Ronald Luff

• Research Director at Quest Diagnostics Incorporated

In the United States, human papillomavirus (HPV) and Papanicolaou (Pap) testing (cotesting) for cervical screening in women ages 30 to 65 years is the preferred strategy, and cytology alone is acceptable. Recently, a proprietary automated test for identifying high-risk HPV types for primary cervical screening was approved by the US Food and Drug Ad...

Our understanding of preinvasive HPV-associated squamous lesions supports only two conceptual divisions: HPV infection and true precancer. Transient infections generally regress over the course of 1–2 years, and lesions with HPV persistence are associated with an increased risk of developing a cancer precursor (precancer) or invasive cancer. This c...

The terminology for human papillomavirus (HPV)-associated squamous lesions of the lower anogenital tract has a long history marked by disparate diagnostic terms derived from multiple specialties. It often does not reflect current knowledge of HPV biology and pathogenesis. A consensus process was convened to recommend terminology unified across lowe...

The terminology for human papillomavirus (HPV)-associated squamous lesions of the lower anogenital tract has a long history marked by disparate diagnostic terms derived from multiple specialties. It often does not reflect current knowledge of HPV biology and pathogenesis. A consensus process was convened to recommend terminology unified across lowe...

The terminology for human papillomavirus(HPV)–associated squamous lesions of the lower anogenital tract has a long history marked by disparate diagnostic terms derived from multiple specialties. It often does not reflect current knowledge of HPV biology and pathogenesis. A consensus process was convened to recommend terminology unified across lower...

Human papillomavirus (HPV) types 16 and 18 are the 2 most frequent types associated with cervical cancer. Identifying their presence or absence in cervical samples may assist in triaging women for subsequent management. The Cervista HPV 16/18 genotyping test specifically detects the presence of HPV 16 and 18 in ThinPrep cervical specimens. The obje...

Location-guided screening in cervical cytology offers a potentially significant advance over routine manual screening. A prospective, 2-armed, masked clinical trial of the BD FocalPoint GS Imaging System using SurePath slides (BD Diagnostics-TriPath, Burlington, NC) compared routine manual screening and quality control rescreening with computer-ass...

A fluid-based, direct-to-vial method of thin-layer gynecologic cytology (ThinPrep Pap Test) is reported to be more effective than the conventional Papanicolaou test in the detection of squamous intraepithelial lesions. This retrospective analysis evaluated the validity of the findings on the thin-layer method using case material at a large independ...

Context.—A fluid-based, direct-to-vial method of thin-layer gynecologic cytology (ThinPrep Pap Test) is reported to be more effective than the conventional Papanicolaou test in the detection of squamous intraepithelial lesions. Objective.—This retrospective analysis evaluated the validity of the findings on the thin-layer method using case material...

The conference participants addressed the following issues: (1) reporting of equivocal diagnoses, (2) strategies to minimize the use of such diagnoses, (3) morphologic criteria, and (4) management of women with equivocal diagnoses. Equivocal diagnoses should be minimized, to the extent possible, by emphasizing cytologist education and training, imp...

Issues: The conference participants addressed the following issues: (1) reporting of equivocal diagnoses, (2) strategies to minimize the use of such diagnoses, (3) morphologic criteria, and (4) management of women with equivocal diagnoses. Consensus position: Equivocal diagnoses should be minimized, to the extent possible, by emphasizing cytolog...

Issues: The conference participants addressed the following issues: (1) reporting of equivocal diagnoses, (2) strategies to minimize the use of such diagnoses, (3) morphologic criteria, and (4) management of women with equivocal diagnoses. Consensus Position: Equivocal diagnoses should be minimized, to the extent possible, by emphasizing cytologist...

The reproducibility of reporting squamous lesions by the Bethesda System (TBS) was evaluated by distributing 20 slides to be classified among 5 panelists considered experts in the field of cytopathology. Four cases were chosen for their classic morphology and the remainder were foreseen to produce possible discrepancies within one diagnostic catego...

Beginning in December 1988, a group of highly motivated professionals assembled under NCI sponsorship for the sole purpose of attempting the impossible—namely, attain a national consensus on using standard terms for the sign-out of cervical/vaginal cytology. What developed was more than many attendees ever expected: a recommended standardized forma...

A mouse monoclonal antibody and a rabbit polyclonal antibody prepared against the placental form of the enzyme glutathione S-transferase (GST-pi) were used to immunohistochemically stain normal and neoplastic human uterine cervical tissues from 88 cases. Of 65 cases of preneoplastic squamous lesions and invasive carcinomas of the cervix, 94% staine...

To the Editor.— Two commentaries accompanied the publication of the 1988 Bethesda System.1 Dr Malkasian,2 representing the American College of Obstetricians and Gynecologists, repeated his organization's support for the use of uniform, descriptive terminology for cervical/vaginal cytological diagnoses as developed in The Bethesda System, but quest...

Based on experience obtained through review of historical case material, the cytology program of the United States Air Force was regionalized into ten cytocenters, which annually process approximately 375,000 gynecologic cases. In order to assure uniformity and quality of diagnosis to multiple supplying clinics, standardized diagnoses were develope...

Based on a continuing need to provide a more rapid response to requests for thawed fresh frozen plasma, the authors evaluated plasma thawing with the use of a microwave oven and compared it with conventional 37 degrees C waterbath thawing methods. Their results indicate that microwave-thawed plasma contains precipitated denatured protein (mainly al...

The effect of rapid massive transfusion upon platelet counts has been studied retrospectively in 24 patients treated for severe trauma. Multiple linear regression analysis showed that a platelet dilution model with an exponential form described the quantitative relationship between the pre- and posttransfusion platelet counts and the volumes of blo...

A type-and-screen procedure was established whereby obstetric patients with no complications would be tested for ABO, Rh, and unexpected antibody. If the antibody screen was negative, cross matches would not be performed. Type and screen could be converted in 20 minutes to cross match, or type-specific blood would be immediately available. Our init...

An epileptic patient whose seizures were controlled with carbamazepine and primidone was followed throughout pregnancy and lactation. Blood levels of primidone decreased during pregnancy and rose postpartum requiring dosage adjustments. Pharmacologically insignificant amounts of the drug were detected in breast milk. A review of the literature reve...

A total of 99 gynecologic smears with atypical cells from 74 patients wearing IUDs was reviewed. Endometrial and cervical tissues were examined. The cases were categorized into two groups, reparative and epithelial atypias. The latter category was further divided into three subgroups: squamous, columnar, and indeterminate type. The squamous atypia...

In 350 pancervico-vaginal (Fast) smears obtained from women using intrauterine contraceptive devices, organisms consistent with Actinomycetes have been found. Actinomycetes, representing cervicitis, endometritis, and pelvic abscesses clinically, have been observed histologically in some of these cases. Special stains, immunofluorescence, and anaero...

The presence of actinomycetelike organisms in cervicovaginal fast smears from women wearing an IUD is reported. Culture of 3 smears from IUD users showed the organisms to be Actinomyces israelii. 8 other cultures from IUD users were studied with fluorescein-conjugated antisera to Actinomyces israelii and the same conclusion was reached. In most of...

An asymptomatic and radiographically occult lung abscess was the primary focus of infection in this case of fatal disseminated aspergillosis in a renal transplant recipient. Extensive neurological evaluation in response to a change in personality failed to reveal a brain abscess, which was the cause of death. This case illustrates the variability i...