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Complete Agreement (complete + agreement)
Selected AbstractsSmears diagnosed as ASCUS: Interobserver variation and follow-upDIAGNOSTIC CYTOPATHOLOGY, Issue 2 2001C.F.I.A.C., Rose Marie Gatscha S.C.T. (A.S.C.P.) Abstract The purpose of this study was to apply atypical squamous cells of undetermined significance (ASCUS) criteria from the Bethesda System for Reporting Cervical/Vaginal Cytologic Diagnoses (TBS) to the rescreen of cases previously diagnosed as ASCUS, to compare initial and rescreen diagnoses, and to analyze agreement with follow-up (cytology or histology). Two cytotechnologists (S.B. and M.J.M.) and one cytopathology fellow (M.A.) rescreened 632 cervicovaginal specimens diagnosed as ASCUS between June 1, 1992,December 31, 1995. Age and LMP were provided. Rescreen diagnoses were categorized as within normal limits (WNL), ASCUS, low-grade squamous intraepithelial lesions (LSIL), high-grade squamous intraepithelial lesions (HSIL), or carcinoma (CA). Complete agreement was found in 200 specimens (32%): 31 (15%) WNL; 91 (45%) ASCUS; 77 (38.5%) SIL; and one (0.50%) CA. Follow-up revealed no abnormality in 67% of the cases reclassified as WNL, 49% of the cases reclassified as ASCUS, and 48% of the cases reclassified as squamous intraepithelial lesions (SIL). SIL was found in 29% of cases reclassified as WNL, 29% of specimens rediagnosed as ASCUS, and 34% of cases reclassified as SIL. Partial agreement was found in 391 specimens (62%). In 41 specimens (6%), rescreeners were in complete disagreement, and follow-up revealed 9/41 (22%) SIL or worse; 21/41 (51%) WNL; and 4/41 (10%) inconclusive. Applying established criteria, 14% (91/632) of cases diagnosed as ASCUS resulted in complete agreement, and 30% (190/632) resulted in partial agreement. Follow-up of cases initially diagnosed as ASCUS revealed SIL or CA in 30% of cases. ASCUS is a significant diagnosis warranting careful patient follow-up. Diagn. Cytopathol. 2001;25:138,140. © 2001 Wiley-Liss, Inc. [source] Interlaboratory comparison of a reduced volume marine sediment toxicity test method using the amphipod Ampelisca abditaENVIRONMENTAL TOXICOLOGY & CHEMISTRY, Issue 3 2004James A. Ferretti Abstract The U.S. Environmental Protection Agency has standardized methods for performing acute marine amphipod sediment toxicity tests. A test design reducing sediment volume from 200 to 50 ml and overlying water from 600 to 150 ml was recently proposed. An interlaboratory comparison was conducted to evaluate the precision of this reduced sediment volume toxicity test method using the marine amphipod Ampelisca abdita. A negative control and three sediment samples of varying degrees of toxicity ranging from low to high were tested by six laboratories. Complete agreement was reached in rank of relative toxicity for all samples tested by five out of six laboratories. Test acceptability for control survival was achieved by all laboratories, and 69% agreement in classification of the sediments as toxic or nontoxic was documented. Coefficients of variation in all test samples were similar to those reported in other interlaboratory studies using marine amphipods. Results of this study indicate that the reduced sediment volume test using A. abdita is a reliable and precise measure of acute toxicity in marine sediment samples. [source] Liverpool Ultrasound Pictorial Chart: the development of a new method of documenting anal sphincter injury diagnosed by endoanal ultrasoundBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 6 2008GE Fowler Objective, To develop and validate a pictorial chart that documents ultrasound examination of the anal sphincter. Design, A new pictorial chart (Liverpool Ultrasound Pictorial Chart [LUPIC]) depicting the normal anatomy of the anal sphincter was developed. Methods, To validate LUPIC, two observers documented the findings of 296 endoanal scans. Reliability was assessed between observers using kappa agreement for presence and position of sphincter defects. To validate the use of LUPIC by different observers, a video of ten endoanal ultrasound scans was reviewed by our local expert (gold standard). Seven clinicians underwent test-retest analysis. Kappa agreement was calculated to assess intra-observer and gold standard versus observer agreement for the overall presence of sphincter defects and compared with the gold standard. Complete agreement for the position and level of sphincter defects was assessed for the five abnormal scans. Main outcome measures, Excellent agreement between the two observers was found for the presence (kappa 0.99), position and level of external anal sphincter defects documented using LUPIC. The intra-observer and gold standard versus observer kappa values of experienced clinicians (A,E) showed good agreement for the overall presence of sphincter defects. Complete agreement for the position and level of sphincter defects was found in 23 of 35 (66%) observations. Conclusions, LUPIC is designed and validated method of documenting anal sphincter injury diagnosed by endoanal ultrasound. Standardisation of endoanal ultrasound findings by using LUPIC may help correlate the degree of damage with patient symptoms. [source] Use of Dynamic Telepathology in Mohs Surgery: A Feasibility StudyDERMATOLOGIC SURGERY, Issue 5 2002Kishwer S. Nehal MD background. Telepathology is an emerging technology for remote pathology consultation and diagnosis. objective. To assess the diagnostic accuracy and utility of a dynamic telepathology system in the setting of Mohs surgery. methods. Using a dynamic telepathology system, a single dermatopathologist at a remote site assessed the following cases: (1) 50 fixed-tissue slides of basal and squamous cell carcinomas for pathologic diagnosis; (2) 40 frozen-section slides from Mohs surgery for the presence or absence of tumor; (3) 20 frozen-section slides from Mohs surgery for intraoperative consultation with the Mohs surgeon. All 110 slides were then randomly reviewed by the same dermatopathologist by conventional light microscopy. Telepathology and conventional light microscopy diagnoses were then compared. results. There was complete agreement between telepathology and conventional light microscopy diagnoses. conclusion. Dynamic telepathology is a convenient, useful, and accurate system for remote diagnosis and consultation in the setting of Mohs surgery. [source] Smears diagnosed as ASCUS: Interobserver variation and follow-upDIAGNOSTIC CYTOPATHOLOGY, Issue 2 2001C.F.I.A.C., Rose Marie Gatscha S.C.T. (A.S.C.P.) Abstract The purpose of this study was to apply atypical squamous cells of undetermined significance (ASCUS) criteria from the Bethesda System for Reporting Cervical/Vaginal Cytologic Diagnoses (TBS) to the rescreen of cases previously diagnosed as ASCUS, to compare initial and rescreen diagnoses, and to analyze agreement with follow-up (cytology or histology). Two cytotechnologists (S.B. and M.J.M.) and one cytopathology fellow (M.A.) rescreened 632 cervicovaginal specimens diagnosed as ASCUS between June 1, 1992,December 31, 1995. Age and LMP were provided. Rescreen diagnoses were categorized as within normal limits (WNL), ASCUS, low-grade squamous intraepithelial lesions (LSIL), high-grade squamous intraepithelial lesions (HSIL), or carcinoma (CA). Complete agreement was found in 200 specimens (32%): 31 (15%) WNL; 91 (45%) ASCUS; 77 (38.5%) SIL; and one (0.50%) CA. Follow-up revealed no abnormality in 67% of the cases reclassified as WNL, 49% of the cases reclassified as ASCUS, and 48% of the cases reclassified as squamous intraepithelial lesions (SIL). SIL was found in 29% of cases reclassified as WNL, 29% of specimens rediagnosed as ASCUS, and 34% of cases reclassified as SIL. Partial agreement was found in 391 specimens (62%). In 41 specimens (6%), rescreeners were in complete disagreement, and follow-up revealed 9/41 (22%) SIL or worse; 21/41 (51%) WNL; and 4/41 (10%) inconclusive. Applying established criteria, 14% (91/632) of cases diagnosed as ASCUS resulted in complete agreement, and 30% (190/632) resulted in partial agreement. Follow-up of cases initially diagnosed as ASCUS revealed SIL or CA in 30% of cases. ASCUS is a significant diagnosis warranting careful patient follow-up. Diagn. Cytopathol. 2001;25:138,140. © 2001 Wiley-Liss, Inc. [source] BJ46a, a snake venom metalloproteinase inhibitorFEBS JOURNAL, Issue 10 2001Isolation, characterization, cloning, insights into its mechanism of action Fractionation of the serum of the venomous snake Bothrops jararaca with (NH4)2SO4, followed by phenyl-Sepharose and C4 -reversed phase chromatographies, resulted in the isolation of the anti-hemorrhagic factor BJ46a. BJ46a is a potent inhibitor of the SVMPs atrolysin C (class P-I) and jararhagin (P-III) proteolytic activities and B. jararaca venom hemorrhagic activity. The single-chain, acidic (pI 4.55) glycoprotein has a molecular mass of 46 101 atomic mass units determined by MALDI-TOF MS and 79 kDa by gel filtration and dynamic laser light scattering, suggesting a homodimeric structure. mRNA was isolated from the liver of one specimen and transcribed into cDNA. The cDNA pool was amplified by PCR, cloned into a specific vector and used to transform competent cells. Clones containing the complete coding sequence for BJ46a were isolated. The deduced protein sequence was in complete agreement with peptide sequences obtained by Edman degradation. BJ46a is a 322-amino-acid protein containing four putative N-glycosylation sites. It is homologous to the proteinase inhibitor HSF (member of the fetuin family, cystatin superfamily) isolated from the serum of the snake Trimeresurus flavoviridis, having 85% sequence identity. This is the first report of a complete cDNA sequence for an endogenous inhibitor of snake venom metalloproteinases (SVMPs). The sequence reveals that the only proteolytic processing required to obtain