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PubMed2000

Accuracy of cytologic diagnoses made from touch imprints of image-guided needle biopsy specimens of nonpalpable breast abnormalities.

We investigated the diagnostic utility and accuracy of touch imprints (TIs) prepared from core-needle biopsy (CNB) specimens of nonpalpable breast abnormalities. We reviewed air-dried, Diff-Quik-stained TIs prepared from 172 consecutive CNB specimens obtained with stereotactic or sonographic guidance. Using criteria established for fine-needle aspirates, TIs were categorized as benign, atypical, suspicious, malignant, or unsatisfactory (i.e., showing fewer than six benign epithelial cell clusters or cell distortion). Cytologic diagnoses of TIs were then correlated with the histologic diagnoses of corresponding CNB specimens. CNB specimens were histologically diagnosed as carcinoma (102 cases), benign (59 cases), low-grade phyllode tumor (six cases), and atypical ductal hyperplasia (five cases). TIs were cytologically diagnosed as malignant (63 cases), benign (35 cases), suspicious (19 cases), atypical (18 cases), and unsatisfactory (37 cases). Correlation of the cytologic and histologic diagnoses showed that five TIs diagnosed as benign were false-negative results for histologically diagnosed carcinomas (four cases) and phyllodes tumor (one case). False-negative results were attributed to poor representation of malignant cells. Two TIs diagnosed as suspicious were false results for two histologically diagnosed fibroadenomas. The false suspicious findings resulted from TIs with high cellularity, cytologic atypia, or no familiar (i.e., as seen on fine-needle aspirates) smear pattern. Unsatisfactory TIs were noted in both benign (44%) and malignant (11%) CNB specimens. When lesions categorized as suspicious were grouped with the malignant cases and those classified as atypical were grouped with the negative cases, TI sensitivity and specificity, were 83% and 95%, respectively. Fibroadenomas are difficult to identify on TIs and are likely to be misdiagnosed as suspicious. While high- and intermediate-grade carcinomas are easily categorized using TIs, low-grade carcinomas are best categorized as suspicious because of overlapping cytologic features with proliferative breast lesions. Increased experience with cytologic analysis of TIs improves the accuracy of cytologic diagnoses.

Biopsy, Needle↗

PubMed2000

Usefulness of cervical collection by the exact touch, the saccomanno single sampler, combined with automated primary screening.

Automated-primary screening is frequently performed, but conventional smears have to be rescreened on coverslip edges because automated systems do not analyze cells near the coverslip edges because of focusing problems. This disadvantage can be overcome by obtaining conventional samples smeared in the center of the slide, e. g., by the Exact Touch (ET), a single sampler introduced by G. Saccomanno. PAPNET-assisted primary screening was performed on 263 samples collected by ET. The smears were classified as "negative" or as "review." The negative cases were rapidly rescreened but not near the coverslip edges. The review cases were fully reanalayzed by the optic microscope. Ten positive smears were identified among the review cases: 3 smears showed changes due to human papillomavirus, 3 low-grade squamous intraepithelial lesions, and 4 high-grade squamous intraepithelial lesions. The detection of abnormal cells was easy by means of the combined use of ET and PAPNET. The ET-PAPNET technique was very useful in analyzing conventional smears and in reducing the time-consuming process of detecting abnormal cells.

Cervix Uteri↗

PubMed1995

Bone marrow biopsy imprints (touch preparations) for assessment of iron stores.

Noninvasive evaluation for iron deficiency is compromised in many individuals due to the presence of chronic inflammatory processes and/or malignancy, thus necessitating bone marrow examination for definitive diagnosis. However, bone marrow aspiration is not obtainable or is inadequate for interpretation (dry tap) in some individuals, and decalcified bone marrow biopsies require 24-48 hr to prepare, and may falsely indicate absence of iron. We evaluated the accuracy of bone marrow biopsy imprints (touch preparations) compared with aspirate particle smears for semiquantitation of bone marrow iron stores. Results indicate that Prussian blue-stained bone marrow biopsy imprints accurately reflect the quantity of iron, compared with bone marrow aspirate particle smears, allowing for rapid determination of iron stores in individuals in whom a bone marrow aspirate cannot be obtained.

