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At least 415 records · Page 23Linked to original sources
PubMed1988

Age dependent dehydration of postmitotic cells as measured by X-ray microanalysis of bulk specimens.

In this paper we give a brief outline of our bulk specimen technique developed to measure intracellular water concentration in frozen-hydrated biological specimens by means of energy dispersive X-ray microanalysis. Fractured surface of the deep-frozen tissue samples is analyzed in an electron microscope (a specimen area of 15 x 11.5 micron is scanned) using 20 kV accelerating voltage and 1-5 pA effective beam current (measured in the specimen). Strong electric charging, which is the main problem associated with the low temperature X-ray microanalysis of frozen-hydrated specimens, is reduced by choosing optimum temperature range for the measurements (170-185 K) and by etching a thin surface layer on specimen surface. The main advantage of the method over other X-ray microanalytical techniques using sections and bulk specimens for water and dry-mass content determinations in cells (which are shortly reviewed) is the simple specimen preparation, the easy sample handling and the good stability of specimen during measurements. The main disadvantage is the poor spatial resolution as compared to the analysis of sections. Measurements with our method provided meaningful results of the change in intracellular water contents in various postmitotic cells of rats dependent on age. The observed decline of the intracellular water contents results in increased ionic strength and slower diffusion in old cells than in young ones. These effects may be implicated in senescent deterioration of cell metabolism.

Aging↗
PubMed1994

Nuclear morphometry in automatic biopsy and radical prostatectomy specimens of prostatic carcinoma. A comparison.

Nuclear shape analysis performed upon prostatectomy specimens of prostatic carcinoma distinguished individual patients with good and poor prognoses. In order to be useful for prognosis assessment preoperatively, nuclear morphometry must be measured on needle biopsy specimens. We compared nuclear morphometry on automatic biopsy and radical prostatectomy specimens in 20 patients with prostatic carcinoma. Nuclear size was smaller (paired Student t test, P < .0001) in biopsy specimens (perimeter 17.0 +/- SD 4.9 microns, area 29.9 +/- 6.6 microns2) than in prostatectomy specimens (perimeter 24.6 +/- 4.4 microns, area 48.2 +/- 8.7 microns2). Nuclear shape was more abnormal in automatic biopsy specimens (nuclear roundness factor 82.0 +/- 18.8, ellipticity 90.5 +/- 27.7) than in surgical specimens (nuclear roundness factor 43.5 +/- 8.8, ellipticity 54.0 +/- 14.7) (P < .0001). Study of specimens obtained by automatic biopsy preoperatively and automatic biopsy of the prostatectomy specimens at various steps of processing revealed that nuclear swelling and rounding occurred after 2-24 hours of formalin fixation. Automatic prostate biopsies may more accurately reflect true nuclear morphometry and should be studied for preoperative prognosis prediction in patients with clinically localized prostatic carcinoma.

Biopsy↗
PubMed1994

Cervical cone margins as a predictor for residual dysplasia in post-cone hysterectomy specimens.

OBJECTIVE: To determine the relation between dysplasia at cervical cone margins and the presence or absence of residual dysplasia in post-cone hysterectomy specimens. METHODS: We performed a 6-year retrospective, multicenter study and reviewed 250 cases in which the patient had a cold-knife cervical cone biopsy followed by a hysterectomy within 6 months. Pathology reports from 23 institutions described the margins in conization specimens and the subsequent status of residual dysplasia in the hysterectomy specimens. RESULTS: There was a statistically significant difference in the prevalence of residual dysplasia in hysterectomy specimens between patients with positive margins on cone biopsy (47%) and those with negative margins (23%) (P < .01). The positive predictive value for residual dysplasia given positive cone margins was 47%, and the negative predictive value was 77%. The grade of post-cone residual dysplasia increased commensurately with the grade of dysplasia in the conization specimen. CONCLUSIONS: The presence of dysplasia at the cervical cone margin relates significantly with the presence of residual dysplasia in the post-cone hysterectomy specimen. The grade of residual dysplasia in the post-cone hysterectomy specimen increased as the grade of dysplasia in the conization specimen increased. Free margins on a cone biopsy specimen with dysplasia offer reassurance that invasive cancer is not present in the remaining uterus.

