Association between weight gain and knee osteoarthritis: a systematic review.

OBJECTIVE: Although weight loss is recommended to manage knee osteoarthritis (KOA), adults tend to gain weight with age which may affect KOA symptoms and progression. We conducted a systematic review and data synthesis to investigate the association between weight gain and KOA, defined by clinical features, structural progression, and total knee replacement (TKR). DESIGN: MEDLINE and EMBASE were systematically searched for controlled trials and cohort studies of participants with (or at risk of) KOA examining the relationship between weight gain and KOA clinical features (pain, function, quality of life), structural progression, and TKR. Risk of bias was assessed using the ROBINS-I tool. Results were organised by outcome, with meta-analyses performed where appropriate. RESULTS: Twenty-three studies were included. Results showed significant detrimental effects of weight gain on pain (4 of 7 studies), stiffness (2 of 2 studies), function (5 of 6 studies), and the single studies examining quality of life, and clinical and radiographic KOA. Weight gain adversely affected cartilage (6 of 9 studies), bone marrow lesions (1 of 4 studies), meniscal damage (1 of 3 studies) and effusion/synovitis (1 of 1 study). Weight gain significantly increased TKR (3 of 6 studies): meta-analysis of 2 with available data demonstrated significant increases in TKR/5 kg weight gain in women, HR 1.34 (95% CI 1.18-1.51), and in men, HR 1.25 (95% CI 1.16-1.34). CONCLUSIONS: Weight gain in adults is associated with increased clinical and structural KOA and TKR. Prevention of weight gain should be considered to improve outcomes in KOA.

Medium optimization for submerged fermentative production of ß-cyclodextrin glucosyltransferase by isolated novel alkalihalophilic Bacillus sp. NCIM 5799 using statistical approach.

ß-cyclodextrin glucosyltransferase (ß-CGTase) is an essential enzyme to catalyse the biotransformation of starch into ß-cyclodextrins (ß-CD). ß-CD has widespread applications in the biomedical, pharmaceutical and food industries. The present study focused on ß-CGTase production using an efficient natural microbial strain and statistical production optimization for enhanced production. The isolated organism Bacillus sp. NCIM 5799 was found to be 5 µm short bacilli under FE-SEM and alkalihalophilic in nature. The ß-CGTase production was optimized using a combination of Plackett-Burman design (PBD) and Central Composite Design-Response Surface Methodology (CCD-RSM). On PBD screening Na2 CO3 , peptone and MgSO4 .7H2 O were found to be significant for optimal ß-CGTase production, whereas the soluble starch and K2 HPO4 concentrations were found to be nonsignificant for ß-CGTase production. The significant factors obtained after PBD were further optimized using CCD-RSM design. Peptone was found to have a significant interaction effect with Na2 CO3 , and MgSO4 ·7H2 O and Na2 CO3 exhibited a significant effect on the production of CGTase. The production of ß-CGTase was enhanced in the presence of peptone (3%) and Na2 CO3 (0·8%). CGTase production obtained was 156·76 U/ml when optimized using CCD-RSM. The final optimized medium (RSM) shows 7·7- and 5·4-fold high productions as compared to un-optimized and one factor at a time production media.

PERSPECTIVE: Temperature-dependent density and thermal expansion of cryoprotective cocktails.

Density is a key thermophysical property, affecting the response of materials to temperature changes in different ways, consistent with the phase of state. In fluids, temperature variation across the domain leads to colder areas being heavier than warmer areas, where buoyancy effects drive fluid flow and thereby increase heat transfer. This phenomenon is known as natural heat convection, which in general is a more efficient heat transfer mechanism than heat conduction in the absence of flow. In solids, where the material is locked in place, colder areas tend to contract while warmer areas tend to expand, leading the material to deform. When this deformation is constrained by the geometry of the domain and/or its container, mechanical stresses develop. This phenomenon is known as thermomechanical stress (or thermal stress), which can lead to structural damage such as fractures. The picture becomes even more complex during vitrification (or glass formation), where the material gradually changes from liquid to an amorphous solid over a significant temperature range. There, due to temperature variation across the domain, fluid mechanics and solid mechanics effects may coexist. It follows that characterization of the density as a function of temperature is crucial for the analyses of thermal, fluid, and mechanical effects during cryopreservation, with the goals of protocol planning, optimization, and preserving structural integrity. For this purpose, the current study focuses on the density of the material and its companion property of thermal expansion. Specifically, this paper reviews literature data on thermal expansion of cryoprotective agents (CPAs), discusses the mathematical relationship between thermal expansion and density, and presents new calculated density data. This study focuses on the CPA cocktails DP6, VS55, M22, and their key ingredients at various concentrations, including DMSO, propylene glycol, and formamide. Data for DP6 combined with a selection of synthetic ice modulators (SIMs) are further presented.

