Routine audit of breast fine needle aspiration (FNA) cytology specimens and aspirator inadequate rates

Routine audit of breast fine needle aspiration (FNA) cytology specimens and aspirator inadequate rates In an attempt to improve the quality of the breast FNA specimens we instigated a continuing audit of this procedure in this hospital. All FNAs since 1990 have had the following recorded: mode of aspiration, e.g. freehand or image guided, patient presentation (screening or symptomatic), patient diagnostic category, cytological diagnosis and final histological diagnosis. Aspirator performance was assessed by means of the inadequate aspiration rate (IR) of FNAs performed on patients with a final diagnosis of cancer (FDC) and diagnostic category A patients (clinically or radiologically malignant lesions). An ongoing annual review of the performance of all the aspirators was undertaken, all of whom received individual feedback. Counselling and further training were offered where indicated by poor performance. Over the period 1990–1995 a total of 13 537 FNAs were performed by 27 aspirators. The IR on category A and FDC cases over this period was 16.0% and 18.1%. The best performance achieved by an aspirator in a calendar year was an IR of 3.6% with no inadequate specimens in either FDC or category A lesions, and the best performance over the entire period was an average IR of 11.75% and 14.25% for FDC and category A groups, respectively. The overall IR on category A patients ranged from 15.9% to 23.8% and on FDC cases from 12.2% to 21.7%. There was a significant improvement in individual junior aspirator performance when their first year was compared with their last year on the unit. In some cases a deterioration in intra-aspirator performance was observed, from an IR of 6% to 33%. The overall IR rate of the unit remained stable for FDC patients, 15.5% in 1990 compared with 15.1% in 1995. This appeared to be largely due to a high proportion of the aspirations being performed by experienced personnel with consistent IRs. However, concealed within the overall rate there were some poor performers who benefited from counselling and/or further training. These results indicate an important role for audit in identifying poor aspirators who benefit from targeted training and advice, thereby improving the quality of FNA specimens, and ultimately patient care.     

Comparison of bednets treated with alphacypermethrin, permethrin or lambdacyhalothrin against Anopheles gambiae in the Gambia

In the Gambian village of Saruja, where malaria is transmitted mainly by mosquitoes of the Anopheles gambiae complex, a trial was undertaken of the acceptability and efficacy of bednets treated with one of three pyrethroid insecticides – alphacypermethrin 40 mg/m², permethrin 500 mg/m² and lambdacyhalothrin 10 mg/m^2. Fewer mosquitoes were found alive under nets treated with insecticide than under control nets. Significantly more dead mosquitoes were found under nets treated with alphacypermethrin than under nets treated with permethrin or lambdacyhalothrin. Side-effects were reported by a proportion of the users of nets treated with each of the insecticides, but none were severe and their prevalence was similar between treatment groups. Unwashed nets treated with alphacypermethrin were more effective at killing anopheline mosquitoes in bioassays than nets treated with permethrin or lambdacyhalothrin. Killing activity was reduced when nets were washed, irrespective of which insecticide was used. Bednets treated with alphacypermethrin are well accepted, effectively killed anopheline mosquitoes and should therefore be evaluated for personal protection against malaria transmission.     

The family Capilloventridae (Annelida, Clitellata) in Australia, with descriptions of two new species of Capilloventer

Two new freshwater species of the small family Capilloventridae are recorded from rivers in south-eastern Australia. Capilloventer acheronensis sp. n. has all hair setae anteriorly and dissimilar crotchet setae without hairs posteriorly while Capilloventer longicapitus sp. n. has an elongate prostomium, very long hair setae anteriorly and all bifid setae posteriorly. Immature specimens from south-west Western Australia appear to represent a further species and are tentatively included within the family. Additional specimens of Capilloventer australis Erséus, 1993 have allowed some features (setae, segmental glands, genitalia and ventral buccal organ) to be described in more detail. The new C. australis specimens are from the upper reaches of Victorian rivers, showing that it is a freshwater species, rather than a marine incursion as the estuarine type locality suggested. There are now more freshwater species than marine species, although the origin and phylogenetic relationships of the family remain unclear.     

Molecular Weight Determination of Nucleic Acids by Gel Electrophoresis in Non-aqueous Solution

IN most areas of research concerned with the structure, function and synthesis of nucleic acids the measurement of molecular weights plays an inescapable part. There are many instances of problems hinging on a rather precise knowledge of the molecular weight of a nucleic acid; examples of particular current interest concern both animal and viral messengers, which are larger than can be accounted for by the total protein message that they encode and ribosomal-RNA, the molecular weight of which bears on the question of the stoichiometry of ribosomal components. Unfortunately the classical methods of molecular weight determination present great difficulties. The quantities of material required are frequently outside the range of feasibility. Moreover, the non-ideality in these highly charged molecules and polydispersity^1,2 resulting from contamination with minor cellular components, or commonly products of nuclease degradation (as well as the need to determine the partial specific volume), combine to make molecular weight measurement a major research undertaking. The remarkable spread of published values for widely studied RNA species reflects these problems.     

