Purpose of this study was to evaluate the accuracy of mammography, ultrasonography, and magnetic resonance imaging (MRI), in the detection of breast implant rupture and to make a correlation with findings at explantation. The study population consisted of 63 women with 82 implants, undergoing surgical explantation. Implant rupture status was blindly determined obtaining diagnosis of rupture, possible rupture, or intact implant. Strictly predetermined rupture criteria were applied and compared with findings at surgery, which were considered the gold standard. False-positives and false-negatives were retrospectively evaluated to identify pitfalls in the investigation. All associations between imaging signs and surgical findings were evaluated by using chi-square test. The respective sensitivity and specificity of investigations are reported. Our experience suggests that MRI is the more accurate method for identification of breast implant rupture, even if it should be performed following the diagnostic algorithm proposed.

A mammographic breast cancer screening programme has been ongoing in the Florence District (Italy) since 1970 and a favourable impact of screening on breast cancer mortality of women aged 50-70 has been shown by means of a case-control study. Two hundred and eleven screen- and 116 interval-detected cancers in the period 1975-1986 have been identified, and detection rates calculated, for first and repeated screening test (2nd to 7th). Overall, 22,980 subjects were screened and 44,988 repeated tests performed. The observed number of interval cancers has been compared with the expected incident cancers and their ratio (O/E) studied at different time intervals since last test. The O/E ratio at the third year since the last test was 0.98 for the age-group 40-49 0.50 (95% CI: 0.23-0.95) and 0.39 (95% CI: 0.26-0.94) for the 50-59 and 60-69 groups, respectively. The prevalence/incidence ratio (P/I) was then calculated as an early indicator of efficacy. For the 40-49 age-group the P/I ratio at first test was 1.09, suggesting poor anticipation of diagnosis. In contrast, for women 50-59 and 60-69 results suggest quite a good diagnosis anticipation (P/I: 3.14; 4.82), confirming the result of the previous case-control study on mortality reduction. The proportion of advanced carcinomas (stage II or worse) and 5-year survival have been analysed and discussed. The study confirms the opportunity of using early indicators of screening efficacy for monitoring of screening services.

No abstract

Infection with human papillomavirus (HPV) has been detected in 95 to 100% of cervical cancers, the second most common female cancer worldwide (30), and persistent infection with high-risk HPV (HR-HPV) types is known to be the first step in the process of carcinogenesis. Several epidemiologic and molecular studies suggest the use of HPV testing in order to improve the efficacy of population-based screening programs for cervical cancer. HPV testing has been found to be useful for triaging minor cytological abnormalities and in the follow-up of treated cervical intraepithelial neoplasia (CIN) (2,4,7,27). HR-HPV DNA testing has been shown to be more sensitive than cytology and may improve patient management when used in addition to cytology (3, 4, 11); such testing is also under investigation as a primary screening tool (1, 10, 26). The negative predictive value of HR-HPV testing is very high (99.0%), which may allow screening intervals to be increased for women found to be negative by both cytology and HPV testing (16).The Digene Hybrid Capture 2 assay (HC2) (Digene, Gaithersburg, MD) is commonly used for HPV testing to detect 13 common HR-HPV types (types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68). Recently, the Roche AMPLICOR HPV test (AMP) (Roche Molecular Systems, CA) was made available for the same purpose. AMP detects the same 13 HR-HPV types detected by HC2 and, moreover, uses amplification of the ␤-globin gene as an internal measure of sample integrity and adequacy. Since it is a PCR-based method, the assay can be performed on small aliquots of samples in liquid cytology media or on samples obtained from archival paraffin-embedded tissue, and it is extremely sensitive (detects Ͻ100 copies of HPV DNA/PCR). In addition, incorporation of AmpErase (uracil-N-glycosylase [UNG]) into the master mix allows selective destruction of carryover products (containing deoxyuridine) from previous amplification reactions. However, evaluation of both analytical and clinical sensitivity is needed to support the use of AMP in clinical practice and cervical cancer screening programs.In the present study, we assessed the prevalence of HR-HPV in samples from subjects with cytological abnormalities (atypical squamous cells of undetermined significance [ASC-US], atypical glandular cells of undetermined significance [AGC-US], low-grade squamous intraepithelial lesions [LSIL], and high-grade squamous intraepithelial lesions [HSIL]) as well as in samples from women with normal cytology; we also evaluated the analytical agreement between AMP and HC2 in detecting HR-HPV, and for analytical determinations, genotyping was carried out on discordant samples. In addition, the clinical sensitivity and specificity of AMP for histologically * Corresponding author. Mailing address: Centro per lo Studio e la Prevenzione

An experimental investigation was designed to establish the distribution of mechanical properties throughout a high‐density polyethylene (HDPE) gas pipe wall. The proposed approach used a continuous and uniform filament that was automatically machined from the pipe on a precision lathe at a very low cutting speed and an optimal depth of cut to minimize heating and structural disturbances. Typical engineering stress–strain curves, in every layer, were obtained on a testing machine especially designed for polymers, and they were statistically analyzed. The stress–strain behavior of HDPE pipe material could basically be divided into three distinctive zones, the second of which remained important. The average stress level illustrating cold drawing for a given layer was almost constant throughout the pipe wall. The measured stresses and moduli correlated very well with the pipe thickness, and they increased from the outer layers toward the inner layers. This was explained by the crystallinity evolution because the pipe production process was based on a convective water‐cooling system with a temperature gradient, which generated residual stresses. Computed statistical stress–strain correlations at yielding, the onset of cold drawing, and fracture points revealed acceptable linear relations for an error level of p ≤ 0.05. On the other hand, an increasing linear correlation characterized the relationship of the yield stress and elastic modulus. This result was confirmed by literature for standard specimens, prepared by compression molding, that did not represent an actual pipe structure with respect to an extrusion thermomechanical history. Such an approach to mechanical property variability within an HDPE pipe wall highlighted the complexity of the hierarchical structure behavior in terms of stress–strain and long‐term brittle failure. © 2005 Wiley Periodicals, Inc. J Appl Polym Sci 97: 272–281, 2005