Paired cultures of glutaraldehyde-fixed, nontransformed and chemically-transformed human fibroblasts were examined by quantitative microscopy. Significant differences were found to exist between the two cell types with respect to projected cell and nuclear area, dry weight distribution, cell cytoplasmic thickness and intracellular distribution of protein. Quantitative measurements of nuclear DNA failed to reveal a major difference between the two cell populations.

4-Nitroquinoline-1-oxide↗

PubMedDate not supplied

HIV eradication: thinking the unthinkable.

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Anti-HIV Agents↗

PubMedDate not supplied

Second sight: the microscope in medicine.

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History, Ancient↗

PubMedDate not supplied

Relieving muscle fatigue and eyestrain in microscopy.

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Asthenopia↗

PubMedDate not supplied

Simultaneous condyloma acuminatum and dysplasia of the uterine cervix.

A population of 116,090 asymptomatic women between the ages of 20 and 40 was examined for the cytologic presence of dysplasia and koilocytosis presumably resulting from condyloma acuminata of the uterine cervix. Subpopulations of 50 women with severe dysplasia and 50 with severe dysplasia and koilocytosis (= condyloma) were selected for a short-term study of progression to carcinoma or carcinoma in situ. The cytologic preparations examined by morphometry to determine the quantitative morphologic characteristics of the epithelial populations in the two groups showed that patients with condyloma and dysplasia had a different population of cells than those with dysplasia alone. Histologic studies showed that there were significantly more mitotic abnormalities in the condylomatous lesions, consistent with viral alterations of mitosis. While short-term follow-up (three to four years) failed to show that patients with both dysplasia and condyloma were at higher risk of developing cancer than patients with dysplasia alone, patients with condyloma of the cervix should be closely followed clinically since they have a higher risk of other cervical abnormalities.

Adult↗

PubMedDate not supplied

Cocaine use in pregnancy.

BACKGROUND: Cocaine use during pregnancy has many deleterious effects on both the mother and the fetus, including the following: preterm labor (< 37 weeks' gestation), congenital anomalies, intrauterine growth retardation (IUGR), abruptio placenta, low-birth-weight infants (< 2500 g), neonatal death, and sudden infant death syndrome (SIDS). Potentially catastrophic maternal outcomes include a pre-eclampsia-like syndrome, acute pulmonary edema, seizures, cardiac arrhythmia, and sudden death. Family physicians who practice obstetrics might encounter cocaine-abusing women as part of their primary care practice. This article reviews the current knowledge regarding the pharmacology, pathophysiology, prevalence, demographics, and methods of detecting cocaine use in pregnancy. METHODS: Material for this paper came from a MEDLINE review of the literature from 1988 to the present. RESULTS AND CONCLUSIONS: Family physicians who practice obstetrics, especially those who practice in urban minority settings, are likely to encounter pregnant women who are abusing cocaine. Signs of maternal cocaine use are dilated pupils and increased heart rate, blood pressure, respirations, and reflexes. Other signs include agitated sensorium, arrhythmias, and seizures. Preterm labor, pre-eclampsia, and acute pulmonary edema can all be caused by maternal cocaine use. Methods of testing for cocaine are urine or meconium drug screening. Hair analysis is presently being researched but is not yet at a level of clinical reliability. Getting the patient into prenatal care as early as possible has been shown to improve birth outcomes.

Cocaine↗

PubMedDate not supplied

Relationship between human immunodeficiency virus-1 RNA identification in placenta and perinatal transmission.

OBJECTIVES: The objectives of this study were to identify human immunodeficiency virus (HIV)-associated nucleic acids in placenta with 35S RNA in situ hybridization and to correlate the presence of virus with perinatal HIV transmission. STUDY DESIGN: Blood from nine mother-infant pairs was collected for CD4+ lymphocyte count and p24 antigen analysis. Placental specimens were obtained for in situ hybridization, viral culture, and hematoxylin-eosin histologic analysis. Neonatal infection was diagnosed by p24 antigen analysis, polymerase chain reaction, and viral culture. Pediatric follow-up was obtained by personal communication and review of chart records. RESULTS: Three of 10 placentas from nine HIV-positive pregnant women (one set of twins) were found to contain evidence of HIV infection by RNA in situ hybridization. Maternal age, gravidity, parity, previous number of terminations, duration HIV-seropositive, maternal CD4+ at delivery, and neonatal cord CD4+ count were similar in those whose placentas contained virus versus those in whom virus was not identified. The incidence of histologic changes was similar in the HIV-positive and negative placentas from seropositive subjects and was similar to the incidence of histologic changes in placentas from known seronegative subjects. Placental culture failed to demonstrate the presence of virus in vitro. Of the three placentas that had positive in situ hybridization, two infants became HIV-positive. CONCLUSIONS: 35S RNA in situ hybridization identified the presence of nucleic acids in syncytiotrophoblasts from formalin-fixed, paraffin-embedded placentas. This technique is a useful tool to screen placentas at birth for HIV-RNA to judge the likelihood of perinatal HIV transmission.

Adult↗

PubMedDate not supplied

Using a clinical practice guideline to measure physician practice: translating a guideline for the management of heart failure.

BACKGROUND: Effective clinical practice guidelines should improve clinical outcomes, and measures of physician use of clinical practice guidelines should correlate with improved outcomes. This study translates a clinical practice guideline on heart failure into review criteria to measure physician performance and the effectiveness of the clinical practice guideline. METHODS: A panel of 11 family physicians and 1 cardiologist systematically reviewed the clinical practice guideline for its clinical importance, educational relevance, and evaluative appropriateness. Then a subset of 4 family physicians rigorously applied each recommendation to established criteria for measurability and developed an evaluation tool useful in medical record review. RESULTS: The heart failure clinical practice guideline was found to be an excellent educational tool. Using it to measure physician performance, however, was limited to diagnostic tests and drug prescribing. Of 45 recommendations, 5 fulfilled criteria for measurability; 1 recommendation had A-level evidence, whereas 2 recommendations had B-level and 2 had C-level evidence. CONCLUSION: This study illustrates the logistic issues and challenges in developing a measure of physician adherence to clinical practice guidelines. Medical record review is inadequate to measure many recommendations. Physicians use of this clinical practice guideline must be evaluated as an intermediate step to measuring the effectiveness of clinical practice guidelines based on patient outcomes.

Evidence-Based Medicine↗