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Cervical Dysplasia Diagnosis with Fluorescence Spectroscopy
Published in Mary-Ann Mycek, Brian W. Pogue, Handbook of Biomedical Fluorescence, 2003
Rebecca Richards-Kortum, Rebekah Drezek, Karen Basen-Engquist, Scott B. Cantor, Urs Utzinger, Carrie Brookner, Michele Follen
If the Pap smear indicates HGSIL, the current standard of care is to perform colposcopy, colposcopically directed biopsies, and endocervical curettage (scraping of the endocervical canal) [29]. LGSILs and atypias may be followed, but if abnormalities persist for more than 6–12 months, colposcopy is recommended [29]. A colposcope uses a magnifying lens to view the cervix with white and green light after the application of 3–5% acetic acid. White epithelium and vascular atypia of the cervix are the hallmark of SILs [30]. As lesions progress, progressive vascular atypia develops. Figure 2 shows an example of the typical colposcopic view of progressive cervical lesions.
Objects and epistemologies in criminal law
Published in Emilie Cloatre, Martyn Pickersgill, Knowledge, Technology and Law, 2014
Emilie Cloatre, Martyn Pickersgill
The presence of injury upon the body of a rape assault survivor has been demonstrated as a strong predictor of successful criminal prosecution (Du Mont and White 2007). Forensic practitioners, either doctors (known as Forensic Medical Examiners (FMEs)) or nurses (Forensic Nurse Examiners (FNEs)), spend the majority of the forensic intervention that follows the reporting of a rape assault observing the body and recording anything that they determine constitutes abnormal phenomena (Rees 2011). This observation and recording process is separated into genital and non-genital examinations, and while injuries are often not difficult to observe macro-scopically upon non-genital areas, the same cannot be said for the ano-genital region. Consequently, since the 1990s, a gynaecological technology known as the colposcope has been recommended for use within forensic medical examinations (Slaughter and Brown 1992). The colposcope, initially designed to investigate the cervix and tissues of the vagina and the vulva following the return of an irregular pap smear, is a type of microscope that can magnify the genital (and anal) areas up to 30 times (Rogers 2004). It comes complete with a light for illumination and a camera for recording the examination. According to those promoting the use of the colposcope within forensic medical examinations, magnification and illumination is likely to increase the probability of observing signs of genital injury; meanwhile, the camera enables improved contemporaneous recording of the examination, producing better evidence for criminal justice as well as medico-legal research (Brennan 2006). However, not all forensic practitioners are convinced that this device is useful or appropriate, and some challenge its incorporation on both victim-centric and scientific grounds.
Predicting cervical cancer biopsy results using demographic and epidemiological parameters: a custom stacked ensemble machine learning approach
Published in Cogent Engineering, 2022
Krishnaraj Chadaga, Srikanth Prabhu, Niranjana Sampathila, Rajagopala Chadaga, Swathi K S, Saptarshi Sengupta
Currently, this cancer diagnosis involves two tests: First, the patient is required to undergo a cytology test called the pap smear or Papanicolaou’s test (da Silva et al., 2022). In this test, cells are gently removed from the cervix and the surrounding regions with a tiny brush to be examined under a powerful microscope. Cell abnormalities and cancer cells can be easily identified using this method. The next step is to conduct a thorough colposcopy exam (Ren et al., 2022). The protocol for this procedure involves four significant steps. The first step involves the observation of columnar and squamous epithelium using a saline solution under the influence of a magnifier lens. Abnormalities in the tissue are observed in the squamous epithelium. Generally, it is pink in colour. Crypt apertures and nabothian follicles are the critical points of interest. These artefacts define the transformation zone’s external boundary. The SQJ characterizes the inner perimeter. The full view of the region of interest is sometimes impossible to view from a source since the SQJ may retract into the canal. The columnar epithelium has a dark red appearance with complicated patterns. A green filter can then be attached to the colposcope to enhance the vision of the vasculature by maximizing the contrast. Reticulated and hair-pin-shaped capillaries are the two structures observed in this stage. These unique patterns can only be found in specific regions in the cervix, as described in Figure 1. In the next step, the cervix is observed under the influence of acetic acid solution (5%). This idiosyncratic procedure was first performed by Hans Hinselmann in 1925 (Yoon et al., 2022). The epithelium tissues are observed once again. The clinicians can easily distinguish the change in the appearance of the squamous and columnar epithelium tissues due to the presence of acid. During this phase, precancerous lesions might also be seen. The last step involves the physician applying Lugol’s solution to the cervix. This procedure is called as the Schiller’s test (Jaya & Latha, 2022). The healthy cervical and vaginal tissues become black or brown. Abnormal entities such as cervical polyps do not get stained by the iodine solution. As a result, the test strengthens the ability to distinguish between normal and aberrant transformation zone regions. The abnormal development of cells on the cervix characterizes cervical cancer. The biopsy result of colposcopy is used to diagnose cervical cancer in most cases. However, they can lead to false positive and negative results (Beer, 2021). The inaccurate results are dangerous since the patient does not receive appropriate treatments and can lead to a severe prognosis.