An empirical model for magnetic field dependent resistivity and magnetoresistance in manganites: application on polycrystalline charge-ordered La0.4Gd0.1Ca0.5MnO3.

In this paper, we have investigated the electrical and magnetic response of a La0.4Gd0.1Ca0.5MnO3 polycrystalline sample. This sample seems to exhibit fascinating phenomena like charge ordering, magnetic phase separation, training effects and kinetic arrest. It also shows colossal values of negative magnetoresistance (∼91.7% at 96 K under 1 T applied magnetic field), which raises the possibility of using this sample for technological applications. We have also proposed, in this work, a new empirical model to describe the evolution of resistivity and magnetoresistance as a function of magnetic field. This model was successfully tested on the La0.4Gd0.1Ca0.5MnO3 sample in spite of its complicated magnetic behavior, which suggests the use of this model for other magnetic samples in order to check its validity.

Charge transport mechanisms in sol-gel grown La0.7Pb0.3MnO3/LaAlO3 manganite films.

In this communication, structural, microstructural, transport and magnetotransport properties are reported for La0.7Pb0.3MnO3/LaAlO3 (LPMO/LAO) manganite films having different thicknesses. All the films were irradiated with 200 MeV Ag+15 swift heavy ions (SHI). Films were grown using the sol-gel method by employing the acetate precursor route. Structural measurements were carried out using the X-ray diffraction (XRD) method at room temperature, while atomic force microscopy (AFM) was performed for the surface morphology. Temperature dependent resistivity under different applied magnetic fields for all the films shows metal to insulator transition at temperature TP. In addition to the metal to insulator transition at TP, the films also exhibit low temperature resistivity upturn behavior. Resistivity, TP and upturn behavior are highly influenced by the film thickness, applied magnetic field and irradiation. To understand the nature of charge transport for the low temperature resistivity behavior and metallic and insulating (semiconducting) regions, various models and mechanisms have been verified and the most suitable mechanism has been found for each region in the resistivity curves. Magnetoresistance (MR) is affected by temperature, film thickness and irradiation. MR behavior has been understood in terms of combined and separate contributions from grains and grain boundaries in the films.

Correction: Charge transport mechanisms in sol-gel grown La0.7Pb0.3MnO3/LaAlO3 manganite films.

Correction for 'Charge transport mechanisms in sol-gel grown La0.7Pb0.3MnO3/LaAlO3 manganite films' by Eesh Vaghela et al., Phys. Chem. Chem. Phys., 2017, DOI: 10.1039/c6cp07730g.

Current-voltage characteristics and electroresistance in LaMnO3-δ/La0.7Ca0.3MnO3/LaAlO3 thin film composites.

In this communication, we report results of the electrical transport properties across the interface of composites consisting of n-type LaMnO3-δ (LMO) and p-type La0.7Ca0.3MnO3 (LCMO) manganites grown on LaAlO3 (LAO) single crystalline substrates using low cost wet chemical solution deposition (CSD) and sophisticated, well-controlled dry chemical vapor deposition (CVD) chemical techniques. The XRD ϕ-scan studies reveal the single crystalline nature of both bilayered composites, with parallel epitaxial growth of LMO and LCMO layers onto the LAO substrate. The valence states of Mn ions in both layers of both composites were identified by performing X-ray photoelectron spectroscopy (XPS). The I-V characteristics of the LMO/LCMO interfaces show strong backward diode-like behavior at higher applied voltages well above the crossover voltage (VNB). Below VNB, the interfaces demonstrate normal diode-like characteristics throughout the studied temperature range. The electric field-induced modulation of the LMO/LCMO junction resistance of the interfaces has been observed. Electric field-dependent electroresistance (ER) modifications at different temperatures have also been studied. The electrical transport properties have been discussed in the context of various mechanisms, such as charge injection, tunneling, depletion region modification and thermal processes across the interface. The effects of structurally and chemically developed sharp interfaces between the LMO and LCMO layers on the transport properties of the presently studied bilayered thin film composites have been discussed on the basis of correlation between the physicochemical characterization and charge transport behavior. A comparison of different aspects of the transport properties has been presented in the context of the structural strain and crystallinity of the composites grown using both wet and dry chemical techniques.