Analysis of Variance↗
PubMed1994

Transbronchial needle aspiration for cytology specimens.

Transbronchial needle aspiration (TBNA) for diagnosis and staging of bronchogenic carcinoma has evolved in the USA since the late 1970's. Initial reports advised that aspirated specimens be flushed into a container by normal saline or Hank's solution and processed in a cytology laboratory usually by Millipore filter and other techniques. A highly sophisticated cytology laboratory is the key to the success of this procedure. This study was designed to assess a simpler alternative method of processing the specimen by a direct smear technique. From June 1990 to September 1990, 40 procedures were performed on 34 consecutive patients. Seventy two paired direct smear and fluid specimens for cytology examination were collected. Fifty specimens were found to be negative in both types of specimen preparation. Fifteen were found to be positive in both types of specimens preparation, and six specimens were found to be positive only in the direct smear preparation. One of the 72 specimens was found to be positive in the Millipore and other preparation techniques. Based on our data, we conclude that the use of the direct smear for TBNA specimen preparation is an effective, simpler, and improved method. Proper use of it may increase the diagnostic yield and result in better acceptance of this new procedure.

Biopsy, Needle↗
PubMed1997

Cryptosporidiosis in HIV-infected patients: diagnostic sensitivity of stool examination, based on number of specimens submitted.

OBJECTIVES: To determine the optimal number of stool specimens needed for the diagnosis of cryptosporidiosis. METHODS: Four hundred thirty-five admissions were reviewed (291 patients) in which stool specimens were examined for Cryptosporidium parvum oocysts (mean of 1.47 specimens per admission), using a modified acid-fast stain. The diagnostic yield of each specimen was determined. RESULTS: Cryptosporidium parvum oocysts were found in 81 of 435 admissions (18.6%). Ninety-six percent of the positive cases were detected on the first stool specimen analysis, and 100% were detected by the second specimen. CONCLUSIONS: Examination of one specimen is generally appropriate for the diagnosis of cryptosporidiosis in a hospitalized patient with AIDS presenting with diarrhea. Examination of a second specimen may be appropriate if the first specimen is negative and there is a high clinical index of suspicion.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

[Viral hepatitis markers in saliva specimens from patients with acute hepatitis A, B and C].

Anti-HVA IgM, HBsAg, anti-HBc IgM, anti-HVC were determined in the blood sera and saliva specimens obtained from patients with acute hepatitis A, B, C (HA, HB, HC) and from healthy persons of the control group. 37 HA patients, 27 HB patients and 24 HC patients, observed in the dynamics of the disease (for a period of 1 month and longer from the appearance of manifestations of the disease), as well as 30 practically healthy persons (the control group) were examined. Anti-HVA IgM could be found in saliva specimens taken from the HA patients 100% of cases, but could not be found in saliva specimens from the persons of the control group and HB patients. The presence of HBsAg was established in 92.8% and anti-HBc IgM, in 100% of cases in saliva specimens from patients with acute HB. In no case HB markers were found in saliva samples obtained from HA patients and from the persons of the control group. In HBsAg-positive saliva specimens HB virus DNA was detected by the method of polymerase chain, reaction, which opened new aspects for the modern interpretation of the role of saliva as a factor in the natural transmission of HB. Anti-HVC could be found in all patients both in the blood serum and saliva specimens, but proved to be absent in the persons of the control group, as well as in HA and HB patients. The dynamic study of HA, HB and HC patients for the detection of anti-HVA and anti-HBc IgM, HBsAg and anti-VHC demonstrated the possibility of detecting these markers for 1 month and longer in the blood sera and in saliva specimens. The results of these investigations suggest that saliva specimens may be regarded as an alternative to blood sera in the diagnosis of HA, HB and HC in patients with acute viral hepatitis; these results also open prospects for the use of saliva specimens as an object of study in diagnostic laboratories, the deciphering of viral hepatitis outbreaks, the diagnosis of HA in persons with anicteric forms of HA.

Acute Disease↗
PubMed1998

Evaluation of an automatic polymerase chain reaction assay for identification of Mycobacterium tuberculosis in respiratory specimens.