Biopsy↗

PubMed1992

Serotonin-like immunoreactivity in Merkel cells and their afferent neurons in touch domes from the hairy skin of rats.

Immunoreactivity to serotonin was observed in Merkel cells as well as the afferent type I nerves terminating upon them in touch domes excised from the belly skin of rats. Type I nerves were strongly immunoreactive and could be traced through the dermis of the domal papilla. Merkel cell immunoreactivity was sometimes seen in the entire cell, but was often localized in the Merkel cell cytoplasm adjacent to nerve terminals and may have been in the terminals themselves. Domes were fixed by immersion in 4% paraformaldehyde-lysine-sodium-m-periodate (PLP) fixative at 4 degrees C for 2.5-3 hours and cryoprotected in 30% sucrose overnight. Sections were processed with the avidin-biotin complex peroxidase (ABC), peroxidase-antiperoxidase (PAP), and indirect immunofluorescence techniques with rabbit antiserum generated against serotonin.

Afferent Pathways↗

PubMed2006

Is intraoperative touch imprint cytology of sentinel lymph nodes in patients with breast cancer cost effective?

BACKGROUND: Sentinel lymph nodes (SLNs) are generally evaluated postoperatively, requiring 5-7 days for assessment. SLNs can also be evaluated intraoperatively by using touch imprint cytology (TIC), thus providing the surgeon immediate feedback and allowing for concurrent completion node dissection (CND) for positive SLNs. The authors hypothesized that TIC, when compared with standard postoperative SLN assessment alone, would permit a cost-effective evaluation of SLNs in patients with clinically node-negative breast cancer. METHODS: A decision-analysis model was created to compare TIC with standard postoperative SLN assessment alone. Sensitivity and specificity of TIC were determined prospectively from 342 patients who underwent SLN biopsy assessed by both techniques. Short-term health states associated with surgical staging were defined, and utilities were estimated using EuroQol-5D. Base-case analysis was performed to estimate quality-adjusted life years and the incremental cost-effectiveness ratio. Sensitivity analyses were performed to examine stability of model parameters. RESULTS: For each tumor stage, TIC was cost effective, and for patients with larger tumors (T3 and T4), TIC was the dominant strategy. The analysis was robust to changes in sensitivity and specificity of TIC, prevalence of metastasis, probability of complications, and cost. However, when utility associated with standard SLN assessment was 0.9 or greater, this became the preferred strategy. CONCLUSIONS: TIC is cost effective for assessing SLN metastasis intraoperatively. For patients with larger tumors, it is not only more effective, but also less costly than standard SLN assessment alone. TIC may be particularly useful for patients who experience significant anxiety while awaiting results of standard SLN assessment.

Algorithms↗

PubMed1986

Sensory neurons supplying touch domes near the body midlines project bilaterally in the thoracic spinal cord of rats.

Sensory neurons that project bilaterally to laminae III-V of the dorsal horns in the thoracic spinal cord of rats were described in a previous anatomical study. The electrophysiological experiments reported here show that these neurons innervate skin near the dorsal and ventral midlines. Three series of experiments were undertaken: the regions of skin supplied by subdivisions of thoracic nerves were mapped by recording from the subdivisions while mechanically stimulating the skin; subdivisions containing the axons of contralaterally projecting sensory neurons were identified by antidromic activation from the contralateral dorsal horn; the receptive fields of individual sensory neurons and dorsal horn neurons were characterized by single-unit recording methods. Contralaterally projecting sensory neurons had axons in subdivisions of the thoracic nerves that supply skin adjacent to the body midlines. Their receptive fields were located near the dorsal or ventral midline but did not extend onto the contralateral side of the body. Most of the neurons were slowly adapting "type I" units supplying touch domes. Dorsal horn neurons receiving input from contralateral sensory neurons had receptive fields that overlapped the dorsal or ventral midline. This bilateral representation of skin near the midlines may be important for the fusion of the sensory maps of the right and left sides of the body.

Action Potentials↗

PubMed2002

Utility of intraoperative consultation touch preparations.

