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Biomedical subjects

K Schreiber

Publications and source records attributed to K Schreiber.

103 records · Page 6Linked to original sources
PubMedDate not supplied

Screening of asymptomatic women for endometrial cancer.

This report describes the preliminary results of a feasibility study of detection of endometrial carcinoma in an asymptomatic population of women aged 45 and above. The initial sample of 1,280 women was evaluated by several cytologic smear techniques and by two endometrial sampling methods assigned by computer. The clinical approaches and the techniques used are detailed. During this initial period of study, eight histologically proved endometrial cancers were diagnosed, two of which were deeply invasive. With one exception, the eight patients were either obese or had a history of treatment with conjugated estrogens. A relatively small number of women with endometrial hyperplasia of various types were also identified. The accuracy of the detection methods and their long-term impact on morbidity and mortality cannot be assessed as yet. Incidentally, a small number of cancers and precancerous states of organs other than the endometrium have also been diagnosed.

Aged↗
PubMedDate not supplied

The fine structure of exfoliated cervical and vaginal cells.

In order to understand the means by which cellular aggregates were maintained in gynecologic samples, the fine structure of samples derived from a number of women of various ages was examined with special attention paid to the intercellular junctions. Most cells in the samples were squamous cells containing numerous intercellular fibrils and glycogen granules. Parabasal or intermediate cells were also seen as well as occasional endocervical cells. All of these cell types were often found as parts of aggregates and, while other cell junctions were present, desmosomes were the most prominent. It was concluded that desmosomes were probably responsible for maintaining the aggregated state of many of the cells found in gynecologic samples.

Adult↗
PubMedDate not supplied

A quick method for concentrating and processing cancer cells from serous fluids and fine-needle nodule aspirates.

A quick method of concentrating cancer cells and the preparation of cytological slides from body fluids and aspirates is described, using a single Ficoll gradient and cytocentrifuge. The method eliminates the disadvantages of conventional techniques, i.e., excess contamination by red (erythrocytes) or white (leukocytes) blood cells and a scarcity of cancer cells. Because the technique is simple and requires only standard cytotechnological equipment, it can be easily adopted as an aid to diagnostic routine in cancer cytology.

Ascitic Fluid↗
PubMedDate not supplied

Eosinophilic pleural effusions.

Forty-three pleural fluids from 30 patients with eosinophilic pleural effusion (EPE) were examined and correlated with biochemical and clinical findings. The percentage of eosinophiles ranged from 12% to 83%, averaged 38% and was accompanied by a high lymphocyte count, averaging 34%. The fluids were shown to be exudates. A history of allergy or immune disorders was elicited from seven patients and allergy to drug from one patient. Eight patients gave a history of thoracic trauma unrelated in time to the effusion. Three patients received transvenous pacemakers. In the remaining 11 patients the presence of the eosinophilic pleural effusion could not be correlated with any clinical data. Regardless of clinical setting, which in six patients included a past history of cancer, EPE proved to be a self-limiting disease with a favorable outcome. Thus, this diagnosis by cytologic examination of the sediment is of considerable prognostic significance even in patients with a history of other disorders that may give rise to effusions. Possibly the most significant observation recorded was the presence of a large population of lymphocytes in EPE. The role of these cells in the mechanism of EPE is discussed.

Adolescent↗
PubMedDate not supplied

Assessment of fine needle aspiration as a screening test for occult prostatic carcinoma.

As part of an ongoing study of objective parameters of prognostic value in prostatic carcinoma, a routine procedure was developed to aspirate all prostates prior to surgery. These targets were different from those of other workers in the field of prostatic fine needle aspiration (FNA), who generally advocate that FNA be confined to suspicious nodules. The aspirations were performed by a large group of practicing urologists who had no special training in prostatic FNA except for guidelines provided by their peers and information available in the literature. This approach permitted an assessment of the performance of FNA as a screening test rather than as a diagnostic procedure. During the period from January 1983 to February 1987, 1,683 patients had prostatic FNAs performed (plus subsequent histologic study). The following diagnoses were rendered: "inadequate/scanty specimen" in 625 cases (37%), "negative/atypical" in 844 cases (50%) and "suspicious/positive" in 214 cases (13%). Histologic examination showed stage A1 prostatic adenocarcinoma in 18 patients. The cytologic diagnoses on these 18 patients were inadequate/scanty in 3 (17%), negative/atypical in 13 (72%) and suspicious/positive in 2 (11%). Of the 214 patients with a positive/suspicious diagnosis by FNA, the diagnosis of prostatic carcinoma was confirmed by tissue evidence in 200; the other 14 patients had either no evidence of prostatic carcinoma on surgical biopsy (needle biopsy/transurethral resection/suprapubic prostatectomy) or had no surgical biopsy. Eight of the 14 patients developed clinical evidence of carcinoma, 1 died of urinary bladder carcinoma and 1 was lost to follow-up. In the remaining four patients, there is still no evidence of prostatic carcinoma after about one-and-one-half years of follow-up. These results indicate that (1) specialized training is required in order to obtain adequate smears by prostatic FNA; (2) prostatic FNA is not a good screening technique for detecting stage A1 prostatic carcinoma; and (3) a positive diagnosis by prostatic FNA, even when not confirmed by tissue biopsy, is still an indication of disease.