Transport properties and electroresistance of a manganite based heterostructure: role of the manganite-manganite interface.

In this paper, we report the results of the investigations on the transport properties performed across the manganite-manganite interface in the LaMnO3-δ/La0.7Ca0.3MnO3/LaAlO3 (LMO/LCMO/LAO) heterostructure. The bilayered heterostructure was synthesized by a low cost and simple chemical solution deposition (CSD) method by employing the acetate precursor route. The same LMO/LCMO/LAO heterostructure was also grown using the dry metal oxide chemical vapor deposition (CVD) method and the results of transport characterization have been compared on the basis of wet and dry chemical methods used. XRD Φ-scan measurements were carried out to verify the structural quality and crystallographic orientations of LMO and LCMO manganite layers, for both wet and dry chemical method grown heterostructures. For wet and dry chemical methods, the temperature dependent resistance of the LMO/LCMO interface suggests the metallic nature. The asymmetric I-V curves collected at different temperatures show normal diode characteristics which get transformed to backward diode characteristics at high temperatures under high applied voltages at Vtr for both the methods. The values of Vtr are strongly dependent on the chemical method used. I-V data have been fitted using the Simmons model at different temperatures and discussed in terms of the spin-flip scattering mechanism for both wet and dry chemical method grown heterostructures. The electric field dependent electroresistance (ER) behavior of the presently studied LMO/LCMO manganite-manganite interface, grown using wet and dry chemical methods, has been understood on the basis of complex mechanisms including charge injection, formation of the depletion region, the tunneling effect, thermal processes and junction breakdown and their dependence on the applied electric field, field polarity and temperature studied.

The perspectives of biomarker-based electrochemical immunosensors, artificial intelligence and the Internet of Medical Things toward COVID-19 diagnosis and management.

The World Health Organization (WHO) has declared the COVID-19 an international health emergency due to the severity of infection progression, which became more severe due to its continuous spread globally and the unavailability of appropriate therapy and diagnostics systems. Thus, there is a need for efficient devices to detect SARS-CoV-2 infection at an early stage. Nowadays, the reverse transcription polymerase chain reaction (RT-PCR) technique is being applied for detecting this virus around the globe; however, factors such as stringent expertise, long diagnostic times, invasive and painful screening, and high costs have restricted the use of RT-PCR methods for rapid diagnostics. Therefore, the development of cost-effective, portable, sensitive, prompt and selective sensing systems to detect SARS-CoV-2 in biofluids at fM/pM/nM concentrations would be a breakthrough in diagnostics. Immunosensors that show increased specificity and sensitivity are considerably fast and do not imply costly reagents or instruments, reducing the cost for COVID-19 detection. The current developments in immunosensors perhaps signify the most significant opportunity for a rapid assay to detect COVID-19, without the need of highly skilled professionals and specialized tools to interpret results. Artificial intelligence (AI) and the Internet of Medical Things (IoMT) can also be equipped with this immunosensing approach to investigate useful networking through database management, sharing, and analytics to prevent and manage COVID-19. Herein, we represent the collective concepts of biomarker-based immunosensors along with AI and IoMT as smart sensing strategies with bioinformatics approach to monitor non-invasive early stage SARS-CoV-2 development, with fast point-of-care (POC) diagnostics as the crucial goal. This approach should be implemented quickly and verified practicality for clinical samples before being set in the present times for mass-diagnostic research.

Transport and magnetotransport studies on Sol-Gel grown nanostructured La0.7Pb0.3MnO3 manganites.

