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Sample records for cervical mass lesion

  1. Os Odontoideum: Rare Cervical Lesion

    DTIC Science & Technology

    2011-11-01

    the articulation between C1 and the os odontoideum on flexion imaging. The remainder of his cervical vertebral bodies had normal alignment with no...appears normal. Figure 3. Flexion view of plain cervical spine. This image shows abnormal translation of the articulation between C1 and the C2 os...worldwide. Peer Reviewed Title: Os Odontoideum: Rare Cervical Lesion Journal Issue: Western Journal of Emergency Medicine, 12(4) Author: Robson

  2. No Carious Cervical Lesions: Abfraction

    PubMed Central

    Shetty, Sumanth M; Shetty, Rashmi G; Mattigatti, Sudha; Managoli, Noopur A; Rairam, Surabhi G; Patil, Ashwini M

    2013-01-01

    Abfraction or Theory of Abfraction is a theory explaining the non-carious cervical lesions (NCCL). It suggests that they are caused by flexural forces, usually from cyclic loading; the enamel, especially at the cementoenamel junction (CEJ), undergoes this pattern of destruction by separating the enamel rods. Clinical aspect importance of these ineart lesions are at most important to be detected for early intervention and treatment modalities as options during the progression of the disease. How to cite this article: Shetty SM, Shetty RG, Mattigatti S, Managoli NA, Rairam SG, Patil AM. No Carious Cervical Lesions: Abfraction. J Int Oral Health 2013; 5(5):142-5. PMID:24324319

  3. No carious cervical lesions: abfraction.

    PubMed

    Shetty, Sumanth M; Shetty, Rashmi G; Mattigatti, Sudha; Managoli, Noopur A; Rairam, Surabhi G; Patil, Ashwini M

    2013-10-01

    Abfraction or Theory of Abfraction is a theory explaining the non-carious cervical lesions (NCCL). It suggests that they are caused by flexural forces, usually from cyclic loading; the enamel, especially at the cementoenamel junction (CEJ), undergoes this pattern of destruction by separating the enamel rods. Clinical aspect importance of these ineart lesions are at most important to be detected for early intervention and treatment modalities as options during the progression of the disease. How to cite this article: Shetty SM, Shetty RG, Mattigatti S, Managoli NA, Rairam SG, Patil AM. No Carious Cervical Lesions: Abfraction. J Int Oral Health 2013; 5(5):142-5.

  4. Intraventricular mass lesions

    SciTech Connect

    Morrison, G.; Sobel, D.F.; Kelley, W.M.; Norman, D.

    1984-11-01

    Determining the precise etiology of an intraventricular mass can be a difficult diagnostic problem. CT and angiographic findings were reviewed in a series of 73 patients who had intraventricular masses. The histologic diagnosis can be suggested preoperatively by an analysis of the frequency of lesions occurring at a given ventricular location, lesion density before and after administration of contrast material, age, and sex of the patient, morphologic appearance of the mass, and presence or absence of hydrocephalus. Angiography is useful when meningioma, choroid plexus papilloma and carcinoma, or arteriovenous malformation are considered.

  5. CERVICAL SPINE LESIONS IN RHEUMATOID ARTHRITIS PATIENTS.

    PubMed

    Macovei, Luana-Andreea; Rezuş, Elena

    2016-01-01

    to gather clinical and laboratory data on rheumatoid arthritis patients with cervical spine damage (incidence and prevalence, correlation between duration of disease and the time of lesion onset, to assess signs and symptoms and the role of laboratory investigations). The spine is an axial organ with an important role in support and resistance. It is a pillar with a very complex morphological and functional structure. The vertebral column is crossed by many kinematic chains. The main problem of the cervical spine caused by rheumatoid arthritis is cervical instability which describes all cervical lesions that can lead to neurovascular damage or major disturbance of pain generating statics at movement. The evolving disease shows chronic inflammation of the synovium, which is a self-maintained process and an immunologically induced phenomenon. The chronic inflammation of the synovium forms granulation tissue that invades peripheral joints towards the center and causes ligament cartilage and bone damage. The present paper investigated cervical spine lesions in 107 rheumatoid arthritis patients who were admitted to the 1st Rheumatology Clinic of Iasi Rehabilitation Hospital between January 2013 and December 2014. Our study focused on assessing signs and symptoms seen in spine affected by rheumatic disease. the disease causes destructive lesions due to granulomatous infiltration of rachidian structures and medullary sheaths. These lesions lead to damaged discs and instability that produces subluxations and dislocations. The suboccipital region is most affected; in other regions of the spine, high lesions of C4-C5 prevail, where osteolysis damage of spinal apophyses are found. In atlas and axis joints, rheumatoid arthritis causes the inflammation of bursa, synovium and joint capsule and leads to synovial pannus formation. This causes the destruction of cartilage and subchondral bone. Atlantoaxial dislocation is caused by erosive synovitis of atlanto-epistrophic joint

  6. Os Odontoideum: Rare Cervical Lesion

    PubMed Central

    Robson, Kristie A

    2011-01-01

    We report the case of a 22-year-old Marine who presented to the emergency department, after a martial arts exercise, with transient weakness and numbness in all extremities. Computed tomography cervical spine radiographs revealed os odontoideum. Lateral flexion–extension radiographs identified atlanto-axillary instability. This abnormality is rare and can be career ending for military members who do not undergo surgical fusion. PMID:22224150

  7. CO2 laser application in gynecology: experience in microsurgery of cervical lesions

    NASA Astrophysics Data System (ADS)

    Knapp, Piotr A.

    1995-03-01

    A CO2 laser device was used for treating cervical lesions in 1574 patients. Of the total, 163 were diagnosed as CIN. Patients were selected for the study as a result of mass screening during the period from 1988 to 1992 of Bialystok Province, Poland. Treatment of cervical lesions with laser proved to be effective. In the author's opinion it is an essential step in preventing cervical malignancy.

  8. Diaphragm paralysis from cervical disc lesions.

    PubMed

    Cloward, R B

    1988-01-01

    An opera singer, who "made her living with her diaphragm", developed a post-traumatic unilateral radiculopathy due to cervical disc lesions, C3 to C6. During one year of severe neck and left arm pain she gradually lost the ability to sing difficult operatic passages which brought an end to her music career. Following a three level anterior cervical decompression and fusion, the neck and arm pain was immediately relieved. One week later her voice and singing ability returned to its full strength and power permitting her to resume her activities as a vocalist. The diagnosis of paresis of the left hemi-diaphragm as part of the cervical disc syndrome was implied by postoperative retrospective inference.

  9. Effects of occlusal load on cervical lesions.

    PubMed

    Litonjua, L A; Bush, P J; Andreana, S; Tobias, T S; Cohen, R E

    2004-03-01

    Toothbrush abrasion has been considered to cause cervical lesions. However, some investigators have proposed that occlusal loading factors direct tensile stresses at the cervical area, resulting in wedge-shaped abfraction defects. The purpose of this study is to investigate the role of axial and non-axial load on the development of cervical lesions. Matched paired premolars, extracted for orthodontic purposes, were used in a custom-fabricated toothbrushing apparatus. A periodontal sulcus width of 0b1 mm with 1 mm gingival recession was simulated with denture base resin. In phase 1, eight matched premolar pairs were subjected to 80 h (1b4 million strokes) of brushing and 300 g of toothbrush force. Toothpaste slurry was applied continuously through the toothbrush. One specimen in each pair was subjected to 250 h and 45 kg of continuous axial load, while the other unloaded tooth served as a negative control. In phase 2, 10 matched premolar pairs were subjected to the same conditions; however, the experimental teeth were subjected to 250 h and 45 kg of intermittent non-axial load, directed at a 45 degrees angle to the buccal cusp. Rubber impressions were made of the cervical lesions, then trimmed, weighed, and compared to determine the amount of tooth material lost. When teeth were loaded axially, there was significantly less tooth material loss (P < 0b02); however, when teeth were loaded non-axially, there was no significant difference (P =0b80) when compared with controls. Optical and scanning electron microscopy did not reveal any significant differences in the morphology between pairs. Our data suggest that the application of occlusal load may not necessarily play a significant role in the progression of cervical tooth wear commonly referred to as abfraction.

  10. Non carious cervical lesions. A review.

    PubMed

    Ceruti, P; Menicucci, G; Mariani, G D; Pittoni, D; Gassino, G

    2006-01-01

    Non-carious cervical lesions (NCCL) are characterized by a loss of hard dental tissue near the cement-enamel-junction. Commonly, their shape is like a wedge with the apex pointing inwards. Other times, they appear as regular depressions, like a dome or a cup. Their main characteristic is the presence of hard-mineralized tissue. According to the literature, the prevalence of cervical lesions is 85%, while their incidence is about 18% among permanent teeth. NCCL are currently classified as erosion, abrasion, or abfraction. Their etiology seems to be related to different factors: hexogen and endogen acids, mechanical abrasive action, tooth flexion under axial and non-axial loads. Moreover, it seems that a fundamental role is ascribable to tooth bending phenomena due to the strength components parallel or oblique to the occlusal level, which occur during the normal function as well as during parafunctions. The frequent therapeutic failures are probably due to the same factors causing the onset of the original lesion. Several materials have been proposed to restore NCCL: amalgam (abandoned), glass-ionomer cements, compomers, and composite resins. Early failures of these restorations have often been reported in the literature, probably due to the same factors which originally caused the lesions. Further investigations are required to determine more reliable restorative therapies.

  11. Treatments for hypersensitive noncarious cervical lesions

    PubMed Central

    Veitz-Keenan, Analia; Barna, Julie Ann; Strober, Brad; Matthews, Abigail G.; Collie, Damon; Vena, Donald; Curro, Frederick A.; Thompson, Van P.

    2014-01-01

    Background The Practitioners Engaged in Applied Research and Learning (PEARL) Network conducted a three-armed randomized clinical study to determine the comparative effectiveness of three treatments for hypersensitive noncarious cervical lesions (NCCLs): use of a potassium nitrate dentifrice for treatment of hypersensitivity, placement of a resin-based composite restoration and placement of a sealant. Methods Seventeen trained practitioner-investigators (P-Is) in the PEARL Network enrolled participants (N = 304) with hypersensitive posterior NCCLs who met enrollment criteria. Participants were assigned to treatments randomly. Evaluations were conducted at baseline and at one, three and six months thereafter. Primary outcomes were the reduction or elimination of hypersensitivity as measured clinically and by means of patient-reported outcomes. Results Lesion depth and pretreatment sensitivity (mean, 5.3 on a 0- to 10-point scale) were balanced across treatments, as was sleep bruxism (present in 42.2 percent of participants). The six-month participant recall rate was 99 percent. Treatments significantly reduced mean sensitivity (P < .01), with the sealant and restoration groups displaying a significantly higher reduction (P < .01) than did the dentifrice group. The dentifrice group’s mean (standard deviation) sensitivity at six months was 2.1 (2.1); those of the sealant and restoration groups were 1.0 (1.6) and 0.8 (1.4), respectively. Patient-reported sensitivity (to cold being most pronounced) paralleled clinical measurements at each evaluation. Conclusions Sealing and restoration treatments were effective overall in reducing NCCL hypersensitivity. The potassium nitrate dentifrice reduced sensitivity with increasing effectiveness through six months but not to the degree offered by the other treatments. Practical Implications Sealant or restoration placement is an effective method of immediately reducing NCCL sensitivity. Although a potassium nitrate dentifrice

  12. Cervical spine lesions after road traffic accidents: a systematic review.

    PubMed

    Uhrenholt, Lars; Grunnet-Nilsson, Niels; Hartvigsen, Jan

    2002-09-01

    A systematic critical literature review. To determine whether occult pathoanatomical lesions in the cervical spine of road traffic fatalities exist and if they can be identified using optimal autopsy techniques. Previous investigations have examined pathoanatomical conditions of the cervical spine of road traffic fatalities. However, different methods of investigation have been used, and results of studies are conflicting. Hence, potential pathoanatomical conditions in fatalities and survivors remain a controversial issue. Articles were retrieved searching the MEDLINE, Mantis, and Cochrane libraries. Studies examining the cervical spine of road traffic fatalities at autopsy were included and evaluated according to a set of quality criteria. For in-depth review, only studies using surface cryoplaning microtomy autopsy technique and a control group were included. Twenty-seven articles of which three fulfilled the quality criteria were reviewed. In these studies, subtle pathoanatomical lesions were found in the cervical intervertebral discs, cartilaginous endplates, and the articular surfaces and capsules of the zygapophysial joints. The lesions were found exclusively in the traumatized patients and in none of the patients in the control group. Occult pathoanatomical lesions in the cervical intervertebral disc and zygapophysial joints after fatal road traffic trauma may exist. Present imaging methods, especially conventional radiography, do not visualize these subtle lesions; hence, underreporting of pathoanatomical lesions during standard autopsy is probably common. These findings may have clinical relevance in the management of road traffic trauma survivors with potentially similar pathoanatomy.

  13. Proposal for clinical classification of multifactorial noncarious cervical lesions.

    PubMed

    Loomba, Kapil; Bains, Rhythm; Bains, Vivek Kumar; Loomba, Anju

    2014-01-01

    Noncarious cervical lesions often present with overlapping symptoms and have a multifactorial etiology. The dimensions of the lesion axially (depth) and occlusogingivally (width), along with the orientation of the walls of the lesion to each other (angle), are the 3 factors that can be quantified to classify the lesion and assess its progress over time. This article analyzes these factors and proposes a simple classification system based upon the clinical appearance of the lesion in order to derive simple, therapeutic, treatment-based classifications.

  14. Distribution of human papillomavirus genotypes in cervical lesions

    PubMed Central

    Ma, Li; Cong, Xiao; Shi, Mai; Wang, Xiu-Hong; Liu, Hai-Yan; Bian, Mei-Lu

    2017-01-01

    The aims of the present study were to investigate the distribution of human papillomavirus (HPV) genotypes in cervical lesions, and the association between different HPV genotypes and cervical lesions. Between January 2013 and June 2014, the HPV type determinations of nucleic acid by use of fluorescence polymerase chain reaction (PCR) method of 15,192 outpatients in China-Japan Friendship Hospital were performed and the infection status was analyzed. The results showed that: i) 2,366 Cases were HPV positive and 12,826 cases were HPV negative, the overall infection rate was 15.57% (2,366/15,192), in which a single genotype of HPV infection rate was 11.63% (1,767/15,192), and multiple genotypes of HPV infection rate was 3.94% (599/15,192); ii) HPV16, HPV52 and HPV58 infections were the most common HPV genotypes, the infection rates were 3.95% (600/15,192), 2.86% (435/15,192) and 2.67% (406/15,192), respectively; and iii) According to the gold standard of histopathological analysis via hematoxylin-eosin staining, HPV16, HPV52 and HPV58 accounted for 58.80% (154/267) of all CIN2 or above squamous epithelial lesions. Furthermore, three cases with pathological changes of the cervical severe glandular epithelium were all HPV18 infection. The difference was statistically significant (χ2=60.74, P<0.001). Single HPV subtype infection was primarily associated with HPV16, HPV52 and HPV58. In conclusion, HPV type detection had a may be important in screening of cervical lesions as a difference in pathogenic ability was noted among different HPV genotypes. As cervical cancer is an infectious disease, HPV testing may help detect more precancerous lesions, thus reducing the morbidity and mortality of cervical cancer. HPV16, HPV52 and HPV58 were associated with severe cervical squamous epithelial lesions; HPV18 was associated with cervical severe glandular cell pathological changes, although it was not the most common HPV genotype in China. When positive, a clinical cervical

  15. Sialyl Lewis x expression in cervical scrapes of premalignant lesions.

    PubMed

    Velázquez-Márquez, Noé; Santos-López, Gerardo; Jiménez-Aranda, Lucio; Reyes-Leyva, Julio; Vallejo-Ruiz, Verónica

    2012-12-01

    Sialylated oligosaccharides of glycoproteins and glycolipids have been implicated in tumour progression and metastases. Altered expression of glycosidic antigens has been reported in cervical cancer. In cervix premalignant lesions, an increased expression of sialic acid has been reported. In the present study we determined the expression profiles of the glycosidic antigens Tn, sialyl Tn (sTn), Lewis a (Lea), sialyl Lewis a (sLea), Lewis x (Lex) and sialyl Lewis x (sLex) in cervical scrapes with cytological diagnoses of normal, low-grade squamous intraepithelial lesions (LGSIL) and highgrade squamous intraepithelial lesions (HGSIL). Cervical scrapings were collected to detect tumour antigens expressions by flow cytometry using monoclonal antibodies. Cytometry analysis of Tn, sTn, Lea and Lex did not reveal differences at the expression level among groups. The number of positive cells to sLea antigen increased in the HGSIL group with respect to the normal group (p=0.0495). The number of positive cells to sLex antigen in the samples increased with respect to the grade of squamous intraepithelial lesion (SIL) (p less than 0.001, Mann-Whitney U test). The intensity of expression of this antigen increased in the HGSIL samples with respect to normal samples (p less than 0.0068). sLex antigen could be a candidate to be used as biomarker for the early diagnosis of cervical cancer.

  16. Conservative restoration of proximal-cervical lesions.

    PubMed

    Setien, Victor; Armstrong, Steven R; Vargas, Marcos A

    2003-01-01

    One of the authors has used this technique successfully for the past three years in various clinical situations that involve both difficult access anterior and posterior teeth. This is a tooth-structure conserving clinical procedure that can provide a simplified approach for restoring otherwise difficult clinical lesions.

  17. [Etiology and pathogenesis of precancerous lesions and invasive cervical carcinoma].

    PubMed

    Panjković, Milana; Ivković-Kapicl, Tatjana

    2008-01-01

    Cervical cancer is the second most common gynecological malignancy in the world. Human papilloma virus (HPV) infection is the leading ethiologic agent in the development of premalignant and malignant cervical diseases. HPV is a member of the Papovaviridae family and until now over 100 types have been recognized There are two types of viral infection: latent and productive. Virus induced oncogenesis is the result of interaction between virus oncoproteins E6 and E7 and tumor supresor host genes p53 and Rb. Many cofactors such as immunosuppression, early sexual relationship, multiple sexual partners, other sexualy transsmited infections and smoking are contributing factors of the precancerous and invasive cervical lesions. According to the oncogenic potential HPV are divided into three groups: low, intermediate and high oncogenic risk viruses. Molecular technics which are used for the virus detection are: In situ hibridisation, Hyybrid capture test and polymerasa chain reaction. Human papilloma virus testing has an important role in the follow up and treatment of women with "atypical squamous cells of unknown significant" changes in cervical smears and low-grade squamous intraepithelial lesions, changes in punch biopsy.

  18. Microbiological characterization and effect of resin composites in cervical lesions

    PubMed Central

    Carlo, Bonfanti; Piccinelli, Giorgio; Faus-Matoses, Vicente; Cerutti, Antonio

    2017-01-01

    Background Non carious cervical lesions associated to muscle hyperfunctions are increasing. Microhybrid resin composites are used to restore cervical abfractions. The purpose of this study was to investigate if resin composites modify tooth plaque, inducing an increment of cariogenic microflora and evaluate their effect, in vivo and in vitro, against S. mutans. Material and Methods Eight abfractions were restored with two microhybrid resin composites (Venus, Heraeus-Kulzer® and Esthet-X, Dentsply®), after gnatological therapy, in three patients with muscle hyperfunctions. For each abfraction three samples of plaque were taken from the cervical perimeter: before the restoration, one week and three months after restoration. The samples were evaluated both by traditional microbiological methods and by Polymerase Chain Reaction (PCR). In vitro, disk-shaped specimens of the two composites were prepared to estimate the effects against pre-cultured S. mutans, after incubation at 37°C for 24h and assessed by a turbidimetric technique. Results In vivo no differences were found in plaque growth, for all samples, before and after restoration with both composites; in vitro, instead, a significant reduction of S. mutans growth was found between specimens of two composites (Mann-Whitney U-test p>0,06). Conclusions In this study a relevant consideration was elicited: composite materials, in vivo, do not modify plaque composition of non carious cervical lesions to a potential cariogenic plaque. Key words:Abfraction, restoration, S. mutans, composite, class V. PMID:28149461

  19. Co-expression of metalloproteinases 11 and 12 in cervical scrapes cells from cervical precursor lesions

    PubMed Central

    Valdivia, Alejandra; Peralta, Raúl; Matute-González, Manuel; García Cebada, Juan Manuel; Casasola, Ivonne; Jiménez-Medrano, Cristina; Aguado-Pérez, Rogelio; Villegas, Vanessa; González-Bonilla, Cesar; Manuel-Apolinar, Leticia; Ibáñez, Miguel; Salcedo, Mauricio

    2011-01-01

    The metalloproteinases (MMP) 11 and 12 have been shown to be expressed in cervical cancer (CC). In order to extend our previous results, these MMPs were evaluated in cervical precursor lesions. One hundred seventeen cervical scrapes: thirty-six normal, thirty-six Low grade squamous lesions (LSIL), thirty-six High grade (HSIL), nine CC; and, also ninety-nine paraffin-embedded cervical lesions: fifteen normal cervices, thirty eight LSIL, sixteen HSIL, and five CC were collected. The samples were analyzed for relative expression by real time RT-PCR or immunohistochemistry assay. We were able to identify a relative increased expression of MMP11 in 75% and 78% from LSIL and HSIL samples, respectively. While MMP12 expression was 64% and 75% in LSIL and HSIL, respectively. Positive samples for MMP11 expression were also positive for MMP12 expression and also increased according to illness progression. In the tissues, MMP11 or MMP12 expression was observed in the cytoplasm of the neoplastic cells, while in the normal epithelium was absent. The reaction was always stronger for MMP12 than MMP11. MMP11 expression was present in 77% and 66% of LSIL and HSIL, while MMP12 expression was 73% and 68%. There was a relationship between MMP11 or MMP12 expression and HPV infection. Our data are showing a relationship between diagnostic of precursor lesions and the MMP11 and 12 expressions, suggesting that their expression could be an early event in the neoplastic lesions of the cervix and could have clinical significance. PMID:22076168

  20. Nuclear expression of Rac1 in cervical premalignant lesions and cervical cancer cells

    PubMed Central

    2012-01-01

    Background Abnormal expression of Rho-GTPases has been reported in several human cancers. However, the expression of these proteins in cervical cancer has been poorly investigated. In this study we analyzed the expression of the GTPases Rac1, RhoA, Cdc42, and the Rho-GEFs, Tiam1 and beta-Pix, in cervical pre-malignant lesions and cervical cancer cell lines. Methods Protein expression was analyzed by immunochemistry on 102 cervical paraffin-embedded biopsies: 20 without Squamous Intraepithelial Lesions (SIL), 51 Low- grade SIL, and 31 High-grade SIL; and in cervical cancer cell lines C33A and SiHa, and non-tumorigenic HaCat cells. Nuclear localization of Rac1 in HaCat, C33A and SiHa cells was assessed by cellular fractionation and Western blotting, in the presence or not of a chemical Rac1 inhibitor (NSC23766). Results Immunoreacivity for Rac1, RhoA, Tiam1 and beta-Pix was stronger in L-SIL and H-SIL, compared to samples without SIL, and it was significantly associated with the histological diagnosis. Nuclear expression of Rac1 was observed in 52.9% L-SIL and 48.4% H-SIL, but not in samples without SIL. Rac1 was found in the nucleus of C33A and SiHa cells but not in HaCat cells. Chemical inhibition of Rac1 resulted in reduced cell proliferation in HaCat, C33A and SiHa cells. Conclusion Rac1 is expressed in the nucleus of epithelial cells in SILs and cervical cancer cell lines, and chemical inhibition of Rac1 reduces cellular proliferation. Further studies are needed to better understand the role of Rho-GTPases in cervical cancer progression. PMID:22443139

  1. Epidemiological Investigation and Risk Factors for Cervical Lesions: Cervical Cancer Screening Among Women in Rural Areas of Henan Province China.