Adenocarcinoma↗
PubMedDate not supplied

Value of aspiration cytology of the thyroid in metastatic disease.

Metastases may simulate primary malignant tumors of the thyroid, causing problems in the diagnosis and management of patients with a history of cancer. In the seven-year period of July 1978 through June 1985, 8 of 549 needle aspirates of the thyroid contained metastatic tumor, 6 of which were subsequently confirmed by histologic study. The primary sites of origin were the breast, kidney, colon and stomach as well as lymphoma. The cytologic features observed in the aspiration biopsy material from the six cases were characteristic of each of the primary tumors. Three of the patients had had prior resections of carcinomas (breast, colon and stomach) while in three patients the cytologic diagnosis of the thyroid aspirates led to the discovery of the primary tumor (kidney and two lymphomas). One case of lymphoma/leukemia and one case of previously biopsied lung carcinoma were confirmed on clinical grounds. It is of critical importance that primary thyroid neoplasms occurring in patients known to have primary tumors elsewhere be distinguished from disseminated tumors involving the thyroid. Our experience suggests that fine needle aspiration is of considerable value in this differential diagnosis. Needle aspirates of the thyroid are also of value in leading to the diagnosis of unsuspected nonthyroidal primary cancer.

Adult↗
PubMedDate not supplied

Use of the esophageal balloon in the diagnosis of carcinomas of the head, neck and upper gastrointestinal tract.

A study was undertaken to demonstrate the safety, efficacy and value of esophageal balloon cytology in the diagnosis of esophageal lesions and as a tool in screening a high-risk patient population. The sampling was performed 110 times on 96 patients, 11 with known obstructive carcinoma of the esophagus and 85 thought to be at risk for esophageal cancer: 74 with treated or untreated cancer of the head and neck area and 11 with dysphagia or other findings requiring clarification. The method was well tolerated by the patients, and the cytologic smears were of excellent quality. Malignant or suspicious cells were found in smears from 7 to 11 patients with documented esophageal cancer and in 7 of 85 patients believed to be at risk. In the latter group there were three unsuspected recurrent cancers of the oropharyngeal region and one unsuspected carcinoma in situ of the esophagus. There were no false-suspicious or false-positive results. This noninvasive technique of esophageal cytology obviously deserves additional trials as an adjunct in the diagnosis of carcinoma of the head and neck and upper gastrointestinal tract, especially in high-risk patients.

Aged↗
PubMedDate not supplied

Cell content in repetitive canine bronchoalveolar lavage.

To determine the effects and effectiveness of small volume (50 ml) bronchoalveolar lavage, lavages were performed on healthy mongrel dogs under a number of protocols. The differential and total cell counts in small volume bronchoalveolar lavages were determined. These factors were compared to those obtained by large volume (500 to 600 ml) lavage of the same segment in a second experimental group. Small volume lavage yielded a greater total cell count per milliliter and a greater concentration of polymorphonuclear leukocytes (PMNs) than large volume lavage, in which there was a somewhat higher concentration of bronchial cells. We compared the cell populations from lobes lavaged at 48-hour intervals. No significant changes in these populations or in pulmonary histology were noted. Our results suggest that small volume bronchoalveolar lavage provides a representative sample of the total free cell yield from the lower respiratory tract. Furthermore, small volume bronchoalveolar lavage performed at 48-hour intervals does not influence the distribution of these cells or significantly damage the pulmonary parenchyma.

Animals↗
PubMedDate not supplied

The monodisperse cervical smear: quantitative analysis of cell dispersion and loss with enzymatic and chemical agents.

The proper utilization of flow-through instruments for the automatic detection of malignant cells in human cervical specimens requires that the cells be in the form of a monodisperse suspension. Information regarding the degree of cell dispersion and of cell loss is therefore of critical importance in the evaluation of any procedure used to render cervical specimens monodispe automatic detection of malignant cells in human cervical specimens requires that the cells be in the form of a monodisperse suspension. Information regarding the degree of cell dispersion and of cell loss is therefore of critical importance in the evaluation of any procedure used to render cervical specimens monodispe automatic detection of malignant cells in human cervical specimens requires that the cells be in the form of a monodisperse suspension. Information regarding the degree of cell dispersion and of cell loss is therefore of critical importance in the evaluation of any procedure used to render cervical specimens monodisperse. We have devised a simple method for the simultaneous assessment of these two parameters using smears prepared with the Perkin-Elmer Uni-Smear Spinner. Our quantitative evaluation indicates that none of the 15 enzymatic and chemical agents tested to disperse cervical specimens produced an adequate monodispersed cell suspension without unacceptable cell loss. Electron microscopic evidence is used to illustrate the deleterious effects of some of the agents employed.

Amylases↗