Search PubMed⌕ Search

Biomedical subjects

T J Colgan

Publications and source records attributed to T J Colgan.

At least 37 records · Page 2Linked to original sources
PubMed1992

Prevalence of human papillomavirus in sinonasal papillomas: a study using polymerase chain reaction and in situ hybridization.

Inverted and fungiform papillomas of the sinonasal cavity share a common origin from the Schneiderian membrane, but they differ widely in their rates of recurrence and progression to carcinoma. To determine the role of human papillomavirus in the etiology of these lesions, 15 inverted papillomas, five fungiform papillomas, and two squamous cell carcinomas associated with inverted papilloma were examined for the presence of HPV by in situ hybridization (ISH) and polymerase chain reaction (PCR). ISH was carried out on formalin-fixed, paraffin-embedded material using HPV types 6/11, 16/18, and 31/33/35 DNA probes. Tissue DNA was amplified by PCR with HPV L1 consensus primers, and the product was detected by gel electrophoresis, Southern blotting, and hybridization with type specific probes (HPV types 6/11, 16, 18). Three of 15 inverted papillomas and two of five fungiform papillomas were positive for HPV 6/11 by ISH, whereas PCR detected HPV 6/11 sequences in two of 15 inverted and three of five fungiform papillomas. Biopsies from two patients who had serial resections contained HPV 6/11 in the original lesions and all recurrences. No HPV was detected in the carcinomas by ISH, whereas PCR detected HPV 16 in one carcinoma. These findings confirm the presence of HPV DNA sequences in both inverted and fungiform sinonasal papillomas as well as in an associated squamous carcinoma. This would suggest a role for HPV in the pathogenesis of Schneiderian membrane lesions. Furthermore, our data indicate that ISH and PCR are equally sensitive in detecting HPV in sinonasal papillomas.

Adult↗
PubMed1991

Paraganglioma of the vulva.

A case of vulvar paraganglioma is reported. Following presentation with vulvar pain, a 1-cm nodule was excised from the labium minus of a 58-year-old woman. Histologically, the tumor was composed of nests of round eosinophilic cells with moderately pleomorphic nuclei, beneath an intact squamous epithelium. Ultrastructural studies indicated two cell types within the neoplasm: chief cells with numerous small neurosecretory granules and peripheral slender sustentacular cells. A reticulin stain confirmed the "zellballen" nature of the neoplasm, and the neoplastic cells showed moderate argyrophilia on a Grimelius stain. The immunoperoxidase stains for chromogranin and neuron-specific enolase were strongly positive in the neoplastic chief cells. Immunostaining using anti-S-100 antibody confirmed the finding of sustentacular cells by identifying many slender cellular processes among the chief cells. These light and electron microscopic findings are diagnostic of paraganglioma, an entity not previously reported in the vulva to our knowledge.

Cell Nucleus↗
PubMed1991

Squamous metaplasia of the peritoneum.

The capacity of the peritoneal serosa to undergo metaplasia to müllerian-type epithelium is well recognized. We report a case of squamous metaplasia of the peritoneum that was studied by light microscopy. Immunohistochemical techniques, and electron microscopy. The pathogenesis of peritoneal squamous metaplasia is obscure, but may be a response to chronic irritation.

Adult↗
PubMed1990

The topography and invasive potential of cervical adenocarcinoma in situ, with and without associated squamous dysplasia.

Thirty-eight cases of cervical adenocarcinoma in situ (ACIS) were studied to see if the topography of the ACIS and any stromal invasion by adenocarcinoma were associated with the presence (22 cases) or absence (16 cases) of squamous cervical intraepithelial neoplasia (CIN). Neither the topography of the ACIS (proximal linear extent, focality, presence of ACIS beneath the transformation zone, and circumferential extent) or the presence of invasive adenocarcinoma was associated with the presence or absence of CIN. We conclude that the course of ACIS, at least as reflected by cervical topography and invasive potential, seems to be unaffected by the coexistence of squamous neoplasia.

Adenocarcinoma↗
PubMed1990

Detection of metastatic vulvar and cervical squamous carcinoma in regional lymph nodes by use of a polyclonal keratin antibody.

A polyclonal keratin antibody (pK), a marker for epithelial cells, was used to evaluate lymph nodes (LNs) from patients with invasive squamous carcinomas of the cervix (CxCa) or vulva (VCa) to determine whether this technique could increase the detection of metastases (mets) over that obtained by light microscopy using a routine hematoxylin and eosin (H&E)-stained slide. The LN status of 15 cases of stage 1B CxCa and 14 cases of VCa was determined using a routine H&E slide. Subsequently, all LNs were resectioned and examined using a pK immunoperoxidase stain. In 329 lymph nodes from 14 cases of CxCa and 9 cases of VCa originally classified as LN-negative, only a single met was detected by the pK technique. In five cases of VCa and one case of CxCa (121 LNs), with LN mets or LN tumor emboli on the original H&E, three additional microscopic foci of mets were detected by pK. Of the four foci of mets discovered by pK, one was visible in retrospect on the original H&E section, and all four were easily identified on examination of a serial H&E section adjacent to the pK section. These results suggest that pK stains are unlikely to significantly increase our sensitivity in detecting mets in CxCa and VCa, beyond merely further sectioning and H&E staining of nodes.

