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Objective Recent meta-analyses have shown that loop treatment of the cervix of >10 mm depth may be associated with adverse outcomes in future pregnancies. The aim of this study is to assess the rate of incomplete excision and recurrent disease in relation to depth of excision in women of reproductive age undergoing loop treatment.Design Observational cohort study.Setting Colposcopy Clinic, Northern Gynaecological Oncology Centre, Gateshead, UK.Population In all, 1558 women undergoing loop treatment for high-grade cervical intraepithelial neoplasia (HGCIN) between 1998 and 2003.Methods Women were followed up until 2008. Recurrence was analysed using Kaplan-Meier plots.Outcome measures Incomplete excision rates and recurrence rates. Recurrence was defined as post-treatment disease with highgrade histology. Any dyskaryotic cytology on follow-up was also documented.Results Recurrent high-grade disease on histology was found in 57/1558 (3.7%) women. In women £35 years old, despite a greater rate of incomplete excision at the endocervical margin at loop depths <10 mm compared with ‡10 mm (24.4% versus 13.3%, P < 0.01), the recurrence rate was similar between the two groups (4.3% versus 3.4%, log-rank, P = 0.52). In contrast, a loop depth <10 mm was associated with a higher disease recurrence rate (7.5% versus 3.0%, log-rank, P = 0.05) in women >35 years. ConclusionIn women of reproductive age requiring treatment for HGCIN, colposcopists performing loop excision should aim for <10 mm depth. This provides adequate treatment for HGCIN and minimises the potential risk of adverse outcomes in future pregnancies.

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The effect of cholecystokinin on the myoelectric activity of the small intestine was determined in conscious dogs. Six animals were implanted with electrodes along the small intestine, and a cannula was placed in the stomach. A second cannula was inserted into the duodenum in three animals, and a pancreatic fistula was prepared in three animals. Recordings were made in the fasted state, during the intravenous infusion of either saline or cholecystokinin-octapeptide (CCK-OP), during the intraduodenal infusion of either saline or L-tryptophan, and during the fed state. CCK-OP disrupted the fasted pattern of myoelectric activity, caused a dose-dependent increase in spike potentials, and caused a dose-dependent increases in pancreatic protein secretion. Stimulation of myoelectric activity occurred at doses that produced submaximal protein secretion; however, the stimulation was not identical to that seen with feeding. Intraduodenal infusion of L-tryptophan increased pancreatic protein secretion, interrupted the fasted pattern of motility, and induced a pattern similar to that seen with feeding. We conclude that CCK alters small intestinal motility and may play a role in the changes in small-bowel motility caused by the ingestion of food.

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This article discusses the fundamental basis of high strength Al alloy design and describes the role of alloying elements, mechanical processing parameters and heat treatments toward the evolution of microstructure that controls the desired properties i.e. strength, fracture toughness, stress corrosion cracking (SCC) resistance, fatigue crack initiation and propagation resistance, and weldability in 7xxx series Al alloys. The beneficial effects of suitable micro/trace alloying elements, and deleterious effects of certain impurity elements on a variety of properties are further discussed within the present context.