An evaluation of ‘rapid review’ as a method of quality control of cervical smears using the AxioHOME microscope

An evaluation of ‘rapid review’ as a method of quality control of cervical smears using the AxioHOME miscroscope One method of quality control which has recently been recommended by professional bodies in the UK is the ‘rapid review’ method. This involves the microscopic 30 s review of all negative cervical smears with the intention of flagging potential missed abnormalities. Although it has been suggested that rapid review is better than 10% random rescreening of negative smears, the efficiency and efficacy of this method of quality control have not been thoroughly evaluated. We have used the AxioHOME system, which can record the area of a slide covered and the screening time, to investigate slide coverage during rapid review quality control, as performed by 15 cytoscreeners and MLSOs reviewing a test set of 22 slides each. The test set comprised 18 negative slides, three positive slides, and one unsatisfactory slide. We have recorded two distinct methods of rapid review in use amongst cytotechnologists, the step method and the whole slide method. The data show that rapid review takes longer on average than the recommended 30 s, the mean screening times being 76 s and 82 s for the step and whole slide methods, respectively. Abnormal smears were missed on three of 15 occasions by the step method (sensitivity 80%, positive predictive value 85%), and on seven of 30 occasions by the whole slide method (sensitivity 76.6%, positive predictive value 45%). However, the 95% confidence intervals were wide (57.7–90.7% for the step method, and 51.9–95.7% for the whole slide method). Analysis of scanning tracks and screening rates shows significant flaws in the methodology of rapid review. Abnormal cells were not identified, although dyskaryotic cells were included in the scanning track on nine occasions, seven using the whole slide method and two using the step method. On one occasion (using the step method) abnormal cells were not identified because they were not included in the scanning track. Further research is in progress to determine optimal methods of rapid review, and whether the rapid review technique is as effective as automated screening systems for quality assurance in cytology. Evaluation de la technique de ‘Relecture Rapide’ comme méthode de contrôle de qualité des frottis cervico-utérins, à l'aide du microscope AxioHOME Une des méthodes de contrôle de qualité récemment recommandée par le corps professionnel du Royaume Uni est la méthode dite de ‘relecture rapide’. Cette méthode consiste en une deuxième lecture d'une durée de trente secondes de tous les frottis cervicaux négatifs et dont l'objectif est de détecter les anomalies ayant pu échapper au premier examen. Bien qu'il ait été suggéré que cette méthode de relecture rapide soit meilleure que la relecture de 10% des frottis négatifs tirés au sort, le rendement et l'efficacité de cette méthode de contrôle de qualité n'ont pas été évalués complètement. Nous avons utilisé le système AxioHOME capable d'enregistrer la plage de la lame qui a été explorée ainsi que le temps de lecture afin d'étudier la surface explorée au cours de cette relecture rapide telle qu'elle a pu être pratiquée par quinze cytotechniciens et MLSOs, chacun ayant relu une série test de vingt deux lames. Cette série test comprenait dix huit lames négatives, trois lames positives et un frottis non satisfaisant. Nous avons noté que les cytotechniciens utilisaient deux méthodes de relecture rapide différentes, la méthode ‘pas à pas’ et la méthode ‘globale’. Les données montrent que la relecture rapide prend, en moyenne, un temps supérieur aux trente secondes recommandées, la moyenne des temps de lecture étant de 76 secondes et de 82 secondes respectivement pour la méthode ‘pas à pas’ et la méthode ‘globale’. Les anomalies n'ont pas été détectées dans trois cas sur quinze par la méthode ‘pas à pas’ (sensibilité 80%, valeur prédictive positive 85%), et dans 7 cas sur 30 par la méthode globale (sensibilité 76,6%, valeur prédictive positive 45%). Toutefois, l'intervalle de confiance à 95% est important (57,7%-90,7% pour la méthode ‘pas à pas’ et 51,9%-95,7% pour la méthode globale). L'analyse des surfaces balayées et des taux de détection montre des points faibles significatifs de cette méthodologie de relecture rapide. Dans 9 cas, les anomalies n'ont pas été identifiées alors que des cellules dyskaryotiques étaient présentes dans les plages balayées au cours de la relecture (sept utilisant la méthode globale et deux utilisant la méthode ‘pas à pas’). Dans un cas (avec la méthode ‘pas à pas’) les cellules anormales n'ont pas été identifiées parce qu'elles étaient absentes des plages de relecture. Des études sont en cours afin de déterminer quelles sont les méthodes optimales de relecture rapide et si ces techniques de relecture rapide sont aussi efficaces que les systèmes de lecture automatisée pour l'assurance de qualité en cytologie cervico-utérine. ‘Rapid Review’ als Methode der Qualitätskontrolle gynäkologischer Abstriche, Überprüfung mit dem AxioHOME-Mikroskop Die empfohlene ‘Rapid Review’ Kontrolle aller negativen Abstriche in nur 30 Sekunden anstelle des Nachscreenens von 10% der Präparate ist in ihrer Zuverlässigkeit bislang nicht überprüft worden. Mit Hilfe des AxioHOME-Mikroskops ist es möglich sowohl die ausgewertete Fläche, als auch die erforderliche Zeit zu erfassen. 15 Auswerter prüften mit der Methode jeweils einen Testsatz von 22 Präparaten. Er enhielt 18 negative, 3 positive und 1 nichtauswertbaren Abstrich. Getestet wurden zwei verschiedene Vorgehensweisen: die schrittweise und die das ganze Präparat erfassende. Beide erfordern mehr Zeit als 30 Sekunden; der mittlere Zeitaufwand betrug für die Schrittmethode 76 und für die Ganzheitsmethode 82 Sekunden. Die Schrittmethode verfehlte 3/15 Anomalien (Sensitivität 80%, positiver prädiktiver Wert 85%), die Ganzheitsmethode 7/30 (Sensitivität 76,6%, positiver prädiktiver Wert 45%). Der 95% Konfi denzbereich reichte für die Schrittmethode von 57,5–90,7% und für die Ganzheitsmethode von 51,9–95,7%). Die Analyse deckt wesentliche Schwachstellen des Rapid Review-Verfahrens auf. In 9 Fällen lagen nicht erkannte Zellatypien in den kontroll ierten Bahnen (7 bei des Schrittmethode, 2 bei der Ganzheitsmethode). Einmal lagen sie bei der Schrittmethode ausserhalb der geprüften Bahnen. Weitere Studien werden prüfen ab das Rapid Review-Verfahren automatisierten Systemen vergleichbar ist.     

