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Biomedical subjects

M D Hicklin

Publications and source records attributed to M D Hicklin.

31 records · Page 2Linked to original sources

Transfer factor: delayed hypersensitivity to Schistosoma mansoni and tuberculin in Macaca mulatta.

Delayed hypersensitivity in Macaca mulatta infected with either Schistosoma mansoni or mycobacteria was demonstrated by biopsies of skin test sites. Both dialyzable and nondialyzable leukocyte extracts from infected donors transferred delayed hypersensitivity to recipient monkeys. In two recipients, skin test conversion was associated with in vitro transformation of the recipients' lymphocytes.

Animals↗

Immunopathology of lymphocytic choriomeningitis viurs infection of newborn mice. Antithymocyte serum effects on glomerulonephritis and wasting disease.

Antithymocyte serum, when administered neonatally to mice, delayed the maturation of the lymphoid system, permitting development of cellular tolerance to LCM virus at an older age than is ordinarily possible. Humoral antibody formation was not prevented and the animals exhibited the paradox of high titers of both circulating virus and antibody. This, in turn, was followed by a chronic immunopathologic glomerulonephritis in most animals. Some animals developed wasting disease between 1 and 2 months of age, characterized by reticular cell hyperplasia and widespread infiltration into tissues and organs.

Animals↗

Rescreening as a quality control procedure in cytopathology.

Many cytopathologists regard the 10% rescreening regulation of the Center for Disease Control and Social Security Administration as an unsatisfactory procedure for internal monitoring of cytoscreener performance. The principal deficiencies actually lie in the lack of specified performance criteria and an associated decision rule. By specifying these mission elements of a monitoring strategy are obtained as attribute acceptance sampling plans. The acceptance sampling approach to monitoring cytoscreener performance by rescreening "negative" slides id discussed.

Cytodiagnosis↗

Retrospective evaluation of gynecologic cytodiagnosis. II. Interlaboratory reproducibility as shown in rescreening large consecutive samples of reported cases.

Two laboratories exchanged and rescreened a large sample of cases with cervicovaginal smears they had consecutively accessioned to examine the reproducibility of gynecologic cytodiagnosis under optimum conditions. At least a "working agreement" (diagnoses within +/- 1 category on a ten-category scale) was achieved in diagnoses of normal, benign reaction and squamous abnormality (from minimal dysplasia though invasive cancer) in 18,859 cases (96.8%), of endometrial abnormality in 21 cases (42%) and of "unsatisfactory" in 99 cases (20.7%). Larger differences occurred in greater than or equal to 30% of cases except in the categories of "normal" and "benign reaction," reaching a maximum of 82% for moderate dysplasia. Reexamining 382 cases decreased disagreement by category to the 20% to 65% range only in the five categories of dysplasia plus carcinoma in situ. Agreement was not predicated on the presence of endocervical cells or squamous metaplasia; the basis for "unsatisfactory" calls was not uniform. Comparison of the laboratories' diagnoses with referee diagnoses or, on 178 cases, with tissue diagnoses also demonstrated differences in diagnostic criteria.

Adult↗

Retrospective evaluation of gynecologic cytodiagnosis. I. Reproducibility using an experimental diagnostic scale.

A system for the exchange of specimens between two independent laboratories ("A" and "B") was designed to enable them to review a consecutive series of one another's gynecologic smears. Another cytopathologist "refereed" diagnoses differing beyond agreed limits and examined all smears called carcinoma in situ or a more severe lesion by either laboratory. A ten-numeral gradient nomenclature scale was developed to code all cytodiagnoses for data processing. This analysis of the reproducibility of the experimental diagnostic system is based on all participants' examination of 100 selected specimens, half contributed by reviewing laboratory A and half by reviewing laboratory B, with the target value of each specimen established by the contributor. Intralaboratory reproducibility, expressed by a correlation coefficient (r), ranged from 0.78 to 0.93. After adjusting for straightforward squamous-cell lesions, r ranged from 0.88 to 0.91. Intralaboratory agreement +/- 1 scalar category, defined as a "working consensus," ranged from 77% to 84%. Interlaboratory correlation ranged from r = 0.74 to 0.94. Adjustment for squamous-cell lesions exerted less effect than it had on intralaboratory reproducibility. Interlaboratory agreement within one category ranged from 58% (laboratory B reviewing specimens contributed by laboratory A) to 92% (referee examining specimens contributed by laboratory B). Initially, laboratory A tended to classify a given specimen higher on the scale than did laboratory B and the referee, but as the study progressed, both laboratories tended to converge toward a more congruent diagnostic position, with referee greater than A greater than B. The level of discrimination attained by all participants validates use of this system to compare a larger series of diagnoses.

Adenocarcinoma↗

Comparison of written-visual and microslide-screening test measures in cytotechnology.

A study was conducted to ascertain the relationships among different competence assessment methods for cytotechnologists. Of primary concern was the extent to which examinations using multiple choice questions, color plate photomicrographs and filmstrip formats measure abilities in common with or predict performance levels on a practical, job-sample-microslide examination format in gynecologic cytopathology. The majority of cytotechnologists who volunteered for these tests were trained in schools of cytotechnology approved by the Committee on Allied Health Education and Accreditation (CAHEA) of the American Medical Association (AMA). School training, certification by the International Academy of Cytology (IAC) and by the American Society of Clinical Pathologists (ASCP) and participation in current continuing education activities were all associated with relatively higher test scores. The filmstrips format was least consistent in reflecting these distinctions. Overall, participants' scores in each test correlated to varying degrees with their scores on all other tests. Combinations of certain formats appear to have limited potential as performance evaluation methods; some of their drawbacks are presented.

Allied Health Personnel↗