    PubMed

    Zhang, Qingwei; Xie, Wenyan; Wang, Feng; Li, Rong Hong; Cui, Lina; Wang, Huifen; Fu, Xiuhong; Song, Jiayu

    2016-06-01

    BACKGROUND This cross-sectional study aimed to investigate the prevalence of cervical lesions and evaluate risk factors for cervical intraepithelial neoplasia (CIN) among women taking part in cervical cancer screening in rural areas of Henan province, China. MATERIAL AND METHODS Cervical cancer screening using the ThinPrep cytologic test (TCT) and gynecologic exam was conducted on 1315 women age 20-68 years in rural areas of Henan province, China. Colposcopy and biopsies were carried out for histopathologic diagnosis when indicated. Univariate and multivariate logistic regressions were performed to evaluate risk factors associated with cervical lesions. RESULTS Among 1315 women screened, CIN prevalence detected by histopathology was 1.22% (0.38% of CIN 1, 0.76% of CIN 2, and 0.08% of CIN 3). Cervical cancer prevalence was 2.66%. Multivariate analysis confirmed risk factors for cervical lesions included older age (the 21-40 age group vs. the 41-66 age group, OR=0.13, 95% CI: 0.03~0.57), postmenopause (OR=0.11, 95% CI: 0.03~0.45), cervical inflammation (OR=0.06, 95% CI: 0.01~0.31), and smoking (OR=6.78, 95% CI: 1.20~38.23). CONCLUSIONS Older age (41-66 years), presence of HPV infection, postmenopause, cervical inflammation, and smoking are strong risk factors for cervical lesions among women in rural areas of Henan province, China. Particular efforts should be made to provide cervical cancer screening for these women.

  2. Human Papillomavirus in Brazilian women with and without cervical lesions

    PubMed Central

    2011-01-01

    Background Human Papillomavirus (HPV) high-risk (HR) types are the causal factor for cervical cancer and premalignant dysplasia. Data on frequency of HPV types provide a basis to design and evaluate HPV prevention programs. Taking into account the heterogeneity of HPV types across and within populations this study aims to access the HPV frequency in Brazilian women. Results We identified 24 different types of HPV, including a Betapapillomavirus and a likely new type, previously reported, from 132 women positive for the virus analysed by Hybrid Capture II assay. These women were infected by a single or multiple HPV types and 142 HPV strains were identified. HR types were found in 75% of women and HPV types 16, 18, 45, 58, and 66 had the highest frequency. Significant differences in frequency of HR HPV types were found for presence of cervical lesions, and for different HPV species and women age. Conclusions Compared with previous studies in Brazil, our data indicated differences in frequency and HPV type diversity, a significant association of other HR-types but HPV16 and 18 and cervical lesions, and a trend for distinct distribution of HPV types by age. PMID:21208414

  3. The terminology of pre-invasive cervical lesions in the UK cervical screening programme.

    PubMed

    Herrington, C S

    2015-12-01

    The terminology of non-invasive epithelial abnormalities associated with an elevated risk of having or developing invasive cervical carcinoma (pre-invasive lesions) has been modified frequently over time as understanding of the underlying biology, and approaches to disease management, have changed. The arguments are now converging on the conclusion that the most appropriate terminology for cervical squamous intraepithelial abnormalities should be two-tier rather than three-tier. Given the findings of the Lower Anogenital Squamous Terminology (LAST) project in the USA, which have recently been endorsed by the World Health Organisation classification of tumours of female reproductive organs, the recommended terms are low-grade and high-grade squamous intraepithelial lesion (SIL), with the option of including the relevant cervical intraepithelial neoplasia (CIN) grade in parentheses. Although, at first sight, this appears to represent only a small change, there is a fundamental conceptual difference between the systems. The CIN system requires, first, the identification of a CIN lesion and, second, the determination of its grade on a continuum, with subsequent division into three grades. The SIL system is based on the existence of two different forms of human papillomavirus (HPV) infection, with productive infection leading to low-grade SIL and transforming infection leading to high-grade SIL.

  4. Prevalence of human papillomavirus genotypes among women with cervical lesions in the Shaanxi Province of China.

    PubMed

    Li, J; Wang, Y Y; Nan, X; Tian, X F; Yan, T; Wang, P; Yin, Y; Liu, Y; Yuan, R; Wang, G Q; Fu, Y L

    2016-03-31

    This study aimed to investigate human papilloma virus (HPV) genotypes among women with cervical lesions in Shaanxi Province, China, to obtain information regarding cervical lesion prevention and treatment. The study included 4508 HPV-positive subjects; cervical swab specimens were collected and tested for HPV infection status and HPV genotypes using polymerase chain reaction and reverse dot-blot hybridization. Women positive for HPV with cervical lesions, including chronic cervicitis, cervical intraepithelial neoplasia, and cervical squamous cell carcinoma (SCC), were examined; HPV-positive women with no cervical lesions were controls. Data were pooled and weighted estimates have been presented. For women with no cervical lesions and positive for one HPV genotype, HPV 52, 16, 58, 81, 33, and 56 were the most common; for multiple-HPV genotype infection, HPV 16, 52, 6, 18, 58, and 66 were the most common. Collectively, HPV 16, 58, 52, 18, 33, and 81 were the most common in women with cervical lesions. HPV 16 comprised 26.71% of single-genotype and 15.64% of multiple-genotype infections. The proportion of HPV-16-positive cases was 29.15%, which was the highest among all HPV genotypes (P < 0.01). Single-HPV genotype infection was the most common in cervical HPV infection (77.48%); infection with two HPV genotypes comprised 72.22% of multiple-genotype infections. The proportion of single-low-risk HPV genotype infections decreased with increase in cervical lesion severity; there were no single- or multiple-low-risk genotype HPV infections in cervical SCC patients. The proportion of multiple-genotype HPV infections with at least one high-risk genotype increased with cervical lesion severity.

  5. [Demand for abortion. Detection of cervical cancer and precancerous lesions].

    PubMed

    Benmoura, D

    1994-03-01

    Eighteen years of experience with cervical screening in the Center for Social Gynecology in Marseilles has demonstrated the existence of a group at high risk of cervical dysplasia. Its characteristics are early initiation of sexual activity, sexually transmitted disease, sexual promiscuity, and an unfavorable socioeconomic environment. Precancerous lesions are sometimes observed before the age of 18. Pap tests are done during preabortion consultations at the Center except in very young patients, those who are too emotionally distressed, and those with inflammations from vaginitis. The test may be done before the abortion because in the first trimester the cells do not yet show changes that would interfere with interpretation of the Pap smear. Bleeding after the abortion interferes with reading the slide. Results of 405 Pap tests conducted during a reference period from August 1992 to July 1993 among women seeking abortions at the Center for Social Gynecology were compared to those of 1601 women undergoing gynecological examinations at two other centers. Among patients at the Center for Social Gynecology and the other two centers respectively, 3.5% and 1.4% were diagnosed with condylomas, 1.5% and 1.2% with dysplasia, and 1.25% and 0.5% with condylomas and dysplasia. During the reference period, only 20% of women were screened. The number of lesions detected suggests that a higher proportion of women should be screened in this population of women often lacking regular medical care.

  6. Human papillomavirus infections among women with cervical lesions and cervical cancer in Eastern China: genotype-specific prevalence and attribution.

    PubMed

    Zhang, Lei; Bi, Qingqing; Deng, Hua; Xu, Jing; Chen, Juan; Zhang, Meilian; Mu, Xiaofeng

    2017-01-31

    Cervical cancer and its precursor, high-grade cervical intraepithelial neoplasia (CIN2/3), are associated with persistent high-risk human papillomavirus (HPV) infection. HPV genotype prevalence varies with severity of cervical lesions, patient age and geographical location. The aim of this study was to investigate HPV genotypes prevalence and attribution according to the severity of cervical lesions among Chinese women. A 4-year surveillance study was performed. A total of 1664 female patients were included and their cervical histological diagnosis consisted of cervical intraepithelial neoplasia grade 1 (CIN1, 376 cases), grade 2 (CIN2, 408 cases), grade 3 (CIN3, 336 cases) and invasive cervical cancers (ICC, 544 cases). HPV genotypes prevalence and attribution to cervical lesions were calculated and analyzed. The 95% confidence interval (CI) for proportion was also calculated. HPV positivity rates increased directly with cervical lesions severity (72.4% for CIN1, 81.4% for CIN2, 88.1% for CIN3 and 90.4% for ICC). Infections with multiple HPV types were inversely related to cervical lesions severity. HPV16, 52, 31, 33 and 58 were the most prevalent genotypes in ICC. 49.1% of squamous cell carcinoma, 65.1% of adenocarcinoma and 12.0-43.3% of cervical intraepithelial neoplasia could be attributed to vaccine-covered high-risk genotypes (HPV16/18). Inclusion of HPV52 and HPV31 in future vaccines would provide the highest marginal benefit in protection for individuals residing in this region. These findings provide information about HPV genotypes in this region which may be important to target with future vaccination and screening programs.

  7. High-grade cervical squamous intraepithelial lesion during pregnancy.

    PubMed

    Murta, Eddie Fernando Candido; de Souza, Flávio Henrique Caetano; de Souza, Maria Azniv Hazarabedian; Adad, Sheila Jorge

    2002-01-01

    An increasing incidence of high-grade squamous intraepithelial lesion (HSIL) has been observed among young women. Consequently, an increased number of cases are being discovered during pregnancy. We analyzed the clinical and therapeutic management of HSIL during pregnancy. A retrospective study was conducted from 1979 to 1998, and 58 registries of women with a cytological or histological diagnosis of HSIL during the pregnant-puerperal period were reviewed. Information obtained from medical records included age, gestational age at diagnosis, parity, age of first intercourse, number of sexual partners before pregnancy, tobacco use, cytologic and colposcopic findings, route of delivery, postpartum follow-up, and treatment. This information was compared with a non-pregnant control group with HSIL. The average age of pregnant women with HSIL was 27.9 +/- 5.2 years. The cytologic or histologic diagnosis of HSIL was made in the first trimester in 12 (20.7%) women and in the second trimester in 30 (51.7%) women. Average parity was 2.8 +/- 2 deliveries. Age of first intercourse ranged from 13 to 29 years (16.1 +/- 3.3). Thirty-two women (55.1%) had more than one sexual partner before pregnancy. Thirty-seven (63.8%) refereed tobacco use. According to the aforementioned aspects, no statistical difference was found in relation to control, except to cervical ectopia, which was more frequent in pregnant women (56.9% versus 42.6%). From the total of 58 pregnant women with cytologic or biopsy HSIL diagnosis, 53 had HSIL diagnosis made on cervical biopsy directed by colposcopy performed during the pregnancy; 44 (83%) of them were submitted to conservative management. HSIL was diagnosed by cervical biopsy in postpartum evaluation in 76% pregnant women with vaginal delivery and 78.6% women who underwent cesarean section. A conservative management of HSIL in pregnancy is proposed, with colposcopic evaluation during gestation and postpartum, regardless of route of delivery.

  8. Biomechanics of cervical tooth region and noncarious cervical lesions of different morphology; three-dimensional finite element analysis

    PubMed Central

    Jakupović, Selma; Anić, Ivica; Ajanović, Muhamed; Korać, Samra; Konjhodžić, Alma; Džanković, Aida; Vuković, Amra

    2016-01-01

    Objective: The present study aims to investigate the influence of presence and shape of cervical lesions on biomechanical behavior of mandibular first premolar, subjected to two types of occlusal loading using three-dimensional (3D) finite element method (FEM). Materials and Methods: 3D models of the mandibular premolar are created from a micro computed tomography X-ray image: model of sound mandibular premolar, model with the wedge-shaped cervical lesion (V lesion), and model with saucer-shaped cervical lesion (U lesion). By FEM, straining of the tooth tissues under functional and nonfunctional occlusal loading of 200 (N) is analyzed. For the analysis, the following software was used: CTAn program 1.10 and ANSYS Workbench (version 14.0). The results are presented in von Mises stress. Results: Values of calculated stress in all tooth structures are higher under nonfunctional occlusal loading, while the functional loading is resulted in homogeneous stress distribution. Nonfunctional load in the cervical area of sound tooth model as well as in the sub-superficial layer of the enamel resulted with a significant stress (over 50 [MPa]). The highest stress concentration on models with lesions is noticed on the apex of the V-shaped lesion, while stress in saucer U lesion is significantly lower and distributed over wider area. Conclusion: The type of the occlusal teeth loading has the biggest influence on cervical stress intensity. Geometric shape of the existing lesion is very important in the distribution of internal stress. Compared to the U-shaped lesions, V-shaped lesions show significantly higher stress concentrations under load. Exposure to stress would lead to its progression. PMID:27403064

  9. Postcoital bleeding due to cervical endometriosis

    PubMed Central

    Seval, Mehmet Murat; Cavkaytar, Sabri; Atak, Zeliha; Guresci, Servet

    2013-01-01

    Endometriosis of the uterine cervix is a rare lesion that is generally asymptomatic in gynaecological practice. We present a case with postcoital bleeding due to a cervical mass mimicking cervical polyp or fibroma which was histologically proven as cervical endometriosis later. Cervical endometriosis should be considered in the differential diagnosis of cervical masses with postcoital bleeding. PMID:23376669

  10. Postcoital bleeding due to cervical endometriosis.

    PubMed

    Seval, Mehmet Murat; Cavkaytar, Sabri; Atak, Zeliha; Guresci, Servet

    2013-01-31

    Endometriosis of the uterine cervix is a rare lesion that is generally asymptomatic in gynaecological practice. We present a case with postcoital bleeding due to a cervical mass mimicking cervical polyp or fibroma which was histologically proven as cervical endometriosis later. Cervical endometriosis should be considered in the differential diagnosis of cervical masses with postcoital bleeding.

  11. Role of Brushing and Occlusal Forces in Non-Carious Cervical Lesions (NCCL).

    PubMed

    Sadaf, Durre; Ahmad, Zubair

    2014-12-01

    To assess the association of occlusal forces and brushing with non-carious cervical lesions (NCCL). It was a Cross-sectional study. The study was conducted in Dental clinics, Department of Surgery, The Aga Khan University Hospital Karachi. The study duration was from 1(st) January 2009 to 28(th) Feb 2009. Ninety patients visiting dental clinic were examined clinically. Presence of Non- carious cervical lesions, broken restorations, fractured cusps, presence of occlusal facets, brushing habits, Para functional habits were assessed. All the relevant information and clinical examination were collected on a structured Performa and was analyzed using SPSS version 14.0. . Chi square χ(2) test was applied to assess association among different categorical variables. Twenty three (26%) females and 67 (74%) males were included in the study. Thirty five of them (38.9%) were found to have Non-carious cervical lesions. Presence of NCCL has no association with gender (P value 0.458). A significant association was found between NCCL and teeth sensitivity (P value 0.002).The association between use of hard tooth brush and Non-carious cervical lesions was found significant (P value <0.001). However the association among Non-carious cervical lesions and fractured cups, broken restoration, teeth grinding, jaw clenching, pan chalia chewing and frequency of teeth brushing were insignificant. Hard tooth brushing and teeth sensitivity have significant association with Non-carious cervical lesions. The role of occlusal wear in the formation of NCCL is not significant.

  12. Prevalence of Human Papillomavirus Genotypes Among Women With High-Grade Cervical Lesions in Beijing, China.

    PubMed

    Xiao, Meizhu; Xu, Qiuxiang; Li, Hongyan; Gao, Huiqiao; Bie, Yachun; Zhang, Zhenyu

    2016-01-01

    The aim of the study is to investigate the prevalence of high-risk human papillomavirus (hr-HPV) genotypes among Han women with high-grade cervical lesions in Beijing, China.Cervical cell specimens from patients with histopathologically confirmed cervical lesions at 7 hospitals in Beijing were examined with a validated HPV kit for 13 hr-HPV genotypes during the study period. The patients were divided into a low-grade cervical lesions group (cervical intraepithelial neoplasia grade 1, CIN1) and a high-grade cervical lesions group (CIN2+, including cervical intraepithelial neoplasia grade 2, CIN2; cervical intraepithelial neoplasia grade 3, CIN3; squamous cervical cancer, SCC; and adenocarcinoma of the cervix, ACC) based on the histopathology results.A total of 2817 eligible patients were enrolled, including 610 cases identified as CIN1 and 2207 as CIN2+. The hr-HPV positive rates in the CIN1 and CIN2+ groups were 78.2% (477/610) and 93.3% (2060/2207), respectively. The most frequently detected genotypes were HPV16, 58, 52 and18 in the CIN1 group and HPV16, 58, 33, and 52 in the CIN2+ group, in descending order of prevalence. In addition, the prevalence of HPV18 among the patients with ACC was 28.6% (14/49), significantly >7.2% (54/752) prevalence among the SCC patients (P < 0.001). Additionally, significantly more women in the CIN2+ group had multiple infections compared with those in the CIN1 group (38.1% and 24.9%, respectively; P < 0.001). However, as the cervical lesion grade increased, the prevalence of multiple hr-HPV infections gradually deceased to 44.2% in the CIN2 patients, 36.7% in the CIN3 patients, and 35.3% in the cervical cancer (CC) patients, which included SCC and ACC patients. In cases of multiple hr-HPV infections in the CIN2+ group, double infections accounted for ∼76.6%, and HPV16+58, HPV16+52, and HPV16+18 were the most common combinations, in descending order. The most frequent combination for triple infections was HPV16+58+31, with

  13. Methylenetetrahydrofolate reductase (MTHFR) polymorphisms and promoter methylation in cervical oncogenic lesions and cancer

    PubMed Central

    Botezatu, Anca; Socolov, Demetra; Iancu, Iulia V; Huica, Irina; Plesa, Adriana; Ungureanu, Carmen; Anton, Gabriela

    2013-01-01

    The aim of this study was to investigate the role of methylenetetrahydrofolate reductase (MTHFR) polymorphisms and MTHFR methylation pattern in cervical lesions development among women from Romania, a country with high prevalence of human papillomavirus (HPV) cervical infections. To achieve this goal, blood samples and cervical cytology specimens (n = 77)/tumour tissue specimens (n = 23) were investigated. As control, blood and negative cytological smears (n = 50) were used. A statistically significant association was found between T allele of C677T polymorphism and cervical lesions, heterozygote women presenting a threefold increased risk (normal/cervical lesions and tumours: wild homozygote 34/41 (0.68/0.41), heterozygote 14/51 (0.28/0.51), mutant homozygote 2/8 (0.04/0.08); OR = 3.081, P = 0.0035). Using χ square test for the control group, the HPV-negative and HPV-positive patients with cervix lesions, a significant correlation between viral infection and T allele of C677T polymorphism (P = 0.0287) was found. The MTHFR promoter was methylated in all HGSIL and tumour samples, significant differences being noted between HPV-positive samples, control group and cases of cervical dysplastic lesions without HPV DNA (P < 0. 0001) and between samples from patients with high-risk (hr)HPV versus low-risk (lr)HPV (P = 0.0026). No correlations between polymorphisms and methylation were observed. In Romania, individuals carrying T allele are susceptible for cervical lesions. MTHFR promoter methylation is associated with cervical severity lesions and with hrHPV. PMID:23444906

  14. Methylenetetrahydrofolate reductase (MTHFR) polymorphisms and promoter methylation in cervical oncogenic lesions and cancer.

    PubMed

    Botezatu, Anca; Socolov, Demetra; Iancu, Iulia V; Huica, Irina; Plesa, Adriana; Ungureanu, Carmen; Anton, Gabriela

    2013-04-01

    The aim of this study was to investigate the role of methylenetetrahydrofolate reductase (MTHFR) polymorphisms and MTHFR methylation pattern in cervical lesions development among women from Romania, a country with high prevalence of human papillomavirus (HPV) cervical infections. To achieve this goal, blood samples and cervical cytology specimens (n = 77)/tumour tissue specimens (n = 23) were investigated. As control, blood and negative cytological smears (n = 50) were used. A statistically significant association was found between T allele of C677T polymorphism and cervical lesions, heterozygote women presenting a threefold increased risk (normal/cervical lesions and tumours: wild homozygote 34/41 (0.68/0.41), heterozygote 14/51 (0.28/0.51), mutant homozygote 2/8 (0.04/0.08); OR = 3.081, P = 0.0035). Using χ square test for the control group, the HPV-negative and HPV-positive patients with cervix lesions, a significant correlation between viral infection and T allele of C677T polymorphism (P = 0.0287) was found. The MTHFR promoter was methylated in all HGSIL and tumour samples, significant differences being noted between HPV-positive samples, control group and cases of cervical dysplastic lesions without HPV DNA (P < 0. 0001) and between samples from patients with high-risk (hr)HPV versus low-risk (lr)HPV (P = 0.0026). No correlations between polymorphisms and methylation were observed. In Romania, individuals carrying T allele are susceptible for cervical lesions. MTHFR promoter methylation is associated with cervical severity lesions and with hrHPV. © 2013 The Authors. Published by Foundation for Cellular and Molecular Medicine/Blackwell Publishing Ltd.

  15. GLASS IONOMER CEMENTS AND THEIR ROLE IN THE RESTORATION OF NON-CARIOUS CERVICAL LESIONS

    PubMed Central

    Francisconi, Luciana Fávaro; Scaffa, Polliana Mendes Candia; de Barros, Vivian Rosa dos Santos Paes; Coutinho, Margareth; Francisconi, Paulo Afonso Silveira

    2009-01-01

    Glass ionomer based materials are clinically popular in several areas of restorative dentistry, but restoration of cervical lesions has proven particularly successful. Various etiologies, conformations, locations and structural characteristics make non-carious cervical lesions more challenging to adhesive restorative procedures and marginal seal in the long run. Due to their characteristics, glass ionomer cements (GICs) have precise indication for these cases. Moreover, the use of a GIC base underneath composite resin, the so-called "sandwich" or mixed technique, allows associating the good characteristics of composite resins and GICs, and has been considered quite useful in the restoration of non-carious cervical defects. The aim of this paper is to critically review the literature and discuss peculiar features of GICs regarding their role in the restoration of non-carious cervical lesions. PMID:19936509

  16. Distribution of HPV genotypes in cervical intraepithelial lesions and cervical cancer in Tanzanian women

    PubMed Central

    2011-01-01

    Background Infection with human papillomavirus (HPV) is associated with uterine cervical intraepithelial neoplasia (CIN) and invasive cancers (ICC). Approximately 80% of ICC cases are diagnosed in under-developed countries. Vaccine development relies on knowledge of HPV genotypes characteristic of LSIL, HSIL and cancer; however, these genotypes remain poorly characterized in many African countries. To contribute to the characterization of HPV genotypes in Northeastern Tanzania, we recruited 215 women from the Reproductive Health Clinic at Kilimanjaro Christian Medical Centre. Cervical scrapes and biopsies were obtained for cytology and HPV DNA detection. Results 79 out of 215 (36.7%) enrolled participants tested positive for HPV DNA, with a large proportion being multiple infections (74%). The prevalence of HPV infection increased with lesion grade (14% in controls, 67% in CIN1 cases and 88% in CIN2-3). Among ICC cases, 89% had detectable HPV. Overall, 31 HPV genotypes were detected; the three most common HPV genotypes among ICC were HPV16, 35 and 45. In addition to these genotypes, co-infection with HPV18, 31, 33, 52, 58, 68 and 82 was found in 91% of ICC. Among women with CIN2-3, HPV53, 58 and 84/83 were the most common. HPV35, 45, 53/58/59 were the most common among CIN1 cases. Conclusions In women with no evidence of cytological abnormalities, the most prevalent genotypes were HPV58 with HPV16, 35, 52, 66 and 73 occurring equally. Although numerical constraints limit inference, findings that 91% of ICC harbor only a small number of HPV genotypes suggests that prevention efforts including vaccine development or adjuvant screening should focus on these genotypes. PMID:22081870

  17. Immunohistochemical expression of p16, Ki-67 and p53 in cervical lesions - A systematic review.

    PubMed

    Silva, Daliana Caldas; Gonçalves, Ana Katherine; Cobucci, Ricardo Ney; Mendonça, Roberta Cecília; Lima, Paulo Henrique; Cavalcanti, Geraldo

    2017-07-01

    This study evaluated the immunohistochemical (IHC) expression of p16, p53 and Ki-67 in precancerous lesions and in cervical cancer (CC). Identification and review of publications assessing IHC expression in cervical intraepithelial neoplasia (CIN) and CC until February 15, 2017. Systematic review of studies in women with and without cervical lesions in order to evaluate whether there is overexpression of these biomarkers. A total of 28 publications met the criteria which included 6005 patients. The analysis showed that there is higher IHC expression of these biomarkers associated with the more severe lesions. Nineteen out of 22 evaluated studies have shown that there is a higher p16 expression in more severe lesions (CC), while in p53 expression only 4 out of the 9 studies showed a higher expression among more severe cases. Regarding the Ki-67 expression, it was observed that 9 out of 14 studies showed higher expression in more severe lesions. A complete absence of or just minimal IHC expression was observed in the normal cervical epithelium, whilst a significant increase in the expression of these biomarkers was detected according to the severity of lesions. Results suggest that these biomarkers can be considered useful tools for discriminating between the stages of the progressive cervical disease. Copyright © 2017. Published by Elsevier GmbH.