Etude olfactométrique de l'action de diverses substances allélochimiques végétales dans la recherche de l'hote par Diadromus pulchellus (Hymenoptera,Ichneumonidae)

Résumé La recherche de l'habitat d'un hôte potentiel par D. pulchellus, endoparasite considéré comme spécialiste des nymphes d'A. assectella, est abordée chez les adultes femelles et mâles, en olfactométrie, par l'étude de leur comportement locomoteur. L'activité locomotrice et l'attraction sont ainsi analysées en présence de substances allélochimiques issues ou non de végétaux pouvant abriter un hôte. Que les composés soufrés testés soient stables ou non, ils ne déclenchent pas d'attraction chez les hyménoptères quel que soit leur sexe et le type d'olfactomètre utilisé, contrairement aux imagos du phytophage-hôte, A. assectella, attirés par les composés soufrés instables spécifiques du poireau. L'activité locomotrice des hyménoptères des deux sexes est stimulée par divers composés volatils soufrés de synthèse ou émis naturellement par les Crucifères et par les Allium consommés par les larves d'A. assectella. Les substances efficaces sont généralément stables et sont caractérisées par le groupement actif R-S-, à condition que R ne soit pas un allyle. Par ailleurs, des composés volatils non soufrés contenus dans des végétaux autres que les Allium et les Crucifères ne stimulent pas le comportement locomoteur des hyménoptères. Ces différentes observations permettent d'envisager que D. pulchellus est un spécialiste inféodé à des microlépidoptères s'alimentant sur des végétaux soufrés et non sur les seuls Allium.

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Summary Searching the host habitat by the endoparasite wasp Diadromus pulchellus, considered to be a specialist of Acrolepiopsis assectella nymphs, is studied in females and males by analysis of locomotory behaviour in olfactometers. Thus, locomotor activity and attraction are studied in the presence or absence of air-borne volatiles emitted by plants able to shelter a potential host-moth. Stable and unstable sulphur compounds used do not release attraction in female and male ichneumonids whatever the type of olfactometer used. By contrast, phytophagous host adults are attracted by unstable specific sulphur compounds of the leek. Locomotor activities of D. pulchellus females and males are stimulated by various volatile sulphur compounds of synthetic origin or naturally occurring in Allium eaten by A. assectella larvae and in Crucifera. The effective compounds generally are stable and characterized by the active group R-S — in which the alkyl moiety must not be an allyl one. On the other hand, volatiles without sulphur, emitted by plants which do not belong to Cruciferae or Allium, do not stimulate the hymenopteran locomotor activity. These observations suggest that D. pulchellus is oligophagous, attracted to microlepidoptera developing on plants containing sulphur compounds and not only on Allium.

