No abstract

Direct observations by phase microscopy have demonstrated that small numbers of pathogenic staphylococci survive prolonged periods of time within living human polymorphonuclear leukocytes. Non-pathogenic microorganisms are rapidly destroyed in similar preparations. Leukocytes in which staphylococci remained viable often appeared less vigorous after ingesting microorganisms, but intracellular survival could not be correlated with obvious leukocyte damage with any consistency. Both pathogenic and non-pathogenic cocci were seen to divide within living granulocytes during the first few minutes after ingestion. Occasionally pathogenic staphylococci multiplied in dying cells after long periods of intracellular residence. Phagocytosis of more than one pair of staphylococci by a single leukocyte appeared to act as a stimulus to bacterial destruction. Multiple ingestions of pathogenic staphylococci reduced the incidence of survival of the total microbiol population contained within the cell.

Background Patients with ovarian serous tumors of low malignant potential (OSLMP) who have peritoneal implants, especially invasive implants, are at increased risk of developing tumor recurrence. The ability of peritoneal washing (PW) cytology, to detect the presence and type of peritoneal implants has not been adequately investigated, and its prognostic significance is unknown. Methods We retrospectively reviewed records and PW specimens of 101 patients diagnosed with and treated for OSLMP between 1996 and 2010 at The University of Texas MD Anderson Cancer Center. We compared patients’ staging biopsy findings with those of our review of the PWs. Follow-up data were also analyzed. Results Of the 96 patients with staging biopsy results available, 26 (27%) had peritoneal implants (17 noninvasive, 9 invasive), 19 (20%) had endosalpingiosis, and 51 (53%) had negative findings. The PW specimens of 18 of the 26 patients (69%) with peritoneal implants were positive for serous neoplasm, and a correlation was found between cytologic and histologic findings (p < 0.0001). The sensitivity, specificity, positive predictive, and negative predictive values were 69%, 84%, 62% and 88%, respectively. Four of 101 patients had disease recurrence, 3 of these patients had invasive implants and 1 patient had noninvasive implants. None of the patients who had negative staging biopsy findings or endosalpingiosis but PW specimens positive for serous neoplasm developed disease recurrence. Conclusions PW cytology detects the presence of peritoneal implants with moderate accuracy. Long-term studies are needed to determine whether positive PW cytologic findings are an independent predictor of tumor recurrence.

The results of this study can be used to guide patients' expectations regarding the functional outcome of treatment for a nonunion of the lower extremity.

There is no size threshold below which a papilloma of the breast can be safely watched or ignored without risking a missed diagnosis of atypia or cancer. Identification of papillomas in patients with new nonpapillary breast cancers can change patient management in up to half of these patients. Finally, breast ultrasound significantly enhances identification of unsuspected papillomas.