We evaluated the performance of an automatic polymerase chain reaction (PCR) detection system for identification of Mycobacterium tuberculosis in respiratory specimens. Six hundred and two respiratory specimens, including 557 sputa and 45 bronchial washing samples, were analyzed using the COBAS AMPLICOR Mycobacterium tuberculosis (MTB) test. The results were compared with those obtained from acid-fast microscopy, conventional culture, and clinical history. In cases of discrepancy between the results of the COBAS AMPLICOR MTB test and culture, the medical history of the patient was reviewed, the COBAS AMPLICOR MTB test was repeated, and the gene encoding M. tuberculosis superoxide dismutase was screened using PCR (SOD-PCR). Fourteen samples were excluded because the internal control test result was negative. Of 57 specimens that were culture positive for Mycobacterium species, 40 appeared to have growth of M. tuberculosis and 21 were smear positive for acid-fast bacteria. The sensitivity, specificity, and positive and negative predictive values for the COBAS AMPLICOR MTB test evaluated at our laboratory were 85.0% (34/40), 99.3% (544/548), 89.5% (34/38), and 98.9% (544/550), respectively. Three specimens that were culture positive for M. tuberculosis but negative by COBAS AMPLICOR MTB test were positive when rechecked by both COBAS AMPLICOR MTB test and SOD-PCR. Among the four specimens with positive reactions on both COBAS AMPLICOR MTB test and SOD-PCR that were culture negative, two were from patients who had been receiving antituberculosis treatment, one was from a patient who had been treated for tuberculosis for 1 year, and the other was from a patient who died of sepsis with adult respiratory distress syndrome. In more than 70% of smear-negative and culture-positive specimens and 86.4% of smear-positive specimens, M. tuberculosis was identified by the COBAS AMPLICOR MTB test within 10 hours after receipt of the specimens. Our data show that the COBAS AMPLICOR MTB test provides rapid and accurate detection of M. tuberculosis in respiratory specimens.

Adult↗
PubMed1998

Cytologic examination of exfoliative specimens obtained during endoscopy for diagnosis of gastrointestinal tract disease in dogs and cats.

OBJECTIVE: To determine whether cytologic examination of exfoliative specimens obtained during endoscopy was as useful as histologic examination of mucosal biopsy specimens for the diagnosis of gastrointestinal tract disease in dogs and cats and to compare the diagnostic accuracy of 2 techniques (brush or touch) in preparing specimens for cytologic examination. DESIGN: Prospective case series. ANIMALS: 85 dogs and 23 cats. PROCEDURE: Specimens for cytologic and histologic examination were obtained during routine endoscopic examination of the stomach, small intestine, and colon. A diagnosis was made on the basis of cytologic findings (graded objectively) and compared with the diagnosis on the basis of histologic findings. RESULTS: The diagnostic accuracy of cytologic examination was high for all 3 organs. Sensitivities, specificities, and predictive values of positive and negative results were > 90% in most instances. The diagnostic accuracy of the brush technique was equal or superior to that of the touch technique for 84% of specimens. The brush technique was most useful in detecting cellular infiltrates in the lamina propria, whereas the touch technique was more likely to detect acute mucosal inflammation. Percentages of false-positive (3.2%) and false-negative (6.9%) cytologic interpretations were low. CLINICAL IMPLICATIONS: Endoscopy is safe and requires little time to procure specimens for cytologic examination, which can be obtained concurrently with mucosal biopsy specimens. Cytologic examination of exfoliative specimens obtained during endoscopy is a useful and reliable adjunct to histologic examination of biopsy specimens in the diagnosis of gastrointestinal tract disease in dogs and cats.

Animals↗
PubMed2003

An unexpected distribution of sodium concentration in serum specimens stored for more than 30 years.

PURPOSE: Sera from over 50,000 pregnant women in the Collaborative Perinatal Project have been frozen at -20 degrees C since 1959 to 1966, and with the health data on their offspring constitute a resource that is still actively used. In two studies using these specimens, we measured sodium concentration to assess desiccation. METHODS: Sodium was measured in over 5,000 specimens by two different methods. For 10 specimens with unusually low sodium values, a substudy was done to investigate the cause. RESULTS: High sodium levels (>140 mmol/L) were present in more than 20% of specimens, and levels were unusually low (<130 mmol/L) in more than 40% of specimens. The substudy showed that filtering the specimens increased sodium levels and that about 14% of the sodium was trapped in particulate matter. CONCLUSIONS: High sodium levels in these specimens were probably due to desiccation and possibly to leaching of sodium from the glass containers. Low sodium levels were probably caused by the particulate matter, which clogged the analytical sampling devices and also trapped sodium. In serum specimens that have been stored for long periods, use of routine laboratory procedures for analysis can yield erroneous results. Furthermore, measured analyte levels can be affected by more than just degradation and desiccation.