the mature protein is the cleavage of the signal peptide. Gel filtration analyses of the inhibitory complexes indicate that inhibition occurs by formation of a noncovalent complex between BJ46a and the proteinases at their metalloproteinase domains. Furthermore, the data shows that the stoichiometry involved in this interaction is of one inhibitor monomer to two enzyme molecules, suggesting an interesting mechanism of metalloproteinase inhibition. [source] The impact of the 2005 International Society of Urological Pathology (ISUP) consensus on Gleason grading in contemporary practiceHISTOPATHOLOGY, Issue 4 2009Piotr Zareba Aims:, To investigate the impact of the 2005 International Society of Urological Pathology (ISUP) Gleason grading consensus in contemporary practice. Methods and results:, The Gleason scores (GS) were compared in two consecutive patient cohorts with matched biopsies and prostatectomies: (i) 908 patients evaluated before the ISUP consensus (July 2000,June 2004) and (ii) 423 patients evaluated after the ISUP consensus (October 2005,June 2007). All biopsies and prostatectomies were performed and scored in one institution and were sampled and processed identically. There was a higher percentage of biopsy and prostatectomy specimens with GS , 7 after the ISUP consensus (GS , 7 on biopsy in 32% before ISUP versus 46% after ISUP; GS , 7 on prostatectomy in 53% before ISUP versus 68% after ISUP; P < 0.001). No significant difference in the complete and ±1 unit Gleason agreement was found before and after the ISUP consensus. There was a trend towards better complete agreement for GS , 7 after the ISUP consensus. Conclusions:, There was a shift towards higher GS on biopsy and prostatectomy in our practice after the ISUP consensus, although , there was no significant impact on the biopsy,prostatectomy Gleason agreement. The significance of this shift for patient management and prognosis is uncertain. [source] Kinetic study of the ruthenium(VI)-catalyzed oxidation of benzyl alcohol by alkaline hexacyanoferrate(III)INTERNATIONAL JOURNAL OF CHEMICAL KINETICS, Issue 7 2002A. E. Mucientes The kinetics of the Ru(VI)-catalyzed oxidation of benzyl alcohol by hexacyanoferrate(III), in an alkaline medium, has been studied using a spectrophotometric technique. The initial rates method was used for the kinetic analysis. The reaction is first order in [Ru(VI)], while the order changes from one to zero for both hexacyanoferrate(III) and benzyl alcohol upon increasing their concentrations. The rate data suggest a reaction mechanism based on a catalytic cycle in which ruthenate oxidizes the substrate through formation of an intermediate complex. This complex decomposes in a reversible step to produce ruthenium(IV), which is reoxidized by hexacyanoferrate(III) in a slow step. The theoretical rate law obtained is in complete agreement with all the experimental observations. © 2002 Wiley Periodicals, Inc. Int J Chem Kinet 34: 421,429, 2002 [source] Discordance in the histopathologic diagnosis of difficult melanocytic neoplasms in the clinical settingJOURNAL OF CUTANEOUS PATHOLOGY, Issue 4 2008Saurabh Lodha Background:, The gold standard for diagnosing melanocytic neoplasms is by histopathologic examination. However, lack of agreement among expert dermatopathologists in evaluating these tumors has been well established in experimental settings. Objective:, This study examines the discordance among dermatopathologists in evaluating difficult melanocytic neoplasms in a clinical setting where the diagnosis impacts patient management. Methods:, Retrospective review of consultation reports over a 6-year period. Results:, There was complete agreement among the consultants in 54.5% of the cases. However, a high level of disagreement was found in 25% of the cases. Limitations:, The analysis was limited to two consultant dermatopathologists. Conclusions:, There are limitations to the practical applications of histologic criteria for diagnosing difficult melanocytic tumors. It is not malpractice for a pathologist to have rendered a diagnosis that did not predict clinical outcome as long as ,standard of care' has been followed in his/her evaluation of the specimen. [source] Comparison of the technical and clinical performance of the Elecsys® HBsAg II assay with the Architect®, AxSym®, and Advia® Centaur HBsAg screening assaysJOURNAL OF MEDICAL VIROLOGY, Issue 5 2010S. Louisirirotchanakul Abstract South East Asia has some of the highest prevalence rates of hepatitis B virus (HBV) infection (,8%) in the world, and the emergence of hepatitis B surface antigen (HBsAg) mutant strains is a growing problem. Assays with the highest levels of sensitivity, including mutant detection, should be used for routine HBsAg screening. In this large multicenter study, the clinical and technical performance of the fully automated Elecsys HBsAg II assay was compared with the Architect, AxSYM, and Advia Centaur HBsAg assays for HBsAg