UK national audit of breast fine needle aspiration cytology in 1990–91: diagnostic criteria

A survey into the practice of fine needle aspiration cytology of the breast amongst members of the British Society for Clinical Cytology in 1990 and 1991 was performed. This paper presents their reported use of diagnostic categories in reporting and the criteria found useful in the diagnosis of benign and malignant disease. A wide variety of diagnostic categories are in use. the criteria used in diagnosis largely follow recommendations found in standard textbooks, but some less well recognized features were also suggested.     

Ventilation and Its Effect on "Infinite Pool" Exchangers

SYNOPSIS. Unlike internal exchange surfaces, the skin contactsan "infinite pool" of air or water with which exchange of gases,water, ions, and other solutes may occur. Even though the "infinitepool" may be well mixed, an unstirred diffusion boundary layeris always present about the skin and may constitute a significantresistance to exchange. The thickness of the diffusion boundarylayer (as approximated by the fluid dynamic boundary layer)is related to the flow of the respiratory medium, viscosityand density of the medium, and the morphology of the exchangesurface. Oxygen microelectrode studies suggest that, in mostcircumstances, the diffusion boundary layer in water is at leastas thick as the blood-respiratory medium distance in amphibianskin. Accordingly, the movement of water about the skin {i.e.,skin ventilation) should have pronounced effects on cutaneousexchange, especially at low "free stream" velocities. Mountingphysiological evidence suggests that: (1) skin ventilation canaugment cutaneous gas exchange; and (2) some vertebrates activelyventilate their skins, especially in aquatic hypoxia. The ubiquityand significance of diffusion boundary layers are central toa general understanding of cutaneous exchange and all surface-mediatedexchange processes.     

United Kingdom national audit of breast fine needle aspiration cytology in 1990–91-organization and level of activity

A survey amongst members of the British Society for Clinical Cytology (BSCC) was performed in 1990 and 1991 into their experience of fine needle aspiration (FNA) cytology of the breast. Here we present the findings of that part of the survey covering organizational aspects of the service and methods of specimen handling. the replies demonstrate differences in approach to many of the topics covered. There is a preference for the examination of direct smears (rather than cytospins) with air dried Giemsa staining and wet fixation Papanicolaou staining finding nearly equal favour. Some perceived problems were highlighted, including availability and funding of training and quality assurance as well as facilities for liaison between pathologists, clinicians and radiologists.     

Studies on Chironomidae in experimental recirculating stream systems. I. Orthocladius (Euorthodadius) calvus sp.nov.

SUMMARY.

• 1 Large nutnbers of a previously undescribed species of Orthocladius (Euorthocladius) were amongst the first animals to colonize a pair of artificial recirculating streams.
• 2 The larva, pupa and adults are described and compared with O. (E.) thienemanni which occurs abundantly in adjacent streams.

     

The assessment of multiple variables on breast carcinoma fine needle aspiration (FNA) cytology specimens: method, preliminary results and prognostic associations

The assessment of multiple variables on breast carcinoma fine needle aspiration (FNA) cytology specimens: method, preliminary results and prognostic associations
We have assessed multiple biological variables on breast carcinoma FNA specimens using a Cytoblock technique. The growth fraction (MIBI), oestrogen receptor (ER), progesterone receptor (PR), p53 mutant protein, c-erbB-2, epidermal growth factor receptor (EGFR), NCRCl Vepithelial membrane antigen (EMA) and DNA plopidy were examined. Objective quantification using image analysis (CAS 200) was applied as appropriate. Fifty cases were examined in this preliminary study. Excellent correlation between the Cytoblock preparations and parallel tissue sections was seen. Of the cancers, 81% were aneuploid with only 19% diploid in character, but 67% of the carcinomas were of histological grade 3. The mean nuclear area staining with MIBl was 31.3% and with ER was 26.7%. Twenty-four percent (24.1%) of the nuclear area showed immunoreactivity with PR. Significant immunostaining was seen in 38%, 46%, 38% and 95% of carcinomas with c-erbB-2, p53, EGFR and EMA, respectively. A significant association between histological grade of the resected tumours and both MIBl (P=0.04) and EGFR (P=0.02) expression in the Cytoblock samples was seen. p53 (P = 0.03) and EGFR (P=0.01) immunoreactivity showed an association with tumour size. EGFR (P=0.04) immunostaining also showed a relationship with the lymph node status of the patient. The technique is, we believe, a useful one for the assessment of multiple variables on breast cytology specimens; these preliminary data suggest that some of these may be useful in predicting prognosis in breast cancer patients.