Adult↗
PubMed1980

Effect of moderately elevated temperatures on dermatophyte survival in clinical and laboratory-infected specimens.

The effect of increased temperature during transportation of clinical dermatophyte specimens was investigated. Recovery rates from untransported specimens cultured at dermatologists' offices and from duplicate transported specimens were compared. During the months of hot weather specimens could be exposed intermittently to temperatures as high as 60 degrees C during transportation from Tucson area clinics to the University laboratory. The rates of recovery from known positive specimens were found not to be significantly different at these places regardless whether specimens were transported during the hot months or cooler months of the year. In a controlled experimental approach to the effect of this elevated temperature on clinical specimens weighed amounts of skin scales collected from guinea pigs artificially infected with Trichophyton mentagrophytes were exposed to 60 degrees C for up to four hours and then digested with 0.5% (:300) trypsin for one hour. Analysis of plate counts done from the digestion mixture showed no significant difference between counts obtained from specimens exposed to elevated temperature and unexposed controls.

Animals↗
PubMed2006

Effect of specimen order on Chlamydia trachomatis and Neisseria gonorrhoeae test performance and adequacy of Papanicolaou smear.

STUDY OBJECTIVE: To evaluate the effect of specimen collection order on the performance of diagnostic tests for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC), and the specimen adequacy of ThinPrep Papanicolaou (Pap) smears. DESIGN: Prospective cohort study. SETTING: Public adolescent clinic. POPULATION: 313 women. INTERVENTIONS: The order of five cervical testing specimens was randomized for (1) ligase chain reaction (LCR) and (2) polymerase chain reaction (PCR) for both CT and GC; (3) transcription-mediated amplification (TMA) for CT; (4) culture for CT; and (5) cytology and LCR for GC and CT performed on ThinPrep Pap specimens. For CT and GC, a reference standard was based on three different tests performed on separate specimens. Generalized estimating equations were used to account for repeated measures. MAIN OUTCOME MEASURE: Sensitivity and specificity of diagnostic tests. RESULTS: The proportion of inadequate Pap smears was independent of specimen order. As a group, nucleic acid amplification test (NAAT) sensitivity and specificity for GC and CT were similar in the first two (early) and last three (late) swabs. Although point estimates for sensitivity were higher in the early swabs compared to the late swabs for GC LCR (13% difference), GC PCR (13%), and CT TMA (10%), these differences were not statistically significant. Their clinical significance warrants further investigation. CONCLUSIONS: In clinical settings where both Pap smears and STI testing are performed in adolescents, clinical considerations can influence the order of specimen collection, since neither Pap specimen adequacy nor test performance of NAAT for CT and GC were significantly associated with swab order.

Adolescent↗
PubMed1999

Laparoscopic leash: a simple technique to prevent specimen loss during operative laparoscopy.

BACKGROUND: Surgical specimens can be lost in the peritoneal cavity during operative laparoscopy. Although specimens left might cause no complications, peritonitis and adhesion formation have been reported, requiring subsequent laparoscopy or laparotomy. We report a simple technique to prevent loss of surgical specimens during laparoscopy. TECHNIQUE: A suture is placed through the specimen, and the trocar sleeve is removed. Free ends of the suture are held with a clamp outside the abdomen while the port is reinserted into the abdomen. The suture is pulled to see the specimen when necessary. When morcellation is required, the leashed area of the specimen is the last to be extracted. This procedure takes less than 2 minutes. EXPERIENCE: We have used this technique for longer than 1 year for 18 myomectomies and seven bilateral salpingo-oophorectomies. No specimens were lost in the peritoneal cavity, and there were no complications related to the procedure. CONCLUSION: The laparoscopic leash is a simple and reproducible preventive technique that adds insignificant time to operations but saves much time that might be wasted localizing a misplaced specimen.