     

Characterization of lamin proteins in BHK cells

Lamins are structural proteins found in rat liver nuclear envelope and are major constituents of the nuclear matrix. 2-D gel electrophoresis indicates that BHK cell nuclear matrix is composed of four major proteins (62 kD, 68 kD, 70 kD and 72 kD). Three of these proteins are very similar to lamins A, B and C of rat liver nuclear envelope according to their molecular mass and isoelectric points. An anti-serum specific to BHK matrix proteins has been raised. On 2-D immunoblot, this serum detects all the 62, 68 and 72 kD polypeptide isovariants but only one of the two isovariants of the 70 kD polypeptide. Rat lamins A, B and C react with the anti-BHK matrix serum. However, when a monoclonal antibody to rat liver lamins A, B and C is used (Burke, B, Tooze, J & Warren, G, EMBO j 2 (1983) 361 [23]), only the 72 kD (lamin A-like) and the 62 kD (lamin C-like) BHK polypeptides are detected. Our results suggest that although a strong similarity exists between BHK and rat lamins, there is no identical cross-reactivity between the two species.     

Beta-adrenergic induced potassium current in Xenopus oocyte: involvement of cyclic AMP

The effect of a beta-adrenergic agonist, on full-grown Xenopus oocytes, still surrounded by their ovarian envelopes, has been studied by electrophysiological methods. The oocytes were hyperpolarized by isoproterenol. Under voltage clamp, the elicited outward current reversed at a membrane potential of - 95 mV, a value close to the K+ equilibrium potential. The isoproterenol induced current varied linearly with the membrane potential in the range studied (- 120 mV, - 30 mV). Half-maximum current was obtained at 3.10(-8) M isoproterenol. Propranolol (10(-7) M) completely suppressed the response to isoproterenol (10(-9) to 10(-5) M). 8-Br-cAMP induced a current which also reversed at - 95 mV. Methyl-isobutyl-xanthine (MIX), a potent inhibitor of phosphodiesterases, potentiated the current induced by isoproterenol. These experiments strongly suggest that the increase in K+ permeability due to catecholamines is mediated by cAMP.     

A dimeric germacranolide and other sesquiterpene lactones from Mikania species

The investigation of two Mikania species, both previously placed in the genus Kanimia, afforded in addition to known compounds several new germ     

Dynamic organization of mitochondrial membranes: A crosslinking study with dimethylsuberimidate

Rat liver mitochondria were treated with dimethylsuberimidate, a bifunctional alkylating agent, and the effects were evaluated kinetically. Concurrently with the modification of amino groups, mitochondrial proteins were crosslinked and the organelles lost their osmotic response. When the dimethylsuberimidate reaction was performed in the presence of succinate, more primary amino groups were available when compared with a sucrose medium. Concomitantly, osmotic stabilization and crosslinking of mitochondrial proteins were accelerated. The activity of aspartate aminotransferase was also studied in crosslinked mitochondria. The enzyme activity was only slightly modified when mitochondria were amidinated in a sucrose medium and solubilized thereafter with Triton X-100 or cetyltrimethylammonium bromide. In contrast, in the presence of succinate, 60% of activity was lost after solubilization with Triton X-100, but not after solubilization with cetyltrimethylammonium bromide. This finding was correlated with the changes in intramitochondrial localization of the enzyme (A. Waksman and A. Rendon, 1974,Biochimie54, 907–924). When carbonylcyanide-p-trifluoromethoxyphenylhydrazone was added in both cases (sucrose or sucrose plus succinate), the rates of osmotic stabilization, amidination reaction, crosslinking of proteins, and aspartate aminotransferase activity were similar to those observed in a sucrose medium alone. The present results suggest that organizational changes of the mitochondrial membranes induced by succinate, including intramitochondrial protein movement, are prevented by carbonylcyanide-p-trifluoromethoxyphenylhydrazone.     

