N gas egress from patients' airways during LN spray cryotherapy.

Spray cryotherapy using liquid nitrogen (LN) is a general surgical tool used to ablate benign or malignant lesions. Adequate egress of the gaseous nitrogen (N) generated during this process must be provided for safe use when LN is used within the body rather than topically. When delivered to either the gastrointestinal tract (requiring active venting via a suction tube) or body cavities open to room barometric pressure (such as lung airways) allowing for passive venting, the N gas generated from the boiling process must be evacuated.

Metered Cryospray™: a novel uniform, controlled, and consistent in vivo application of liquid nitrogen cryogenic spray.

In this article, a novel cryotherapy approach using a uniform, controlled, and consistent in vivo application of liquid nitrogen (LN) spray as a Metered Cryospray (MCS) process is described. Although MCS may be used for many potential clinical applications, this paper focuses on the development that led to the controlled and consistent delivery of radial LN cryogen spray in order to generate a uniform circumferential effect and how the amount of MCS can be adapted to specifically ablate targeted diseases within a patient's lumen such as an airway or esophagus.

Use of loop electrosurgical excision procedure specimens to provide tissue fractions for immunologic analyses.

Objective: To determine if dividing loop electrosurgical excision procedure (LEEP) specimens to provide tissue for research increases rates of LEEP specimen misdiagnosis and recurrent cervical intraepithelial neoplasia.

Materials And Methods: In this chart review, 42 women with biopsy-confirmed cervical intraepithelial neoplasia (CIN) 2,3 had up to 20% of their LEEP specimens sectioned and used for immunologic analysis. The remainder of each specimen was assessed routinely.

Can Monsel's Transmit Nosocomial Infections? A Microbiological Investigation.

OBJECTIVE.: Our objective was to test whether common nosocomial pathogenic bacteria can be cultured in Monsel's paste, 20% ferric subsulfate, an astringent solution with styptic qualities that causes hemostasis when applied topically to small cuts. MATERIALS AND METHODS.

Immunotherapy of human cervical high-grade cervical intraepithelial neoplasia with microparticle-delivered human papillomavirus 16 E7 plasmid DNA.

Objective: The purpose of this study was to evaluate the safety of the administration of a bacterial expression plasmid encoding a 13 amino acid sequence that is highly homologous with human papillomavirus E7 within poly (lactide-co-glycolide) microparticles (ZYC101) in women with HLA A2+ antigen and persistent cervical intraepithelial neoplasia grade 2/3 and human papillomavirus 16.

Study Design: Fifteen women entered an institutional review board-approved dose-escalating phase I study with the use of three levels of blood monitoring and urine studies, Papanicolaou tests, and colposcopy. Escalation required no serious adverse events.

Endocervical curettage at conization to predict residual cervical adenocarcinoma in situ.

Objective: To determine if performing an endocervical curettage (ECC) at the time of conization is a useful diagnostic tool for predicting residual cervical adenocarcinoma in situ (AIS) among women who might wish to preserve their fertility.

Methods: All patients diagnosed with AIS from 1995 to 2000 at four institutions were identified. Data were retrospectively extracted from clinical records.

Cytologic and biopsy findings leading to conization in adenocarcinoma in situ of the cervix.

Objective: To investigate the utility of currently available screening tests in preoperatively detecting adenocarcinoma in situ of the cervix.

Methods: Patients with a cone biopsy diagnosis of adenocarcinoma in situ from 1987 to 2000 at our institution were identified. Results from Papanicolaou smears, cervical biopsies, and endocervical curettages preceding the diagnostic cone biopsy were collected from medical records and referring providers.

Managing atypical squamous cells of undetermined significance (ASCUS): human papillomavirus testing, ASCUS subtyping,or follow-up cytology?

Objective: This study related morphologic subtype, human papillomavirus status, and a second cytologic examination to the follow-up biopsy-proven high-grade squamous intraepithelial lesion (HSIL; grade II or III cervical intraepithelial neoplasia) after a cytologic diagnosis of atypical squamous cells of undetermined significance (ASCUS).

Study Design: Seven hundred four liquid-based cervical cytology specimens were classified as normal, "ASCUS, favor reactive" (AFR), "ASCUS, not otherwise specified," "ASCUS, favor low-grade squamous intraepithelial lesion," "ASCUS, favor HSIL" (AFHS), low-grade squamous intraepithelial lesion, and HSIL. Human papillomavirus typing used polymerase chain reaction-restriction fragment length polymorphism analysis.

Trimodal spectroscopy for the detection and characterization of cervical precancers in vivo.

Objective: The objective of this study was to assess the potential of 3 spectroscopic techniques (intrinsic fluorescence, diffuse reflectance, and light scattering) individually and in combination (trimodal spectroscopy) for the detection of cervical squamous intraepithelial lesions.

Study Design: The study was conducted with 44 patients who underwent colposcopy for the evaluation of an abnormal Papanicolaou smear. Fluorescence and reflectance spectra were collected from colposcopically normal and abnormal sites and analyzed to extract quantitative information about tissue biochemistry and morphologic condition.

Atypical glandular cells of undetermined significance in conventional cervical/vaginal smears and thin-layer preparations.

Background: Biopsy follow-up of a cervical/vaginal smear interpretation of atypical glandular cells of undetermined significance (AGUS) most often reveals either a benign reactive process or a squamous cervical intraepithelial neoplasia (CIN) rather than a glandular one. The ThinPrep Papanicolaou test (TP) has been shown to increase diagnostic sensitivity for CIN. To the authors' knowledge there are few studies examining its effectiveness in diagnosing uterine glandular lesions, either endocervical or endometrial.

NAD(P)H and collagen as in vivo quantitative fluorescent biomarkers of epithelial precancerous changes.

During the development of neoplasia, epithelial tissues undergo biochemical and structural changes that can manifest in tissue fluorescence. There have been several reports on different in vivo fluorescence characteristics between normal and precancerous (dysplastic) tissues. However, it has been difficult to identify and quantify the origins of these changes, mainly because of distortions introduced in measured tissue fluorescence spectra by tissue scattering and absorption.

Early-stage cervical adenocarcinoma treated by surgical intent: the role of para-aortic lymph node dissection.

Objective: Previous reports suggest that cervical adenocarcinomas have a unique pattern of spread and are more apt to metastasize to para-aortic lymph nodes. The purpose of this study was to further define the node of para-aortic lymph node dissection in early-stage cervical adenocarcinoma treated by surgical intent.

Methods: Institutional review board approval was obtained to perform a computerized search of the data of all women diagnosed with cervical adenocarcinoma between 1982 and 2000.

Management of adenocarcinoma in situ, micro-invasive, and early stage adenocarcinoma of the cervix.

The incidence of glandular neoplasms of the uterine cervix has been steadily increasing over the past two decades. Given the fact that these lesions are more difficult to diagnosis and are relatively infrequent, less is known about them compared with their squamous counterparts. In addition, because these lesions tend to arise in women of childbearing age, there is a particular need to understand whether the in-situ and early invasive forms of adenocarcinoma are amenable to conservative treatment measures that spare fertility like their squamous counterparts.

Stage IIB-IVB cervical adenocarcinoma: prognostic factors and survival.

Objective: The incidence of cervical adenocarcinoma is increasing relative to squamous cell carcinoma and all cervical cancers. Few reports have described the outcome of patients with advanced cervical adenocarcinoma. The purpose of this study was to determine the prognostic factors and survival for patients with stage IIB-IVB disease.