Reduction in interval cancer rates following the introduction of two-view mammography in the UK breast screening programme.

BACKGROUND: The introduction of two-view mammography at incident (subsequent) screens in the National Health Service Breast Screening Programme (NHSBSP) has led to an increased number of cancers detected at screen. However, the effect of two-view mammography on interval cancer rates has yet to be assessed. METHODS: Routine screening and interval cancer data were collated from all screening programmes in the United Kingdom for women aged 50-64, screened between 1 April 2003 and 31 March 2005. Interval cancer rates were compared based on whether two-view mammography was in use at the last routine screen. RESULTS: The reduction in interval cancers following screening using two-view mammography compared with one view was 0.68 per 1,000 women screened. Overall, this suggests the introduction of two-view mammography at incident screen was accompanied by a 15-20% reduction in interval cancer rates in the NHSBSP. CONCLUSION: The introduction of two-view mammography at incident screens is associated with a reduction in incidence of interval cancers. This is consistent with previous publications on a contemporaneous increase in screen-detected cancers. The results provide further evidence of the benefit of the use of two-view mammography at incident screens.

A randomised comparison of SurePath liquid-based cytology and conventional smear cytology in a colposcopy clinic setting.

OBJECTIVE: The objective of this study was to compare the sensitivity of cervical cytology using conventional smears and SurePath liquid-based cytology (LBC). DESIGN: Prospective randomised evaluation of diagnostic test. SETTING: A single institution colposcopy clinic. POPULATION: Women attending first visit colposcopy appointments were offered entry into the study. METHODS: Cervical cytology samples from 913 women of age 16-75 years were randomly processed as SurePath LBC or conventional smears. Conventional smears were taken for 453 women and a SurePath LBC taken for 451 women. Cytology results were correlated with colposcopic findings and histology from colposcopic biopsies, treatment and follow up. MAIN OUTCOME MEASURES: To compare the sensitivity of SurePath LBC and conventional smears for histologically proven abnormality. Other outcome measures include a comparison of their sensitivity for high-grade abnormalities and their satisfactory rate. RESULTS: Accounting for all randomised samples, there was a trend towards improved sensitivity for SurePath LBC (79.1 versus 73.7%, P = 0.1). However, excluding unsatisfactory cytology (and samples not taken) eliminated this trend; the sensitivity for both LBC and conventional smears for any epithelial abnormality was 81%. With a threshold of atypical squamous cells of uncertain significance (ASC-US), both SurePath LBC and conventional smears had a sensitivity of 92% for high-grade lesions. SurePath LBC was less likely to be reported as unsatisfactory (2.7 versus 9.1%, P < 0.0001). CONCLUSIONS: In this context, with a threshold of ASC-US, both SurePath LBC and conventional smears offer high sensitivity for the detection of CIN2/3, but SurePath LBC is less likely to be reported as unsatisfactory.

Two-dimensionally infinite polyhedra with vertices related by symmetry operations.

It is shown that an infinitely extended polyhedron of one sheet composed of plane polygons of finite size, and in which all the vertices are related to one another by symmetry operations, can always be constructed by folding a stiff, unstretchable sheet (such as a piece of paper). It is also shown that only 11 such polyhedra have faces that are regular polygons; these polygons are equilateral triangles and squares. The 4 of these 11 polyhedra that are not known to have been published previously are presented here.

Individual differences in multiple-bag spindles of cat superficial lumbrical muscles.

A total of 791 spindle poles was analysed with regard to intrafusal fibre composition in the first and second superficial lumbrical muscles from the right and left hindfeet of 9 male and 5 female adult cats. Bag and chain muscle fibres were identified by their myofibrillar ATPase staining profile in the B region, after either acid or alkaline preincubation. A high proportion of the spindle pole population (43.2%) was observed to contain three or more (up to 5) bag fibres; those poles were classified as multiple-bag spindle poles. In the 334 muscle spindles in which both poles were studied, 42 bag fibres (12.6%) were found to be of the 'mixed' type, that is a fibre in which the two poles differ in their ATPase staining profile (either bag1/bag2 or bag/chain). The variability of the intrafusal fibre content observed in spindles of these muscles has been studied in relation to individual characteristics such as sex, weight and side of the animal. In general, multiple-bag spindles are more frequent in male than in female cats and in right as compared to left side muscles. Nearly all 'mixed' bag intrafusal fibres (38 out of 42) were observed in spindles containing 3 or more bag fibres. In 3-bag spindles the proportion of 'mixed' bag spindles is approximately the same in male and female cats. The ratio of 'dynamic' (mean polar bag1 content) to 'static' (mean polar bag2 plus chain fibre content) intrafusal effectors per muscle tends to increase in spindles of right side muscles and to decrease in the heaviest animals. The quantitative and qualitative differences in fibre content of spindles observed in first lumbrical muscles of different animals suggest that the spindle fibre composition, especially that of the 'dynamic' bag1 fibre, may be related to individual predetermined and/or acquired factors.