Sol-Gel synthesis offers relatively inexpensive scale processing of mixed oxide materials with a good control over the stoichiometry and morphology which helps to tailor the required materials on atomic scale to suit specific applications. Nanophasic polycrystalline samples of La0.7Pb0.3MnO3 (LPMO) manganites having perovskite type structure synthesized by novel Sol-Gel technique using acetate precursor route were sintered at various temperatures in the range 950-1150 degrees C for studying the effect of grain size modifications on their structural, transport and magnetotransport properties. X-ray diffraction (XRD) studies show that the samples exhibit rhombohedral structure crystallizing in space group R-3C. Microstructural investigations using Scanning Electronic Microscopy (SEM), Atomic Force Microscopy (AFM) and Lateral Force Microscopy (LFM) measurements reveal the observation of secondary grain growth behavior starting in the sample sintered at 1000 degrees C. The d.c. four probe resistivity measurements with and without applied magnetic field in the temperature range of 2-380 K, show the effect of secondary grain growth on the magnetoresistance (MR) behavior of LPMO manganites. The microstructural studies show the atomic scale engineering at nanoscale which is reflected in the improvement of surface to volume ratio (D(-1)) which in turn modifies the physical properties of samples under investigation. All the samples exhibit resistivity minima at approximately 30 K which can be explained in terms of e-e interaction at 0 Tesla field. There is a correlation between the parameters derived from e-e scattering model and the secondary grain growth present in the samples. The results of the microstructural and MR measurements on the nanostructured LPMO manganites have been discussed in detail.

A mutation in NFkappaB interacting protein 1 causes cardiomyopathy and woolly haircoat syndrome of Poll Hereford cattle.

Cardiomyopathy and woolly haircoat syndrome (CWH) of Poll Hereford cattle is a lethal, autosomal recessive disorder. Cardiac and haircoat changes are congenital, neonatal ocular keratitis develops in some cases and death usually occurs within the first 12 weeks of life. We undertook a homozygosity mapping approach to identify the chromosomal location of the causative gene. Seven candidate genes were examined for homozygosity in affected animals: desmoplakin and junction plakoglobin (both previously implicated in human cardiocutaneous syndromes), desmocollin 2, desmoglein 2, plakophilin 2, nuclear factor kappa B (NFKB1) and NFkappaB interacting protein 1 (PPP1R13L, also known as NKIP1). Homozygosity in 13 affected animals was observed at the PPP1R13L locus, located on bovine chromosome 18. Subsequent sequence analysis revealed a 7-bp duplication (c.956_962dup7) in exon 6 of this 13-exon gene. This frameshift variant is predicted to result in the substitution of three amino acids and the introduction of a premature stop codon at position 325 of the protein product (p.Ser322GlnfsX4). PPP1R13L interacts with NFkappaB, a family of structurally related transcription factors that regulate genes controlling inflammation, immune responses and cell proliferation and survival. CWH represents a large-animal model for cardiocutaneous disorders caused by a mutation in the PPP1R13L gene. The identification of this bovine mutation also indicates that PPP1R13L and other genes affecting NFkappaB activity may be candidate genes in the study of human cardiovascular disease.

Microsatellite diversity among the primitive tribes of India.

The present study was undertaken to determine the extent of diversity at 12 microsatellite short tandem repeat (STR) loci in seven primitive tribal populations of India with diverse linguistic and geographic backgrounds. DNA samples of 160 unrelated individuals were analyzed for 12 STR loci by multiplex polymerase chain reaction (PCR). Gene diversity analysis suggested that the average heterozygosity was uniformly high ( >0.7) in these groups and varied from 0.705 to 0.794. The Hardy-Weinberg equilibrium analysis revealed that these populations were in genetic equilibrium at almost all the loci. The overall G(ST) value was high (G(ST) = 0.051; range between 0.026 and 0.098 among the loci), reflecting the degree of differentiation/heterogeneity of seven populations studied for these loci. The cluster analysis and multidimensional scaling of genetic distances reveal two broad clusters of populations, besides Moolu Kurumba maintaining their distinct genetic identity vis-à-vis other populations. The genetic affinity for the three tribes of the Indo-European family could be explained based on geography and Language but not for the four Dravidian tribes as reflected by the NJT and MDS plots. For the overall data, the insignificant MANTEL correlations between genetic, linguistic and geographic distances suggest that the genetic variation among these tribes is not patterned along geographic and/or linguistic lines.

Grain size dependent transport and magnetoresistance behavior of chemical solution deposition grown nanostructured La0.7Sr0.3MnO3 manganite films.