  18. Prevalence of carious and non-carious cervical lesions in archaeological populations from North America and Europe.

    PubMed

    Ritter, André V; Grippo, John O; Coleman, Thomas A; Morgan, Michèle E

    2009-01-01

    The purpose of this study was to report the prevalence of carious and non-carious cervical lesions in the teeth of five archaeological populations. A secondary purpose was to report the association between age, gender, diet, tooth wear, carious cervical lesions, and non-carious cervical lesions. One hundred and four archaeological specimens from subjects originating from five distinct geographical areas were examined to detect the presence of carious cervical lesions, non-carious cervical lesions, and tooth wear. Data were tabulated and statistics used to describe prevalence and non-causal associations. Carious cervical lesions were prevalent in all populations except among Labradoreans, while non-carious cervical lesions were found predominantly in Mexicans. The authors found no association between non-carious cervical lesions and age, gender, and diet in any of the populations. Tooth wear was noted in all populations, but the highest rates of severe wear were noted among the Labradoreans and New Mexicans. Age was associated with tooth wear in all populations except Ohioans. There was no association between tooth wear and non-carious cervical lesions. The prevalence of carious cervical lesions among the five archaeological populations studied ranged from 0 to 65%. Non-carious cervical lesions were not prevalent among these populations, being found predominantly in Mexicans (26%). CLINICAL SIGNIFICANCE Historically, carious and non-carious cervical lesions can be found in individuals with no access to modern oral hygiene tools. The findings of this study are not conclusive, however, as the associations described are not causal. (J Esthet Restor Dent 21:324-335, 2009).

  19. Distribution and attribution of high-risk human papillomavirus genotypes in cervical precancerous lesions in China.

    PubMed

    Wang, Wenpeng; An, Jusheng; Song, Yan; Wang, Minjie; Huang, Manni; Wu, Lingying

    2017-07-01

    While human papillomavirus vaccine was recently approved by China Food and Drug Administration, mapping of high-risk human papillomavirus distribution and attribution in cervical precancerous lesions in China becomes critical in development of a high-risk human papillomavirus-based cervical cancer screening and prevention strategy. In total, 1016 patients with cervical precancerous lesions diagnosed in the National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences were analyzed retrospectively, including 111 patients with low-grade squamous intraepithelial lesions and 905 patients with high-grade squamous intraepithelial lesions. HPV16, 58, 52, 33, and 31 were the most common high-risk human papillomavirus genotypes in order of decreasing frequency among high-risk human papillomavirus-positive high-grade squamous intraepithelial lesions; this differed from the high-risk human papillomavirus distribution in low-grade squamous intraepithelial lesions (HPV16, 52, 39, 56, and 58). The distribution of high-risk human papillomavirus genotypes in single-type infections for high-grade squamous intraepithelial lesions (HPV16, 58, 33, and 52) was similar to that in multiple-type infections (HPV16, 58, 52, and 33). By contrast, a more diverse distribution spectrum of high-risk human papillomavirus genotypes for low-grade squamous intraepithelial lesions was observed between single-type (HPV16, 52, 39, and 56) and multiple-type infection (HPV52, 68, 58, 59, 39 and 56). A previously published method was adopted to calculate the fractional proportion of individual high-risk human papillomavirus genotypes in multiple infections. For this proportional attribution, HPV16 (48.9%), 58 (10.0%), 33 (5.5%), and 52 (5.5%) were the most frequent among all high-grade squamous intraepithelial lesions, whereas HPV16 (13.2%), 52 (11.6%), 39 (9.5%), and 56 (7.6%) were the most frequent among all low-grade squamous intraepithelial lesions. Differences in high-risk human

  20. Ultrasound elastography in the differential diagnosis of benign and malignant cervical lesions.

    PubMed

    Lu, Rong; Xiao, Ying; Liu, Minhui; Shi, Dazun

    2014-04-01

    This study aimed to evaluate the clinical value of ultrasound elastography in the differential diagnosis of benign and malignant cervical lesions and to compare the accuracy of the elasticity score and strain ratio in differentiating cervical lesions. B-mode sonography and ultrasound elastography were performed on 84 cervical lesions (40 benign and 44 malignant) in 84 patients. All of the images were obtained transvaginally. The elasticity score was determined by a 5-point scoring method. Calculation of the strain ratio was based on a comparison of the average strain measured in the lesion with the adjacent tissue of the same depth, size, and shape. The findings were compared with histopathologic results. With the use of receiver operating characteristic curves, the diagnostic value of the elasticity score and strain ratio methods was determined. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of the elasticity score in the differential diagnosis of cervical lesions were 81.8%, 85.0%, 83.3%, 85.7%, and 81.0%, respectively, whereas those of the strain ratio were 90.9%, 90.0%, 90.5%, 90.9%, and 90.0%. A strain ratio cutoff value of 4.525 was used as a standard to distinguish benign from malignant lesions. The strain ratio values of malignant lesions were much higher than those of benign lesions (range, 4.85-8.91 versus 0.62-4.50). The differences were statistically significant (P < .01). Ultrasound elastography is a promising technique that is easy and rapid to perform and can help identify cervical lesions that are likely to be malignant. It is obvious that the strain ratio yielded better results than the elasticity score. Both methods are semiquantitative, but quantification of the strain ratio is finer than that of the elasticity score.

  1. Cervical soft tissue lesions in the shaken infant syndrome: a case report.

    PubMed

    Porzionato, Andrea; Macchi, Veronica; Aprile, Anna; De Caro, Raffaele

    2008-10-01

    Cervical soft tissue lesions have rarely been described in the shaken baby syndrome; they include ruptures of intervertebral discs and haemorrhages in the ligamenta flava, and in the interspinal and sternocleidomastoid muscles. We present here the autopsy case of a 30-month old girl who suffered an assault with multiple injury mechanisms, i.e., beating, sexual abuse and shaking trauma. External examination of the neck did not reveal bruises or excoriations, but cervical dissection showed haemorrhagic infiltration of the clavicular head of the sternocleidomastoid muscle, carotid region, posterior musculature of the pharynx and oesophagus, and retro-pharyngeal/oesophageal spaces. These findings were ascribed to the repeated violent movements of shaking trauma. The case presented confirms the occurrence of cervical soft tissue lesions in the shaken baby syndrome and reports injuries which have not previously been described. In suspected cases of shaken baby syndrome, particular attention must be paid to the examination of cervical soft tissue structures.

  2. Meta-analysis of type-specific human papillomavirus prevalence in Iranian women with normal cytology, precancerous cervical lesions and invasive cervical cancer: Implications for screening and vaccination.

    PubMed

    Jalilvand, Somayeh; Shoja, Zabihollah; Nourijelyani, Keramat; Tohidi, Hamid Reza; Hamkar, Rasool

    2015-02-01

    To predict the impact of current vaccines on cervical cancer and for the improvement of screening programs, regional data on distribution of human papillomavirus (HPV) types in women with or without cervical cancer is crucial. The present meta-analysis intend to comprehensively evaluate the HPV burden in women with invasive cervical cancer, high-grade squamous intraepithelial lesion (cervical intraepithelial neoplasia 2 and 3), low-grade squamous intraepithelial lesion (cervical intraepithelial neoplasia 1), atypical squamous cells of undetermined significance and normal cytology, as these data will help decision making in regards with screening programs and HPV vaccination in Iran. To determine the HPV prevalence and type distribution in Iranian women with or without cervical cancer, 20 published studies were included in this meta-analysis. In total, 713, 124, 104, 60, and 2577 women invasive cervical cancer, high-grade squamous intraepithelial lesion (cervical intraepithelial neoplasia 2 and 3), low-grade squamous intraepithelial lesion (cervical intraepithelial neoplasia 1), atypical squamous cells of undetermined significance and normal were reviewed, respectively. Overall HPV prevalence in women with invasive cervical cancer, high-grade squamous intraepithelial lesion (cervical intraepithelial neoplasia 2 and 3), low-grade squamous intraepithelial lesion (cervical intraepithelial neoplasia 1), atypical squamous cells of undetermined significance and normal cytology were 77.4%, 71.8%, 65.3%, 61.7%, and 8.4%, respectively. The six most common types were HPV 16, 18, 6/11, 31, and 33; among them HPV 16 was the most frequent type in all five different groups. According to this study, it was estimated that HPV vaccines could have a great impact on prevention of cervical cancer in Iran. In conclusion, this meta-analysis highlights the necessity of introducing vaccination program in Iran.

  3. Interest of human papillomavirus DNA quantification and genotyping in paired cervical and urine samples to detect cervical lesions.

    PubMed

    Ducancelle, A; Legrand, M C; Pivert, A; Veillon, P; Le Guillou-Guillemette, H; De Brux, M A; Beby-Defaux, A; Agius, G; Hantz, S; Alain, S; Catala, L; Descamps, P; Postec, E; Caly, H; Charles-Pétillon, F; Labrousse, F; Lunel, F; Payan, C

    2014-08-01

    Cervical cancer is caused by persistent infection with high-risk human papillomavirus (HR-HPV). Conventional human papillomavirus (HPV) testing requires cervical sampling. However, vaginal and urine self-sampling methods are more acceptable for patients and result in increased participation when they are available in screening programs. In this context, we have developed a non-invasive screening method via the detection of HPV DNA in urine samples. To compare HPV viral loads and genotypes in paired cervical and urine samples, and to assess correlation between virological and cytological results in women seeking gynecological consultation. Paired urine and cervical specimens were collected and analyzed from 230 of 245 women participating in the previously described prospective PapU study. HPV DNA detection and quantification were performed using a real-time PCR method with short fragment PCR primers. Genotyping was carried out using the INNO-LiPA HPV genotyping assay. The prevalence of HPV in the 230 paired urine and cervical smear samples was 42 and 49 %, respectively. Overall agreement for HPV positivity and negativity between the paired samples was 90 % (κ = 0.80). High HPV viral load in both cervical and urine samples was associated with cytological abnormalities. HPV-positive women were mostly infected with HR-HPV types. The agreement between high- and low-risk HPV (LR-HPV) detection in both samples was 97 % (κ = 0.95 for HR-HPV and κ = 0.97 for LR-HPV). High concordance rates for HPV-DNA quantification and high/low-risk HPV genotyping in paired urine/cervical samples suggest that urinary HPV DNA testing could be useful for cervical lesion screening.

  4. Declining rates of high-grade cervical lesions in young women in Connecticut, 2008-2011.

    PubMed

    Niccolai, Linda M; Julian, Pamela J; Meek, James I; McBride, Vanessa; Hadler, James L; Sosa, Lynn E

    2013-08-01

    Vaccines that prevent infection with human papillomavirus (HPV) types 16 and 18 that are known to cause cervical cancer have been available in the United States since 2006. High-grade cervical lesions are important for monitoring early vaccine impact because they are strong surrogates for cancer yet can develop within years after infection as opposed to decades. Trends in high-grade cervical lesions including cervical intraepithelial neoplasia grades 2, 2/3, and 3 and adenocarcinoma in situ among women ages 21 to 39 years old were examined using a statewide surveillance registry in Connecticut from 2008 to 2011. During this time period, HPV vaccine initiation increased among adolescent females from 45% to 61%. Analyses were stratified by age, according to census tract measures of proportion of population Black, Hispanic, living in poverty, and by urban/nonurban counties. The annual rate per 100,000 females ages 21 to 24 years declined from 834 in 2008 to 688 in 2011 (P(trend) < 0.001). No significant declines were observed among women ages 25 to 39 years. Significant declining trends also occurred in census tracts with lower proportions of the population being Black, Hispanic, or living below the federal poverty level. Declines in high-grade cervical lesions have occurred among young women during 2008 to 2011. This is the first report of declines in cervical neoplasia in the United States since HPV vaccines became available. Continued surveillance is needed to measure vaccine impact and monitor health disparities.

  5. Location and Density of Immune Cells in Precursor Lesions and Cervical Cancer.

    PubMed

    Bedoya, Astrid M; Jaramillo, Roberto; Baena, Armando; Castaño, Jorge; Olaya, Natalia; Zea, Arnold H; Herrero, Rolando; Sanchez, Gloria I

    2013-04-01

    Only a small proportion of women infected with Human Papillomavirus (HPV) develop cervical cancer. Host immune response seems to play a role eliminating the viral infection and preventing progression to cancer. Characterization of tumor infiltrating lymphocytes (TILs) in cervical pre-neoplastic lesions and cervical cancer may be helpful to understand the mechanisms that mediate this protection. The aim of this study was to determine if there are differences in the localization and density (cells/mm(2)) of CD8+ T-cells, CD4+ T-cells and Tregs (CD25 + Foxp3+) in cervical pre-neoplastic lesions and cervical cancer. Immunohistochemical analysis of sections of 96 (26 CIN1, 21 CIN2, 25 CIN3, and 24 SCC) samples revealed that regardless of CIN grades, CD8+ T-cells are more abundant than CD4+, CD25+ and Foxp3+ cells in both the stroma and epithelium. There was a higher density of CD8+ cells in the stroma of cervical cancer compared to CIN3 (OR = 4.20, 95% CI 1.2-15), CIN2 (OR = 7.86, 95% CI 1.7-36.4) and CIN1 (OR = 4.25, 95% CI 1.1-17). Studies evaluating whether these cells are recruited before or after cancer progression will be helpful to understand the role of these cells in the natural history of HPV-induced lesions.

  6. Role of Brushing and Occlusal Forces in Non-Carious Cervical Lesions (NCCL)

    PubMed Central

    Sadaf, Durre; Ahmad, Zubair

    2014-01-01

    Objective: To assess the association of occlusal forces and brushing with non-carious cervical lesions (NCCL). Methodology: It was a Cross-sectional study. The study was conducted in Dental clinics, Department of Surgery, The Aga Khan University Hospital Karachi. The study duration was from 1st January 2009 to 28th Feb 2009. Ninety patients visiting dental clinic were examined clinically. Presence of Non- carious cervical lesions, broken restorations, fractured cusps, presence of occlusal facets, brushing habits, Para functional habits were assessed. All the relevant information and clinical examination were collected on a structured Performa and was analyzed using SPSS version 14.0. . Chi square χ2 test was applied to assess association among different categorical variables. Result: Twenty three (26%) females and 67 (74%) males were included in the study. Thirty five of them (38.9%) were found to have Non-carious cervical lesions. Presence of NCCL has no association with gender (P value 0.458). A significant association was found between NCCL and teeth sensitivity (P value 0.002).The association between use of hard tooth brush and Non-carious cervical lesions was found significant (P value <0.001). However the association among Non-carious cervical lesions and fractured cups, broken restoration, teeth grinding, jaw clenching, pan chalia chewing and frequency of teeth brushing were insignificant. Conclusion: Hard tooth brushing and teeth sensitivity have significant association with Non-carious cervical lesions. The role of occlusal wear in the formation of NCCL is not significant. PMID:25598758

  7. Periodontal and Restorative Treatment of Gingival Recession Associated with Non-Carious Cervical Lesions: Case Study.

    PubMed

    Pereira, Analice Giovani; Teixeira, Daniela Navarro Ribeiro; Soares, Michelle Pereira Costa Mundim; Gonzaga, Ramon Corrêa de Queiroz; Fernandes-Neto, Alfredo Júlio; Soares, Paulo Vinícius

    2016-01-14

    The association between the presence of gingival recession and non-carious cervical lesions is a common finding in dentistry. These diseases have multifactorial etiology and the treatment should be multidisciplinary. Although traditionally the majority of professionals treat non-carious cervical lesions only with conventional restorative procedures, in most cases a combination of periodontal and restorative treatments provides the best functional and esthetic results. Thus, the objective of this case report was to present a new option for treatment, which consists of a subepithelial connective tissue graft associated with a coronally advanced flap placed on dentin and non-carious cervical lesions restored with lithium disilicate partial veneers. A patient complaining about the esthetic aspects of her teeth and cervical dentin hypersensitivity was submitted to occlusal adjustments and daily diet analysis in order to manage etiologic factors. Experienced operators then performed restorative and surgical treatments. Periodontal clinical attachment level (probing depth + gingival margin), bleeding on probing, plaque index, and the integrity of the restorations were observed. During the monitoring period, the treatment was effective, with good functional and esthetic results. The hypersensitivity disappeared, and neither inflammatory characteristics in gingival tissue nor failures in restorations were noted. It might be concluded that treatment with a combination of techniques can be effective and predictable for patients with gingival recession and non-carious cervical lesions that may or may not require restorative procedures under controlled conditions. Copyright© by the International Academy of Periodontology.

  8. Confocal fluorescence microscopy for detection of cervical preneoplastic lesions

    NASA Astrophysics Data System (ADS)

    Sheikhzadeh, Fahime; Ward, Rabab K.; Carraro, Anita; Chen, Zhaoyang; van Niekerk, Dirk; MacAulay, Calum; Follen, Michele; Lane, Pierre; Guillaud, Martial

    2015-03-01

    We examined and established the potential of ex-vivo confocal fluorescence microscopy for differentiating between normal cervical tissue, low grade Cervical Intraepithelial Neoplasia (CIN1), and high grade CIN (CIN2 and CIN3). Our objectives were to i) use Quantitative Tissue Phenotype (QTP) analysis to quantify nuclear and cellular morphology and tissue architecture in confocal microscopic images of fresh cervical biopsies and ii) determine the accuracy of high grade CIN detection via confocal microscopy. Cervical biopsy specimens of colposcopically normal and abnormal tissues obtained from 15 patients were evaluated by confocal fluorescence microscopy. Confocal images were analyzed and about 200 morphological and architectural features were calculated at the nuclear, cellular, and tissue level. For the purpose of this study, we used four features to delineate disease grade including nuclear size, cell density, estimated nuclear-cytoplasmic (ENC) ratio, and the average of three nearest Delaunay neighbors distance (3NDND). Our preliminary results showed ENC ratio and 3NDND correlated well with histopathological diagnosis. The Spearman correlation coefficient between each of these two features and the histopathological diagnosis was higher than the correlation coefficient between colposcopic appearance and histopathological diagnosis. Sensitivity and specificity of ENC ratio for detecting high grade CIN were both equal to 100%. QTP analysis of fluorescence confocal images shows the potential to discriminate high grade CIN from low grade CIN and normal tissues. This approach could be used to help clinicians identify HGSILs in clinical settings.

  9. The association of lymph node volume with cervical metastatic lesions in head and neck cancer patients.

    PubMed

    Liang, Ming-Tai; Chen, Clayton Chi-Chang; Wang, Ching-Ping; Wang, Chen-Chi; Lin, Whe-Dar; Liu, Shih-An

    2009-06-01

    The aim of this study was to determine if volume of cervical lymph node measured via computed tomography (CT) could differentiate metastatic from benign lesions in head and neck cancer patients. We conducted a retrospective review of chart and images in a tertiary referring center in Taiwan. Patients with head and neck cancers underwent radical, modified radical or functional neck dissection were enrolled. The CT images before operation were reassessed by a radiologist and were compared with the results of pathological examination. A total of 102 patients were included for final analyses. Most patients were male (n = 96, 94%) and average age was 50.1 years. Although the average nodal volume in patients with cervical metastases was higher than those of patients without cervical metastases, it was not an independent factor associated with cervical metastasis after controlling for other variables; however, central nodal necrosis on enhanced CT image [odds ratio (OR) 18.95, P = 0.008) and minimal axial diameter >7.5 mm (OR 6.868, P = 0.001) were independent factors correlated with cervical metastasis. Therefore, the volume of cervical lymph node measured from CT images cannot predict cervical metastases in head and neck cancer patients. Measurement of minimal axial diameter of the largest lymph node is a simple and more accurate way to predict cervical metastasis instead.

  10. Prevalence of cervical neoplastic lesions and Human Papilloma Virus infection in Egypt: National Cervical Cancer Screening Project.

    PubMed

    el-All, Howayda S Abd; Refaat, Amany; Dandash, Khadiga

    2007-07-04

    Data from Egyptian studies provide widely varying estimates on the prevalence of pre-malignant and malignant cervical abnormalities and human papilloma virus (HPVs) infection. To define the prevalence and risk factors of pre-invasive and invasive cervical cancer (cacx), a community based full-scale cross sectional, household survey including 5453 women aged between 35 and 60 years was conducted. The study period was between February 2000 and December 2002. Initially, conventional Papanicolaou (Pap) smears were evaluated using the Bethesda system (TBS), followed by colposcopic guided biopsy (CGB) for all epithelial abnormalities (EA). In a third step, HPV was tested on all EA by in-situ hybridization (ISH) using first the broad spectrum HPV probe recognizing HPVs 6, 11, 16, 18, 30, 31, 35, 45, 51 and 52 followed by subtyping with probes 6/11, 16/18 and 31/33. Lastly, unequivocal cases were immunostained for herpes simplex type-2 (HSV-2), cytomegalovirus (CMV), and human immunodeficiency virus (HIV). EA representing 7.8% (424/5453), were categorized into atypical squamous cell of undetermined significance (ASCUS) (34.4%), atypical glandular cell of undetermined significance (AGCUS) (15.3%), combined ASCUS and AGCUS (3.1%), low grade squamous intraepithelial lesions (SIL) (41.0%), high grade SIL (5.2%) and invasive lesions (1%). CGB of EA (n = 281) showed non neoplastic lesions (12.8%), atypical squamous metaplasia (ASM) (19.2%), cervical intraepithelial neoplasia I (CIN) (44.4%), CIN II (4.4%), CINIII (2.8%), endocervical lesions (5.2%), combined squamous and endocervical lesions (10.0%), invasive squamous cell carcinoma (SCC) (0.02%) and extranodal marginal zone B cell lymphoma (MZBCL) (0.02%). The overall predictive value of cytology was 87% while the predictive value for high grade lesions was 80%. On histological basis, HPVs were present in 94.3% of squamous lesions while it was difficult to be identified in endocervical ones. ISH revealed positivity for pan HPV

  11. Evaluation of a new tampon device for cytologic autocollection and mass screening of cervical cancer and its precursors.

    PubMed

    Bernstein, A; Vitner, S; Webber, J M

    1985-02-01

    A new autocollection tampon device for obtaining material for cervical cytologic testing was compared with cervical scraping and endocervical aspiration in order to evaluate the cytodiagnostic results. In 1428 cases there proved to be a 94% correlation between these methods. In addition, both smears were compared in a group of patients known to have neoplastic disease of the cervix. In evaluating cervical cancer both techniques detected 100% of the cases. However, the smears, both regular and tampon, were able to diagnose only 96.5% and 89% of grade 3 lesions and 86% and 81% of grades 1 and 2 lesions, respectively. False negative results occurred in 8.2% of the regular smears and 15% of the tampon smear group. These preliminary data, if confirmed by more broad and in-depth studies, suggest the new autocollection tampon may be a useful tool for mass cervical screening.

  12. Prevalence and risk factors for cervical cancer and pre-cancerous lesions in Rwanda.

    PubMed

    Makuza, Jean Damascène; Nsanzimana, Sabin; Muhimpundu, Marie Aimee; Pace, Lydia Eleanor; Ntaganira, Joseph; Riedel, David James

    2015-01-01

    Cervical cancer prevalence in Rwanda has not been well-described. Visual inspection with acetic acid or Lugol solution has been shown to be effective for cervical cancer screening in low resource settings. The aim of the study is to understand the prevalence and risk factors for cervical cancer and pre- cancerous lesions among Rwandan women between 30 and 50 old undergoing screening. This cross-sectional analytical study was done in 3 districts of Rwanda from October 2010 to June 2013. Women aged 30 to 50 years screened for cervical cancer by trained doctors, nurses and midwives. Prevalence of pre-cancerous and cancerous cervical lesions was determined. Bivariate and multivariate logistic regressions were used to assess risk factors associated with cervical cancer. The prevalence of pre-cancer and invasive cervical cancer was 5.9% (95% CI 4.5, 7.5) and 1.7% (95% CI 0.9, 2.5), respectively. Risk factors associated with cervical cancer in multivariate analysis included initiation of sexual activity at less than 20 years (OR=1.75; 95% CI=(1.01, 3.03); being unmarried (single, divorced and widowed) (OR=3.29; 95% CI=( 1.26, 8.60)); Older age of participants (OR= 0.52; 95% CI= (0.28, 0.97)), older age at the first pregnancy (OR=2.10; 95% CI=(1.20, 3.67) and higher number of children born (OR=0.42; 95%CI =(0.23, 0.76)) were protective. Cervical cancer continues to be a public health problem in Rwanda, but screening using VIA is practical and feasible even in rural settings.

