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Biomedical subjects

J Sayer

Publications and source records attributed to J Sayer.

10 recordsLinked to original sources

High grade anal dysplasia in visually normal mucosa in homosexual men: seven cases.

BACKGROUND: Anal cancer and anal human Papillomavirus (HPV) infection are increased in homosexual men. METHODS: We screened high risk homosexual men as part of a longitudinal study examining the effect of HIV infection on the risk of development of high grade anal intraepithelial neoplasia (AIN II, III). RESULTS: We found seven men who had histological evidence of AIN II-III with visually normal findings by anoscopy. Two men were HIV-seronegative, five were HIV-seropositive, and only one of the HIV-seropositive men had a low CD4 count < 200. Abnormal cytological results seen over follow-up periods of 3 months to 2.5 yr suggest the persistence of visually inapparent anal abnormalities. Two of the men had had small internal warts at earlier examinations, and three of the seven men subsequently developed visually abnormal anal findings. All men had HPV 16 DNA detected at some point. CONCLUSIONS: We hypothesize that high grade anal neoplasia may develop deep in the glands and can be detected by cytology before visible lesions are detected even with the aid of a colposcope. However, the implications of finding high grade anal cytology are not known at this time. Natural history studies are ongoing.

Adult

Identification and significance of dysmorphic versus isomorphic hematuria.

Hematuria may be of glomerular or nonglomerular origin. Dysmorphic erythrocytes are found in the urine of patients with glomerular bleeding, whereas isomorphic erythrocytes characterize nonglomerular or urological hematuria. Urine specimens from 100 patients with microscopic hematuria were collected: 50 had a known glomerular pathological condition and 50 had urological disease. Scanning electron microscopy of the urine specimens showed a marked difference in morphology between dysmorphic and isomorphic red blood cells. This differentiation can be made with a simpler instrument, the standard Coulter counter. Accurate prediction of glomerular versus nonglomerular hematuria was made in 97 of the 100 patients by Coulter counter analysis. The test is rapid, simple and readily reproducible. A permanent graphic record of the red blood cell morphology can be obtained for each patient. Identification of glomerular versus nonglomerular hematuria can be of practical use in the clinical management of patients.

Erythrocyte Volume