Why remove all cervical polyps and examine them histologically?

A retrospective analysis of 1366 cervical polyps showed that none had malignant features and 67% were removed from asymptomatic women. A policy removing only cervical polyps from symptomatic women or those with abnormal cervical cytology and limiting histological examination to these polyps would result in significant savings and reduce the small risk of morbidity associated with polypectomy.

Intervertebral disc structure: observation by a novel use of ultrasound imaging.

The internal structure of intervertebral discs is clinically important in the management of back pain. No current routine imaging modality is able to image disc structure satisfactorily. The aim of this work was to investigate and validate ultrasound imaging so that it might be applied to assessment of structural integrity and degree of degeneration. The optimum imaging technique was determined using a 3.5 MHz probe in one female subject. The applicability of this technique to investigate disc structure in the entire thoracolumbar spine was further investigated in 13 subjects. The optimum disc imaging technique was found to be a posterolateral approach, 1 to 2 cm lateral of the dorsal midline, that revealed structure within the disc not apparent using other approaches. It was demonstrated that posterolateral imaging introduces a smaller reproducibility error in measurements of linear dimensions close to the disc. It is possible to observe internal structure within the disc between T11 and L3 in at least 54% of individuals.

Reduction of menstrual blood loss by danazol in unexplained menorrhagia: lack of effect of placebo.

In women with menorrhagia of unknown cause, the efficacy of the drug danazol in reducing heavy menstrual blood loss was investigated making objective measurements of menstrual blood loss. Drug regimens tested were daily administration of 200 or 100 mg danazol for 12 weeks and daily danazol given in the luteal phase or during menstruation. The results suggest that 200 mg danazol daily is the most acceptable regimen clinically since it significantly reduced menstrual blood loss and was associated with a relatively low incidence of side effects. In 16 women on this dose menstrual blood loss was suppressed from a mean pre-treatment loss of 183 +/- 25 ml to 38 +/- 11 ml (p < 0.01) in the second, and 26 +/- 9 ml (p < 0.01) in the third treatment months. The majority of women had regular episodes of bleeding with no alteration in cycle length and a reduction in the number of days of bleeding. Although 100 mg daily suppressed menstrual blood loss, particularly by the third month of treatment, it increased the number of episodes of bleeding in some women which they found unacceptable. Both 200 mg and 100 mg relieved dysmenorrhoea in the majority of women presenting with the symptoms. Danazol taken daily in the early follicular or luteal phase of the menstrual cycle did not significantly alter menstrual blood loss. There was no effect of placebo therapy on measured menstrual blood loss in a single blind trial in eight women with menorrhagia.

Isolation and purification of human endometrial stromal and glandular cells using immunomagnetic microspheres.

Isolation of pure preparations of the different cell populations of human endometrium is a prerequisite for studies of in-vitro function. Sieving of dispersed endometrial cells, followed by adsorption onto immunomagnetic microspheres coated with antibody to Thy-1 was used to separate glandular and stromal cells. The purity of these cell populations was checked with antibodies to cytokeratin and Thy-1. The stromal cells were 98% pure and 90% viable, gland cells were 82% pure with 76% viability. The purified cells were able to proliferate in vitro as shown by thymidine incorporation.

Bone marrow-derived cell populations in uterine and ectopic endometrium.

Uterine endometrium contains numerous bone marrow-derived cells. The spectrum of cell types is different from that of any other tissue, and the differences in endometrium from women with endometriosis may reflect a different endometrial phenotype in these women. The cell types of bone marrow origin found in ectopic endometrium may indicate the degree of differentiation of the tissue. It was found that, in normal endometrium, the CD45+ cell population comprised T cells, macrophages, CD56+ large granular lymphocytes, some CD16+ cells and a few B cells. Changes in these cell populations during the menstrual cycle were similar in endometrium from both controls and patients with endometriosis, and resembled that reported previously by others. In ectopic endometrium, the frequency of CD45+ cells remained within the same range as that of uterine endometrium but without any obvious pattern of change during the menstrual cycle. CD56+ large granular lymphocytes, an immune cell type characteristic of uterine endometrium, were also found in ectopic endometrium. Our results indicate that ectopic endometrium, as well as comprising both glandular and stromal cells, contains bone marrow-derived cell populations similar to those of uterine endometrium. This suggests that the same processes of cell migration and/or differentiation occur in ectopic and uterine endometrium.

Skin test studies on close contacts of leprosy patients in India.

Skin-test studies with a series of tuberculins have been carried out in close contacts of multibacillary (MB) leprosy patients around three leprosy centers in India, and casual contacts of the disease around two centers. The results show that the rate of acquisition of leprosin A positivity is associated with age and the closeness of contact with MB leprosy. At the age of 15 years, the differences between the two types of contact were highly significant (p less than 0.00001). Many responses to leprosin A are directed toward the group iv species-specific, antigens of the leprosy bacillus, and the significance of positivity is discussed in relation to protective immunity from leprosy. The differences from Iran show that positivity to leprosin A is not solely the effect of the degree of contact with the disease, but must also have a genetic or environmental element, the latter being favored. The results from Miraj show that the high levels of tuberculin, scrofulin, and vaccin positivity seen in Fathimanagar, and to a lesser extent in Karigiri, are not a consequence of contact with leprosy. BCG vaccination made little difference to the leprosin A positivity of close contacts of leprosy patients, although it significantly enhanced positivity among casual contacts around Miraj (p less than 0.002). BCG vaccination significantly increased tuberculin positivity in Miraj and Karigri, and in those under 11 years of age in Fathimanagar. It made no difference to the already high level of positivity found in older persons around Fathimanagar.(ABSTRACT TRUNCATED AT 250 WORDS)