of meeting national, regional, and local needs. We present a new approach to training in cervical cytology, using an interactive program of cytological images. The method used to prepare the program and the problems encountered are described. The authors have the feeling that giving details of the organizational and management structure adopted for the project implementation might help other pathologists realize more or less similar CD-ROM training programs in their own field of activity.
Retrobulbar administration of steroids in herpes simplex uveitis. Efficacy of treatment in rabbits.
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Credé prophylaxis and neonatal corneal infection with herpesvirus: a model.
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PROBLEMS IN TREATING THE LOWER-CLASS PSYCHOTIC.
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Aims and conduct of psychotherapy.
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Adaptive integration of psychiatric symptoms in ego regulation.
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Hyperthermic adjuvant perfusion chemotherapy for Stage I malignant melanoma of the extremity with literature review.
Thirty-nine patients with clinical Stage I malignant melanoma of the extremities were treated with hyperthermic perfusion chemotherapy using melphalan followed by excision or wide re-excision of the area and regional lymph node dissection. Four patients with positive lymph nodes, on histologic examination, were considered pathologic Stage II. Seventy-two patients with clinical Stage I extremity melanomas, who were treated by conventional surgical methods, served as concurrent controls, and were comparable in the distribution of their various pretreatment characteristics. The actuarial survivals for clinical Stage I perfusion patients calculated by the life-table method at 5, 10, and 15 years were 91%, 86%, and 77%, respectively, and disease-free survivals were 85%, 80%, and 80%, respectively. These figures were significantly better than controls. A Breslow depth of invasion of greater than 1.5 mm showed a significant difference in both clinical and pathologic Stage I disease as compared with the controls. Similarly, perfused patients aged less than or equal to 50 years survived significantly better than controls in both clinical and pathologic Stage I disease. The literature has been reviewed.
Association of human papillomavirus with squamous carcinoma of the uterine cervix.
The frequent association of human papillomavirus infection with preinvasive and invasive cancers of the cervix has led to speculation that the viruses may be involved in the neoplastic process. We have carried out some epidemiological studies of the prevalence of human papillomavirus infection in the female genital tract to evaluate more fully the oncogenic potential of these viruses in the cervix. A non-invasive method of detecting the virus has been developed for this purpose using DNA hybridization of cervical scrapings. The technique has been used to carry out prospective studies of patients with cervical intraepithelial neoplasia (CIN) and to investigate infection in women treated by laser therapy for CIN. We have also studied women with normal cervices to determine the prevalence of human papillomaviruses in the normal population. Further studies have involved the investigation of the effect of interferon on virus replication and epithelial proliferation in women with CIN III.
Evaluation of NMP179 for the detection of squamous intraepithelial neoplasia in ThinPrep cervical slides using a combination of double immunostaining and morphometric methods of analysis.
This study investigates the potential value of the nuclear matrix protein NMP179 as a marker of abnormal squamous cells in ThinPrep slides. Forty-six cervical scrapes were collected as cell suspensions and ThinPrep slides were prepared. They were double-immunostained for NMP179 and Cytokeratin 18 (CK18), an endocervical cell marker. The method of analysis adopted for the study was designed to distinguish the abnormal squamous cells from benign epithelial cell so that the percentages of abnormal squamous cells that expressed the marker could accurately be determined. Initially, an attempt was made to identify benign and abnormal cells in the ThinPrep slides on the basis of their morphology and immunostaining patterns. Discrimination between the various types of epithelial cells was incomplete using this approach and a more precise method of discrimination between the different epithelial cell types was carried out using a combination of double immunostaining (NMP179 and CK18) and morphometry using nuclear area and nuclear cytoplasmic ratios. Once the different epithelial cell types had been identified, the specificity and sensitivity of NMP179 were determined. The optimal sensitivity (89.9%) was achieved at the N/C ratio 0.36; however, the specificity of NMP179 was very low for all N/C ratios and ranged from 38.8% to 42.2%.
DNA adduct assay in cervical epithelium.
Numerous epidemiological studies have shown that there is an association between smoking and cervical cancer. However, the essential evidence to show whether this relationship is casual or causal is lacking. The demonstration of DNA modification by tobacco components in the cervical epithelium would provide biochemical evidence to support a causal role. In this study, DNA from 39 cervical biopsies was analysed for the presence of DNA adducts using the 32P-postlabeling technique. A questionnaire on smoking habit and a urinary cotinine assay were used to identify smokers and nonsmokers. DNA samples from smokers [identified from questionnaire] were found to have significantly higher adduct levels than nonsmokers (Mann-Whitney one-tailed U-test, 95% CI > 0.339, P = 0.024). Exclusion of the women whose urinary cotinine levels did not confirm their self-reported smoking status (smoker or nonsmoker) increased this significance (95% CI > 0.508, P = 0.01). Women who had abnormal cervical smears had significantly higher DNA adduct levels than those with normal smears (95% CI > 0.439, P = 0.015). Monitoring of women with high DNA adduct levels may be a way of identifying women at risk of cervical cancer. These findings demonstrate that tobacco smoking by women leads to elevated levels of DNA adducts in cervical epithelium and provides the biochemical evidence to support the concept that smoking is a cause of cervical cancer.
Prevalence of human papillomavirus (HPV) infection in Basque Country women using slot-blot hybridization: a survey of women at low risk of developing cervical cancer.
Cervical smears from 1,178 women with cytologically normal cervices and 67 women with cervical intra-epithelial neoplasia (CIN) or cervical carcinoma were analyzed for the presence of HPV 6, 11, 16 and 18 DNA by slot-blot hybridization. HPV DNA was detected in 17% (95% CI: 14%-19%) of the women with a normal smear; 11% of infected women harboured HPV 16 and 18 (95% CI: 9%-13%, each). HPV DNA was detected in 54% (95% CI: 41%-66%) of patients with abnormal smear; the most prevalent virus type in this group was HPV 16 (45%; 95% CI: 32%-38%). In order to verify the slot-blot results, a proportion of the samples was also investigated by PCR. There was 88% correlation between the 2 tests. The high prevalence of HPV 16 and 18 infection demonstrated in our low-cervical-cancer-risk area further support the role of as yet unidentified co-factors as determinants of the different geographic rates of cervical-cancer incidence.