Biomarkers, Tumor↗
PubMed1989

Human papillomavirus infection of morphologically normal cervical epithelium adjacent to squamous dysplasia and invasive carcinoma.

We have begun a systematic study of human papillomavirus (HPV) infection in colposcopically and/or morphologically normal epithelium of the uterine cervix. Paired biopsies were taken from the lesions (cervical intraepithelial neoplasia [CIN], condyloma, invasive carcinoma) and from the normal-appearing adjacent epithelium 3 to 5 mm from the edge of the lesion. Myometrium or ectocervical epithelium from patients who had undergone hysterectomy for reasons other than genital dysplasia or malignancy served as controls. One biopsy was examined histologically. DNA from the second biopsy was digested with Pst I, and the presence or absence of HPV was determined by Southern blotting using HPV-16 DNA as a probe. HPV was not detected in any of the 12 control samples. Of 30 patients with CIN and/or condyloma, five of 18 who were HPV-positive had either HPV-16 (three cases) or virus resembling HPV-31 (two cases) in the lesion and adjacent epithelium. Of seven patients with invasive carcinoma, four had HPV in the lesion and adjacent epithelium; two of these four patients had typical HPV-16. Such infection of apparently normal epithelium has major implications for our understanding of the pathogenesis, treatment, and follow-up of patients with cervical neoplasia.

Blotting, Southern↗
PubMed1987

The anatomic distribution of cervical adenocarcinoma in situ: implications for treatment.

The anatomic distribution of cervical adenocarcinoma in situ was ascertained in 23 cases of adenocarcinoma in situ, 10 of which also had "early" invasive adenocarcinoma. The adenocarcinoma in situ involved both surface and gland epithelia in all cases, involved a variable number of quadrants, involved glands beneath the transformation zone in about two thirds of cases, was multifocal only occasionally, extended up the endocervical canal for a variable distance (up to 30 mm), and was associated with squamous dysplasia in about half of cases. From this topographic outline of adenocarcinoma in situ, it is recommended that if cervical conization is chosen as conservative therapy for adenocarcinoma in situ the "cone" be cylindrical in shape, to include the transformation zone and deep glands, and extend at least 25 mm up the endocervical canal.

Adenocarcinoma↗
PubMed1983

Predicting the outcome of endometrial hyperplasia by quantitative analysis of nuclear features using a linear discriminant function.

Nuclear parameters from 24 cases of atypical endometrial hyperplasia were determined by means of graphic tablet and microcomputer. Eight of the 24 hyperplasias progressed to carcinoma, but the remaining 16 did not progress during a mean follow-up period of 11.8 years. A linear discriminant function selected the mean and standard deviation of maximal nuclear diameter as useful predictors of clinical outcome. The linear discriminant function predicted the correct outcome in 83% of the cases. This study suggests that measurement of nuclear parameters in atypical endometrial hyperplasia may provide a more objective means of predicting the behavior of the various forms of hyperplasia.

Cell Nucleus↗
PubMed1980

Reappraisal of the value of testicular biopsy in the investigation of infertility.

One hundred and forty-two biopsies were reviewed to reappraise the value and indications for testicular biopsy in the investigation of infertility. These biopsies were categorized within the following morphologic patterns: normal, hypospermatogenesis, maturation arrest, Sertoli cell-only syndrome, and Klinefelter's syndrome. The morphology of the biopsies was correlated with the available sperm count, and the contribution of the biopsy to the patient's treatment was assessed. Testicular biopsy has proved most useful in azoospermia for the identification of obstruction. In oligospermia, biopsy appears to be of little use.

Biopsy↗
PubMedDate not supplied

Cell preparation methods and criteria for sample adequacy. International Academy of Cytology Task Force summary. Diagnostic Cytology Towards the 21st Century: An International Expert Conference and Tutorial.