Identification of rat brain polysomes synthesizing the brain specific enolase (14.3.2 protein), S100 protein and alpha and beta tubulin subunits

Polysomes prepared from frozen rat brain powder were fractionated by centrifugation in a sucrose gradient. Individual fractions were used to program a reticulocyte lysate in a run-off reaction. The products of cell-free synthesis were assayed for the brain-specific enolase (14.3.2 protein) and S100 protein by immunoprecipitation with specific antisera and for tubulin by two-dimensional electrophoresis in polyacrylamide slab gels. The relative synthesis of these proteins by unfractionated free brain polysomes were 0.1 per cent, 0.05 per cent and 0.7 per cent respectively. After centrifugation in a sucrose gradient polysomes synthesizing S100 protein were separated from those synthesizing the other two markers. There was a threefold enrichment in the specific messenger RNA activity for each of the three proteins studied in their respective peak fractions of polysomes.     

Enhanced bismuth digestive absorption in rats by some sulfhydryl compounds: nmr study of complexes formed

In a preliminary paper [Therapie 34, 397 (1979), we showed that cysteine enhances bismuth digestive absorption in rats. In this paper, we have studied in rats the effects of various thiol compounds (mercaptopropionic acid, penicillamine, cysteine, homocysteine, 2-mercaptoethylamine, mercaptoethane) and nonthiol compounds (methionine, serine, alanine) orally administered on the absorption and elimination of bismuth also given orally. Bismuth was measured in blood and urine by electrothermal atomic absorption spectrophotometry.All of the thiol substances, and particularly cysteine, homocysteine, and mercaptopropionic acid, have considerably enhanced bismuth absorption and elimination: whereas, nonthiol substances have had no effect. Moreover, the acute toxicity of bismuth was enhanced when bismuth was given as a complex with cysteine (LD₅₀ = 156± 20 mg/kg).Studies by nmr spectroscopy of interactions between bismuth and these organic compounds have shown that bismuth induces an important chemical shift of the protons of the alpha carbon of the sulfhydrile group. Mainly, studies of ¹³C and ¹⁵N have confirmed this fact. The selectivity of such a complexation, in our pH conditions, may be tentatively explained on the ground of hard and soft acid and base (HSAB) theory.We have suggested that an increase in the concentration of thiol compounds in the gas-trointestinal tract arising from food, or more probably from microorganism synthesis, could be an explanation for human encephalopathies.     

Changements de l'epithélium médian des bourgeons palatins de souris au stade de préfusion

Résumé Avant d'entrer en contact, les surfaces de fusion des processus palatins subissent des modifications. Certaines cellules épithéliales superficielles deviennent turgescentes, alors que d'autres conservent un aspect dense et aplati, elles se lysent et éclatent. Des noyaux semblables à ceux des assises profondes se retrouvent en surface, paraissant migrer vers le bourgeon antagoniste. Des projections filamenteuses apparaissent, quelques unes établissant un contact avec l'épithélium opposé, d'autres restant seulement sous forme d'expansion. Ces observations sont concordantes en microscopie photonique et en microscopie électronique à balayage.

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Modification of the medial epithelium of the palatal shelves of mice at the prefusion stage. A light and scanning electron microscopy study

Summary The fusion surfaces of the palatal processes are modified before coming into contact. Several superficial epithelial cells become hypertrophied, undergo lysis and burst, whereas others remain flattened and densely stained. Nuclei, similar to those localized in deeper layers are found on the surface and seem to migrate towards the opposite process. Filamentous projections appear and some establish a linkage with the opposite epithelium, whereas others expand freely from the surface. Light microscope observations agree with scanning electron microscopy findings.

     

A limnological reconnaissance of Lake Tebenquiche,Salar de Atacama,Chile

A number of expeditions to the area of Salar de Atacama, Chile, 68° 15'W, 20° 30'S, have involved studies of the biological and chemical features of Lake Tebenquiche, situated in the interior of the salar. Chemically, Tebenquiche is hypersaline, with practically anoxic waters dominated by sodium and chloride ions but with high concentrations of sulphate also. The lake is surrounded and invaded by macrophytes, dominated by Scirpus olmeyi and Juncus, which provide organic material for the formation of bacterial mats. The fauna of limnetic crustaceans is almost exclusively of Artemia salina. The most important genera of bacteria are: Marinomonas, Halobacterium, Acinetobacter and the sulphur reductors Vibrio and Bacillus. The Cyanobacteria are represented exclusively by Oscillatoria.