Equipment Design↗
PubMed1998

"Rush" skin biopsy specimens in a tertiary medical center: diagnostic yield and clinical utility.

BACKGROUND: Skin biopsy specimens are submitted for "rush" or "stat" processing, thereby indicating a sense of urgency about the clinical situation. OBJECTIVE: Our purpose was to determine the patient population who underwent biopsy on a "rush" basis and assess the way in which interpretation of the skin biopsy specimen influences clinical management. METHODS: A retrospective study was performed on the "rush" biopsy specimens sequentially requested during 1 year. Histologic findings, the clinical situation, and the effect of the biopsy result on clinical management were determined. RESULTS: A total of 90 adult patients, many critically ill, were identified. The majority of patients were admitted to hematology-oncology services (58%). The other 42% were admitted to a variety of clinical services. The chief clinical concerns in hematology-oncology patients were graft-versus-host disease and cutaneous infection. Only 5.5% of biopsy specimens taken to exclude graft-versus-host disease were used in immediate clinical decision-making compared with 45% of biopsy specimens for oncology patients with suspected infection and 42% for all other services. CONCLUSION: Many urgent skin biopsy specimens were not used for immediate clinical decision-making. The usefulness of skin biopsy varies with the clinical situation, and some situations are more prone to yield equivocal histologic data. Knowledge of these situations may reduce the number of unhelpful biopsy specimens. Therapy based on clinical findings had often been initiated before receiving the biopsy results, but biopsy findings are often helpful as confirmatory data. Diagnostic findings were not necessary for a biopsy specimen to provide useful data and nonspecific findings interpreted in light of clinical findings were also useful.

Adult↗
PubMedDate not supplied

Single-specimen bile cytology: a prospective study of 80 patients with obstructive jaundice.

PURPOSE: To determine the sensitivity, specificity, and charges associated with single-specimen bile cytologic study in patients with obstructive jaundice. MATERIALS AND METHODS: Eighty consecutive patients with presumed malignant biliary strictures underwent percutaneous biliary drainage (PBD). Cytologic evaluation was performed on a single bile specimen from each patient collected at the time of the PBD. Final diagnoses were obtained from either percutaneous (n = 14) or surgical (n = 66) histologic specimens (gold standard). Both data sets were then compared to determine the sensitivity and specificity of bile cytology. The charges associated with bile cytodiagnosis were compared to those for other biopsy procedures utilized in the same setting. RESULTS: Eighty bile specimens were obtained with a mean of 14 mL (range, 3-65 mL) per patient with 79 (99%) specimens adequate for cytologic processing. Eleven (13%) specimens were acellular. The overall sensitivity was 15% and specificity was 100%; these values were not dependent on the volume of the bile specimen (P > .10) or type of malignancy (P = .10). For bile cytodiagnosis, the mean charge was $160 and the successful biopsy rate (true-positive plus true-negative results/total number procedures) was 27%. CONCLUSION: Single-specimen bile cytology has a low sensitivity; however, because of its convenience, simplicity, atraumatic nature, and low relative charge versus comparable procedures, it may be useful as an adjunct to PBD in patients with suspected malignant biliary disease.

Aged↗
PubMed2000

Diagnostic effect of an improved preembedding method of prostate needle biopsy specimens.

The authors compared the influence of a conventional and an optimized submitting method of prostate core needle biopsy specimens on the frequency of cancer detected and the pathologic characteristics of the adenocarcinoma bearing biopsy specimens. The patients included were part of the prostate-specific antigen (PSA) screening program of Tyrol/Austria. Of the systematic core needle biopsy specimens from 500 unselected men obtained within 1 year from the Urological Department, University of Innsbruck, the core biopsy specimens of 250 cases were submitted conventionally, floating free in formalin-filled containers, whereas the biopsy specimens of the other 250 cases were stretched and orientated between 2 meshes in tissue cassettes at the time of biopsy before formalin fixation. On 136 cases diagnosed as adenocarcinoma the number and the length of cores as well as number of the cores involved by cancer and the tumor size were morphometrically determined. The diagnosis of benign prostatic hyperplasia, isolated high-grade prostatic intraepithelial neoplasia (PIN), atypical foci suspicious for cancer, and carcinoma was made in 66%, 5.6%, 4.8%, and 23.6% after conventional submission and in 61.6%, 6.4%, 1.2%, and 30.8% of the cases after optimized preembedding respectively. In the adenocarcinoma cases the optimizedly preembedded material showed higher mean total core length (126.5 mm versus 93.9 mm; P < .0001), a higher mean total tumor length (14.1 mm versus 8.6 mm; P = .01), and more cores involved by cancer (2.9 versus 2.4; P = .01) compared with the conventionally worked-up biopsy specimens. Optimized preembedding of core needle biopsy specimens in tissue cassettes could be quickly and routinely done by the assistance of the urologists at the time of biopsy. The significant improvement of the histologic yield of optimizedly preembedded prostatic needle biopsy specimens led to a higher frequency of cancer diagnosis, a reduction of cases with atypical foci suspicious for cancer and a significantly lower number of cases with only 1 core biopsy involved by cancer.

