Level of agreement and biopsy correlation using two- and three-tier systems to grade cervical dyskaryosis.

At present, a three-tier system is used to grade cervical dyskaryosis in the UK, although the two-tier Bethesda system is used in the United States, and the British Society for Clinical Cytology has recommended that a two-tier system be implemented here. In this study, we have retrospectively re-graded 117 conventional cervical smears using both systems to determine the intra- and interobserver variation and compare the cytology grading in both systems with the final histology. The intra and interobserver agreement was moderate using both grading systems, but the agreement between cytology grade and final histology was poor in both the two- and three-tier systems, and slightly worse using two-tier grading. However, when each of the three histological categories is considered separately the two-tier system appears to work better. Therefore, changing the way in which cervical dyskaryosis is graded in the UK may result in poorer agreement between the cervical smear result and the final histological diagnosis if introduced without proper training, monitoring and assessment.

Behavioral arousal in newborn infants and its association with termination of apnea.

Arousal is an important protective mechanism that aids in the resolution of obstructive sleep apnea in adults and children, but its role in neonatal apnea has not been investigated. The primary aim of the present study was to determine the role of arousal in the termination of apnea in preterm infants. Videorecording was used to identify spontaneous behavioral arousal in a group of healthy full-term (n = 7) and preterm (n = 10) infants before and during polygraphic monitoring of cardiorespiratory variables and in a group of preterm infants with apnea (n = 10) during similar polygraphic monitoring. Spontaneous arousal rates (mean +/- SE) in full-term infants before and during polygraphic monitoring were 0.18 +/- 0.03 and 0.23 +/- 0.07 episodes/min, respectively. Corresponding values in nonapneic preterm infants were 0.24 +/- 0.03 and 0.24 +/- 0.02 episodes/min. In apneic preterm infants, mean spontaneous arousal rate during polygraphic recording was 0.26 +/- 0.02, but it was considerably higher during apneic sleep periods (0.59 +/- 0.17) than during nonapneic sleep periods (0.25 +/- 0.01). The frequency of occurrence of arousal was significantly higher (P less than 0.005) in long vs. short apnea, mixed vs. central apnea, and severe vs. mild apnea. Although a clear association between arousal and apneic resolution was observed in preterm infants, lack of arousal responses in a large number of apneic episodes suggests that behavioral arousal is not essential for the termination of apnea in these infants.

The Tutoring Network: A unique nonprofit educational/civic/professional organization.

The Tutoring Network is a nonprofit organization that emphasizes rigorous screening of educational therapists and careful matching of their expertise with the needs of learning-disabled students. It operates a clearinghouse for information pertinent to learning disabilities and strives to facilitate better communication among professionals concerned with the learning-disabled. This paper chronicles the birth and growth of The Tutoring Network and explores possibilities for replication.

Taste preference of the adult rat as a function of prenatal exposure to ethanol.

Two groups of pregnant rats (n = 10) received exposure to either 10% ethanol or water. All male offspring (n = 43) received a six-day preference test (ethanol vs water) at 90 days of age. Fluid consumption scores indicated a significant preference for water by all Ss. However, those animals receiving prenatal ethanol exposure consumed significantly more ethanol during preference testing than did the animals receiving prenatal water exposure.