  13. Prevalence and risk factors for cervical cancer and pre-cancerous lesions in Rwanda

    PubMed Central

    Makuza, Jean Damascène; Nsanzimana, Sabin; Muhimpundu, Marie Aimee; Pace, Lydia Eleanor; Ntaganira, Joseph; Riedel, David James

    2015-01-01

    Introduction Cervical cancer prevalence in Rwanda has not been well-described. Visual inspection with acetic acid or Lugol solution has been shown to be effective for cervical cancer screening in low resource settings. The aim of the study is to understand the prevalence and risk factors for cervical cancer and pre- cancerous lesions among Rwandan women between 30 and 50 old undergoing screening. Methods This cross-sectional analytical study was done in 3 districts of Rwanda from October 2010 to June 2013. Women aged 30 to 50 years screened for cervical cancer by trained doctors, nurses and midwives. Prevalence of pre-cancerous and cancerous cervical lesions was determined. Bivariate and multivariate logistic regressions were used to assess risk factors associated with cervical cancer. Results The prevalence of pre-cancer and invasive cervical cancer was 5.9% (95% CI 4.5, 7.5) and 1.7% (95% CI 0.9, 2.5), respectively. Risk factors associated with cervical cancer in multivariate analysis included initiation of sexual activity at less than 20 years (OR=1.75; 95% CI=(1.01, 3.03); being unmarried (single, divorced and widowed) (OR=3.29; 95% CI=( 1.26, 8.60)); Older age of participants (OR= 0.52; 95% CI= (0.28, 0.97)), older age at the first pregnancy (OR=2.10; 95% CI=(1.20, 3.67) and higher number of children born (OR=0.42; 95%CI =(0.23, 0.76)) were protective. Conclusion Cervical cancer continues to be a public health problem in Rwanda, but screening using VIA is practical and feasible even in rural settings. PMID:26664527

  14. Effect of biological agents on cervical spine lesions in rheumatoid arthritis.

    PubMed

    Kaito, Takashi; Hosono, Noboru; Ohshima, Shirou; Ohwaki, Hajime; Takenaka, Shota; Fujiwara, Hiroyasu; Makino, Takahiro; Yonenobu, Kazuo

    2012-09-15

    A retrospective cohort analysis. To determine the effect of biological agents (BAs) on the development and progression of cervical spine lesions and identify predictors of lesion progression. The introduction of BAs has facilitated advances in the treatment of rheumatoid arthritis (RA). BAs reduce disease activity and limit structural joint damage. However, the effect of BAs on cervical spine lesions remains unclear. Thirty-eight subjects who received more than 2 years of continuous BA treatment were enrolled. The mean x-ray interval was 4.4 years. RA activity was evaluated by disease activity score (DAS)-C reactive protein (CRP) and matrix metalloproteinase (MMP)-3. Radiographical definitions of cervical lesions were atlanto-dental interval (ADI) more than 3 mm for atlanto-axial subluxation (AAS), Ranawat value less than 13 mm for vertical subluxation (VS), and anterior or posterior listhesis more than 2 mm for subaxial subluxation (SS). Definitions of radiographical progression were an increase of ADI more than 2 mm for AAS, a decrease of both Ranawat and Redlund-Johnell values more than 2 mm for VS, and an increase of listhesis more than 2 mm for SS. RA activity responded dramatically to BA therapy (DAS-CRP from 4.3 to 2.3, P < 0.01; MMP-3 from 207.9 ng/mL to 105.6 ng/mL, P < 0.01). Baseline radiographical evaluation showed no pre-existing cervical spine lesions in 12 cases, AAS in 15 cases, and VS in 11 cases. Radiological progression was found in 1 (8%) patient in the no lesion group, 12 patients (80%) in the AAS group, and 9 patients (80%) in the VS group. The incidence of progression was significantly lower in the no lesion group compared with the other groups. Multivariate regression analysis showed that the presence of pre-existing cervical lesions was the single greatest predictor of progression. BAs prevented the development of de novo cervical spine lesions in patients with RA, but failed to inhibit progression of pre-existing RA lesions.

  15. Cervical Strip Biopsy for High-Grade Cervical Intraepithelial Lesions: a Valid Alternative to Conventional Punch Technique.

    PubMed

    Schneider, A; Wagner, K; Rakozy, C; Stolte, C; Bothur-Schäfer, P; Welcker, T; Choly, N; Roesgen, A; Rothe, H; Böhmer, G

    2015-10-01

    Introduction: To evaluate, if targeted strip biopsies decrease trauma/pain perception while maintaining diagnostic accuracy in patients with the diagnosis of high-grade squamous intraepithelial lesions of the uterine cervix. Patients and Methods: Between July 1st and December 31st 2014 we performed colposcopically directed strip biopsies in 102 patients with colposcopic suspicion of high-grade squamous intraepithelial lesions of the uterine cervix. We used a 3 mm curette for harvesting tissue samples under VITOM® videocolposcopy. So far, 60 patients underwent additional loop excision. Histologic examination of strip biopsies and loop specimens included routine hematoxylin and eosin staining as well as immunohistochemical staining for p16, Ki 67 and stathmin-1. Results: 55 patients (53 %), were histologically diagnosed with cervical intraepithelial neoplasia grade 3 on strip biopsies. Adenocarcinoma in situ was diagnosed in 2 patients (2 %), cervical intraepithelial neoplasia grade 2 in 35 patients (34 %), and cervical intraepithelial neoplasia grade 1 in 10 patients (10 %). The agreement between histologic results of strip biopsy and loop specimen was highly significant: In all 60 strip biopsies diagnosed with high-grade squamous intraepithelial lesions this diagnosis was confirmed histologically during follow-up loop specimen excision (high-grade squamous intraepithelial lesions in 58 patients, invasive disease in 2 patients). The pain level experienced during strip biopsy was rated on average 0.25 on a scale from 0 to 10. No clinically significant bleeding was reported. Conclusion: Targeted strip biopsies with a 3 mm curette are a reliable procedure to diagnose high-grade squamous intraepithelial lesions of the uterine cervix and yield high patient satisfaction (Video 1).

  16. Restorative material and loading type influence on the biomechanical behavior of wedge shaped cervical lesions.

    PubMed

    Pereira, Fabrícia Araújo; Zeola, Livia Fávaro; de Almeida Milito, Giovana; Reis, Bruno Rodrigues; Pereira, Rodrigo Dantas; Soares, Paulo Vinícius

    2016-04-01

    To evaluate the influence of restorative materials used on the rehabilitation of MOD cavities and loading type, on biomechanical behavior of wedge-shaped (WS) lesions in endodontically treated maxillary premolars. The investigation was conducted by 3D finite element analysis (FEA) and strain gauge test. Six models were generated, with MOD cavities and endodontic treatment: A (MOD amalgam restoration), R (MOD composite restoration), AL (A + cervical lesion (L)), RL, ALR (A + cervical lesion restored with composite (LR)), and RLR. Each model underwent two compressive loading (100N): axial and oblique-45° angle to the long axis on the buccal cusp. The models were analyzed by von Mises criteria. For strain gauge test, 14 standardized maxillary premolars were treated according to the groups described for FEA. Two strain gauges were bonded on each sample submitted to compressive loading in a mechanical testing machine. A presented higher stress concentration and strain values than R. Oblique loading promoted highest stress concentration and strain rates for all groups. ALR and RLR presented similar stress-strain distribution pattern when compared to A and R. The interaction between MOD cavity restored with amalgam and oblique loading propitiated the highest stress concentration and strain values on cervical region and WS lesion. The MOD cavity restored with composite resin is a better option than amalgam to improve the biomechanical behavior of wedge-shaped lesion, avoiding dental failure. In addition, the occlusal interferences must be removed, allowing homogeneous contact distribution and preventing WS lesion progression.

  17. Detection of HPV-induced cervical (pre) neoplastic lesions: a tissue microarray (TMA) study.

    PubMed

    Arafa, Mohammad; Boniver, Jacques; Delvenne, Philippe

    2008-10-01

    The aim of this study was to evaluate the usefulness of a panel of biomarkers in the characterization of human papillomavirus (HPV)-induced cervical lesions. Management of these lesions depends on their histologic confirmation. Misinterpretation especially for benign mimics results in a significant diagnostic disagreement. For these reasons, a continuous effort is still needed to discover surrogate markers, which could support the final diagnosis. Archival biopsies of normal ectocervical and endocervical tissues, squamous metaplasia, cervical intraepithelial neoplasia (CIN), squamous cell carcinoma, adenocarcinoma in situ, and adenocarcinoma were retrieved to perform a tissue microarray (TMA). A panel of markers was tested on the TMA obtained slides by in situ hybridization (HPV DNA) and immunohistochemistry (p16, involucrin, Ki-67, and HPV L1 proteins). The sensitivity to detect high-risk HPV DNA increased with lesion's severity. In situ hybridization signals suggesting integrated viral physical status predominated in CIN II/III, squamous cell carcinoma, and glandular (pre) neoplastic lesions. The p16 and Ki-67 protein expression increased from CIN I to CIN III and to infiltrative lesions. Involucrin positivity was better appreciated in well-differentiated diagnostic entities (ectocervix, mature metaplasia, and CIN I). HPV L1 antibody detected the viral capsid protein in a low proportion of CIN I and II. In conclusion, using a panel of cervical biomarkers improves the final reporting of various HPV-induced epithelial lesions. Carefully constructed TMA with single spots of 1-mm diameter are powerful tools, which have a high reliability in representing full tissue sections.

  18. Management of precancerous cervical lesions in iran: a cost minimizing study.

    PubMed

    Nahvijou, Azin; Sari, Ali Akbari; Zendehdel, Kazem; Marnani, Ahmad Barati

    2014-01-01

    Cervical cancer is a common, preventable and manageable disease in women worldwide. This study was conducted to determine the cost of follow-up for suspicious precancerous cervical lesions within a screening program using Pap smear or HPV DNA test through the decision tree. Patient follow-up processes were determined using standard guidelines and consultation with specialists to design a decision tree model. Costs of treatment in both public and private sectors were identified according to the national tariffs in 2010 and determined based on decision tree and provided services (visits to specialists, colposcopy, and conization) with two modalities: Pap smear and HPV DNA test. The number of patients and the mean cost of treatment in each sector were calculated. The prevalence of lesions and HPV were obtained from literature to estimate the cost of treatment for each woman in the population. Follow-up costs were determined using seven processes for Pap smear and 11 processes for HPV DNA test. The total cost of using Pap smear and HPV DNA process for each woman in the population was 36.1$ and 174 $ respectively. The follow-up process for patients with suspicious cervical lesions needs to be included in the existing screening program. HPV DNA test is currently more expensive than Pap smear, it is suggested that we manage precancerous cervical lesions with this latter test.

  19. Surgical resection of neoplastic cervical spine lesions in relation to the vertebral artery V2 segment

    PubMed Central

    Al Barbarawi, Mohamed; Odat, Ziad; Alheis, Mwaffaq; Qudsieh, Suhair; Qudsieh, Tareq

    2010-01-01

    Neoplastic cervical spine lesions are seen infrequently by the spinal surgeon. The surgical management of these tumors, particularly with associated neurovascular compromise, is challenging in terms of achieving proper resection and spinal stabilization and ensuring no subsequent recurrence or failure of fixation. In this report we highlight some of the problems encountered in the surgical management of tumors involving the cervical spine with techniques applied for gross total resection of the tumor without compromising the vertebral arteries. Ten patients with neoplastic cervical spine lesions were managed in our study. The common cardinal presentation was neck and arm pain with progressive cervical radiculo-myelopathy. All patients had plain X-rays, computer tomography scans, and magnetic resonance imaging of the cervical spine. Digital subtraction or magnetic resonance angiograms were performed on both vertebral arteries when the pathology was found to be in proximity to the vertebral artery. When a tumor blush with feeders was evident, endovascular embolization to minimize intraoperative bleeding was also considered. A single approach or a combined anterior cervical approach for corpectomy and cage-with-plate fixation and posterior decompression for resection of the rest of the tumor with spinal fixation was then accomplished as indicated. All cases made a good neurological recovery and had no neural or vascular complications. On the long-term follow-up of the survivors there was no local recurrence or surgical failure. Only three patients died: two from the primary malignancy and one from pulmonary embolism. This report documents a safe and reliable way to deal with neoplastic cervical spine lesions in proximity to vertebral arteries with preservation of both arteries. PMID:21577335

  20. [Natural history of precursor lesions of cervical cancer].

    PubMed

    Tranbaloc, P

    2008-06-01

    Precursor lesions of invasive cancer of uterine cervix begin at the squamocolumnar junction. On this zone in permanent transformation, human papillomavirus (HPV) gives condylomatous lesions, pure or associated with neoplasic transformation of the epithelium. For 50 years, various histological classifications have been proposed. First, four groups have been designed: light, moderate, severe dysplasia and in situ carcinoma. Secondly, Richart proposed the cervix intraepithelial neoplasia classification (CIN) with three grades (1 to 3) according to their severity. Progression from CIN 1 to CIN 3 and invasive carcinoma is admitted and is consistent with the concept of lesional continuum. However, because of the elevated rate of spontaneous regression of CIN 1, it is probably a lesion of very low potential aggressivity and its role as a precursor is uncertain. Now two groups of different evolutivity are currently considered: low grade and high grade lesions. The last one's, at the opposite of the first, are monoclonal, have major epithelial abnormalities with sometimes abnormal mitoses and are frequently aneuploid. Aggressivity depends on the persistence of HR HPV more than on progressive morphologic transformation. By integrating in-host genoma, it induces modifications on cellular cycle proteins. Revelation by immunohistochemistry brings help to diagnosis of high grade lesions when traditional morphology is ambiguous.

  1. Association between colposcopic findings and histology in cervical lesions: the significance of the size of the lesion.

    PubMed

    Kierkegaard, O; Byralsen, C; Hansen, K C; Frandsen, K H; Frydenberg, M

    1995-04-01

    The relation between eight specific colposcopic diagnostic findings and the histologic grade of a cervical lesion in 896 women was evaluated. The size of the transformation zone (TZ), the size of the lesion, the intensity of the color tone, distinct margins, the pathology of the vessels, and the presence of micropapillae as single findings were highly statistically correlated to the histologic grade (P < 0.0001). By logistic regression analysis the risk for a higher histologic grade when assessed by colposcopy was greatest in women with variation of the acetowhite color (odds ratio (OR) = 16.0; 95% CI, 10.0-26.0) followed by coarse vessels (OR = 10.0; CI, 3.2-34.0). Lesion-size larger than 50% of the visible cervix had an OR of 3.6 (CI, 2.1-6.3). Extention beyond TZ had an OR of 0.4 (CI, 0.2-0.4) and larger TZ had an OR of 0.5 (CI, 0.3-0.9). In conclusion we found that the size of the cervical lesion had some independent predictive value and should be considered in future trials.

  2. A combined approach to non-carious cervical lesions associated with gingival recession

    PubMed Central

    Lee, HyeJin; Jin, Sung-Ho

    2016-01-01

    Non-carious cervical lesions (NCCLs) with gingival recession require specific consideration on both aspects of hard and soft tissue lesion. In the restorative aspect, careful finishing and polishing of the restorations prior to mucogingival surgery is the critical factor contributing to success. Regarding surgery, assessment of the configuration of the lesion and the choice of surgical technique are important factors. The precise diagnosis and the choice of the proper treatment procedure should be made on the basis of both restorative and surgical considerations to ensure the successful treatment of NCCLs. PMID:27508164

  3. Transoral robotic-assisted surgery for the approach to anterior cervical spine lesions.

    PubMed

    Molteni, Gabriele; Greco, Marco Giuseppe; Presutti, Livio

    2017-09-01

    The Da Vinci robotic surgical system is increasingly being used by head and neck surgeons in transoral approaches for head and neck cancer. Our experience using the Da Vinci system for transoral robotic-assisted surgery (TORS) is presented. The feasibility of TORS for lesions involving the anterior portion of C1-C2 and the cranio-cervical junction has been evaluated from an anatomical viewpoint in a cadaveric laboratory. Two patients treated using the Da Vinci system to reach C1-C2 benign lesions are presented. The anatomical cadaveric study showed that this approach is safe and feasible. The first two cases which we describe confirmed the advantages of the Da Vinci system in the anterior approach to the cervical spine and allowed the limitations of this procedure to be assessed. TORS may be useful to reach anterior lesions of the cervical spine localized at the level of C1 and C2: first, for removal of small benign and well-delineated lesions; and second, for diagnostic purposes with biopsy of large lesions. Further studies and new instruments are needed to confirm the safety and results of this approach in terms of morbidity.

  4. [Prevalence and etiologic factors of non-carious cervical lesions. A study in a Senegalese population].

    PubMed

    Faye, B; Sarr, M; Kane, A W; Toure, B; Leye, F; Gaye, F; Dieng, M B

    2005-12-01

    The non carious cervical lesion (NCCL) is a loss of tooth tissue at the neck of affected teeth that is unrelated to tooth decay. They are commonly encountered in clinical practice and present in a variety of forms. The purpose of this paper is to determine the prevalence of the NCCL in a Senegalese population. From 655 patients, 112 with cervical lesions were identified i.e. a global prevalence of 17.10%. The prevalence rate for abrasion was reported to be 77.70%, 12.50% for abfraction and 9.80% for erosion. Etiological factors were studied for abrasion and erosion. 54% of the patients with abrasion used their toothbrush horizontally. For erosion, only external factors were identified: consumption of acidic drinks (9 patients) or alcohol (1 patient) and professional environment (1 patient). Dentists should consider these lesions in their daily practice.

  5. [Diagnostic value of multiply biopsies and endocervical curettage on cervical lesions].

    PubMed

    Zhang, Ling; Du, Hui; Zhang, Wei; Yang, Bin; Wang, Chun; Belinson, Jerome L; Wu, Ruifang

    2015-04-01

    To investigate the value of multiply biopsies and endocervical curettage (ECC) on diagnosing cervical lesions. For the detection of cervical lesions, Shenzhen cervical cancer screening trial II (SHENCCAST II) program combined methods of HPV screening with liquid-based cytology (LBC), any positive indicators was then performed multiply biopsies and ECC under colopscopy. A total of 2,558 clear colposcopic images and pathological diagnoses were reviewed. To analyse the pathological results and primary screening results of the negative colopscopic images for discussing the value of multiply biopsies and ECC. Overall 2,558 women's colposcopic images and sampling results were completed and validated. 69.98% (1,790/2,558) women had normal colposcopy appearances. Among them, 2.23% (40/1,790) were diagnosed as cervical intraepithelial neoplasia II or worse (CIN II+). The odds ratio of high-grade squamous intraepithelial lesion (HSIL) was 28.37 (P=0.000) and atypical squamous cell cannot exclude HSIL (ASC-H) was 15.07 (P=0.001). HPV types 16, 52, 58, 31, 33 and 18 were related to high-grade cervical lesion with the odds ratio of 3.11 (P=0.017). Hybrid capture II (HC-II) DNA test results shown that women with HPV positive were 3.58 times more risky than those of HPV negative, which was related to high-grade cervical lesion (P=0.025). Among the 2,558 women, CIN II+ detective rate from ECC were 40.7% (44/108) in older group (≥40 years) were higher than that of 19.2% (24/125) in younger group (<40 years; χ2=13.01, P=0.000). CIN II+ detective rate from multiply biopsies were 90.7% (98/108) in older group (≥40 years) were higher than that of 88.8% (111/125) in younger group (<40 years; χ2=0.24, P>0.05). The highest risky items of detecting CIN II+ were as follows: (1) HSIL or ASC-H; (2) HPV types 16, 18, 52 and 58 positive (either one); (3) HC-II HPV positive, at least 2 of the 3 items were included among 32 cases of the 40 CIN II+ with normal colposcopy appearances. The

  6. Methylenetetrahydrofolate reductase (MTHFR) polymorphisms and susceptibility for cervical lesions: a meta-analysis.

    PubMed

    Long, Shuyu; Yang, Xingliang; Liu, Xiaojiao; Yang, Pei

    2012-01-01

    The association between the methylenetetrahydrofolate reductase (MTHFR) C677T/A1298C polymorphisms and the susceptibility to cervical lesions was unclear. This study was designed to investigate their precise association using a large-scale meta-analysis. The previous 16 studies were identified by searching PubMed, Embase and CBM databases. The crude odds ratios and their corresponding 95% confidence intervals (CIs) were used to estimate the association between the MTHFR C677T/A1298C polymorphisms and the susceptibility to the cervical lesions. The subgroup analyses were made on the following: pathological history, geographic region, ethnicity, source of controls and source of DNA for genotyping. Neither of the polymorphisms had a significant association with the susceptibility to the cervical lesions in all genetic models. Similar results were found in the subgroup analyses. No association was found between the MTHFR C677T polymorphism and the cervical lesions in the Asia or the America populations though a significant inverse association was found in the Europe population (additive model: P = 0.006, OR = 0.83, 95% CI = 0.72-0.95; CT vs. CC: P = 0.05, OR = 0.83, 95% CI = 0.69-1.00; TT vs. CC: P = 0.05, OR = 0.73, 95% CI = 0.53-1.00). Interestingly, women with the MTHFR A1298C polymorphisms had a marginally increased susceptibility to invasive cancer (ICC) when compared with no carriers but no statistically significant difference in the dominant model (P = 0.06, OR = 1.21, 95% CI = 0.99-1.49) and AC vs. AA (P = 0.09, OR = 1.21, 95% CI = 0.97-1.51). The MTHFR C677T and A1298C polymorphisms may not increase the susceptibility to cervical lesions. However, the meta-analysis reveals a negative association between the MTHFR C677T polymorphisms and the cervical lesions, especially in the European populations. The marginal association between the MTHFR A1298C polymorphisms and the susceptibility to cervical cancer requires a further study.