Characterization of the enzymatic defect in late-onset muscle phosphofructokinase deficiency. New subtype of glycogen storage disease type VII.

Human phosphofructokinase (PFK) exists in tetrameric isozymic forms, at least in vitro. Muscle and liver contain homotetramers M4 and L4, respectively, whereas red cells contain five isozymes composed of M (muscle) and L (liver) type subunits, i.e., M4, M3L, M2L2, and ML3, and L4. Homozygous deficiency of muscle PFK results in the classic glycogen storage disease type VII characterized by exertional myopathy and hemolytic syndrome beginning in early childhood. The genetic lesion results in a total and partial loss of muscle and red cell PFK, respectively. Characteristically, the residual red cell PFK from the patients consists of isolated L4 isozyme; the M-containing hybrid isozymes are completely absent. In this study, we investigated an 80-yr-old man who presented with a 10-yr history of progressive weakness of the lower limbs as the only symptom. The residual red cell PFK showed the presence of a few M-containing isozymes in addition to the predominant L4 species, indicating that the genetic lesion is a "leaky" mutation of the gene coding for the M subunit. The presence of a small amount of enzyme activity in the muscle may account for the atypical myopathy in this patient.

High incidence of long-chain fibers in spindles of cat superficial lumbrical muscles.

Forty-two complete spindle poles of cat superficial lumbrical muscles were analyzed with particular regard to the length and the diameter of intrafusal fiber types. Poles were reconstructed from serial transverse sections of fresh-frozen muscles. The staining module, which was repeated throughout the whole muscle, comprised sections treated for glycogen detection and sections treated for detecting myofibrillar ATPase activity after preincubation at three different pH's (see METHODS). The identification of intrafusal fiber types was essentially based on the ATPase activity of the B region of the intrafusal fibers. Long-chain fibers, i.e., chain fibers that have at least one pole that extends by more than one millimeter beyond the end of the spindle capsule (6), were very commonly observed. Of 42 spindle poles analyzed, 30 (71%) contained at least one long-chain fiber (one in 17 spindle poles, 2 in 11 poles, and 3 in 2 poles). Of 246 poles of chain fibers, 45 (18%) were "long". In four spindles, in which both poles could be completely examined, 10 long-chain fibers were observed. In eight of these, only one pole was long; the opposite pole ended either intracapsularly or at a short distance outside the capsule. Since long-chain fiber poles, presently considered to be among the effectors of static skeletofusimotor (beta) axons, are present in a large proportion of muscle spindles of lumbrical muscles, it would be of particular interest to reevaluate the beta-supply of these muscles by physiological methods.

Regional assignment of human liver-type 6-phosphofructokinase to chromosome 21q22.3 by using somatic cell hybrids and a monoclonal anti-L antibody.

The three structural loci encoding human phosphofructokinase, a key regulatory enzyme of glycolysis, are located on separate chromosomes. The gene coding for the liver-type subunit PFKL has previously been assigned to chromosome 21. We have used a subunit- and human-specific monoclonal antibody to liver PFK to detect the expression of human PFKL in hamster X human hybrid cell lines. A cell line carrying an 8;21 translocation which contains all of chromosome 21 except the band 21q22.3 was negative for the expression of PFKL whereas cell lines carrying the reciprocal 8;21 translocation were positive. In addition, a cell line with a ring chromosome 21 containing a breakpoint which excluded the distal part of the q22.3 band was negative for expression of PFKL. These results indicate that human PFKL is located on chromosome 21q22.3.

Induction of parturition in cattle using dexamethasone and cloprostenol: economic performance and disease incidence after treatment.