Grain-size dependence of electronic transport and magnetoresistance (MR) properties of nanostructured La0.7Sr0.3MnO3 (LSMO) manganite thin films on LaAlO3 (100) single crystal substrates prepared using Chemical Solution Deposition (CSD) technique have been studied. The LSMO thin films were annealed at temperatures in the range of 700-1000 degrees C for different time intervals [6 h and 12 h] and crystallized as singlephase LSMO. Microstructural studies carried out using AFM show a marginal increase in the grain-size from 50 to 90 nm as the temperature was varied from 700 degrees C to 1000 degrees C respectively. It has been observed that the insulator-metal transition (T(p)) and MR depend on the grain size. In zero applied field, resistivity reduction is approximately 10(3) at 5 K for the films annealed at 700 degrees C [T(p) approximately 341 K] and 1000 degrees C [T(p) approximately 373 K]. MR versus H isotherms reveal that MR enhances in the vicinity of T(p) but decreases at low temperatures. The results obtained from the electronic and magnetotransport studies are in good agreement with the change in surface morphology of the films studied, which shows that the randomly distributed domains are composed of faceted grains. Synthesizing conditions, annealing temperature and time control the growth and alignment of grains into the domains, which cause better conduction at grain interface.

Mechanism of Anti-bacterial Activity of Zinc Oxide Nanoparticle Against Carbapenem-Resistant Acinetobacter baumannii.

Acinetobacter baumannii is a multi-drug resistant opportunistic pathogen, which causes respiratory and urinary tract infections. Its prevalence increases gradually in the clinical setup. Carbapenems (beta-lactam) are most effective antibiotics till now against A. baumannii, but the development of resistance against it may lead to high mortality. Therefore, it is of utmost importance to develop an alternative drug against A. baumannii. In the present study, we have synthesized ZnO nanoparticle (ZnO-NP) and characterized by X-ray diffraction, Fourier transform infrared (FTIR) spectroscopy and UV-Visible spectroscopy. Prepared ZnO-NPs have the size of 30 nm and have different characteristics of ZnO-NPs. Growth kinetics and disk diffusion assay showed that ZnO-NP demonstrated good antibacterial activity against carbapenem resistant A. baumannii. We have also investigated the mechanism of action of ZnO-NPs on the carbapenem resistant strain of A. baumannii. The proposed mechanism of action of ZnO involves the production of reactive oxygen species, which elevates membrane lipid peroxidation that causes membrane leakage of reducing sugars, DNA, proteins, and reduces cell viability. These results demonstrate that ZnO-NP could be developed as alternative therapeutics against A. baumannii.

A cephalometric study to establish the relationship of the occlusal plane to the three different ala-tragal lines and the Frankfort horizontal plane in different head forms.

BACKGROUND: The aim of the study is to compare the relationship of the occlusal plane to 3 different ala-tragal lines, namely the superior, middle and inferior lines, in individuals having different head forms and its relation to the Frankfort horizontal plane. METHODOLOGY: A total of 75 lateral cephalometric radiographs of subjects with natural dentition, having full complement of teeth, between the age group of 18-25 were screened and selected. Lateral cephalogram were made for each subjects in an open mouth position. Prior to making the lateral cephalogram, radiopaque markers were placed on the superior, middle and inferior tragus points and on the inferior border of the ala of the nose. Cephalometric tracing was done over each cephalogram. RESULTS: In mesiocephalic head form the middle ala-tragal line was most parallel to the occlusal plane having a mean angle of (1.96°). In dolichocephalic headform, the superior ala-tragal line was most parallel to the occlusal plane having a mean angle of (0.48°). In brachycephalic head form, the middle ala-tragal line was most parallel to the occlusal plane having a mean angle of (2.08°). The mean angulations of occlusal plane to FH plane is 11.04°, 10.16° and 10.60° in mesiocephalic, dolichocephalic and brachycephalic head forms, respectively. RESULTS AND CONCLUSION: The study concludes that the middle ala-tragal line can be used as a reference for the mesiocephalic head form and the superior ala-tragal line for the dolichocephalic and brachycephalic head form as a reference to establish the occlusal plane.

A comparison of the effectiveness of malignancy detection in body fluid examination by the cytopathology and hematology laboratories.