  7. Methylenetetrahydrofolate Reductase (MTHFR) Polymorphisms and Susceptibility for Cervical Lesions: A Meta-Analysis

    PubMed Central

    Liu, Xiaojiao; Yang, Pei

    2012-01-01

    Background The association between the methylenetetrahydrofolate reductase (MTHFR) C677T/A1298C polymorphisms and the susceptibility to cervical lesions was unclear. This study was designed to investigate their precise association using a large-scale meta-analysis. Methods The previous 16 studies were identified by searching PubMed, Embase and CBM databases. The crude odds ratios and their corresponding 95% confidence intervals (CIs) were used to estimate the association between the MTHFR C677T/A1298C polymorphisms and the susceptibility to the cervical lesions. The subgroup analyses were made on the following: pathological history, geographic region, ethnicity, source of controls and source of DNA for genotyping. Results Neither of the polymorphisms had a significant association with the susceptibility to the cervical lesions in all genetic models. Similar results were found in the subgroup analyses. No association was found between the MTHFR C677T polymorphism and the cervical lesions in the Asia or the America populations though a significant inverse association was found in the Europe population (additive model: P = 0.006, OR = 0.83, 95% CI = 0.72–0.95; CT vs. CC: P = 0.05, OR = 0.83, 95% CI = 0.69–1.00; TT vs. CC: P = 0.05, OR = 0.73, 95% CI = 0.53–1.00). Interestingly, women with the MTHFR A1298C polymorphisms had a marginally increased susceptibility to invasive cancer (ICC) when compared with no carriers but no statistically significant difference in the dominant model (P = 0.06, OR = 1.21, 95% CI = 0.99–1.49) and AC vs. AA (P = 0.09, OR = 1.21, 95% CI = 0.97–1.51). Conclusions The MTHFR C677T and A1298C polymorphisms may not increase the susceptibility to cervical lesions. However, the meta-analysis reveals a negative association between the MTHFR C677T polymorphisms and the cervical lesions, especially in the European populations. The marginal association between the MTHFR A1298C

  8. CEACAM1 in Cervical Cancer and Precursor Lesions: Association With Human Papillomavirus Infection

    PubMed Central

    Albarran-Somoza, Benibelks; Franco-Topete, Ramon; Delgado-Rizo, Vidal; Cerda-Camacho, Felipe; Acosta-Jimenez, Lourdes; Lopez-Botet, Miguel; Daneri-Navarro, Adrian

    2006-01-01

    Carcinoembryonic antigen-related cell adhesion molecule 1 (CEACAM1) is an adhesion molecule expressed in a wide variety of tissues including epithelial cells, leukocytes, and tumors that may establish both homotypic and heterotypic interactions. The aim of this work was to study the protein expression pattern of CEACAM1 in cervical cancer and precursor lesions in the context of human papillomavirus (HPV) infection. We used immunohistochemistry to analyze CEACAM1 expression in formalin-fixed, paraffin-embedded cervical tissues from 15 healthy women, 15 patients with low-grade squamous intraepithelial lesions (SIL), 15 patients with high-grade SIL, and 15 patients with squamous carcinomas. HPV types were identified by PCR. CEACAM1 was either undetectable (13/15) or low (2/15) in normal cervical tissues. By contrast, CEACAM1 expression was increased in high-grade SIL (10 samples staining intermediate/high and 4 samples staining low) as compared with low-grade SIL with undetectable (n=3) or low (n= 12) expression. CEACAM1 expression was undetectable or low in cervical carcinoma. Our results suggest that CEACAM1 may be an interesting progression marker in SIL and cervical cancer, in particular due to reported immunoregulatory properties. PMID:16924126

  9. HPV-16 infection and cervical cancer: modeling the influence of duration of infection and precancerous lesions.

    PubMed

    Baussano, Iacopo; Ronco, Guglielmo; Segnan, Nereo; French, Katherine; Vineis, Paolo; Garnett, Geoff P

    2010-03-01

    The patterns of transmission, clearance, and progression of HPV infection and the related precancerous lesions are key to accurately model cervical cancer epidemiology and prevention. We have developed an age-structured dynamic model of the transmission of HPV-16 infection. This mathematical model accounts, for the first time, for the effect of infection and precancerous lesions duration on the natural history of HPV-16 infection and precancerous lesions. The model's output has been fitted to contemporaneous sets of data from Turin, Italy, to estimate parameters that have had been indirectly tested by comparing them with other estimates reported in the literature. The average probability of HPV-16 infection transmission per sexual partnership was about 40%. The HPV-16 clearance and progression rates decreased as the length of time with infection increased, clearance ranging between 1.6 per woman-year (in the first 6 months of infection) and 0.036 (after more than 6 years of infection), and progression between 0.072 and 0.018 per woman-year. The rate of clearance of precancerous lesions (CIN2+) was inversely dependent on age, while the progression of CIN2+ toward invasive cervical cancer increased as the precancerous lesions persisted. The present study also suggests that an exclusive role of women's age in shaping the rate of progression to cancer is unlikely. These results should inform future analyses. Including more accurately the role of the duration of infection and precancerous lesions as determinants of the cervical cancer occurrence in models of cervical cancer control may influence predictors of the effectiveness of intervention strategies.

  10. Expression of the p16 and Ki67 in Cervical Squamous Intraepithelial Lesions and Cancer.

    PubMed

    Kanthiya, Kanjana; Khunnarong, Jakkapan; Tangjitgamol, Siriwan; Puripat, Napaporn; Tanvanich, Sujitra

    2016-01-01

    To evaluate the expression of p16 and Ki67 in cervical intraepithelial neoplasia (CIN) and cancer. We performed a immunohistochemical study of p16 and Ki67 in 243 cervical tissues 53 nondysplastic lesions, 106 CIN1, 61 CIN2/3 and 23 squamous cell carcinomas. The expression of p16 and Ki67 was interpreted independently by 2 researchers and the sensitivity and specificity to detect clinically significant lesions (≥ CIN2) were determined. The overall agreement results of positive or negative immunostaining of intrainter observer variability were 0.659 for p16 and 0.808 for Ki67. p16 expression was demonstrated in 91.3% of invasive carcinomas, 78.7% of CIN2/3, 10.4% of CIN1 and 9.4% of nondysplasic lesions. The corresponding Ki67 expression was: 100% of all invasive carcinomas, 75.4% of CIN2/3, 22.6% of CIN1, and 11.3% with nondysplasia. The expression was significantly different between CIN2/3 vs CIN1 for both p16 and Ki67 (pvalues <0.001 both), and cancer vs CIN2/3 for Ki67 (pvalue 0.008). The differences were not significant between CIN1 vs nondysplasia (pvalues 1.000 for p16 and 0.130 of Ki67), and cancer vs CIN2/3 for p16 (p value 0.219). The sensitivity and specificity to detect > CIN2 were 84.5% and 90.5% by p16 and 82.1% and 88.6% by Ki67. The rates for 16 and Ki67 expression were directly associated with the severity of cervical lesions. Significant differences in these markers expression may be useful in cases with equivocal histologic features among cervical intraepithelial lesions, but not between CIN1 and nondysplastic lesions. The two markers had high sensitivity and specificity in determining >CIN2.

  11. Prevalence and Distribution of Ossified Lesions in the Whole Spine of Patients with Cervical Ossification of the Posterior Longitudinal Ligament A Multicenter Study (JOSL CT study)

    PubMed Central

    Hirai, Takashi; Yoshii, Toshitaka; Iwanami, Akio; Takeuchi, Kazuhiro; Mori, Kanji; Yamada, Tsuyoshi; Wada, Kanichiro; Koda, Masao; Matsuyama, Yukihiro; Takeshita, Katsushi; Abematsu, Masahiko; Haro, Hirotaka; Watanabe, Masahiko; Watanabe, Kei; Ozawa, Hiroshi; Kanno, Haruo; Imagama, Shiro; Fujibayashi, Shunsuke; Yamazaki, Masashi; Matsumoto, Morio; Nakamura, Masaya; Okawa, Atsushi; Kawaguchi, Yoshiharu

    2016-01-01

    Ossification of the posterior longitudinal ligament (OPLL) can cause severe and irreversible paralysis in not only the cervical spine but also the thoracolumbar spine. To date, however, the prevalence and distribution of OPLL in the whole spine has not been precisely evaluated in patients with cervical OPLL. Therefore, we conducted a multi-center study to comprehensively evaluate the prevalence and distribution of OPLL using multi-detector computed tomography (CT) images in the whole spine and to analyze what factors predict the presence of ossified lesions in the thoracolumbar spine in patients who were diagnosed with cervical OPLL by plain X-ray. Three hundred and twenty-two patients with a diagnosis of cervical OPLL underwent CT imaging of the whole spine. The sum of the levels in which OPLL was present in the whole spine was defined as the OP-index and used to evaluate the extent of ossification. The distribution of OPLL in the whole spine was compared between male and female subjects. In addition, a multiple regression model was used to ascertain related factors that affected the OP-index. Among patients with cervical OPLL, women tended to have more ossified lesions in the thoracolumbar spine than did men. A multiple regression model revealed that the OP-index was significantly correlated with the cervical OP-index, sex (female), and body mass index. Furthermore, the prevalence of thoracolumbar OPLL in patients with a cervical OP-index ≥ 10 was 7.8 times greater than that in patients with a cervical OP-index ≤ 5. The results of this study reveal that the extent of OPLL in the whole spine is significantly associated with the extent of cervical OPLL, female sex, and obesity. PMID:27548354

  12. Screening, prevalence, and risk factors for cervical lesions among HIV positive and HIV negative women in Swaziland.

    PubMed

    Jolly, Pauline E; Mthethwa-Hleta, Simangele; Padilla, Luz A; Pettis, Jessica; Winston, ShaCoria; Akinyemiju, Tomi F; Turner, Hannah J; Ejiawoko, Amarachi; Brooks, Raina; Preko, Lena; Preko, Peter O

    2017-02-21

    Cervical Cancer (CC) is the number one cancer among women in sub-Saharan Africa. Although CC is preventable, most women in developing countries do not have access to screening. This cross-sectional study was conducted to determine the prevalence and risk factors for cervical lesions using visual inspection with acetic acid (VIA) among 112 HIV positive and 161 negative women aged 18-69 years. The presence of cervical lesions was greater among HIV positive (22.9%) than HIV negative women (5.7%; p < 0.0001). In logistic models, the risk of cervical lesions among HIV positive women was 5.24 times higher when adjusted by age (OR 5.24, CI 2.31-11.88), and 4.06 times higher in a full model (OR 4.06, CI 1.61-10.25), than among HIV negative women. In the age-adjusted model women who had ≥2 lifetime sexual partners were 3 times more likely (OR 3.00, CI 1.02-8.85) to have cervical lesions compared to women with one lifetime partner and the odds of cervical lesions among women with a history of STIs were 2.16 greater (OR 2.16, CI 1.04-4.50) than among women with no previous STI. In the fully adjusted model women who had a previous cervical exam were 2.5 times more likely (OR 2.53, CI 1.06-6.05) to have cervical lesions than women who had not. The high prevalence of HIV infection and the strong association between HIV and cervical lesions highlight the need for substantial scale-up of cervical screening to decrease the rate of CC in Swaziland.

  13. Synergic effect of oral contraceptives, GSTP1 polymorphisms, and high-risk HPV infection in development of cervical lesions.

    PubMed

    Chagas, B S; Gurgel, A P A D; Paiva Júnior, S S L; Lima, R C P; Cordeiro, M N; Moura, R R; Coelho, A V C; Nascimento, K C G; Silva Neto, J C; Crovella, S; Freitas, A C

    2017-08-17

    Human papillomavirus (HPV) infection is considered a risk factor for cervical cancer. Even if the high-risk HPV (HR-HPV) infection is necessary, environmental co-factors and genetic susceptibility also play an important role in cervical cancer development. In this study, a possible association of rs1695 GSTP1 polymorphisms, HR-HPV infection, and oral contraceptive use with cancer lesion development in women was investigated. The study population comprised 441 Brazilian women from the Northeast region including 98 HPV-infected women with high-grade squamous intraepithelial lesions, 77 HPV-infected women with low-grade squamous intraepithelial lesions, and 266 HPV-negative women with no lesion, used as a control. Our data did not show a significant association between the GSTP1 polymorphism A/G (rs1695) and any HPV-related cervical abnormalities. However, considering the use of oral contraceptives, the GSTP1 rs1695 polymorphism was associated with higher susceptibility to the development of cervical lesions in HR-HPV-infected women. Our study suggests a synergic effect of oral contraceptive use, GSTP1 polymorphisms, and HR-HPV infection in the development of cervical lesions. Together, these risk factors may induce neoplastic transformation of the cervical squamous epithelium, setting conditions for secondary genetic events leading to cervical cancer.

  14. Distribution of HPV Genotypes and Involvement of Risk Factors in Cervical Lesions and Invasive Cervical Cancer: A Study in an Indian Population

    PubMed Central

    Srivastava, Shikha; Shahi, U P; Dibya, Arti; Gupta, Sadhana; Roy, Jagat K

    2014-01-01

    Human papilloma virus (HPV) is considered as the main sexually transmitted etiological agent for the cause and progression of preneoplastic cervical lesions to cervical cancer. This study is discussing the prevalence of HPV and its genotypes in cervical lesions and invasive cervical cancer tissues and their association with various risk factors in women from Varanasi and its adjoining areas in India. A total of 122 cervical biopsy samples were collected from SS Hospital and Indian Railways Cancer Institute and Research Centre, Varanasi and were screened for HPV infection by PCR using primers from L1 consensus region of the viral genome. HPV positive samples were genotyped by type-specific PCR and sequencing. The association of different risk factors with HPV infection in various grades of cervical lesion was evaluated by chi-square test. A total of 10 different HPV genotypes were observed in women with cervicitis, CIN, invasive squamous cell cervical carcinoma and adenocarcinoma. Increased frequency of HPV infection with increasing lesion grade (p=0.002) was observed. HPV16 being the predominant type was found significantly associated with severity of the disease (p=0.03). Various socio- demographic factors other than HPV including high parity (p<0.0001), rural residential area (p<0.0001), elder age (p<0.0001), low socio-economic status (p<0.0001) and women in postmenopausal group (p<0.0001) were also observed to be associated with cervical cancer.These findings show HPV as a direct cause of cervical cancer suggesting urgent need of screening programs and HPV vaccination in women with low socio-economic status and those residing in rural areas. PMID:25035855

  15. Photomechanical studies on non-carious-cervical-lesions of the teeth (Invited Paper)

    NASA Astrophysics Data System (ADS)

    Kishen, A.; Tan, K. B. C.; Asundi, A.

    2005-06-01

    This study aims to examine the biomechanical factor underlying the origin of Non-Carious-Cervical-Lesions by examining the strain distribution in the enamel and dentine. A digital moire interferometry was utilized for this purpose. It is observed from this study that the enamel displayed marked strains in the lateral direction, while the dentine experienced marked strains in the axial and lateral directions during compression. The strains in the enamel and the dentine displayed both normal and shear components. The shear strain in the lateral direction within the enamel and the normal and shear strains in the axial and lateral directions within the coronal dentine concentrated at the cervical region. These experiments highlights that the biting loads will contribute to the loss of hard tissue in the cervical region.

  16. Potential impact of nonavalent HPV vaccine in the prevention of high-grade cervical lesions and cervical cancer in Portugal.

    PubMed

    Pista, Angela; de Oliveira, Carlos Freire; Lopes, Carlos; Cunha, Maria J

    2017-10-01

    To estimate the potential impact of the nonavalent HPV vaccine for high-grade cervical lesions and invasive cervical cancer (ICC) in Portugal. The present secondary analysis used data collected in the CLEOPATRE II study on the prevalence of HPV 6/11/16/18/31/33/45/52/58 among female patients aged 20-88 years. The prevalence of HPV types in patients with cervical intraepithelial neoplasia (CIN) grades 2/3 and ICC was examined. Data were included from 582 patients. There were 177, 341, and 64 patients with CIN2, CIN3, and ICC, respectively, and 169 (95.5%), 339 (99.4%), and 62 (96.9) of them had HPV infections. Of patients with HPV infections, HPV 16, 18, 31, 33, 45, 52, and 58 infections were identified in 150 (88.8%), 329 (97.1%), and 60 (96.8%) patients with CIN2, CIN3, and ICC, respectively. HPV genotypes 6, 11, 16, 18, 31, 33, 45, 52, and 58 were identified in 540 (94.7%) of the patients with HPV infections. The addition of the five HPV genotypes included in the nonavalent HPV vaccine (HPV 31/33/45/52/58) could result in the new HPV vaccine preventing 94.7% of CIN2/3 and ICC occurrences. © 2017 International Federation of Gynecology and Obstetrics.

  17. Association of human papillomavirus type 16 and its genetic variants with cervical lesion in Korea.

    PubMed

    Park, Jeong Su; Shin, Sue; Kim, Eui-Chong; Kim, Ji Eun; Kim, Yong Beom; Oh, Sohee; Roh, Eun Youn; Yoon, Jong Hyun

    2016-11-01

    Persistent human papillomavirus type 16 (HPV16) is the major risk factor for cervical cancer. HPV16 intratypic variants differ in their geographical distribution and oncogenic potential. This study aimed to analyze the distribution of HPV16 variants and their association with cervical lesion histopathology in Korean women. In total, 133 HPV16-positive cervical samples from women admitted to Seoul National University Boramae Hospital were analyzed by sequencing E6, E7, and L1 genes and the long control region (LCR), and the variant distribution according to cervical lesion grade was determined. Isolates were grouped into a phylogenetic lineage, and A1-3, A4, C, and D sublineages were detected in 54.1, 37.8, 0.7, and 7.4% of samples, respectively. The most commonly observed LCR variations were 7521G>A (91.5%), 7730A>C (59.6%), and 7842G>A (59.6%). Furthermore, A4 or D sublineage-positive women had a higher risk for cervical cancer than women who were positive for A1-3. Among HPV phylogenetic clusters, A1-3 was the predominant sublineage, and within A1-3, the 350G polymorphism was highly frequent. These results differed from those of previous studies in Korea and other Asian countries. The findings suggest that cervical neoplasia incidence in HPV16-infected patients could be affected by the distribution of HPV16 variants in the population. © 2016 The Authors. APMIS published by John Wiley & Sons Ltd on behalf of Scandinavian Societies for Medical Microbiology and Pathology.

  18. Clinical Utility of Molecular Biomarkers in Cervical Squamous Intraepithelial Lesions in a Young Adult Population

    PubMed Central

    Spiryda, Lisa Beth; Whitaker, Kara M.; Messersmith, Amy; Banister, Carolyn E.; Creek, Kim E.; Pirisi-Creek, Lucia A.

    2015-01-01

    Objective Although human papillomavirus (HPV) infection is necessary for cervical squamous intraepithelial lesion (SIL/CIN) and cancer to develop, exposure to HPV is not predictive of which women will develop cervical squamous intraepithelial lesion and cancer. This study examines mRNA expression of several potential biomarkers in exfoliated cervical cells collected from college age women. Methods Freshman female students were recruited into the Carolina Women’s Care Study (CWCS) which was designed to prospectively evaluate factors that contribute to persistent HPV infections. One component of this study was to extract mRNA from exfoliated cervical cells. In this study, mRNA expression of FZD, GDF15, IL1β and N-cadherin was assessed through real-time PCR. Statistical analysis was performed with a Student’s t-test; all results were standardized with GAPDH. Results Fifty samples were selected that reflected the demographics of the CWCS participants. IL1β mRNA expression was 9.4-fold higher in cervical cells from women with abnormal Pap tests (p=0.0018); LSIL had 12.7-fold higher expression than negatives (p=0.0011). FZD mRNA expression was 5.7-fold higher in CIN2 as compared to CIN1 (p=0.0041) and 8.5-fold higher compared to cytology/pathology-negative (p=0.0014). Other differences in mRNA expression showed trends but not reaching statistical significance for each condition. Conclusions It appears that several biomarkers involved in the cytokine/inflammatory pathway (IL1 β), cell adhesion pathway (N-cadherin), growth factors (GDF-15), WNT signaling pathway (FZD) may be potential biomarkers in conjunction with the Pap test and HPV that help predict which women are at highest risk for developing CIN3 and cervical cancer. PMID:26579841

  19. Increased expression of sialic acid in cervical biopsies with squamous intraepithelial lesions.

    PubMed

    López-Morales, Dolores; Reyes-Leyva, Julio; Santos-López, Gerardo; Zenteno, Edgar; Vallejo-Ruiz, Verónica

    2010-11-22

    Altered sialylation has been observed during oncogenic transformation. Sialylated oligosaccharides of glycoproteins and glycolipids have been implicated in tumor progression and metastases. In the cervical cancer high levels of sialic acid have been reported in the patients serum, and an increased of total sialic acid concentration has been reported for the cervical neoplasia and cervical cancer. This study investigates the changes in expression and distribution of α2,3-linked sialic acid and α2,6- linked sialic acid in low and high squamous intraepithelial lesions and in normal tissue. Lectin histochemistry was used to examine the expression and distribution of sialic acid in different grades of cervical neoplasia. We applied Maackia amurensis lectin, which interacts with α2,3-linked sialic acid and Sambucus nigra lectin specific for α2,6-linked sialic acid. The histochemical analysis showed that α2,3-linked sialic acid and α2,6- linked sialic acid increased in intensity and distribution in concordance with the grade of squamous intraepithelial lesion (SIL). These results are in concordance with a previous study that reports increased RNAm levels of three sialyltransferases. These results show that the change in sialylation occurs before cancer development and may play an important role in cellular transformation. These findings provide the basis for more detailed studies of the possible role of cell surface glycoconjugates bearing sialic acid in the cellular cervix transformation.

  20. Increased expression of sialic acid in cervical biopsies with squamous intraepithelial lesions

    PubMed Central

    2010-01-01

    Background Altered sialylation has been observed during oncogenic transformation. Sialylated oligosaccharides of glycoproteins and glycolipids have been implicated in tumor progression and metastases. In the cervical cancer high levels of sialic acid have been reported in the patients serum, and an increased of total sialic acid concentration has been reported for the cervical neoplasia and cervical cancer. This study investigates the changes in expression and distribution of α2,3-linked sialic acid and α2,6- linked sialic acid in low and high squamous intraepithelial lesions and in normal tissue. Methods Lectin histochemistry was used to examine the expression and distribution of sialic acid in different grades of cervical neoplasia. We applied Maackia amurensis lectin, which interacts with α2,3-linked sialic acid and Sambucus nigra lectin specific for α2,6-linked sialic acid. Results The histochemical analysis showed that α2,3-linked sialic acid and α2,6- linked sialic acid increased in intensity and distribution in concordance with the grade of squamous intraepithelial lesion (SIL). These results are in concordance with a previous study that reports increased RNAm levels of three sialyltransferases. Conclusions These results show that the change in sialylation occurs before cancer development and may play an important role in cellular transformation. These findings provide the basis for more detailed studies of the possible role of cell surface glycoconjugates bearing sialic acid in the cellular cervix transformation. PMID:21092209

  1. Comparative study of the expression of cellular cycle proteins in cervical intraepithelial lesions.

    PubMed

    Queiroz, Conceição; Silva, Tânia Correia; Alves, Venâncio A F; Villa, Luisa L; Costa, Maria Cecília; Travassos, Ana Gabriela; Filho, José Bouzas Araújo; Studart, Eduardo; Cheto, Tatiana; de Freitas, Luiz Antonio R

    2006-01-01

    Interaction of human papilloma virus oncoproteins E6 and E7 with cell cycle proteins leads to disturbances of the cell cycle mechanism and subsequent alteration in the expression of some proteins, such as p16INK4a, cyclin D1, p53 and KI67. In this study, we compared alterations in the expression of these proteins during several stages of intraepithelial cervical carcinogenesis. Accordingly, an immunohistochemical study was performed on 50 cervical biopsies, including negative cases and intraepithelial neoplasias. The expression patterns of these markers were correlated with the histopathological diagnosis and infection with HPV. The p16INK4a, followed by Ki67, showed better correlation with cancer progression than p53 and cyclin D1, which recommends their use in the evaluation of cervical carcinogenesis. These monoclonal antibodies can be applied to cervical biopsy specimens to identify lesions transformed by oncogenic HPV, separating CIN 1 (p16INK4a positive) and identifying high-grade lesions by an increase in the cellular proliferation index (Ki67). In this way, we propose immunomarkers that can be applied in clinical practice to separate patients who need a conservative therapeutic approach from those who require a more aggressive treatment.

  2. Immunologic treatments for precancerous lesions and uterine cervical cancer

    PubMed Central

    2014-01-01

    Development of HPV-associated cancers not only depends on efficient negative regulation of cell cycle control that supports the accumulation of genetic damage, but also relies on immune evasion that enable the virus to go undetected for long periods of time. In this way, HPV-related tumors usually present MHC class I down-regulation, impaired antigen-processing ability, avoidance of T-cell mediated killing, increased immunosuppression due to Treg infiltration and secrete immunosuppressive cytokines. Thus, these are the main obstacles that immunotherapy has to face in the treatment of HPV-related pathologies where a number of different strategies have been developed to overcome them including new adjuvants. Although antigen-specific immunotherapy induced by therapeutic HPV vaccines was proved extremely efficacious in pre-clinical models, its progression through clinical trials suffered poor responses in the initial trials. Later attempts seem to have been more promising, particularly against the well-defined precursors of cervical, anal or vulvar cancer, where the local immunosuppressive milieu is less active. This review focuses on the advances made in these fields, highlighting several new technologies (such as mRNA vaccine, plant-derived vaccine). The most promising immunotherapies used in clinical trials are also summarized, along with integrated strategies, particularly promising in controlling tumor metastasis and in eliminating cancer cells altogether. After the early promising clinical results, the development of therapeutic HPV vaccines need to be implemented and applied to the users in order to eradicate HPV-associated malignancies, eradicating existing perception (after the effectiveness of commercial preventive vaccines) that we have already solved the problem. PMID:24667138

  3. Noncarious cervical lesions restored with three different tooth-colored materials: two-year results.

    PubMed

    Stojanac, I L; Premovic, M T; Ramic, B D; Drobac, M R; Stojsin, I M; Petrovic, L M

    2013-01-01

    The aim of this two-year prospective clinical study was to evaluate and compare the clinical performance of three different adhesive esthetic materials in noncarious cervical lesions. A total of 90 restorations (30 per material) were placed in 30 patients who ranged in age between 18 and 50 years and of both genders, by a single operator with no previous preparation. The restoration of noncarious cervical lesions was done with either a microfilled composite (Esthet.X/Dentsply/De Trey, Konstanz, Germany, and Prime&Bond NT/Dentsply/De Trey), a nanohybrid composite (TetricEvoCeram/Vivadent, Schaan, Liechtenstein, and AdheSE/Vivadent), or a compomer (Dyract eXtra/Dentsply/De Trey and Xeno III Dentsply/De Trey). All restorations were evaluated by independent examiners using a modified US Public Health Service criteria at baseline and after 12 and 24 months for six clinical categories. Data were analyzed statistically by Pearson's chi-square or the Fisher's exact test at 5% significance level (p<0.05). Results showed that most of the restorations were clinically satisfactory after 12 and 24 months, with no statistically significant differences among the three groups for all evaluated criteria. Treatment of noncarious cervical lesions using composite and compomer materials, combined with the appropriate adhesive systems and properly implemented restorative procedures, gives satisfactory results after a two-year evaluation period.