screening. Nine laboratories (three each from Thailand, Korea, and Singapore) compared the Elecsys HBsAg II assay with their routine HBsAg screening assay against a range of stored and routine clinical samples, including recombinant mutants. The Elecsys HBsAg II assay demonstrated equivalent sensitivity and specificity to the Architect HBsAg assay. However, the Elecsys HBsAg II assay recognized a native mutant sample (L94S, L97V, L98V, T123A) that the Architect HBsAg assay failed to detect. The AxSYM and Advia Centaur HBsAg assays appeared less sensitive for the detection of early HBV infection and also failed to detect some of the recombinant mutant strains. There was almost complete agreement between the Elecsys HBsAg II assay and comparator assays with respect to routine serum samples. The results of this study demonstrate that the Elecsys HBsAg II assay is a highly sensitive and specific screening assay for HBsAg and detects reliably the most important and clinically relevant HBV mutants and genotypes. It is suitable for routine HBsAg screening in Asia. J. Med. Virol. 82: 755,762, 2010. © 2010 Wiley-Liss, Inc. [source] Evaluation of a new, fully automated immunoassay for detection of HTLV-I and HTLV-II antibodiesJOURNAL OF MEDICAL VIROLOGY, Issue 3 2008Xiaoxing Qiu Abstract Screening blood donations for human T-lymphotropic virus types I and II (HTLV-I/II) continues to be important in protecting the safety of blood products and controlling the global spread of these retroviruses. We have developed a fully automated, third generation chemiluminescent immunoassay, ARCHITECT rHTLV-I/II, for detection of antibodies to HTLV-I/II. The assay utilizes recombinant proteins and synthetic peptides and is configured in a double antigen sandwich assay format. Specificity of the assay was 99.98% (9,254/9,256, 95% CI,=,99.92,100%) with the negative specimens from the general population including blood donors, hospital patients and pregnant women from the US, Japan and Nicaragua. The assay demonstrated 100% sensitivity by detecting 498 specimens from individuals infected with HTLV-I (n,=,385) and HTLV-II (n,=,113). ARCHITECT rHTLV-I/II results were in complete agreement with the Murex HTLV-I/II reference assay and 99.7% agreement with the Genelabs HTLV Blot 2.4 confirmatory assay. Analytical sensitivity of the assay was equivalent to Murex HTLV-I/II assay based on end point dilutions. Furthermore, using a panel of 397 specimens from Japan, the ARCHITECT rHTLV-I/II assay exhibited distinct discrimination between the antibody negative (Delta Value,=,,7.6) and positive (Delta Value,=,7.6) populations. Based on the excellent specificity and sensitivity, the new ARCHITECT rHTLV-I/II assay should be an effective test for the diagnosis of HTLV-I/II infection and also for blood donor screening. J. Med. Virol. 80:484,493, 2008. © 2008 Wiley-Liss, Inc. [source] Adherence to recommendations for primary prevention of atopic disease in neonatology clinical practicePEDIATRIC ALLERGY AND IMMUNOLOGY, Issue 5 2010Annalisa Passariello Passariello A, Terrin G, Baldassarre ME, Bisceglia M, Ruotolo S, Berni Canani R. Adherence to recommendations for primary prevention of atopic disease in neonatology clinical practice. Pediatr Allergy Immunol 2010: 21: 889,891. © 2010 John Wiley & Sons A/S The prevalence and severity of atopic manifestations in children are increasing in western countries in the last decades. Specific nutritional intervention may prevent or delay the onset of atopic diseases in infants at high risk of developing allergy. These nutritional interventions should be applied early in the perinatal period to have a chance of success. Thus, we assessed adherence to the dietary management recommendations of the Committee on Nutrition and Section on Allergy and Immunology of the American Academy of Pediatrics (AAP) for the prevention of atopic diseases in neonatal age through an audit study. Questionnaire was administered to the chiefs of 30 maternity units (MU) with more than 1500 live births/yr to report the policy applied in their MU. Twenty-two MU returned the questionnaire. Identification of high-risk newborns was routinely performed only in 7/22 MU (31.8%). High-risk newborns were identified by the presence of at least two or one first-degree relative (parent or sibling) with documented allergic disease by 18.2% and 45.5% of MU, respectively. Specific maternal dietary restrictions during lactation were adopted in 7/22 MU (31.8%). Extensively or partially hydrolyzed formula was prescribed for bottle-fed high-risk infants in 22.7% of MU. Only 2/22 MU have a policy in complete agreement with the nutritional intervention proposed by the AAP. Our study suggest a poor adherence to dietary recommendations for primary prevention of atopic disease in neonatology clinical practice. Further efforts should be planned to improve the knowledge and the application of these preventive strategies. [source] | ||||||||||||||||||||||||||||