Details are given of clinical management and disease problems associated with the routine induction of parturition on a herd basis, as well as the veterinary costs involved. A review of the economic performance of cows calved by this method is made and some guidelines laid down as to the conditions under which such a technique could be used as a management tool.

Glycogen depletion elicited in tenuissimus intrafusal muscle fibres by stimulation of static gamma-axons in the cat.

In this study the experimental conditions used to elicit glycogen depletion in tenuissimus intrafusal muscle fibres were different from those used by Barker, Emonet-Dénand, Harker, Jami & Laporte (1976): the tenuissimus was left in situ; several (4-6) static gamma-axons were stimulated together; the blood flow through the muscle was not reduced during the periods of gamma stimulation except in two experiments; very much longer periods (up to 9 h) of intermittent stimulation by bursts at 50-500/s were used. Bag1 and bag2 fibres were identified by their different ATPase activities in the B region. In two experiments with normal circulation, test responses of several primary endings to short periods of stimulation at 50-100/s were still very strong after stimulation of several static gamma-axons for 5 and 9 h, respectively. Glycogen depletion was observed in a large number of chain and bag2 poles but in only one of nineteen bag1 poles examined. In two other experiments with normal circulation, there was a very pronounced reduction of the test responses after stimulation of several static gamma-axons for 7 and 9 h, respectively. Out of twenty-four bag1 poles examined, nineteen exhibited zones of depletion. In an experiment in which stimulation was conducted as in Barker et al. (1976), i.e. with reduction of muscle blood flow during 1 min periods of stimulation at 50-100/s, the primary endings still gave a strong response after fifteen periods of stimulation in contrast with the marked 'fatigue' that was constantly observed in the former study. No depleted intrafusal fibres were found in the spindles of this muscle. In a last experiment, after an initial pattern of stimulation similar to that described above, the new pattern of stimulation, but with periodical reduction of blood flow, was applied, leading to a 'fatigue' of the test responses in 2 h. In the spindles of this muscle three out of ten bag1 poles were depleted. The variability of glycogen depletion in bag1 fibres appears to be linked to the degree of spindle 'fatigue' which may develop after static gamma stimulation. It seems that in 'fatigued' spindles some factor or factors liberated by the contraction of neighbouring fibres may deplete glycogen in bag1 fibres by a non-neural mechanism. When, in spite of a prolonged stimulation of static gamma-axons, no fatigue of the test responses develops, zones of depletion in bag1 fibres--possibly of neural origin--are very rare, although a large proportion of bag2 and chain fibres are depleted.

Deslizamiento epifisiario femoral proximal / Proximal femoral epiphyseal slipping

Se estudiaron 52 pacientes con DEFP atendidos desde 169 hasta 1984 en los diferentes hospitales. Se revisaron las historias, radiografias y se hizo una valoracion clinica de cada paciente para poder recopilar datos previamente establecidos en un protocolo. Se encontraron 65 DEFP. La edad promedio fue 12.7 anos, con rango de 10.2 anos a 18 anos. 51 de los casos eran de raza blanca o mestiza; 1 de raza negra. 28 casos tenian fenotipo obeso, y 24 flaco longuilineo; se realizo estudio endocrinologico y medicion hormonal en 14 casos, los cuales fueron normales. Hubo 3 casos con antecedentes familiares de DEFP y uno con enfermedad de Perthes. Tuvimos 13 casos (25.1 por ciento ) bilaterales, la cadera izquierda fue la mas comprometida (43 por ciento ); 28 casos eran agudos (43.1 por ciento ) y 37 cronicos (56.9 por ciento ). En la mayoria de los casos se encontro dolor, cojera, deformidad en rotacion externa, acortamiento; 19 casos eran grado I, 16 grado II, 17 grado III y 13 grado IV. Hubo 1 solo caso de condrolisis inicial al momento de la consulta. Los casos I y II se fijaron in situ, los grados III y IV se manipularon y fijaron posteriormente. 2 casos agudos se redujeron con traccion y fijacion y los cronico sse manejaron con diferentes procedimientos descritos. Entre las complicaciones se encontraron: 2 necrosis avasculares, 9 condrolisis, y 1 migracion de los clavos a la articulacion. De acuerdo a los criterios de Herndon y Heymann los resultados fueron excelentes en 32 casos (49.2 por ciento ), buenos en 20 casos (30.7 por ciento ) regulares en 1 caso (1.5 por ciento ), malos en 4 casos (6.2 por ciento ) y pesimos en 8 casos (12.3 por ciento)

Evaluation of tail paste as an oestrus detection aid using serial progesterone analysis.