  4. Unilateral lateral mass fixation of cervical spinal low-grade chondrosarcoma with intralesional resection: A case report

    PubMed Central

    CHEN, BO; YANG, YAN; CHEN, LIANG; ZHOU, FENG; YANG, HUILIN

    2014-01-01

    In total, ~10% of chondrosarcomas arise from the mobile spine, and these are prone to local recurrence despite being low-grade malignant tumors. Almost all patients will present with pain and a palpable mass in the area of the lesion. For adequate management of the disease, an early diagnosis and careful surgical staging are important. The present study reports a case of cervical spinal low-grade chondrosarcoma in a young female presenting with a slow-growing mass that had not metastasized during a 3-year period. A unilateral lateral mass fixation system of screws and rods was installed following an intralesional resection of the tumor. At present, two years following the surgery, the patient exhibits no neurological deficiency symptoms. Therefore, unilateral fixation presents an effective alternative technique for the treatment of patients with a lesion on the cervical spine. PMID:24765168

  5. Genotype distribution of cervical human papillomavirus DNA in women with cervical lesions in Bioko, Equatorial Guinea

    PubMed Central

    García-Espinosa, Benjamín; Nieto-Bona, Ma Paz; Rueda, Sonsoles; Silva-Sánchez, Luís Fernando; Piernas-Morales, Ma Concepción; Carro-Campos, Patricia; Cortés-Lambea, Luís; Moro-Rodríguez, Ernesto

    2009-01-01

    Background The HVP vaccine is a useful tool for preventing cervical cancer. The purpose of this study is to determine the most frequent HPV genotypes in Equatorial Guinea in order to develop future vaccination strategies to apply in this country. Methods A campaign against cervical cancer was carried out in the area on a total of 1,680 women. 26 of the women, following cytological screening, were treated surgically with a loop electrosurgical excision procedure (LEEP). Cases were studied histologically and were genotyped from paraffin blocks by applying a commercial kit that recognized 35 HPV types. Results Cytological diagnoses included 17 HSIL, 1 LSIL, 5 ASC-H and 3 AGUS. Histological diagnosis resulted in 3 cases of microinvasive squamous cell carcinoma stage IA of FIGO, 9 CIN-3, 8 CIN-2, 2 CIN-1, 3 flat condylomas and mild dysplasia of the endocervical epithelium. Fifteen of twenty-five cases genotyped were positive for HPV (60%). HPV 16 and 33 were identified in four cases each, HPV 58 in two other cases, and HPV 18, 31, 52, and 82 in one case, with one HPV 16 and 58 coinfection. Conclusion The frequency of HPV types in the African area varies in comparison to other regions, particularly in Europe and USA. Vaccination against the five most common HPV types (16, 33, 58, 18, and 31) should be considered in the geographic region of West Africa and specifically in Equatorial Guinea. PMID:19740435

  6. Clinical Utility of Molecular Biomarkers in Cervical Squamous Intraepithelial Lesions in a Young Adult Population.

    PubMed

    Spiryda, Lisa Beth; Whitaker, Kara M; Messersmith, Amy; Banister, Carolyn E; Creek, Kim E; Pirisi-Creek, Lucia A

    2016-01-01

    Although human papillomavirus (HPV) infection is necessary for cervical squamous intraepithelial lesion (SIL/CIN) and cancer to develop, exposure to HPV is not predictive of which women will develop SIL/CIN and cancer. This study examines mRNA expression of several potential biomarkers in exfoliated cervical cells collected from college-aged women. Freshman female students were recruited into the Carolina Women's Care Study, which was designed to prospectively evaluate factors that contribute to persistent HPV infections. One component of this study was to extract mRNA from exfoliated cervical cells. In this study, mRNA expression of Frizzled (FZD), growth differentiating factor 15, interleukin 1 beta (IL1β), and N-cadherin was assessed through real-time polymerase chain reaction. Statistical analysis was performed with a Student t test; all results were standardized with glyceraldehyde 3-phosphate dehydrogenase. Fifty samples were selected that reflected the demographics of the Carolina Women's Care Study participants. IL1β mRNA expression was 9.4-fold higher in cervical cells from women with abnormal Pap tests (p = .0018); low-grade squamous intraepithelial lesion had 12.7-fold higher expression than negatives (p = .0011). The FZD mRNA expression was 5.7-fold higher in CIN 2 as compared with CIN 1 (p = .0041) and 8.5-fold higher compared with cytology/pathology negative (p = .0014). Other differences in mRNA expression showed trends but not reaching statistical significance for each condition. It seems that several biomarkers involved in the cytokine/inflammatory pathway (IL1β), cell adhesion pathway (N-cadherin), growth factor (growth differentiating factor 15), and Wingless (WNT) signaling pathway (FZD) may be potential biomarkers in conjunction with the Pap test and HPV that help predict which women are at highest risk for developing CIN 3 and cervical cancer.

  7. Tooth surface floss loss: unusual interproximal and lingual cervical lesions as a result of bizarre dental flossing.

    PubMed

    Gow, Alex M; Kelleher, Martin G

    2003-01-01

    There are many reported cases of cervical abrasion/erosion cavities in the literature with various theories offered in support of their pathogenesis. The vast majority of these cases involve the labial cervical regions of the affected teeth. This case report describes an unusual dental presentation of severe lingual cervical and interproximal lesions predominantly affecting the upper and lower anterior and premolar teeth. The differential diagnosis is presented, along with the likely cause of the lesions: in this case, a bizarre oral hygiene technique. The proposed treatment plan is outlined and the problems associated with restoring such cavities are highlighted.

  8. Non-carious cervical lesions: influence of morphology and load type on biomechanical behaviour of maxillary incisors.

    PubMed

    Soares, P V; Santos-Filho, P C F; Soares, C J; Faria, V L G; Naves, M F; Michael, J A; Kaidonis, J A; Ranjitkar, S; Townsend, G C

    2013-09-01

    The aim of this study was to measure the effect of simulating two different loads on maxillary incisors displaying eight morphological types of non-carious cervical lesions, unrestored and restored with an adhesive restoration, by quantifying the stress distributions generated using finite element analysis. Virtual models of maxillary incisors were generated using the CAD software (RhinoCeros). After composing virtual dental and supporting structures with and without non-carious cervical lesions, each model was meshed using a control mesh device (ANSYS Finite Element Analysis Software). All of the virtual models were subjected to two load types, oblique load and vertical load, to simulate occlusal forces of 100 N each. Comparisons were made between simulated teeth with non-carious cervical lesions, with and without composite resin restorations, and a simulated sound tooth. Data summarizing the stress distributions were obtained in MPa using von Mises criteria. Oblique loading on simulated non-carious cervical lesions resulted in greater stress concentration compared with vertical loading, and non-carious cervical lesions with acute angles displayed higher stress concentrations at the depth of the lesion. Restoring the lesions with an adhesive restoration, such as composite resin, appeared to overcome this stress concentration. Restoring NCCLs with adhesive restorative materials, such as a nanohybrid composite resin, appears to recover the biomechanical behaviour similar to sound teeth. © 2013 Australian Dental Association.

  9. The precancerous effect of emitted cooking oil fumes on precursor lesions of cervical cancer.

    PubMed

    Lee, Chien-Hung; Yang, Sheau-Fang; Peng, Chiung-Yu; Li, Ruei-Nian; Chen, Yu-Chieh; Chan, Te-Fu; Tsai, Eing-Mei; Kuo, Fu-Chen; Huang, Joh-Jong; Tsai, Hsiu-Ting; Hung, Yu-Hsiu; Huang, Hsiao-Ling; Tsai, Sharon; Wu, Ming-Tsang

    2010-08-15

    Although cooking emission from high-temperature frying has been deemed a Group 2A carcinogen by the International Agency for Research on Cancer, little is known about its impact on cervical tumorigenesis. To investigate the precancerous consequence of cooking oil fumes on cervical intraepithelial neoplasm (CIN), a community-based case-control study, which takes all known risk factors into consideration, was conducted in Taiwan. From 2003 to 2008, in a Pap smear screening and biopsy examination network, 206 pathology-verified women with inflammations/atypical squamous cells of undetermined significance or CIN grade-1 (CIN1) and 73 with CIN2-3 (defined as low-grade squamous intraepithelial lesions (LGSIL) and high-grade squamous intraepithelial lesions (HGSIL), respectively); and 1,200 area-and-age-matched controls with negative cytology were recruited. Multinomial logistic regression was applied in the multivariate analysis to determine the likelihood of contracting LGSIL or HGSIL. The risks of the two lesions increased with the increase of carcinogenic high-risk human papillomavirus DNA load, with a clear dose-response relationship. Chefs were observed to experience a 7.9-fold elevated HGSIL risk. Kitchens with poor fume ventilation during the main cooking life-stage correlated to a 3.7-fold risk of HGSIL, but not for LGSIL. More than 1 hr of daily cooking in kitchens with poor fume conditions appeared to confer an 8.4-fold HGSIL risk, with an 8.3-fold heterogeneously higher odds ratio than that (aOR = 1.0) for LGSIL. Similar risk pattern has been reproduced among never-smoking women. Our findings demonstrate the association between indoor exposure to cooking fumes from heated oil and the late development of cervical precancerous lesions. This final conclusion needs to be verified by future research.

  10. Methylated Host Cell Gene Promoters and Human Papillomavirus Type 16 and 18 Predicting Cervical Lesions and Cancer

    PubMed Central

    Milutin Gašperov, Nina; Sabol, Ivan; Planinić, Pavao; Grubišić, Goran; Fistonić, Ivan; Ćorušić, Ante; Grce, Magdalena

    2015-01-01

    Change in the host and/or human papillomavirus (HPV) DNA methylation profile is probably one of the main factors responsible for the malignant progression of cervical lesions to cancer. To investigate those changes we studied 173 cervical samples with different grades of cervical lesion, from normal to cervical cancer. The methylation status of nine cellular gene promoters, CCNA1, CDH1, C13ORF18, DAPK1, HIC1, RARβ2, hTERT1, hTERT2 and TWIST1, was investigated by Methylation Specific Polymerase Chain Reaction (MSP). The methylation of HPV18 L1-gene was also investigated by MSP, while the methylated cytosines within four regions, L1, 5’LCR, enhancer, and promoter of the HPV16 genome covering 19 CpG sites were evaluated by bisulfite sequencing. Statistically significant methylation biomarkers distinguishing between cervical precursor lesions from normal cervix were primarily C13ORF18 and secondly CCNA1, and those distinguishing cervical cancer from normal or cervical precursor lesions were CCNA1, C13ORF18, hTERT1, hTERT2 and TWIST1. In addition, the methylation analysis of individual CpG sites of the HPV16 genome in different sample groups, notably the 7455 and 7694 sites, proved to be more important than the overall methylation frequency. The majority of HPV18 positive samples contained both methylated and unmethylated L1 gene, and samples with L1-gene methylated forms alone had better prognosis when correlated with the host cell gene promoters’ methylation profiles. In conclusion, both cellular and viral methylation biomarkers should be used for monitoring cervical lesion progression to prevent invasive cervical cancer. PMID:26057381

  11. Restoration of non-carious cervical lesions Part II. Restorative material selection to minimise fracture.

    PubMed

    Ichim, I P; Schmidlin, P R; Li, Q; Kieser, J A; Swain, M V

    2007-12-01

    It is still largely unknown as to what material parameter requirements would be most suitable to minimise the fracture and maximising the retention rate of the restoration of cervical non-carious lesions (NCCL). The present paper, as a first of its kind, proposes a radical approach to address the problems of material improvement, namely: numerical-based, fracture and damage mechanics materials optimisation engineering. It investigates the influence of the elastic modulus (E) on the failure of cervical restorative materials and aims to identify an E value that will minimise mechanical failure under clinically realistic loading conditions. The present work relies on the principle that a more flexible restorative material would partially buffer the local stress concentration. We employ a "most favourable" parametric analysis of the restorative's elastic modulus using a fracture mechanics model embedded into finite element method. The advanced numerical modelling adopts a Rankine and rotating crack material fracture model coupled to a non-linear analysis in an explicit finite element framework. The present study shows that the restorative materials currently used in non-carious cervical lesions are largely unsuitable in terms of resistance to fracture of the restoration and we suggest that the elastic modulus of such a material should be in the range of 1GPa. We anticipate that the presented methodology would provide more informative guidelines for the development of dental restorative materials, which could be tailored to specific clinical applications cognisant of the underlying mechanical environment.

  12. [Prevalence of HPV 16, 18, 45 and 31 in women with cervical lesions].

    PubMed

    Pitta, Denise Rocha; Campos, Elisabete Aparecida; Sarian, Luis Otávio; Rovella, Marcello Silveira; Derchain, Sophie Françoise Mauricette

    2010-07-01

    To determine the prevalence of HPV 16, 18, 31 and 45 in cervical screening samples of women with cellular changes and/or colposcopy suggestive of persistent high grade or low grade lesion who were submitted to conization. A total of 120 women were included in the study. Histological analysis of the cervical cones revealed 7 cases of cervicitis, 22 of CIN1, 31 of CIN2, 54 of CIN3, and 6 invasive carcinomas. The cervical screening samples were analyzed before conization for the presence of HPV-DNA by PCR using the consensus primers PGMY09/11. HPV-DNA-positive samples were tested for the presence of HPV16, 18, 31 and 45 using type-specific primers for these HPV. HPV-DNA was detected in 67.5% of the studied women. HPV 16 (40%) was the most prevalent type in most ilesions, followed by HPV 31 (13.3%), 45 (13.3%), and 18 (4.1%). Multiple infections occurred in 15% of the cases and infections with other HPV types were detected in 14% of the sample. HPV 16 and 18 infections do not always occur as a single infection, and may be associated with other HPV types on different occasions.

  13. [Cytologic-colposcopic-histopathologic correlations in preinvasive cervical lesions and cervical Human Papillomavirus infections].

    PubMed

    von der Meden Alarcón, J W; Ruiz Moreno, J A; García León, J F; Kably Ambe, A

    1995-09-01

    Cervico-uterine cancer is the most frequent gynecological neoplasia in Mexico and cervico-vaginal cytology is the most practical and dependable resource in lesions detection. During the last years precursory lesions detection (NIC and HPV infection) has increased. So, every patient presenting with an abnormal cytology should be included in an evaluation program, that includes a colposcopic study with biopsy of suspicious lesions, in order to know cellular abnormality degree, as these studies combination increases diagnosis certainty. Ninety three patients were evaluated by colposcopy, as the Papanicolaou showed abnormality ICN type in any degree or HPV infection data, during the first three years of the Unidad de Colposcopia de la Beneficiencia del Hospital ABC. In 49 patients histopathological study, was done. A correlation of all studies was carried out. There was a correlation cytology-histopathology of 59.18%; and colposcopy-histopathology of 89.79%. It was concluded that evaluation by cytology is insufficient to establish a final diagnosis and treatment, and that colposcopic study is fundamental in the evaluation of the patient with abnormal exfoliative cytology.

  14. Characteristics of non-carious cervical lesions--an ex vivo study using micro computed tomography.

    PubMed

    Hur, B; Kim, H-C; Park, J-K; Versluis, A

    2011-06-01

    The aetiology of non-carious cervical lesions (NCCLs) is not well understood and still controversial. The aim of this ex-vivo study was to examine the morphological characteristics of NCCLs for clinical evidence of enamel loss above the cemento-enamel junction (CEJ) as suggested by the abfraction theory. Fifty extracted human teeth with various types of NCCLs were collected and scanned by micro computed tomography. The reconstructed three-dimensional models were evaluated from multiple aspects, including longitudinal cross-section series. The location of internal line angle and proximal exits of the lesions were evaluated in relation to the level of CEJ. The coronal margins of the lesions were inspected for evidence of enamel loss above the CEJ using the bucco-lingual longitudinal sectional images. Coronal margins of the lesions were located along and/or under the CEJ for all of the 50 samples. In most of the lesions, regardless of lesion type, the proximal exits and internal line angles were located below the CEJ. This study did not detect clinical evidence of enamel loss above the occlusal margin of NCCLs as would have been expected according to the general abfraction mechanism.

  15. A pilot study to assess the morphology and progression of non-carious cervical lesions.

    PubMed

    Sugita, Iori; Nakashima, Syozi; Ikeda, Asaomi; Burrow, Michael F; Nikaido, Toru; Kubo, Shisei; Tagami, Junji; Sumi, Yasunori

    2017-02-01

    This longitudinal pilot study aimed to morphologically and quantitatively investigate the progress of non-carious cervical lesions (NCCLs) by using swept-source optical coherence tomography (SS-OCT). The samples examined comprised sets of NCCL epoxy resin replicas obtained from 10 lesions in 6 patients who attended annual dental visits over 4 or 5 years. SS-OCT images of the replicas were analyzed in terms of the maximum depth (Dmax) and corresponding vertical width (VW) - using an image analyzer to estimate progression of the NCCLs over time. It was found that differences between wedge- and saucer-shaped lesions were morphologically distinguished well by the OCT images. There were significant differences in dimensions among Dmax, VW and horizontal width (HW). HW was the largest and Dmax was the smallest. Although no significant differences in absolute values of annual progression rates were found among Dmax, VW and HW, the percentage increase in Dmax was significantly greater compared to VW and HW. The ratios of Dmax to corresponding VW ranged from 0.49 to 1.01 for the wedge-shaped lesions and from 0.13 to 0.44 for saucer-shaped lesions, respectively. The dimensional analysis demonstrated notable progression with large variations. The wedge-shaped lesions appeared to show greater Dmax values compared to the saucer-shaped lesions. With respect to the depth, the wedge-shaped lesions may progress at a greater rate compared to the saucer-shaped lesions. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Loading and composite restoration assessment of various non-carious cervical lesions morphologies - 3D finite element analysis.

    PubMed

    Soares, P V; Machado, A C; Zeola, L F; Souza, P G; Galvão, A M; Montes, T C; Pereira, A G; Reis, B R; Coleman, T A; Grippo, J O

    2015-09-01

    The present study analysed the effects of different occlusal loading on premolars displaying various non-carious cervical lesions morphologies, restored (or not) with composites, by 3D finite element analysis. A three-dimensional digital model of a maxillary premolar was generated using CAD software. Three non-carious cervical lesions morphological types were simulated: wedged-shaped, saucer and mixed. All virtual models underwent three loading types (100 N): vertical, buccal and palatal loading. The simulated non-carious cervical lesions morphologies were analysed with and without restorations to consider specific regions, such as the occlusal and gingival walls as well as the depth of the lesions. Data summarizing the stress distribution were obtained in MPa using Maximum Principal Stress. Palatal loads were responsible for providing the highest values of accumulated tensile stress on the buccal wall; 27.66 MPa and 25.76 MPa for mixed and wedged-shaped morphologies, respectively. The highest tensile values found on non-carious cervical lesions morphologies restored with composite resin were 5.9 MPa in the mixed morphology, similar to those found on sound models despite their morphologies and occlusal loading. The various non-carious cervical lesions morphologies had little effect on stress distribution patterns, whereas the loading type and presence of composite restorations influenced the biomechanical behaviour of the maxillary premolars. © 2015 Australian Dental Association.

  17. Prevalence of Human Papillomavirus Type 58 in Women With or Without Cervical Lesions in Northeast Brazil

    PubMed Central

    Fernandes, JV; Carvalho, MGF; de Fernandes, TAAM; Araújo, JMG; Azevedo, PRM; Azevedo, JCV; Meissner, RV

    2013-01-01

    Background: Human papillomavirus (HPV) has been recognized as a necessary, but not sufficient, cause of cervical cancer. Aim: In this study, we investigated the prevalence of HPV and the genotype distribution in women from Natal, North-East Brazil, with normal cytology and with cervical lesions of different degrees. Subjects and Methods: Included in this study were 110 women with a normal cytology and 315 with a previous history of cervical cytological abnormalities. The patients were enrolled between January 2005 and December 2008. The cytopathological analyzes were performed by the Pap smear exam, and the pre-malignant and maligant lesions were confirmed based on the histopathological analysis. The presence of HPV was detected by polymerase chain reaction with genotyping by dot blot hybridization. All the data were included in a database, using the software SPSS, Version 10.0 (Chicago Il, USA). Results: Overall HPV prevalence was 65.2% (277/425), with 85.9% (238/277) single and 14.1% (39/277) multiple infection. The most prevalent HPV types were HPVs 16, 58, 18, 31, and 45. HPV 16 was the most prevalent genotype, independently of the health status of patients. HPV 58 was the second most prevalent type in women with normal cytology and in those who had mild or moderate dysplasia. HPV 58 presented equal prevalence to HPV 18 in patients with severe dysplasia. However, it was less prevalent than HPV 18 in women with cervical cancer. Conclusions: The results show a high prevalence of HPV 58, especially in women with mild and moderate dysplasia, revealing the high-frequency circulation of this genotype of HPV in the local population. This finding suggests the need to include this genotype in future HPV vaccines targeting women in this region. PMID:24379999

  18. Prevalence of human papillomavirus types in cervical cancerous and precancerous lesions of Ecuadorian women.

    PubMed

    Mejía, Lorena; Muñoz, Diana; Trueba, Gabriel; Tinoco, Leopoldo; Zapata, Sonia

    2016-01-01

    Human Papillomavirus (HPV) is the most common sexually transmitted infection worldwide and it is responsible for most cases of uterine cancer. In Ecuador there is limited information about HPV types (and variants) in cancerous lesions; however, identifying the type-specific HPV prevalence in cervical lesions of women living in Ecuador is important to better predict the impact of HPV prophylactic vaccination in this country. We studied the prevalence of HPV types in cervical cancerous or precancerous lesions from 164 Ecuadorian women and found that 86.0% were HPV positive. The most common types were HPV16 (41.8%) and HPV58 (30.5%). Interestingly, HPV18 was detected only in 2.8% of the HPV-positive samples. Fifteen DNA sequences (genes E6 and L1) from 16 samples positive for HPV16 belonged to the European lineage, considered one of the least carcinogenic lineages, and 1 (6.25%) to the Asian-American lineage. Similar analysis in 12 HPV58 positive samples showed that 10 (83.3%) sequences grouped in sublineage A2, which belongs to the oldest HPV58 lineage, 1 belonged to A3 and 1 to lineage C. This study suggests that the currently used HPV vaccines (bivalent and tetravalent) may have lower effectiveness in Ecuador than in other geographic locations where HPV18 is more prevalent.

  19. A 12-year clinical evaluation of a three-step dentin adhesive in noncarious cervical lesions.

    PubMed

    Wilder, Aldridge D; Swift, Edward J; Heymann, Harald O; Ritter, André V; Sturdevant, John R; Bayne, Stephen C

    2009-05-01

    The authors conducted a study to evaluate the clinical performance of a dual-cured, three-step dentin adhesive (OptiBond Dual Cure, Kerr, a subsidiary of Sybron Dental Specialties, Orange, Calif.; no longer on the market) at 12 years. The authors restored 100 noncarious cervical lesions without use of macromechanical retention or enamel bevels. In one-half of the lesions (group A), the authors etched only the enamel; in the other half (group B), they etched both enamel and dentin. After etching, they applied a light-cured primer and dual-cured adhesive to enamel and dentin in both groups. They restored the preparations with a resin-based composite. They performed direct evaluations by using modified U.S. Public Health Service criteria at insertion (baseline) and at one year and 12 years after insertion. The 12-year retention rates were 93 percent in group A and 84 percent in group B, for an overall retention rate of 89 percent. Except for marginal discoloration in both groups and retention in group B, the restorations in both groups had Alfa ratings of 88 percent or greater in all of the direct clinical evaluation categories. The 12-year clinical performance, including retention rate, of a dual-cured dental adhesive was excellent and was not affected by dentin acid-etching. This clinical study provides additional evidence for the long-term durability of a three-step etch-and-rinse adhesive in non-carious cervical lesions.

