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Purpose Colposcopy-guided punch biopsy is a cornerstone method for diagnosing vulvar diseases. The aim of this study was to evaluate the concordance rate of clinical findings in vulvar diseases during examinations, in comparison with colposcopy-directed punch biopsy. We also developed a new classification to simplify the categorization of vulvoscopic findings. Methods The concordance rate of the clinical findings was compared with the final histology results from punch biopsies. The data were collected between January 2014 and May 2017 at the Erlangen University Hospital. Results A total of 482 colposcopy-directed punch biopsies of the vulva were obtained in 420 women. The overall concordance rate of the clinical findings in comparison with the histological vulvar punch-biopsy findings was 53.9% for all entities — benign lesions, lichen, low- and high-grade squamous intraepithelial lesions (LSIL/HSILs), and vulvar carcinoma. The concordance rate for detecting LSILs was 64.3% (45/70). The concordance rate for detecting HSILs was 62.3% and for Vulvar carcinoma 65.2%. Conclusions Punch biopsy of suspicious lesions continues to be a cornerstone in diagnosing HSILs and carcinoma of the vulva. Careful work-up of the vulva is recommended when patients have symptoms such as pruritus or pain. The new classification is more specific for diagnosing lesions in the vulva.

BackgroundDisease-related symptoms impair the quality of life of patients with chronic lymphocytic leukaemia (CLL) who do not require systemic therapy. Available therapies are not specifically aimed at symptom control. Because stimulation of the B-cell receptor activates JAK2 in CLL cells and the JAK2 inhibitor ruxolitinib improves symptoms in patients with myelofibrosis, we postulated that ruxolitinib would improve disease-related symptoms in patients with CLL. We did a phase 2 trial of ruxolitinib to test this hypothesis.MethodsSymptomatic patients with CLL who did not require systemic therapy were enrolled at MD Anderson Cancer Center (Houston, TX, USA) between Sept 15, 2014, and Sept 20, 2015. Participants were given 10 mg ruxolitinib orally twice a day. Scores on the Brief Fatigue Inventory (BFI), CLL module of the MD Anderson Symptom Inventory (MDASI) and symptom-associated interference in daily activities, were assessed before treatment and after 3 months. This trial is ongoing and is registered at ClinicalTrials.gov (NCT02131584).Findings41 patients (25 previously untreated for CLL and 16 previously treated) were enrolled. At 3 months, the mean percentage change from baseline in BFI score was 44·3% (SD 35·0, p

The development of an ultra-high-resolution high-dynamic-range infrared optical coherence tomography (OCT) imaging system is reported for the novel purpose of sub-surface inspection of silicon integrated-circuits. This approach utilises an almost octave-spanning supercontinuum source and a balanced-detection scheme in a time-domain OCT configuration to achieve an axial resolution of 2.5@mm in air, corresponding to ~700nm in silicon. Examples of substrate thickness profiling and device feature inspection capabilities for additional circuit navigation and characterisation are presented.

Two new cyclic hexadepsipeptides, exumolides A ( 1 ) and B ( 2 ) were produced by a marine fungus, identified as a Scytalidium sp., collected in the Bahamas. Two dimensional NMR methods, coupled with tandem mass spectrometry (MS-MS), were used to establish the structures of the new compounds. The exumolides exhibit antimicroalgal activity against the unicellular chlorophyte Dunaliella sp. at 20 μg ml −1 in liquid media cell growth assays.

Four new sesquiterpenoid nitrobenzoyl esters (1–4) have been isolated from organic extracts of the culture broth and mycelia of Aspergillus versicolor, a fungus isolated from the surface of the Caribbean green alga Penicillus capitatus. The structures of the four compounds were determined through extensive analysis of 1H NMR, 13C NMR, HMQC, and HMBC data. 9α, 14-Dihydroxy-6β-p-nitrobenzoylcinnamolide (1) displayed significant cytotoxicity against HCT-116 human colon carcinoma cells in vitro and exhibited moderately selective cytotoxicity toward a panel of renal tumor cell lines.