Adenocarcinoma↗
PubMed2000

Endemic contamination of clinical specimens by Mycobacterium gordonae.

Contamination of clinical specimens by Mycobacterium gordonae is a significant endemic problem in many laboratories. To investigate this problem, 84 cases at 1 hospital were retrospectively identified during 20 months. The overall rate of specimen contamination was 2. 4%, and 72 of the contaminated specimens were respiratory. A case-control comparison showed that the risk of respiratory specimen contamination was significantly increased if the specimen was expectorated (odds ratio [OR], 3.62; 95% confidence interval [CI], 1. 36-9.50) or if the patient consumed fluids within 2 days before specimen collection (OR, 8.92; 95% CI, 1.40-71.20). Cultures of tap water, ice, and iced drinking water all yielded M. gordonae at 10(-2)-10(0) cfu/mL. A culture survey of consenting patients showed contamination of 8 (24%) of 34 sputum specimens collected immediately after a tap water mouth rinse. These findings demonstrate that endemic specimen contamination arises from mycobacteria in hospital tap water and provide a foundation for control efforts.

Adult↗
PubMed2001

Molecular subtyping of Treponema pallidum in an Arizona County with increasing syphilis morbidity: use of specimens from ulcers and blood.

A molecular-based subtyping system for Treponema pallidum was used during an investigation of increasing syphilis in Maricopa County, Arizona. Genital ulcer or whole blood specimens from patients with syphilis were assayed by a polymerase chain reaction (PCR) amplification of a T. pallidum DNA polymerase I gene. Positive specimens were typed on the basis of PCR amplification of 2 variable genes. In all, 41 (93%) of 44 of ulcer specimens and 4 (27%) of 15 blood specimens yielded typeable T. pallidum DNA. Twenty-four (53%) of 45 specimens were subtype 14f; other subtypes identified included 4f, 4i, 5f, 12a, 12f, 14a, 14d, 14e, and 14i. Only 2 specimens were from epidemiologically linked patients. This investigation demonstrates that multiple subtypes of T. pallidum can be found in an area with high syphilis morbidity, although 1 subtype (14f) was predominant. Four typeable specimens were from blood, a newly identified specimen source for subtyping.

Arizona↗
PubMed1989

Mammographic and gross pathologic analysis of breast needle localization specimens. Use of a tissue analysis device.

Histologic diagnosis of a nonpalpable breast lesion requires the following: (1) mammographically directed excision of the suspect lesion, (2) recovery of the target lesion from the tissue specimen, and (3) demonstration of the lesion in histologic section. Recovery of lesional tissue is a function of localization within the specimen, whereas histologic demonstration is a function of localization within the paraffin block. Both localizations are pitfalls enroute to accurate diagnosis of the small mammographic lesion. A technique of specimen analysis is presented that uses a specimen holder to assure precise localization of the lesion within the biopsy tissue. The excised specimen is immobilized within the holder, which incorporates a reference grid visible in the specimen radiograph and on the holder surface. The target lesion can be localized in the reference grid of the specimen radiograph and then excised from the corresponding area of the specimen, which remains in the holder until presented to the gross pathologist. Localization of the lesion within a specific paraffin block(s) will permit additional histologic levels for optimal examination while minimizing histologic work load. The advantages of this approach are discussed and contrasted with variations of standard gross technique.

Biopsy, Needle↗