  20. Human Papillomavirus types distribution among women with cervical preneoplastic, lesions and cancer in Luanda, Angola

    PubMed Central

    Damião, Paciência de Almeida; Oliveira-Silva, Michelle; Moreira, Miguel Ângelo; Poliakova, Natalia; de Lima, Maria Emilia RT; Chiovo, José; Nicol, Alcina Frederica

    2016-01-01

    Introduction Cervical cancer is the leading cause of cancer deaths among females in Angola and human papillomavirus (HPV) is the main risk factor for the development of pre-cancerous squamous intraepithelial lesions. The diversity and frequency of HPV types in Angola has yet to be reported. Aim To determine the frequency of HPV among women with squamous intraepithelial lesions from women in Luanda, Angola. Methods Study participants included women diagnosed with cytological abnormalities that voluntarily provided Pap smears (n = 64). Genomic DNA was extracted from the samples for use as templates in the PCR amplification of HPV sequences. PCR products were sequenced to determine HPV type. Results HPV DNA was detected in 71.9% (46/64) in the samples. A higher diversity of HPV types was found in the cytological lesions, such as ASCUS and LSIL (HPV16, 6, 18, 31, 58, 66, 70 and 82, in order of frequency) than that detected for HSIL and SSC (HPV16, 18, 6 and 33). The most prevalent HPV type were: HPV16, HPV6 and HPV18. Conclusion This is the first report on HPV type diversity and frequency in woman of Angola. The results suggest that large-scale studies across Africa would improve our understanding of interrelationship between HPV infections and cervical cancer. More directly, the identification of the HPV types most prevalent suggests that women in Angola would benefit from currently available HPV vaccines. PMID:28154623

  1. Potential of desensitizing toothpastes to reduce the hydrogen peroxide diffusion in teeth with cervical lesions.

    PubMed

    Dávila-Sánchez, Andrés; Montenegro, Andrés Fernando; Alfonso, Arana-Gordillo; Farago, Paulo Vitor; Loguercio, Alessandro D; Reis, Alessandra

    2016-06-01

    To evaluate the occlusive potential of four toothpastes by atomic force microscopy (AFM) before and after bleaching and quantify the hydrogen peroxide (HP) diffusion into the pulp chamber after application of desensitizing toothpastes in teeth with cervical lesions. In 52 human extracted premolars, 2-mm deep artificial cervical lesions (ACL) were prepared and rinsed with EDTA for 10 seconds. Then teeth were adapted in a brushing machine and brushed with one of the following toothpastes [Regular toothpaste with no occlusive compounds Colgate Cavity Protection (CP), Oral-B Pro Health (OB), Colgate ProRelief (PR) and Sensodyne Rapid Relief (RR)] under constant loading (250 g; 4.5 cycles/seconds; 3 minutes). In 13 teeth (control group), no artificial cervical lesion was prepared. After that, the teeth were bleached with 35% HP with three 15-minute applications. The HP diffusion was measured spectrophotometrically as a stable red product based on HP reaction with 4-aminoanthipyrine and phenol in presence of peroxidase, at a wavelength of 510 nm and the dentin surfaces of ACL were evaluated before and after bleaching by AFM. Data was statistically analyzed by one-way ANOVA and Tukey's test (alpha = 0.05). In the AFM images, some modifications of the dentin surface were observed after application of OB and RR. However, only for RR the formation of a surface deposit was produced, which occluded the majority of the dentin tubules. Also, only for RR, this deposit was not modified/removed by bleaching. Despite this, all groups with ACL showed higher HP penetration than sound teeth, regardless of the toothpaste used (P < 0.001).

  2. Alternative rubber dam isolation technique for the restoration of Class V cervical lesions.

    PubMed

    Owens, Barry M

    2006-01-01

    This article describes an expedited, atraumatic technique of restoring cervical abrasion-erosion, abfraction or carious lesions using an alternative placement sequence of the dental rubber dam for adequate field isolation. As shown by this technique, the rubber dam retainer is modified and positioned on the tooth with subsequent placement of the dental dam material over theretainer and tooth. This technique saves time and provides good retraction of the gingival tissue and isolation of the cavity preparation from contamination (saliva, hemorrhage) that can potentially cause post-operative symptoms and possible restoration replacement.

  3. Abfraction, abrasion, biocorrosion, and the enigma of noncarious cervical lesions: a 20-year perspective.

    PubMed

    Grippo, John O; Simring, Marvin; Coleman, Thomas A

    2012-02-01

    Hitherto, noncarious cervical lesions (NCCLs) of teeth have been generally ascribed to either toothbrush-dentifrice abrasion or acid "erosion." The last two decades have provided a plethora of new studies concerning such lesions. The most significant studies are reviewed and integrated into a practical approach to the understanding and designation of these lesions. A paradigm shift is suggested regarding use of the term "biocorrosion" to supplant "erosion" as it continues to be misused in the United States and many other countries of the world. Biocorrosion embraces the chemical, biochemical, and electrochemical degradation of tooth substance caused by endogenous and exogenous acids, proteolytic agents, as well as the piezoelectric effects only on dentin. Abfraction, representing the microstructural loss of tooth substance in areas of stress concentration, should not be used to designate all NCCLs because these lesions are commonly multifactorial in origin. Appropriate designation of a particular NCCL depends upon the interplay of the specific combination of three major mechanisms: stress, friction, and biocorrosion, unique to that individual case. Modifying factors, such as saliva, tongue action, and tooth form, composition, microstructure, mobility, and positional prominence are elucidated. By performing a comprehensive medical and dental history, using precise terms and concepts, and utilizing the Revised Schema of Pathodynamic Mechanisms, the dentist may successfully identify and treat the etiology of root surface lesions. Preventive measures may be instituted if the causative factors are detected and their modifying factors are considered. © 2011 Wiley Periodicals, Inc.

  4. [Correlation of hybrid II capture cytologic exam in diagnosis of cervical lesions related to HPV].

    PubMed

    Saturnino, Ana Conceição Ribeiro Dantas; Diniz, Veruska Cassandra; Sisenando, Herbert Ary Arzabe Anteza Costa Nóbrega; de Souza, Eroisa Maria Conceição Oliveira; de Paiva, Magnus Sérgio Martins; de Brito, Maria Helena Marques Fonseca; Ramos, Eleni Souto Nóbrega

    2005-01-01

    The aim of the present study was confront the results of the cytological examination with hybrid capture II in the diagnosis of induced cervical intraepithelial lesion-HPV, correlating the cytological findings with biomoleculares. The research was carried through in a group of 160 sexually active women who had espontaneamente looked its gynecologists for consultation of routine, having been submitted to the collection of cervicovaginal material for cytology and for examination of hybrid capture II in the Centro de Patologia Clínica and the Hospital e Maternidade Promater, in the city of the Natal-RN. The results had shown to relatively high numbers of positive cases for HPV using hybrid capture II (41.87%) and the cytology (23.75%). The agreement between the two studied methods relatively was raised (59.38%). It was evident also that the viruses with high oncogênico potential had presented found in the compatible cytology with Lesion of low risk (11.88%), followed of Lesion of high risk (NIC II and III); already the viruses with low oncogênico potential were more associates the Lesion of low risk (6.25%), followed of Lesion of high risk. The cytology, exactly with its limitations, is an important method in the detention of attributable patologias to the HPV, emphasizing that the molecular method comes to complement it and to consolidate the cytological findings.

  5. In vivo photoacoustic imaging of uterine cervical lesion and its image processing based on light propagation in biological medium

    NASA Astrophysics Data System (ADS)

    Okawa, Shinpei; Sei, Kiguna; Hirasawa, Takeshi; Irisawa, Kaku; Hirota, Kazuhiro; Wada, Takatsugu; Kushibiki, Toshihiro; Furuya, Kenichi; Ishihara, Miya

    2017-03-01

    For diagnosis of cervical cancer, screening by colposcope and successive biopsy are usually carried out. Colposcope, which is a mesoscope, is used to examine surface of the cervix and to find precancerous lesion grossly. However, the accuracy of colposcopy depends on the skills of the examiner and is inconsistent as a result. Additionally, colposcope lacks depth information. It is known that microvessel density and blood flow in cervical lesion increases associated with angiogenesis. Therefore, photoacoustic imaging (PAI) to detect angiogenesis in cervical lesion has been studied. PAI can diagnose cervical lesion sensitively and provide depth information. The authors have been investigating the efficacy of PAI in the diagnoses of the cervical lesion and cancer by use of the PAI and ultrasonography system with transvaginal probe developed by Fujifilm Corporation. For quantitative diagnosis by use of PAI, it is required to take the light propagation in biological medium into account. The image reconstruction of the absorption coefficient from the PA image of cervix by use of the simulation of light propagation based on finite element method has been tried in this study. Numerical simulation, phantom experiment and in vivo imaging were carried out.

  6. Clinical outcome of modified cervical lateral mass screw fixation technique.

    PubMed

    Kim, Seong-Hwan; Seo, Won-Deog; Kim, Ki-Hong; Yeo, Hyung-Tae; Choi, Gi-Hwan; Kim, Dae-Hyun

    2012-08-01

    The purpose of this study was 1) to analyze clinically-executed cervical lateral mass screw fixation by the Kim's technique as suggested in the previous morphometric and cadaveric study and 2) to examine various complications and bicortical purchase that are important for b-one fusion. A retrospective study was done on the charts, operative records, radiographs, and clinical follow up of thirty-nine patients. One hundred and seventy-eight lateral mass screws were analyzed. The spinal nerve injury, violation of the facet joint, vertebral artery injury, and the bicortical purchases were examined at each lateral mass. All thirty-nine patients received instrumentations with poly axial screws and rod systems, in which one hundred and seventy-eight screws in total. No vertebral artery injury or nerve root injury were observed. Sixteen facet joint violations were observed (9.0%). Bicortical purchases were achieved on one hundred and fifty-six (87.6%). Bone fusion was achieved in all patients. The advantages of the Kim's technique are that it is performed by using given anatomical structures and that the complication rate is as low as those of other known techniques. The Kim's technique can be performed easily and safely without fluoroscopic assistance for the treatment of many cervical diseases.

  7. Human papilloma virus genotypes in women from Nayarit, Mexico, with squamous intraepithelial lesions and cervical cancer.

    PubMed

    Ortega-Cervantes, Laura; Aguilar-Lemarroy, Adriana; Rojas-García, Aurora Elizabeth; Barrón-Vivanco, Briscia Socorro; Vallejo-Ruiz, Verónica; León, David Cantú-De; Hernández, Yael Yvette Bernal; Jáuregui-Martínez, Armando; Medina-Díaz, Irma Martha

    2016-07-01

    In Mexico cervical cancer (CC) is the most common cause of death from neoplasia in women. Study aimed to analyze the current distribution of Human papillomavirus (HPV) types in women from Nayarit, Mexico, with Squamous intraepithelial lesions (SIL) and Cervical cancer (CC). Between January 2011 and July 2013, cervical samples were collected from female residents of the Mexican state of Nayarit and were analyzed by means of a LINEAR ARRAY® HPV genotyping test. Data analyses were performed using Stata ver. 8.0 statistical software. Of the samples analyzed, 91.2%, HPV DNA was detected. Of these positive samples, 82% were High-risk (HR) viral types. The most prevalent HPV genotypes identified were 16, 58, 31, 18, and 70. Forty two percent of participants had a single infection, while 23 and 26% of participants were infected with two or more HPV genotypes, respectively. HPV 16 was the most prevalent genotype identified and was frequently present as a co-infection with HPV types 18, 51, 52, 59, 66, or 70. Women <20 years of age were most often infected with HPV, and the HPV Quadrivalent vaccine (types 16, 18, 6, and 11), currently available in Mexico, no confers protection against a subset of the HPV genotypes identified in the present study (58, 31, 70, and 35). Thus, it is important evaluate the geographical distribution of specific HPV genotypes in all health of center across Mexico in order to implement a successful vaccination program and to diagnose CC in its early stages.

  8. Agreement of colposcope and gynocular in assessment of cervical lesions by swede score: a randomized, crossover pilot trial.

    PubMed

    Ngonzi, Joseph; Bajunirwe, Francis; Wistrand, Charlotte; Mayanja, Ronald; Altman, Daniel; Thorsell, Malin; Wikström Shemer, Elisabeth Andrea

    2013-10-01

    This study aimed to determine if criterion standard colposcopy could be provided by a pocket-sized battery-driven colposcope, the Gynocular. The study was a randomized, crossover, pilot clinical trial for evaluating agreement of diagnosis of cervical lesions by colposcopy using a standard colposcope and a pocket-sized battery-driven colposcope, the Gynocular, in 69 women positive for visual inspection with acetic acid. Swede scores were used at the time of colposcopy and compared with the final histological diagnosis after directed cervical biopsy. To test the level of agreement between the colposcopy and Gynocular, we calculated the percentage agreement and the κ statistic. We calculated the detection rates of cervical lesions of the Gynocular and a standard colposcope using biopsy results as criterion standards. All included patients also underwent a Pap smear. The level of agreement of Swede score between the Gynocular and colposcope was 70.1% and the κ statistic was 0.65 (p < .001). Biopsy identified 4 women (6.7%) with cervical intraepithelial neoplasia 1 (CIN 1) and 1 woman (1.7%) with CIN 2; 2 women (3.4%) had CIN 3, and 2 women had invasive cervical cancer (CIN 3+). Pap smear detected 2 women (3.1%) with CIN 1 but did not identify any high-grade cervical lesion. Cervicitis was present in 17 (27.4%) of the Pap smears and in 34 (57.6%) of the biopsies. The study shows that in visual inspection with acetic acid-positive women, a battery-driven, pocket-sized colposcope has a significant level of agreement with stationary colposcopy in assessing cervical lesions.

  9. Revised terminology for cervical histopathology and its implications for management of high-grade squamous intraepithelial lesions of the cervix.

    PubMed

    Waxman, Alan G; Chelmow, David; Darragh, Teresa M; Lawson, Herschel; Moscicki, Anna-Barbara

    2012-12-01

    In March 2012, the College of American Pathologists and American Society for Colposcopy and Cervical Pathology, in collaboration with 35 stakeholder organizations, convened a consensus conference called the Lower Anogenital Squamous Terminology (LAST) Project. The recommendations of this project include using a uniform, two-tiered terminology to describe the histology of human papillomavirus-associated squamous disease across all anogenital tract tissues: vulva, vagina, cervix, penis, perianus, and anus. The recommended terminology is "low-grade" or "high-grade squamous intraepithelial lesion (SIL)." This terminology is familiar to clinicians, because it parallels the terminology of the Bethesda System cytologic reports. Biopsy results using SIL terminology may be further qualified using "intraepithelial neoplasia" (IN) terminology in parentheses. Laboratory p16 tissue immunostaining is recommended to better classify histopathology lesions that morphologically would earlier have been diagnosed as IN 2. p16 is also recommended for differentiating between high-grade squamous intraepithelial lesions and benign mimics. The LAST Project recommendations potentially affect the application of current guidelines for managing cervical squamous intraepithelial lesions. The authors offer interim guidance for managing cervical lesions diagnosed using this new terminology with special attention paid to managing young women with cervical high-grade squamous intraepithelial lesions on biopsy. Clinicians should be aware of the LAST Project recommendations, which include important changes from prior terminology.

  10. Revised Terminology for Cervical Histopathology and Its Implications for Management of High-Grade Squamous Intraepithelial Lesions of the Cervix

    PubMed Central

    Waxman, Alan G.; Chelmow, David; Darragh, Teresa M.; Lawson, Herschel; Moscicki, Anna-Barbara

    2014-01-01

    In March 2012, the College of American Pathologists and American Society for Colposcopy and Cervical Pathology, in collaboration with 35 stakeholder organizations, convened a consensus conference called the Lower Anogenital Squamous Terminology (LAST) Project. The recommendations of this project include using a uniform, two-tiered terminology to describe the histology of human papillomavirus-associated squamous disease across all anogenital tract tissues: vulva, vagina, cervix, penis, perianus, and anus. The recommended terminology is “low-grade” or “high-grade squamous intraepithelial lesion (SIL).” This terminology is familiar to clinicians, because it parallels the terminology of the Bethesda System cytologic reports. Biopsy results using SIL terminology may be further qualified using “intraepithelial neoplasia” (IN) terminology in parentheses. Laboratory p16 tissue immunostaining is recommended to better classify histopathology lesions that morphologically would earlier have been diagnosed as IN 2. p16 is also recommended for differentiating between high-grade squamous intraepithelial lesions and benign mimics. The LAST Project recommendations potentially affect the application of current guidelines for managing cervical squamous intraepithelial lesions. The authors offer interim guidance for managing cervical lesions diagnosed using this new terminology with special attention paid to managing young women with cervical high-grade squamous intraepithelial lesions on biopsy. Clinicians should be aware of the LAST Project recommendations, which include important changes from prior terminology. PMID:23168774

  11. [Presence of high risk human papilomaviruses (HPV) in the low grade cervical lesion].

    PubMed

    Iljazović, Ermina; Mustadenagić-Mujanović, Jasminka; Karasalihović, Zinaida; Cickusić, E; Avdić, S

    2006-01-01

    Low grade squamous intraepithelial lesion (LGSIL) and atypical squamous cells undetermined significance (ASCUS) are the most frequent verified cellular abnormalities. Their management are still highly controversial mostly caused by uncertainty about their histology and nature of originate. Detection of HPV DNA in the absence of cytological abnormalities can also indicate presence of high-grade cervical intraepithelial neoplasia (CIN). The aim of this study was to show the association of the benign cellular changes, ASCUS and LGSIL with oncogenic types of HPV and to prove the necessity of more intensive screening of this group of patients. Cytology and pathomorphology analyses were performed first. Identification of the presence of human papiloma virus was carried out by the Digene Hybride Capture II test for all patients. Identification of different HPV types for the particular number of patients was carried out by RFLP (Rsetriction Fragments Length of Polymorphism). Out of the 101 patients in the first group 92 (91,08%) were HPV positive, and 41, 58% had no cellular abnormalities, ASCUS or LGSIL. Out of 509 patients of the second group 26.92% were positive for HRHPV, and 78,97% of them had no cellular abnormalities, ASCUS or LGSIL. HPV 16 was detected in 27.36% (ASCUS/LGSIL) of low risk cervical lesion of the first examined period. The combination of smears with the detection of high risk HPV types increases the triage sensitivity especially at patients with mild.

  12. Use of the HPV MLPA assay in cervical cytology for the prediction of high grade lesions.

    PubMed

    Litjens, Rogier J N T M; Theelen, Wendy; van de Pas, Yvonne; Ossel, Jessica; Reijans, Martin; Simons, Guus; Speel, Ernst-Jan M; Slangen, Brigitte F M; Ramaekers, Frans C S; Kruitwagen, Roy F P M; Hopman, Anton H N

    2013-08-01

    Current screening methods for uterine cervical cancer such as Papanicolaou smears and/or high risk human Papillomavirus (HR-HPV) detection have a high negative predictive value but a low positive predictive value for the presence of high grade cervical lesions. Therefore, new parameters are needed to reduce the rate of unnecessary referrals for colposcopy. The predictive value of the HPV multiplex ligation-dependent probe amplification (MLPA) assay, which can assess simultaneously HPV16/18 viral load and viral integration, was evaluated. The assay was applied to 170 cervical cytological samples, and the results were correlated with the matching histological follow-up. The GP5+/6+ assay and qPCR were used as a control for HR-HPV typing. The MLPA assay classified a higher percentage of cases as high-risk (high-viral load and/or viral integration) with higher grades of dysplasia. There was a high correlation between the HPV MLPA assay and qPCR for viral load and HPV genotyping, and between the MLPA assay and the GP5+/6+ assay for HPV genotyping. The sensitivity and specificity of the HPV MLPA assay for the detection of high-grade lesions were 44% and 93%, respectively. This study demonstrates that the HPV MLPA assay can reliably detect HPV 16/18, viral load, and viral integration in cytological samples. Also, high-risk classification correlated well with the presence of high-grade dysplasia. However, for the implementation of the MLPA assay into clinical practice, additional HR-HPV types need to be included to increase the sensitivity of the assay, and thereby increase its negative predictive value.

  13. One-year Clinical Evaluation of Resin Composite Restorations of Noncarious Cervical Lesions in Smokers.

    PubMed

    de Carvalho, Luana Dutra; Gondo, Renata; Lopes, Guilherme Carpena

    2015-08-01

    To evaluate the one-year clinical performance of composite restorations in noncarious cervical lesions placed in smoking and non-smokers using a multimode adhesive system with two adhesive strategies. Among the selected cervical lesions, four experimental groups were formed based on the patients' smoking habit and bonding strategies with a multimode adhesive system (n = 38): G1: etchand- rinse in non-smokers; G2: selective enamel etching in non-smokers; G3: etch-and-rinse in smokers; G4: selective enamel etching in smokers. The restorations were paired, ie, each patient received at least two restorations. A nanofilled resin composite was applied and light cured incrementally in all groups by one operator. Two calibrated examiners evaluated the restorations at baseline, 6 and 12 months after placement. The modified USPHS criteria were used for evaluation. Data were analyzed using the chi-square (for associations between groups) and McNemar tests. No statistically significant difference was found between groups for the criteria of retention, marginal discoloration, color match, marginal integrity, or sensitivity after 6 and 12 months. The assessments over time showed a statistically significant difference only for marginal discoloration at 12 months for groups 1, 3, and 4 when compared to baseline (p = 0.031). There were no statistical differences for any criteria evaluated among smokers and non-smokers, except for color match, where a difference was found after the baseline evaluation. Regarding the adhesive strategy, etch-and-rinse resulted in a clinical performance similar to that of selective enamel etching over 12 months. Neither cigarette smoking habit nor adhesive strategy influenced the clinical performance of resin composite cervical restorations over the first year.

  14. Endobronchial non-Hodgkin's lymphoma presenting as mass lesion.

    PubMed

    Mohapatra, P R; Bhuniya, S; Garg, S; Dimri, K; Janmeja, A K

    2009-01-01

    A 40-year-old male presented with clinical and radiological manifestations of right lung atelectasis and post-obstructive pneumonia. Flexible bronchoscopy revealed gross narrowing of the right upper lobe bronchus and a smooth, white endobronchial mass completely occluding the right lower lobe bronchus. Endobronchial biopsy from the mass lesion yielded low grade B-cell non-Hodgkin's lymphoma. This is one of the rarest presentation of non-Hodgkin's lymphoma.

  15. The prevalence of precancerous cervical cancer lesion among HIV-infected women in southern Ethiopia: a cross-sectional study.

    PubMed

    Gedefaw, Abel; Astatkie, Ayalew; Tessema, Gizachew Assefa

    2013-01-01

    The magnitude of precancerous cervical cancer lesions as well as invasive cervical cancer is higher in HIV-infected women than non HIV-infected women. Thus, screening targeting HIV-infected women is being undertaken in developing countries, including Ethiopia. However, data on the prevalence and determinants of precancerous cervical cancer lesion among HIV-infected women in southern Ethiopia is lacking. Thus, this study aimed to assess the prevalence of and factors associated with precancerous cervical cancer lesion among HIV- infected women in southern Ethiopia. A hospital-based cross-sectional study was conducted from October 2012 to February 2013 among HIV-infected women in Southern Ethiopia. Four hundred forty eight HIV-infected women who had been screened and treated for precancerous cervical cancer lesion were included in the study. Data were collected by using structured and pretested questionnaire. Visual inspection with acetic acid was applied for screening and treatment. SPSS version 16.0 was used for data entry and analysis. Logistic regression analysis was fitted and odds ratios with 95% Confidence intervals and p-values were computed to identify factors associated with precancerous cervical cancer lesion. Out of 448 study participants, 99 (22.1%) were found to be positive for precancerous cervical cancer. Being currently on highly active antiretroviral treatment (AOR=0.52, 95%CI: 0.35, 0.92), history of sexually transmitted disease (AOR=2.30, 95%CI: 1.23, 4.29) and having only one lifetime sexual partner (AOR=0.33, 95%CI: 0.20, 0.56) were factors associated with precancerous cervical cancer lesion. The prevalence of precancerous cervical cancer lesion among HIV-infected women in southern Ethiopia was found to be high. Intervention to access all HIV-infected women like scaling up the limited services and awareness creation should be undertaken. Measures aimed at preventing the acquisition and transmission of sexually transmitted diseases and reducing

  16. Intracranial hypertension secondary to a skull lesion without mass effect.

    PubMed

    Serlin, Yonatan; Benifla, Mony; Kesler, Anat; Cohen, Avi; Shelef, Ilan

    2016-09-01

    We report and discuss five patients with intracranial hypertension due to a skull lesion reducing cerebral sinus patency with a compressive, non-thrombotic mechanism. We illustrate the importance of a high level of suspicion for this condition in patients presenting with headache, papilledema and increased intracranial pressure in the absence of focal signs or radiological evidence of mass effect.