ISSUES: Cell Preparation Methods Standardized fixation and optimal staining Sampling of cervix, sampling error, homogenization of sample, subsampling Assessment of liquid-based preparations: efficacy and economic impact Training and transitional procedures before full implementation of new technologies Criteria for Sample Adequacy Clinician responsibility for collecting and providing representative sample to laboratory Collection instruments, number of slides Cellular content of samples: evidence of transformation zone (TZ) sampling, number of squamous cells present, obscuring factors Screening issues CONSENSUS POSITION The conventional cervical smear remains the standard method of cervical cancer screening but has limitations in individual test sensitivity and specificity. Sample takers should: (1) receive appropriate training in sample collection, (2) be held responsible for providing the laboratory with appropriate samples, and (3) have their performance monitored. The instruments used for sampling should collect cells from both the ectocervix and endocervix; optimally, TZ sampling, represented by the presence of endocervical or squamous metaplastic cells, should be identifiable in samples other than atrophic specimens. The adequacy of a specimen (as judged microscopically) does not guarantee that it is representative of the cervix. Each cytology report should include a comment on cellular content/adequacy of the specimen. Liquid-based preparations may overcome many of the inherent problems with the conventional cervical smear. ONGOING ISSUES: We need further data on the cost-effectiveness of making two slides from cervical specimens and/or using two samplers rather than a single one. Do we have enough information to make recommendations as to the appropriate type of sampler to be used in particular situations, such as routine screening? What is the best method of screening for/detecting endocervical glandular neoplasia? How are such terms as unsatisfactory and inadequate defined in cervical cytology classifications other than the Bethesda System? What number and types of epithelial cells should be present (visualized) in a cervical smear or liquid-based preparation for it to be considered adequate? Do we need to have evidence of TZ sampling in specimens taken during the follow-up period after treatment of squamous intraepithelial lesion or after detection of endocervical glandular neoplasia? What criteria for obscuring factors, such as blood and inflammation, should be used in assessing adequacy? Cost-benefit analyses of utilizing liquid-based preparations are needed. Should we inform women about the technical details of the test methods available or chosen by the laboratory? Are women in a position to decide which method is the most appropriate to assess their cervical scrape sample? We need to obtain more information about the properties of proprietary liquid fixative/transport media with respect to inactivation of viral pathogens, tuberculosis and other bacterial pathogens and suitability for immunobiologic and molecular tests, etc. We need to obtain more information on the use of stoichiometric stains and the limitations of Papanicolaou stain for image analysis systems. The use of liquid-based preparations for nongynecologic cytopathology and ancillary tests must be considered, including criteria for adequacy. We need to obtain more information on the time required for and best methods of training experienced cytotechnologists to become competent at assessing liquid-based cervical preparations.

Cell Biology↗
PubMedDate not supplied

Quality assurance/control issues. International Academy of Cytology Task Force summary. Diagnostic Cytology Towards the 21st Century: An International Expert Conference and Tutorial.

ISSUES: General definitions of quality assurance and quality control (QA/C) have existed in many forms for decades, and a new discipline guides their application to diverse industrial and recently medical processes without much fanfare. However, in the field of cervical cytology screening, the range of QA/C options has recently broadened and become controversial. With the advent of new systems of terminology, larger-scale laboratories and new technologies--plus strong governmental and legal pressures in some nations--the range of extremely difficult and sometimes expensive QA/C choices our community faces is greater than ever. CONSENSUS POSITION: At our conference, the basic definitions of QA/C posed little difficulty. Presentation of the range of methods in use today and of those based on new technologies where use is proposed or has just begun also was achieved with little or no dispute. However, there was lack of consensus on exactly how QA/C methods are to be assessed. Indeed, there was little consistency in the use of different outcome measures with which we can judge success or failure of specific QA/C options. In addition, the tension between pressure to adopt sometimes uncertain or expensive method enhancements and pressure to maintain affordability and the widest possible access for populations that most need cervical cytology screening is greater than ever. ONGOING ISSUES: More data are required that would enable assessment of QA/C options with the clearest possible understanding of cost/benefits and current or new assumptions of risk. Other task forces, such as medicolegal, cost/benefit and those devoted to new technologies, are our essential partners in meeting the challenges described above.

Centers for Medicare and Medicaid Services, U.S.↗
PubMedDate not supplied

Multicenter masked evaluation of AutoCyte PREP thin layers with matched conventional smears. Including initial biopsy results.

