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J W Bishop

Publications and source records attributed to J W Bishop.

At least 19 recordsLinked to original sources
PubMed2000

AutoCyte Prep system vs. conventional cervical cytology. Comparison based on 2,156 cases.

OBJECTIVE: To compare the AutoCyte Prep system (Burlington, North Carolina) with conventional cervical cytology in a university medical center laboratory. STUDY DESIGN: Split-sample conventional and AutoCyte Preps were examined for 2,156 cases. Same-patient conventional and Prep slides were submitted to separate cytotechnologists blindly. The results were compared on review by a cytopathologist. The Prep slides were subsequently scanned on the AutoCyte Screen automated interactive system, with manual review of the flagged cases. The results were compared with anatomic pathology follow-up when available. RESULTS: Of the 158 squamous intraepithelial lesions (SILs) found by both methods, 78% were found by AutoCyte Prep, while 59% were found by conventional smear (P < .01). Among the discordant cases, thin-layer slides revealed 88% more LSIL lesions (P < .05), a comparable number of high grade SIL lesions and a single case of adenocarcinoma that was ambiguous on the conventional slide. The addition of AutoCyte assisted primary screening demonstrated a net benefit, recovering additional cases referenced as atypical glandular cells of undetermined significance and as high grade SIL. CONCLUSION: The AutoCyte Prep system affords excellent cellular presentations and superior sensitivity for SILs when compared to the conventional technique. The use of AutoCyte Screen, for primary screening demonstrated performance equivalent to manual screening, with a significant improvement in sensitivity when measured against biopsy results.

Adenocarcinoma↗
PubMed2000

New technologies in gynecologic cytology.

New technologies are trying to make significant changes in the way we perform the Pap smear test, a test that has undergone no significant modification since its inception. Efforts have focused on improving sampling with liquid-based methods, improving detection of abnormal cells with automated screening and improving the detection of human papillomavirus with assays practical for use in routine clinical material. This article reviews the performance of the new technologies to date, with an emphasis on those that are currently approved for cervical cytology testing. In the aggregate, these technologies can have a positive impact on cervical disease detection and intervention.

Automation↗
PubMed1998

Disseminated mucosal papilloma/condyloma secondary to human papillomavirus.

This report details the histopathologic findings in a woman who acquired the human papillomavirus 6/11 in her late teens and developed papilloma/condyloma of the nasopharynx, oropharynx, anogenital region, urethra, and urinary bladder. General evaluations of immune function reveal no defect, and there was no evidence of HIV infection. The morphologic expression of HPV 6/11 infection appears to be completely dependent on the mucosal epithelium affected. The complete spectrum of benign and premalignant epithelial changes induced by the human papillomavirus family-papilloma, verrucae, condyloma acuminatum, epithelial hyperplasia, and dysplasia-were present in this patient with a single papillomavirus infection. We postulate that this patient has a specific immune deficiency that limits her ability to control local infection and spread of the papillomavirus.

Adult↗
PubMed1998

Cell recovery and appearance in thin-layer preparations in nongynecologic cytology.

OBJECTIVE: To compare the diagnostic efficacy of a thin-layer technique with that of a membrane filter technique using a wide variety of fresh cytologic specimens. STUDY DESIGN: Paired samples from 272 nongynecologic cytology specimens were processed for microscopy using thin-layer and membrane filter preparation techniques. Specimens included 162 body fluids and urines, 32 bronchial aspirates and 78 fine needle aspiration biopsies. The two techniques were compared for diagnostic efficacy, cell density/specimen, cell types recovered, qualitative cytomorphology, ease of interpretation and long-term stability of the final preparations. RESULTS: Diagnoses supported by filter preparations were also supported by their matched thin-layer preparations. The same cell types were recovered by both techniques, and the slide cell density was slightly greater using membrane filters. Qualitative morphology and ease of use were superior with the thin-layer samples. After two years, all thin-layer slides were stable and readable, whereas only 43% of the membrane filter slides were usable. CONCLUSION: Thin-layer techniques are morphologically comparable and, in some ways, superior to membrane filter techniques for processing a wide variety of nongynecologic cytology specimens.

Adult↗
PubMed1998

Cellular morphometry in nongynecologic thin-layer and filter cytologic specimens.