BACKGROUND: Body fluid specimens in many institutions are submitted for cytologic examination as well as for examination in a clinical microscopy or hematology laboratory. The cytology laboratory is generally seen as the standard for detection of malignancy, whereas the clinical microscopy laboratory is often depended on predominantly for cell counting and categorization. METHODS: To analyze the effectiveness of the hematology laboratory at detecting malignant fluids, this study retrospectively analyzed reports on 397 body fluid specimens (cerebrospinal, pericardial, peritoneal, and pleural) that were concurrently submitted over a 12-month period to both the cytopathology laboratory and the hematology laboratory. RESULTS: Thirty-seven (9.3%) of the cases were diagnosed as malignant by at least one of the two examinations. The cytopathology examination reported 27 (73%) of the 37 malignant cases as malignant and 30 (81.1%) as at least atypical (27 malignant and 3 inconclusive), and the hematology examination reported 34 (91.9%) as malignant and 36 (97.3%) as at least atypical. A concordant malignant diagnosis was given by both laboratories in 24 (64.9%) of the 37 cases. CONCLUSIONS: These results show that examination of specimens by the hematology laboratory can provide a highly sensitive diagnostic evaluation in addition to its more customary role of providing timely cell counts.

Pilomatrixoma. Cytologic features with differential diagnostic considerations.

Pilomatrixoma are neoplasms of the hair cortical cells. They are most common during the first two decades of life and, usually, involve the head, neck, and upper extremities. These tumors may be encountered during aspiration biopsy of subcutaneous masses, and are, occasionally, confused with other neoplasms, particularly squamous cell carcinomas and epidermal inclusion cysts. The cytologic features of three such neoplasms are presented, and the characteristics that differentiate them from other benign and malignant lesions of the skin are discussed. The presence of two cell populations, the anucleated shadow cells and the basaloid cells, which lack nuclear features of malignancy, is fairly specific for pilomatrixoma. In addition, the specimens obtained from aspiration may be misinterpreted as originating from a hyperplastic lymph node in view of the intense chronic inflammatory and foreign body reaction seen in the background. Calcific deposits that lack lamellations, unlike psammoma bodies, help in establishing the definitive diagnosis of these benign neoplasms.

Diagnosis of ameloblastoma of the maxilla by fine needle aspiration. A case report.

Ameloblastoma is a tumor of odontogenic epithelium that occurs in the jaws. We describe a case of an ameloblastoma of the maxilla that was diagnosed by fine needle aspiration cytology. The patient presented with a mass in the left maxillary sinus. Cytologic examination of the aspirate material showed numerous sheets of tightly packed basaloid cells. Several sheets of cells were surrounded by a row of columnar cells, with the nuclei oriented away from the basement membrane (peripheral palisading). Histologic examination of the resection specimen confirmed the presence of an ameloblastoma of the maxilla.

Ischemic fasciitis. Report of a case with fine needle aspiration findings.

BACKGROUND: Ischemic fasciitis, also called atypical decubital fibroplasia, was recently described as a distinctive fibroblastic proliferation occurring predominantly in elderly, bed-ridden individuals. This entity can easily be misdiagnosed as a malignant process. CASE: A 70-year-old, white male presented with an enlarging right hip mass. Fine needle aspiration yielded spindled and ovoid cells with ample cytoplasm and occasional nuclear atypia. The histologic features of a subsequent biopsy and resection specimen included a zonal pattern of fibrinoid necrosis with surrounding reactive fibroblasts, histiocytes and vascular proliferation, which are characteristic of ischemic fasciitis. CONCLUSION: Ischemic fasciitis can be mistaken clinically, cytologically and histologically for sarcoma. The cytologic findings seen in this case, when combined with the clinical history, were sufficient to avoid misdiagnosis of malignancy in a benign, proliferative lesion.

Transbronchial fine needle aspiration of the mediastinum. Importance of lymphocytes as an indicator of specimen adequacy.

To determine the effectiveness and accuracy of transbronchial fine needle aspiration of mediastinal masses for the staging of bronchogenic carcinoma, the results and histologic correlations of 97 transbronchial aspirates submitted from 78 patients over a two-year period were reviewed. Malignant cells were present in 25 of 97 aspirates. Of the remaining 75 nonmalignant aspirates, 34 had corresponding mediastinal tissue sections. Review of these 34 aspirates disclosed respiratory epithelial cells without lymphocytes in 20, lymphocytes without respiratory cells in 1 and both cell types in 8. Neither cell type was present in five aspirates. The predictive value of a negative result was 78% for nonmalignant aspirates containing lymphocytes and 36% for nonmalignant aspirates not containing lymphocytes (P less than .05). The presence of lymphocytes in transbronchial needle aspirates of the mediastinum is an essential criterion of specimen adequacy. Negative specimens lacking lymphocytes should be considered unsatisfactory, regardless of the numbers of respiratory epithelial cells present.