Serial progesterone assay of 127 commercial dairy cows over several months identified 363 possible oestrous events. Of these, tail paste correctly identified 81.5 per cent, while the stockmen unaided recorded only 70.2 per cent (national average 55 to 60 per cent). The significance of such a degree of improvement, the factors restricting oestrus detection efficiency and the difficulties in creating the appropriate mental attitude to oestrus detection improvements are discussed.

Induction of parturition in a commercial dairy herd: clinical management and treatment.

Twenty-six dairy cattle were treated with dexamethasone during medium to late pregnancy to induce premature calving. Thirteen produced calves within an average of 5-6 days of treatment. The remainder were given a subsequent injection of cloprostenol 10 days after the steroid treatment and, with one exception, all calved within the following two days. A high incidence of retained placenta was experienced, in common with other methods of inducing parturition, but this was not generally found to be associated with detrimental effects on health or fertility.

Use of cloprostenol with dexamethasone in the termination of advanced pregnancy in heifers.

The difficulty of devising a standard treatment regime for cattle which would predictably terminate pregnancies in the 200 to 250 day range is described. Eight 15-month-old heifers which had been accidentally mated when approximately eight months old were examined by rectal palpation and condition scored. To induce abortion an intramuscular injection of 20 mg dexamethasone phenylpropionate was given followed 11 days later by an intramuscular injection of 500 microgram cloprostenol. A record was made of the time of calving along with calving and post calving details. Two of the heifers aborted before the injection of cloprostenol. The other six aborted within 48 hours of receiving this injection. The practical problems associated with aborting immature cattle are discussed as well as the financial aspects.

Effect of rotational symmetry on colored lattices.

A colored lattice L(c) has a geometrical lattice L. A subgroup lattice L' of L and each of its cosets consist of like-colored points, each coset having a different color. The index of L' in L is given by Delta, the determinant of the matrix (t(jk)) that converts L into L'. This is the order of the factor group {L/L'}, and is also the number n of colors present. The crystal systems-i.e., the combinations of rotational symmetry axes-of L(c), L, and L' are all the same, but L and L' may have different centerings; this results in 39 combinations of centerings, called here the 39 symmetry types of colored lattices. These types are tabulated here, together with the special forms taken by (t(jk)) and the formulas for Delta. In only 7 of the 39 types can the number of colors be arbitrary; in most types certain numbers of colors are impossible.

Colored lattices.

Combinations of translations and color permutations are derived that leave a periodic array of colored points-a colored lattice-apparently unchanged. It is found that there are three types of colored lattices: (1) those in which all rows and nets have more than one color, (2) those in which there are rows with only one color, and (3) those in which there are both rows and nets with only one color. The color permutation groups of colored lattices are all Abelian. The direct product of three independent cyclic subgroups is required by type 1, but only two are required by type 2; in type 3 the color permutation group consists of the n powers of a cyclic permutation of all n colors present-i.e., the group consists of a single cycle.

A simple estimation of the immunoglobulin content of ewe colostrum.

Use of the optical refractometer in performing a rapid assessment of the immunoglobulin content of ovine colostrum under farm conditions was investigated. Refractometer readings were compared with total protein levels and with gamma-globulin levels, determined by the ZSTT, to assess the validity of the technique. In both cases correlation coefficients were high (0.98 and 0.79 respectively). Refractometry was shown to be a valid substitute for the ZSTT in studies on colostrum gamma-globulin levels.

Evaluation of the optical refractometer for lamb serum immunoglobulin estimation.

Resistance of lambs to neonatal diseases has been shown to be related to their serum immunoglobulin levels. These may be estimated in the laboratory by the zinc sulphate turbidity test (ZSTT). An experiment was designed to evaluate the optical refractometer, a relatively simple and inexpensive piece of equipment which measures the refractive index of a serum sample and thus provides an estimate of its total protein content. Refractometer readings of neonatal lamb sera were found to be closely correlated to their ZSTT readings (r = 0.89). The refractometer appears eminently suited to farm use avoiding elaborate and time consuming laboratory procedures. The limitations of the tests are discussed.