Although intraoperative touch preparations (TPs) often are performed in conjunction with frozen sections, the comfort level of using TPs in actual practice and the effect of TP quality and cytologic experience on diagnostic accuracy have not been measured. To investigate the utility of intraoperative TPs and to compare them with that of frozen sections, five pathologists of differing levels of cytologic experience retrospectively reviewed 122 intraoperative TPs and frozen sections. Accuracy rates for individual pathologists were calculated and the accuracy using TPs was compared to that of frozen sections. TP accuracy was correlated with TP quality and cytologic experience. The mean rates of correct, incorrect, and atypical TP diagnoses were 88.5%, 4.1%, and 7.4%, respectively. The mean rates of correct, incorrect, and deferred frozen section diagnoses were 86.1%, 2.5%, and 11.9%, respectively. For the four pathologists with cytologic experience, both TP and frozen section diagnostic accuracy rates were similar; however, the pathologist who lacked cytologic experience had lower TP diagnostic accuracy. All pathologists who had cytologic experience requested a frozen section for cases with an atypical or incorrect TP diagnosis. In cases with a correct TP diagnosis a frozen section was requested 46.3% of the time. TPs of greater technical quality were associated with higher diagnostic accuracy. In conclusion, the use of performing TP and frozen section are complementary and result in increased diagnostic accuracy. For some pathologists, TPs may replace frozen sections in over 50% of cases.

Adult↗

PubMed2004

Gliosarcoma: cytopathologic characteristics on fine-needle aspiration (FNA) and intraoperative touch imprint.

Gliosarcoma (GS) is a rare subtype of glioblastoma multiforme (GBM), which shows a dimorphic population of glial and mesenchymal elements. The cytopathology of GS to our knowledge has not been previously described. Although prognostically insignificant within the group of GBM, an accurate recognition of this subtype may help to rule out other morphologically similar primary and metastatic central nervous system (CNS) neoplasms. Thirteen cases of histologically confirmed GS with concomitant touch imprints (TI) or prior fine-needle aspiration (FNA) were retrieved from the files of The Johns Hopkins Hospital (1985-2002). A comprehensive review of the clinico-radiologic, cytologic, and histologic material was undertaken to define the morphologic characteristics of GS. Material was obtained via computerized tomography (CT)-guided needle biopsy. Slides were stained with DiffQuik and/or hematoxylin and eosin (H and E) stains. Smears were highly cellular and showed a high-grade neoplasm with glial and mesenchymal elements. The latter component, however, predominated and showed a variety of phenotypic patterns, which included fibrosarcoma-like, rhabdoid type, osteoclastic giant cell type, undifferentiated type, and tumor with heterologous components (such as chondroid or osteoid tissue). A rich arborizing capillary network was evident, as were a high mitosis/karyorrhexis index and foci of necrosis. The glial component consisted of pleomorphic round to oval nuclei and numerous gemistocytes embedded in a fibrillary stroma.

Adult↗

PubMed2004

Low sensitivity of the touch imprint cytology of the sentinel lymph node in breast cancer patients--results of a large series.

BACKGROUND AND OBJECTIVES: Touch imprint cytology (TIC) was reported to be a sensitive method of intraoperative sentinel lymph node (SLN) assessment. The objective of our study was to assess the value of the TIC as an intraoperative SLN evaluation method and to determine a subgroup of patients in whom TIC should not be indicated. METHODS: In 250 breast cancer patients with SLN biopsy, TIC of SLNs was performed intraoperatively. The results of TIC were compared to the final histopathological analysis of SLNs. A subgroup analysis of the TIC value was performed with regard to the tumor size. RESULTS: SLN metastases were found in 102/250 patients (41%). Two cases were false positive. The sensitivity of TIC was 34%, specificity 98.6%, accuracy 72%, negative predictive value 69%, and positive predictive value 95%. TIC was significantly more sensitive to detect macrometastases (32/43) compared to micrometastases or ITC (3/59) (P < 0.001). TIC was positive in only 5% (4/77) in T < 10 mm tumors compared to 18% (31/168) in T > 10 mm (P = 0.01). CONCLUSIONS: TIC is a simple, quick, and sensitive method of intraoperative SLNs evaluation for the presence of the macrometastases. TIC has a very limited value in detecting micrometastases and no value in detecting ITC. TIC may not be indicated in T1a + b tumors.