OBJECTIVE: To determine the feasibility and utility of thin-layer cytology preparations for morphometric analysis of nuclear and cytoplasmic area in cells from nongynecologic cytology specimens. STUDY DESIGN: Identical paired samples from nongynecologic specimens (bronchial aspirate, urine, pleural and peritoneal fluid) were used to prepare thin-layer preparations and corresponding traditional membrane filter preparations. The paired preparations were analyzed by static image morphometry measuring eight nuclear and cytoplasmic parameters that allowed calculation of nuclear area, cytoplasmic area and total cell size. Hepatocytes and bronchial columnar, mesothelial, squamous and transitional cells were studied, as was a single case of high grade transitional cell carcinoma. Sufficient numbers of each cell type were measured to allow statistical analysis. RESULTS: Both thin-layer and membrane filter preparation techniques yielded individual cells suitable for morphometric analysis, and there were no consistent morphologic measurement differences between the two methods. The thin-layer preparation had the following significant technical advantages: more numerous easily measured single cells, lack of interfering background and superior specimen stability. Benign oval to round nuclei from a variety of cell types have a mean nuclear area in a narrow range from 29 to 55 microns 2. The mean nuclear area of malignant cells studied was significantly larger (78 microns 2), and there was a significant decrease in absolute cytoplasmic profile area in the malignant population studied. CONCLUSION: Thin-layer cytology preparations have significant advantages for morphometric studies over traditional membrane filter cytologic preparations. The morphometric measurement of nuclear area in benign and malignant cell populations has great potential as a generic screening tool for malignancy in cytologic specimens. Simultaneous measurement of cytoplasmic area adds a powerful dimension. The subsequent calculation of a true nuclear/cytoplasmic ratio may yield a sensitive and specific discriminator for detecting malignant cell populations in human nongynecologic cytology specimens.

Ascitic Fluid↗
PubMed1998

Quantification of tissue eosinophils and lymphocytes in histologic sections.

During a study of eosinophil-predominant gallbladder disease, an image analysis (IA) technique was developed for quantification of eosinophils and lymphocytes in routine formalin-fixed tissue sections. Alternating sections were stained with hematoxylin and eosin for eosinophils and with monoclonal CD45 antibody visualized with diaminobenzidine by an avidin-biotin procedure for lymphocytes. A protocol was then developed using a commercially available image analyzer and two well-defined macro routines. The system was validated with cell block sections prepared from peripheral blood samples with known eosinophil and lymphocyte counts. The eosinophil counts obtained by this IA technique showed excellent correlation with the absolute counts from a peripheral blood analyzer (r2 = 0.987). The lymphocyte counts obtained by IA showed good correlation with the absolute counts (r2 = 0.820). This IA-based technique provides a sensitive, reproducible, and substantiated means of quantifying inflammatory cells in tissue sections. This rapid and easily learned technique adds quantification as a complementary dimension to the subjective assessment of tissue morphology.

Eosinophils↗
PubMed1997

The cost of production in cervical cytology: comparison of conventional and automated primary screening systems.

To thrive in a world of managed care and capitation, knowing the cost of production is critical, especially in cervical cytology. The relative costs of production for preparation and interpretation of cervical cytology for conventional manually read smears and a primary automated screening method were calculated in a university practice setting. The components were disposables, processing, screening, pathologist review, capital equipment, and facilities cost. The production cost for a conventional smear in our laboratory is $9.75, and the comparable production cost by a primary screening automated method would be $12.07, if it were approved for primary screening. Based on these calculations, an interactive automated method approved for primary screening would cost slightly more than conventional testing. Combinations of conventional and automated examinations (secondary screening systems) are not cost feasible unless the additional production expense can be passed through to the payers.

Automation↗
PubMed1997

The cost of diagnosis: a comparison of four different strategies in the workup of solitary radiographic lung lesions.

INTRODUCTION: Due to the large numbers of negative results of sputum examinations in the face of malignant disease, we used a decision analytic model to determine whether, and under what conditions, sputum cytology (Spt) might have a cost-effective role to play in the approach to lung lesions. METHODS: We constructed a decision analytic model to compare the utility of Spt, image-directed fine-needle aspiration (FNA), bronchoscopic examination (Bronch), and open biopsy (OBx) in the evaluation of lung lesions. Prevalence and cost data were derived from local databases and diagnosis-related groups. Diagnostic sensitivity (sens) and specificity (spec) of the tests were derived from the literature and local data. Output of the model was lowest cost per correct malignant diagnosis and included surgical treatment costs. We did not attempt to model survival data or morbidity. Sensitivity analyses were performed using cost, test sensitivity, and lesion size variables. RESULTS: In the baseline case, a patient who is a surgical candidate with lesion size 2.8 cm, prevalence of malignancy=0.67, FNA sens=0.95, Bronch sens=0.80, Spt sens=0.51, OBx is the best initial procedure with a cost per correct diagnosis of $12,888. Sputum examination has the highest cost per correct diagnosis of $63,424. FNA and bronchoscopy have cost per correct diagnosis of $21,543 and $16,615, respectively. Sens analysis shows that OBx is the preferred strategy in the workup of lung lesions in patients who are surgical candidates older than 30 years of age. Spt is the preferred strategy only when the patient is not a surgical candidate, the lesion size is large (>4.7 cm), and only if sputum sens is >0.45. CONCLUSIONS: Spt is not cost-effective in clinical practice, except when the patient has a large clinically unresectable lesion and the laboratory can demonstrate sufficient test sens.

Age Factors↗
PubMed1987

Evaluation of red cell volume distribution width (RDW).