OBJECTIVE: To compare the performance of liquid-based cell preparations from the AutoCyte PREP system (AutoCyte, Inc., Elon College, North Carolina) with the conventional cervical smear in masked, split-sample, multisite trials. STUDY DESIGN: The AutoCyte PREP system utilizes the CytoRich method, which combines liquid preservation, selective reduction of blood and inflammation, thin-layer cell dispersion and discrete staining. In an eight-site multicenter trial, 8,983 cases were evaluated. Parallel AutoCyte PREP slides and matching conventional cervical cytologic smears were screened in a masked fashion, with all abnormals reviewed in a masked, on-site pathologist review. The conventional smear was always prepared first, with the AutoCyte PREP using the residual cells on the collection device. The Bethesda System was used for reporting diagnosis and specimen adequacy. RESULTS: Of the cases, 7,805 (86.9%) had the same interpretation. In 8,750 cases (97.4%), there was agreement within one diagnostic category. The AutoCyte PREP demonstrated a statistically significant, 31% overall improvement in the detection of squamous intraepithelial lesion and invasive cancer when evaluating cases with more than one diagnostic class difference. Biopsy correlation of available data supported the improvement observed in the cytology-based comparison. Recovery of infectious organisms and endocervical component was comparable between preparations, especially in light of the split-sample study design. There was a 39% reduction in unsatisfactory slides and 44% fewer satisfactory but limited by reports. CONCLUSION: The AutoCyte PREP and CytoRich method produce excellent cellular presentations with standardized quality, superior sensitivity and improved adequacy as compared to the conventional method.

Adolescent↗
PubMedDate not supplied

The AutoPap system for primary screening in cervical cytology. Comparing the results of a prospective, intended-use study with routine manual practice.

OBJECTIVE: To evaluate the effectiveness of the AutoPap System in detecting abnormal and normal cervical smears when used in a primary screening/quality control mode, as compared with currently established laboratory practices. STUDY DESIGN: Slides were obtained prospectively and were initially processed in the routine fashion with cytotechnologist screening followed by 10% random quality control rescreening. Slides were then processed on the AutoPap System and allocated into the following groups: (1) approximately 25% of the lowest-ranking slides were placed in the laboratory's archives as within normal limits; (2) the remaining approximately 75% of slides were subjected to manual screening. Approximately 15% of the highest-ranking slides in this group underwent quality control rescreening. For each slide needing manual screening, the cytotechnologist was supplied with a report giving the ranking score of that slide. All discrepant slides for either adequacy or diagnosis were subjected to a truth-determination process. The results obtained from the two arms of the protocol were then compared. RESULTS: The AutoPap System-assisted arm of the study was superior to the current practice arm for the identification of abnormal slides at the level of atypical squamous cells of undetermined significance and above (ASCUS+), low grade squamous intraepithelial lesion (LSIL) and higher LSIL+. AutoPap System-assisted practice was equivalent to current practice for the identification of unsatisfactory and satisfactory but limited by slides. All results showed statistical significance. In addition, AutoPap System-assisted practice in the study indicated improved specificity of diagnosis. CONCLUSION: AutoPap System-assisted practice shows superior sensitivity and specificity when compared to current practice. Its clinical use as a primary screening device should improve the overall practice of cervical cytology as well as provide potential enhancement in overall laboratory productivity.

Algorithms↗
PubMedDate not supplied

AutoPap 300 QC system scoring of cervical smears without "epithelial cell abnormalities".

OBJECTIVE: To examine four morphologic features other than epithelial abnormality to identify if they are associated with a high quality control (QC) score with the AutoPap 300 QC system. STUDY DESIGN: A total of 180 slides (140 with a high QC score and 40 with a low QC score [the control group]) were manually reviewed, and four morphologic features were assessed while blind to the QC score, as follows: adequacy, epithelial fragments and clumps, cytohormonal pattern, and diagnostic categories within normal limits and benign cellular changes (BCC). RESULTS: Both atrophy and a diagnosis of BCC were associated with a high QC score at a statistically significant level. CONCLUSION: Certain characteristics of the slide population submitted for AutoPap QC review could have an impact on the overall laboratory workload (QC review rate). There are opportunities to optimize the workload of the laboratory when using AutoPap for QC selection.

Adult↗
PubMedDate not supplied

Enhancing the performance of the AutoPap 300 QC system with optimal staining and presentation of cervical smears.

OBJECTIVE: To optimize the staining and presentation of slides for the AutoPap 300 QC System, an automated cytology screening system which examines conventionally prepared cervical smears, and to assess subsequent scanning and scoring rates and compare them to those of laboratories not adopting these changes. STUDY DESIGN: In this study, procedures were developed for optimal presentation and staining of slides for the AutoPap System in response to observations made in preclinical trials. Three thousand eight hundred fifty-five slides were then submitted to the device for analysis in a prospective, blind, clinical evaluation study. The scanning and scoring rates were compared to those of a cohort of 12,525 slides that were analyzed in other laboratories which had not adopted these procedures. RESULTS: Two hundred forty (6.2%) slides failed scanning due to physical defects. An additional 70 slides (2.0% of scanned slides) did not complete scoring due to staining limitations. The laboratories in the clinical trials that had not adopted these preanalytic method changes had higher scanning failure rates due to physical limitations (15.0%) and incomplete scoring rates due to staining limitations (6.2%). CONCLUSION: The present study demonstrated that the performance of the AutoPap 300 is enhanced by meticulous attention to preanalytic staining and presentation procedures.

Automation↗