Adult↗

PubMed1995

Diagnosis of Ewing's sarcoma and related tumours by detection of chromosome 22q12 translocations using fluorescence in situ hybridization on tumour touch imprints.

It is increasingly recognized that the identification of t(11;22)(q24;q12) is a useful aid in the accurate diagnosis of Ewing's sarcoma and related tumours. However, cytogenetic studies have a low success rate and adequate tumour is not always available. This study describes the use of fluorescence in situ hybridization (FISH) to detect translocations at 22q12, the site of the EWS gene involved in t(11;22)(q24;q12), on tumour touch imprints made from true cut core-needle biopsy and frozen tumour. Of the seven tumours analysed, five diagnosed as Ewing's sarcoma or primitive neuroectodermal tumour demonstrated chromosome translocation at 22q12. This is a rapid and reliable method to detect a diagnostically relevant chromosome translocation using minimal amounts of fresh or frozen tumour.

Adolescent↗

PubMed1990

Use of a touch sensitive screen and computer assisted image analysis for quantitation of developmental changes in pulmonary structure.

The extensive changes in pulmonary function occurring during early development may reflect variations in the anatomic structure of the respiratory apparatus during this period. Accurate definition of these alterations could yield important information concerning the structure-function correlations of the respiratory system. To facilitate the acquisition of morphometric data from histologic sections of pulmonary tissues, we propose the use of a computer assisted image analysis system with a touch sensitive screen as an interactive peripheral. This allows planimetric measurements and computation of the dimensions of areas of selected light intensities within an image. We present the description, design, and applications of such an image analysis system and report representative results regarding developmental changes in pulmonary structure. In addition, we correlate these results with previously published information regarding pulmonary mechanics during early development to help clarify the maturational changes in pulmonary structure-function relationships.

Animals↗

PubMed1998

Interference competition and the functional response of oystercatchers searching for cockles by touch.

We examined interference competition for food in oystercatchers, Haematopus ostralegus L., feeding on cockles, Cerastoderma edule L., when kleptoparasitism was infrequent. These birds opened cockles by hammering a hole in the shell, searched for them by touch and experienced densities of feeding conspecifics that ranged from 0 to 2362.5 birds/ha. Handling times were not significantly correlated with competitor density, but the probability of successfully opening a cockle declined significantly as competitor density increased because birds were more likely to abandon cockles they had found. Birds were also significantly more likely to carry cockles away from where they were found prior to attempting to open them as competitor density increased. We used an optimal diet model to predict maximum energy intake rates achievable for birds feeding on a given prey population, and experiencing a range of competitor densities. Despite affecting foraging behaviour, the model showed that competitor density had a negligible impact on overall intake rates. Although kleptoparasitism was rare in our study population, only 1.5% (9/586) of cockles being lost to parasites, a recent model suggests that it was likely to be profitable, under the conditions experienced by our birds. We suggest that kleptoparasitism might be infrequent because birds could reduce its likelihood by adjusting their behaviour, with only a minimal cost in terms of a reduced intake rate. Behaviour-based models of interference competition, therefore, need to consider a range of potentially complex avoidance behaviours when attempting to describe the dynamics of this process. Copyright 1998 The Association for the Study of Animal Behaviour

Journal Article↗

PubMed1993

PERINAL--a new no-touch spray to relieve the symptoms of pruritus ani.

A new no-touch aqueous spray has been developed for the topical treatment of pruritus ani. It contains 0.2% hydrocortisone and 1.0% lignocaine hydrochloride, and has been shown in studies involving 83 patients to constitute a most convenient and clinically effective preparation for alleviating the symptoms of this distressing chronic condition.

Aerosols↗

PubMed1987

Immunolocalization of alpha and beta chains of human chorionic gonadotropin, placental lactogen and pregnancy-specific beta-glycoprotein in term placenta by a touch preparation method.

Touch preparations of human placenta yield cells retaining antigenic reactivity to immunoperoxidase stains for alpha and beta chains of human chorionic gonadotropin, placental lactogen, and pregnancy-specific beta glycoprotein. This method is a rapid and simple alternative to conventional frozen and paraffin-embedded sections for detection of placental peptides.