The purpose of this study was to evaluate red cell distribution width (RDW) in the differential diagnosis of patients with well defined iron deficiency (ID), anemia of chronic disease (ACD), and thalassemia trait. Mean RDW in 100 "normals" was 13.1%. Elevated RDW (greater than 15.0%) was observed in 90% of ID (N = 39), 32% of ACD(N = 79), 66% of beta-thalassemia trait (N = 100), 53% of alpha-thalassemia trait men (N = 127), 34% of alpha-thalassemia trait women (N = 116), 3% of sickle cell trait (N = 101), and 88% of sickling disorders (N = 32). The Bessman classification by mean corpuscular volume and RDW was of limited value in separating ID from thalassemia trait but was improved by adopting 16.0% as the upper limit of normal for RDW. Although many attempts have been made to discriminate between ID and thalassemia trait on the basis of red cell values from a cell counter, none (including RDW) is sufficiently specific or sensitive to obviate the need for confirmation of the diagnosis by standard laboratory methods.

Adult↗
PubMed1985

Multiple hormone production in an oat cell carcinoma of the larynx.

A 60-year-old white woman with laryngeal oat cell carcinoma is described. She was a heavy smoker who had been treated seven years earlier with 5,000 rads for a well differentiated squamous cell carcinoma metastatic to a left submandibular lymph node. She presented this time with a two month history of hoarseness and tumor of the supraglottic larynx was found. There was clinical and chemical evidence of an ectopic ACTH syndrome. The histology and fine structure of the tumor were typical of oat cell carcinoma. Immunoreactive ACTH, GRP, NSE, Beta-endorphin, calcitonin, and keratin were found in the cytoplasm of the tumor cells by indirect immunoperoxidase techniques. We could find no previously reported case of laryngeal oat cell carcinoma with ectopic ACTH syndrome or cytoplasmic localization of polypeptides.

Adrenocorticotropic Hormone↗
PubMed1980

Bone marrow and lymph node findings in a fatal case of Kawasaki's disease.

Since the initial description in 1967, the clinical and laboratory features of Kawasaki's disease (KD) have been well documented. We studied a patient with KD who recovered from the acute phase of the disease, but who subsequently died at home from coronary arteritis. We describe this patient because of bone marrow and lymph node findings that have previously received little attention in the English-language literature.

Arteritis↗
PubMed1976

Sensitization and habituation of the plantar cushion reflex in cats.

The plantar cushion reflex in cats was examined as a model system in a mammal for the study of the effects of repeated stimulation on neural transmission. Effects of various frequencies and intensities of stimulation were similar to those seen in other reflex systems. For instance, for a fixed number of stimuli, habituation of the plantar cushion reflex was more marked at 10 Hz than at 2.0 Hz, and with 1.0 X threshold stimulation than with 5.0 X threshold stimulation. Sensitization occurred at intermediate intensities and frequencies of stimulation. Dorsal root potentials were studied; changes in dorsal root potentials during iterated stimulation did not correlate with the changes in the plantar cushion reflex. These changes in the plantar cushion reflex were also unrelated to variations in afferent transmission peripheral to the spinal cord. Sensitization and habituation in the plantar cushion reflex occurred during iterated stimulation, were produced centrally, and were unrelated to mechanisms of presynaptic inhibition.

Animals↗
PubMedDate not supplied

Evaluation of the AutoCyte SCREEN system in a clinical cytopathology laboratory.

OBJECTIVE: To compare the AutoCyte SCREEN (AutoCyte, Burlington, North Carolina, U.S.A.) system with manual screening by experienced cytotechnologists using thin-layer preparations that had been previously extensively studied and their cytologic abnormalities well defined. STUDY DESIGN: AutoCyte PREP (AutoCyte) samples prepared for a previous split-sample study comparing thin-layer preparations to conventional smears were used. These 1,992 AutoCyte PREP samples were in a cohort the abnormal findings of which had been confirmed via independent review by two sets of pathologists. For the current study, these samples were remasked and evaluated by the AutoCyte SCREEN system in a clinical laboratory. The instrument scanned each slide and selected six overview fields and 120 single objects for storage and display. The computer classified each slide in one of the following categories: abnormal, uncertain, normal or unsatisfactory. Independently for each case, a cytotechnologist evaluated the six fields and 120 objects selected by the instrument as abnormal, normal or unsatisfactory. For those cases classified as uncertain by AutoCyte, the technologist then reexamined the cellular displays and entered a consensus classification. These results were then compared to those of an independent review by cytotechnologists of the identical set of slides using routine manual screening. RESULTS: The AutoCyte SCREEN selected 35% of slides for manual review. Technologist and computer rendered equivalent classifications in 79%. Of the total slides screened by the AutoCyte SCREEN, 57% were classified as "uncertain," and 88% of these were subsequently classified as normal by consensus. Using the well-defined abnormal values of the cellular sample as a basis for calculation, the AutoCyte SCREEN-assisted practice had a diagnostic sensitivity of 85% and diagnostic specificity of 97.6%. Comparable values for manual screening of the identical cellular sample were a diagnostic sensitivity of 80% and specificity of 97.4%. CONCLUSION: The AutoCyte SCREEN achieves comparable or greater sensitivity in detecting cervical abnormalities in comparison with manual screening. When combined with the substantial advantage of thin-layer preparations over conventional smears, the AutoCyte SCREEN provides a screening system of superior sensitivity over conventionally prepared and examined cervical smears.

Clinical Laboratory Techniques↗