Chorionic Gonadotropin↗

PubMed1980

Relationship of ploidy and chromatin condensation in the rat liver, moreover a comparison of the nuclear texture in sections and touch preparations.

In touch preparations and tissue sections from normal rat hepatocytes and alpha-amanitine- and actinomycin D-poisoned liver cells the extent of chromatin condensation relatively to the degree of ploidy and the chromatin distribution were studied by means of computer aided cytophotometry. It could be found, that the relationship of the condensed and decondensed chromatin is independent of the degree of ploidy and first of all dependent upon the intoxicant. Therefore, the extent of chromatin condensation can be utilized also in sections as additional parameter for automated cell screening.

Amanitins↗

PubMed1989

Touch cytology, a useful diagnostic method for diagnosis of upper gastrointestinal tract infections.

Candida albicans, Campylobacter pylori, and Giardia lamblia are microorganisms that are frequently found in the upper gastrointestinal tract. A cytological smear of biopsies obtained at endoscopy was compared with the pathologic examination of biopsies. Candida albicans was found in 55 patients, Campylobacter pylori in 54, Giardia lamblia in 31; cytology was positive in 43, 46, and 22 cases, respectively, and biopsy in 29, 43, and 22 cases. Cytology was thus the only positive test in 26 cases with Candida albicans (47% of the 55 cases), in 11 cases of Campylobacter pylori (20%), and in nine cases of Giardia lamblia (29%). We believe that the cytological smear of biopsies (touch cytology) is a quick and sensitive method for diagnosing infections of the upper gastrointestinal tract, increasing the diagnostic yield obtained by biopsy alone.

Campylobacter Infections↗

PubMed1998

Use of touch preps for intraoperative diagnosis of sentinel lymph node metastases in breast cancer.

BACKGROUND: Intraoperative touch prep (TP) is highly accurate for determining positive breast cancer margins and thereby reducing the need for second surgeries. It also may be useful in determining the status of the sentinel lymph node (SLN) during the initial surgical resection. The objective of this study was to test the ability of intraoperative TP to predict metastatic disease and, thus, the necessity for axillary lymph node dissection (ALND) at the time of SLN biopsy. METHODS: Fifty-five patients with invasive breast cancer were entered in the SLN biopsy protocol. The SLN was identified by gamma probe, dissected, and sent to pathology for TP and permanent sections. Level I and II ALND was then performed. Any radiolabeled LN in the lymphadenectomy specimen also was sent for TP and permanent sections. RESULTS: A total of 124 radiolabeled lymph nodes (LNs) were submitted for TP; of these, 93 (75%) were SLNs. Pathologic diagnosis by TP was correct compared with permanent sections for 99.2% of the nodes. There were no false positives. There was one (0.8%) false negative. The positive predictive value was 100% and the negative predictive value was 99%. Sensitivity was 95.7% and specificity was 100%. CONCLUSIONS: TP is a simple, quick, and accurate method for detecting metastatic disease in the SLN and, when used intraoperatively, enables the surgeon to determine whether or not an ALND is necessary at the time of the initial surgery.

Adult↗

PubMedDate not supplied

Use of touch preps for diagnosis and evaluation of surgical margins in breast cancer.

BACKGROUND: The best cosmetic results with conservative breast surgery are obtained at the time of initial excisional biopsy. The usefulness of the touch prep (TP) technique was evaluated for accuracy in diagnosis as well as in evaluation of margins at the time of original breast biopsy. METHODS: Four hundred twenty-eight consecutive patients with breast masses seen from January 1993 to December 1994 were evaluated prospectively using TP. RESULTS: Three hundred forty-five benign and 83 malignant tumors were evaluated. Tumors ranged in size from microscopic to 8 cm. Pathologic diagnosis was correct as compared to permanent section in 99.3%. The three carcinomas missed on TP were focal and in situ. Sensitivity was 96.39%, and specificity was 100%. Positive predictive value was 100%, and negative predictive value was 99.3%. For margin evaluation, the sensitivity and specificity were both estimated to be 100%. CONCLUSIONS: TP has the advantage of being a simple, quick (2 to 3 minutes), safe (no loss of diagnostic material), and accurate method for diagnosis and estimation of tumor margins at the time of the original surgery.

Adult↗