  17. Is There an Association between Body Mass Index and Cervical Length? Implications for Obesity and Cervical Length Management in Pregnancy.

    PubMed

    Venkatesh, Kartik K; Cantonwine, David E; Zera, Chloe; Arjona, Melanie; Smith, Nicole A; Robinson, Julian N; McElrath, Thomas F

    2016-11-24

    Objective Obesity and cervical insufficiency are leading causes of morbidity in pregnancy. We assess the relationship between maternal body mass index (BMI) and second-trimester cervical length. Methods A secondary analysis of a nested case-control study of women with singleton gestations enrolled from 2006 to 2008. The primary exposure was first-trimester BMI, categorized per World Health Organization criteria: normal (18.5 to ≤ 25 kg/m(2)), overweight (25 to ≤ 30 kg/m(2)), and obese (> 30 kg/m(2)). The primary outcome was cervical length > 75th percentile. Results Among 391 pregnant women observed, the median cervical length was 3.6 cm, and the median BMI was 24.8 kg/m(2). In multivariable analyses, after adjusting for BMI, age, race, parity, smoking, and gestational age at delivery, women who were overweight (adjusted odds ratio [AOR]: 2.18; 95% CI: 1.20-3.96) and obese (AOR: 2.83; 95% CI: 1.47-5.43) were more than two times more likely to have a cervical length > 75th percentile. When cervical length and BMI were assessed linearly, for each 1.0 kg/m(2) increase in BMI, cervical length increased by 0.25 mm. These results were robust to utilizing different cutoffs of cervical length and pre-pregnancy BMI. Conclusion This study demonstrates a relationship between BMI and cervical length suggesting that obesity may be associated with longer cervical length. These results will need to be replicated in larger cohorts undergoing universal cervical length assessment.

  18. Multiple Human Papillomavirus Infections with High Viral Loads Are Associated with Cervical Lesions but Do Not Differentiate Grades of Cervical Abnormalities

    PubMed Central

    Depuydt, Christophe; Benoy, Ina; Bogers, Johannes; Antoine, Jerome; Arbyn, Marc; Pawlita, Michael

    2013-01-01

    Multiple human papillomavirus (HPV) genotypes often coexist within cervical epithelia and are frequently detected together in smears of different grades of cervical neoplasia. Describing the association between multiple infections and cervical disease is important in generating hypotheses regarding its pathogenesis. We analyzed the prevalence of multiple HPV infections and their attribution to cervical disease in a screening population of 999 consecutive BD SurePath liquid-based cervical cytology samples enriched with atypical squamous cells of undetermined significance (ASCUS) (n = 100), low-grade squamous intraepithelial lesions (LSIL) (n = 100), and high-grade squamous intraepithelial lesions (HSIL) (n = 97). HPV genotyping was performed only on cytology specimens using a broad-spectrum GP5+/6+-PCR/multiplex HPV genotyping (BSGP5+/6+-PCR/MPG) assay that detects and quantifies 51 HPV genotypes and 3 subtypes. Using a recently defined high viral load cutoff, the quantitative data were scored as high or low viral load. In the 36-month follow-up, 79 histologically confirmed cervical intraepithelial neoplasia grade 2 or greater (CIN2+) cases were identified. In the screening population, there was a trend of having more multiple infections at a younger age. Multiple HPV infections were common. Multiple HPV types were most prevalent in LSIL (75.9% of HPV positives), followed by HSIL (65.5%), ASCUS (64.6%), and negative for intraepithelial lesion or malignancy (NILM) (36.8%). On average, 3.2 and 2.5 HPV types were detected per LSIL and HSIL sample, respectively. Multiple HPV types with high viral loads were most prevalent in LSIL (62.6% of high viral load positives), followed by HSIL (51.9%), ASCUS (40.7%), and NILM (19.3%). Patients with multiple high viral loads showed a 4- to 6-fold-higher risk of having cervical precancerous cytological lesions than did patients with single high viral loads. Compared to NILM, multiple infections, especially with multiple high viral

  19. Detection of cervical lesions by multivariate analysis of diffuse reflectance spectra: a clinical study.

    PubMed

    Prabitha, Vasumathi Gopala; Suchetha, Sambasivan; Jayanthi, Jayaraj Lalitha; Baiju, Kamalasanan Vijayakumary; Rema, Prabhakaran; Anuraj, Koyippurath; Mathews, Anita; Sebastian, Paul; Subhash, Narayanan

    2016-01-01

    Diffuse reflectance (DR) spectroscopy is a non-invasive, real-time, and cost-effective tool for early detection of malignant changes in squamous epithelial tissues. The present study aims to evaluate the diagnostic power of diffuse reflectance spectroscopy for non-invasive discrimination of cervical lesions in vivo. A clinical trial was carried out on 48 sites in 34 patients by recording DR spectra using a point-monitoring device with white light illumination. The acquired data were analyzed and classified using multivariate statistical analysis based on principal component analysis (PCA) and linear discriminant analysis (LDA). Diagnostic accuracies were validated using random number generators. The receiver operating characteristic (ROC) curves were plotted for evaluating the discriminating power of the proposed statistical technique. An algorithm was developed and used to classify non-diseased (normal) from diseased sites (abnormal) with a sensitivity of 72 % and specificity of 87 %. While low-grade squamous intraepithelial lesion (LSIL) could be discriminated from normal with a sensitivity of 56 % and specificity of 80 %, and high-grade squamous intraepithelial lesion (HSIL) from normal with a sensitivity of 89 % and specificity of 97 %, LSIL could be discriminated from HSIL with 100 % sensitivity and specificity. The areas under the ROC curves were 0.993 (95 % confidence interval (CI) 0.0 to 1) and 1 (95 % CI 1) for the discrimination of HSIL from normal and HSIL from LSIL, respectively. The results of the study show that DR spectroscopy could be used along with multivariate analytical techniques as a non-invasive technique to monitor cervical disease status in real time.

  20. The Association between HIV Infection, Antiretroviral Therapy and Cervical Squamous Intraepithelial Lesions in South Western Nigerian Women

    PubMed Central

    Ezechi, Oliver Chukwujekwu; Pettersson, Karen Odberg; Okolo, Clement Abu; Ujah, Innocent Achaya O.; Ostergren, Per Olof

    2014-01-01

    Introduction Findings from studies that evaluated the effect of antiretroviral drug use on the development of cervical squamous intraepithelial lesion differed in their conclusions. This study investigated the association between HIV infection, antiretroviral drug use and cervical squamous intraepithelial lesion in a high HIV and cervical cancer burden setting- Nigeria. Methods A cross sectional study among 1140 women of known HIV status enrolled in a randomised study to determine the test characteristics of visual inspection in detecting cytology diagnosed squamous intraepithelial lesion. Multivariate analysis was used to determine the association between HIV infection, antiretroviral drug use and the twin outcome variables of cervical squamous intraepithelial lesion (SIL) and High grade squamous intraepithelial lesion (HSIL) while controlling for confounders. Results Prevalence of cervical squamous intraepithelial lesion was 8.5%, with a higher prevalence of 14.3% in HIV positive compared to 3.3% in HIV negative women (aOR: 5.4; 95% CI: 2.9–8.8). Not using antiretroviral drugs was found to be associated with an increased risk of SIL (aOR: 2.1; 95% CI: 1.4–3.5) and HSIL (aOR: 2.6; 95% CI: 1.1–6.4). Participants who had a CD4 cell count <200 cells/mm3, were also found to be at increased risk for SIL (aOR: 1.9; 95% CI: 1.1–5.9) and HSIL (aOR: 5.7; 95% CI: 1.1–7.2). Conclusion HIV infection and severe immunosuppression were found to be associated with increased risk of cervical squamous intraepithelial lesion but not viral load. For the first time, in the West African sub-region with specific HIV type and strains, we established the protective effect of antiretroviral drug use against the development of SIL. Integration of cervical cancer screening programme into HIV services and early initiation of antiretroviral drug in HIV positive women especially those with severe immune-suppression could therefore prove to be useful in preventing and controlling

  1. Human Papillomavirus Genotyping and p16(INK4a) Expression in Cervical Lesions: A Combined Test to Avoid Cervical Cancer Progression.

    PubMed

    Zouheir, Yassine; Fechtali, Taoufiq; Elgnaoui, Nadia

    2016-06-01

    Cervical cancer is a major public health problem in Morocco. The cervical cancer has a long precancerous period that provides an opportunity for the screening and treatment. Improving screening tests is a priority goal for the early diagnosis of cervical cancer. This study was conducted to evaluate the combination of p16(INK4a) protein expression, human papillomavirus (HPV) typing, and histopathology for the identification of cervical lesions with high risk to progress to cervical cancer among Moroccan women. A total of 96 cervical biopsies were included in this study. Signal amplification in situ hybridization with biotinylated probes was used to detect HPV. Immunohistochemistry was used to evaluate the expression of p16(INK4a) protein. HPV DNA was detected in 74.0% of the biopsies (71/96). Of the seventy-one positive HPV cases, we detected 67.6% (48/71) of high risk (HR)-HPV (HPV 16 and 18), 24% of low risk-HPV (HPV 6 and 11), 1.4% intermediate risk-HPV (HPV 31, 33, and 35), and 7% coinfections (HPV 6/11 and 16/18). Overexpression of p16(INK4a) protein was observed in 72.9% (70/96) of the biopsies. In addition, p16(INK4a) protein detection was closely correlated with recovery of HR HPV. Our result showed that p16(INK4a) expression level is correlated with HR-HPV status.

  2. Behavioural and neurochemical effects of superior cervical ganglionectomy in rats with septo-hippocampal lesions.

    PubMed

    Bratt, A M; Cassel, J C; Neufang, B; Greene, P L; Jackisch, R; Hertting, G; Will, B E

    1995-01-01

    This longitudinal study, extending over 12 months, assessed the behavioural and biochemical effects of hippocampal sympathetic ingrowth (HSI) into the partially denervated hippocampus. Male Long-Evans rats received fimbria-fornix lesions (FIFO) or sham operations at 90 days of age. At the same time half of the rats from each group sustained bilateral ablation of the superior cervical ganglia (SCGX). A battery of behavioural tests, measuring spontaneous alternation, activity in the open field and home cage, and radial-maze performance, were employed, starting after one very short (16 days) and one extended (216 days) post-operative delay. Neurochemical analyses measuring choline acetyltransferase (ChAT) activity, high-affinity choline (HACU) and noradrenaline uptake by hippocampal synaptosomes (HANU), hippocampal noradrenaline ([NA]), serotonin ([5-HT]) and 5-hydroxyindoleacetic acid ([5-HIAA]) concentrations were carried out in a dorsal, a "middle" and a ventral region of the hippocampus. Lesion of the FIFO induced a significant and enduring deficit in radial-maze performance, in addition to a persistent locomotor hyperactivity. ChAT and HACU were significantly depleted in all three regions of the hippocampus at 12 months, and these deficits were negatively correlated with maze performance. SCGX in the presence of the FIFO lesion significantly reduced [NA] in the middle region of the hippocampus, as compared to SCGX rats, and contributed to a restoration of lesion-induced depletions in [5-HT] and [5-HIAA] in the middle and ventral hippocampal regions, whilst failing to elicit any behavioural changes at either time point. It is concluded that if lesion-induced HSI indeed occurred, as is suggested by neurochemical evidence, it had no effect upon the observed behavioural deficits elicited by transection of the FIFO in the rat.

  3. Mass Media Campaign Improves Cervical Screening across All Socio-Economic Groups

    ERIC Educational Resources Information Center

    Anderson, Jenny O.; Mullins, Robyn M.; Siahpush, Mohammad; Spittal, Matthew J.; Wakefield, Melanie

    2009-01-01

    Low socio-economic status (SES) has been associated with lower cervical screening rates. Mass media is one known strategy that can increase cervical screening participation. This study sought to determine whether a mass media campaign conducted in Victoria, Australia, in 2005 was effective in encouraging women across all SES groups to screen. Data…

  4. Mass Media Campaign Improves Cervical Screening across All Socio-Economic Groups

    ERIC Educational Resources Information Center

    Anderson, Jenny O.; Mullins, Robyn M.; Siahpush, Mohammad; Spittal, Matthew J.; Wakefield, Melanie

    2009-01-01

    Low socio-economic status (SES) has been associated with lower cervical screening rates. Mass media is one known strategy that can increase cervical screening participation. This study sought to determine whether a mass media campaign conducted in Victoria, Australia, in 2005 was effective in encouraging women across all SES groups to screen. Data…

  5. Intramedullary lesion expansion on magnetic resonance imaging in patients with motor complete cervical spinal cord injury.

    PubMed

    Aarabi, Bizhan; Simard, J Marc; Kufera, Joseph A; Alexander, Melvin; Zacherl, Katie M; Mirvis, Stuart E; Shanmuganathan, Kathirkamanthan; Schwartzbauer, Gary; Maulucci, Christopher M; Slavin, Justin; Ali, Khawar; Massetti, Jennifer; Eisenberg, Howard M

    2012-09-01

    The authors performed a study to determine if lesion expansion occurs in humans during the early hours after spinal cord injury (SCI), as has been established in rodent models of SCI, and to identify factors that might predict lesion expansion. The authors studied 42 patients with acute cervical SCI and admission American Spinal Injury Association Impairment Scale Grades A (35 patients) and B (7 patients) in whom 2 consecutive MRI scans were obtained 3-134 hours after trauma. They recorded demographic data, clinical information, Injury Severity Score (ISS), admission MRI-documented spinal canal and cord characteristics, and management strategies. The characteristics of the cohort were as follows: male/female ratio 37:5; mean age, 34.6 years; and cause of injury, motor vehicle collision, falls, and sport injuries in 40 of 42 cases. The first MRI study was performed 6.8 ±2.7 hours (mean ± SD) after injury, and the second was performed 54.5 ± 32.3 hours after injury. The rostrocaudal intramedullary length of the lesion on the first MRI scan was 59.2 ± 16.1 mm, whereas its length on the second was 88.5 ± 31.9 mm. The principal factors associated with lesion length on the first MRI study were the time between injury and imaging (p = 0.05) and the time to decompression (p = 0.03). The lesion's rate of rostrocaudal intramedullary expansion in the interval between the first and second MRI was 0.9 ± 0.8 mm/hour. The principal factors associated with the rate of expansion were the maximum spinal cord compression (p = 0.03) and the mechanism of injury (p = 0.05). Spinal cord injury in humans is characterized by lesion expansion during the hours following trauma. Lesion expansion has a positive relationship with spinal cord compression and may be mitigated by early surgical decompression. Lesion expansion may be a novel surrogate measure by which to assess therapeutic effects in surgical or drug trials.

  6. Persistence of human papillomavirus DNA in cervical lesions after treatment with diathermic large loop excision.

    PubMed Central

    Distéfano, A L; Picconi, M A; Alonio, L V; Dalbert, D; Mural, J; Bartt, O; Bazán, G; Cervantes, G; Lizano, M; Carrancá, A G; Teyssié, A

    1998-01-01

    OBJECTIVE: The aim of this study was to identify human papillomavirus (HPV) in cervical intraepithelial neoplasia (CIN) lesions and to evaluate the persistence of viral DNA after diathermic large loop excision (DLLE) treatment. STUDY DESIGN: Biopsies from 36 patients with low- and high-grade CIN lesions were studied before and after DLLE treatment looking for HPV sequences. DNA was extracted to perform a radioactive polymerase chain reaction (PCR) using GP 5,6 generic primers. PCR products were analyzed by the single-stranded conformational polymorphism (SSCP) which is a simultaneous detection and typing method. Dot-blot hybridization with generic and type-specific biotinylated oligonucleotide probes was applied in some cases. RESULTS: HPV DNA was found in all pretreatment samples, and the viral type was identified in 80% of them, HPV 16 being the most prevalent. The viral type coincided with that detected in the first biopsy in all except one case. Seventy five percent of the patients (27 cases) were negative for CIN at follow up, but 50% of them remained HPV DNA positive. CONCLUSION: DLLE treatment was effective in removing the CIN lesion but not the HPV. This fact points out the need to asses the presence of HPV in DNA during the follow-up, since viral persistence has been considered a high risk factor for recurrence and/or malignant transformation. PMID:9894176

  7. Chemical Profile of the Dentin Substrate in Non-Carious Cervical Lesions

    PubMed Central

    Karan, Kunal; Yao, Xiaomei; Xu, Changqi; Wang, Yong

    2009-01-01

    Objective The molecular structural nature of the dentin substrate in non-carious cervical lesions (NCCLs) is poorly understood. This investigation characterized the chemical structure including inhomogeneities, composition, mineral crystallinity, collagen organization of normal dentin and affected dentin substrates within NCCLs using Raman micro-spectroscopic mapping/imaging. Materials and Methods Three extracted human pre-molars affected with NCCLs were selected and cavities matching the natural lesion with respect to size and location were prepared on the lingual/palatal surface of each tooth to serve as controls. The specimens were sectioned to expose the gingival and occlusal margins of the NCCLs and the control cavities. Micro-Raman spectra and imaging acquired at 1.5 micrometer spatial resolution at positions perpendicular to the lesion surfaces. Results The Raman spectra and imaging comparisons showed the distinct compositional and structural alterations in mineral and matrix components of NCCL affected dentin. A heterogeneous hyper-mineralized layer, with characteristic features such as high phosphate/low carbonate content, high degree of crystallinity and partially denatured collagen were revealed in affected dentin substrate of NCCLs. Significance Generating Raman images based on different strategies from the same data set provides a powerful means to study the structural alterations within heterogeneous dental tissues. Direct overlay of the images indicated that the changes in chemical structure and composition are synchronized. Further studies are required to understand the role that these alterations play in response to acid etching and bonding to these clinically-relevant substrates. PMID:19464050

  8. Imaging of noncarious cervical lesions by means of a fast swept source optical coherence tomography system

    NASA Astrophysics Data System (ADS)

    Stoica, Eniko T.; Marcauteanu, Corina; Bradu, Adrian; Sinescu, Cosmin; Topala, Florin Ionel; Negrutiu, Meda Lavinia; Duma, Virgil Florin; Podoleanu, Adrian Gh.

    2014-01-01

    Non-carious cervical lesions (NCCL) are defined as the loss of tooth substance at the cemento-enamel junction and are caused by abrasion, erosion and/or occlusal overload. In this paper we proved that our fast swept source OCT system is a valuable tool to track the evolution of NCCL lesions in time. On several extracted bicuspids, four levels of NCCL were artificially created. After every level of induced lesion, OCT scanning was performed. B scans were acquired and 3D reconstructions were generated. The swept source OCT instrument used in this study has a central wavelength of 1050 nm, a sweeping range of 106 nm (measured at 10 dB), an average output power of 16 mW and a sweeping rate of 100 kHz. A depth resolution determined by the swept source of 12 μm in air was experimentally obtained. NCCL were measured on the B-scans as 2D images and 3D reconstructions (volumes). For quantitative evaluations of volumes, the Image J software was used. By calculating the areas of the amount of lost tissue corresponding to each difference of Bscans, the final volumes of NCCL were obtained. This swept source OCT method allows the dynamic diagnosis of NCCL in time.

  9. Human papilloma virus genotypes in women from Nayarit, Mexico, with squamous intraepithelial lesions and cervical cancer

    PubMed Central

    Ortega-Cervantes, Laura; Aguilar-Lemarroy, Adriana; Rojas-García, Aurora Elizabeth; Barrón-Vivanco, Briscia Socorro; Vallejo-Ruiz, Verónica; León, David Cantú-De; Hernández, Yael Yvette Bernal; Jáuregui-Martínez, Armando; Medina-Díaz, Irma Martha

    2016-01-01

    Objective In Mexico cervical cancer (CC) is the most common cause of death from neoplasia in women. Study aimed to analyze the current distribution of Human papillomavirus (HPV) types in women from Nayarit, Mexico, with Squamous intraepithelial lesions (SIL) and Cervical cancer (CC). Methodology Between January 2011 and July 2013, cervical samples were collected from female residents of the Mexican state of Nayarit and were analyzed by means of a LINEAR ARRAY® HPV genotyping test. Data analyses were performed using Stata ver. 8.0 statistical software. Results Of the samples analyzed, 91.2%, HPV DNA was detected. Of these positive samples, 82% were High-risk (HR) viral types. The most prevalent HPV genotypes identified were 16, 58, 31, 18, and 70. Forty two percent of participants had a single infection, while 23 and 26% of participants were infected with two or more HPV genotypes, respectively. HPV 16 was the most prevalent genotype identified and was frequently present as a co-infection with HPV types 18, 51, 52, 59, 66, or 70. Conclusion Women <20 years of age were most often infected with HPV, and the HPV Quadrivalent vaccine (types 16, 18, 6, and 11), currently available in Mexico, no confers protection against a subset of the HPV genotypes identified in the present study (58, 31, 70, and 35). Thus, it is important evaluate the geographical distribution of specific HPV genotypes in all health of center across Mexico in order to implement a successful vaccination program and to diagnose CC in its early stages. PMID:27610056

  10. A critical review of non-carious cervical (wear) lesions and the role of abfraction, erosion, and abrasion.

    PubMed

    Bartlett, D W; Shah, P

    2006-04-01

    The terms 'abfraction' and 'abrasion' describe the cause of lesions found along the cervical margins of teeth. Erosion, abrasion, and attrition have all been associated with their formation. Early research suggested that the cause of the V-shaped lesion was excessive horizontal toothbrushing. Abfraction is another possible etiology and involves occlusal stress, producing cervical cracks that predispose the surface to erosion and abrasion. This article critically reviews the literature on abrasion, erosion, and abrasion, and abfraction. The references were obtained by a MEDLINE search in March, 2005, and from this, hand searches were undertaken. From the literature, there is little evidence, apart from laboratory studies, to indicate that abfraction exists other than as a hypothetical component of cervical wear.

  11. Rubber dam isolation of cervical lesions. Part 1: Alternative techniques which avoid injury to the periodontium.

    PubMed

    Liebenberg, W H

    1994-01-01

    While it is arguable that the operative procedures depicted in this article could have been done equally well with alternative forms of isolation, it is indisputable that rubber dam provides for the most thorough 'isolation' in the comprehensive sense of the term. It allows for the finite control over peripheral variables such as access and controlled gingival retraction. This in turn permits meticulous execution of restorative procedures within the luxury of 'true four-handed dentistry'. Most operative procedures are done within the limitations of single handed dentistry as the other 'three hands' are involved with retraction, fluid evacuation and access control. The rubber dam is indeed indispensable and with the increased awareness of infection control it is conceivable that rubber dam isolation will continue to be associated with quality patient care. Part 2 of this article will detail the application of the 'Modified Gingival Retractor' in the isolation of cervical lesions.

  12. Automatic classification of acetowhite temporal patterns to identify precursor lesions of cervical cancer

    NASA Astrophysics Data System (ADS)

    Gutiérrez-Fragoso, K.; Acosta-Mesa, H. G.; Cruz-Ramírez, N.; Hernández-Jiménez, R.

    2013-12-01

    Cervical cancer has remained, until now, as a serious public health problem in developing countries. The most common method of screening is the Pap test or cytology. When abnormalities are reported in the result, the patient is referred to a dysplasia clinic for colposcopy. During this test, a solution of acetic acid is applied, which produces a color change in the tissue and is known as acetowhitening phenomenon. This reaction aims to obtaining a sample of tissue and its histological analysis let to establish a final diagnosis. During the colposcopy test, digital images can be acquired to analyze the behavior of the acetowhitening reaction from a temporal approach. In this way, we try to identify precursor lesions of cervical cancer through a process of automatic classification of acetowhite temporal patterns. In this paper, we present the performance analysis of three classification methods: kNN, Naïve Bayes and C4.5. The results showed that there is similarity between some acetowhite temporal patterns of normal and abnormal tissues. Therefore we conclude that it is not sufficient to only consider the temporal dynamic of the acetowhitening reaction to establish a diagnosis by an automatic method. Information from cytologic, colposcopic and histopathologic disciplines should be integrated as well.

  13. SIRT1 overexpression in cervical squamous intraepithelial lesions and invasive squamous cell carcinoma.

    PubMed

    Velez-Perez, Anneliese; Wang, Xiaohong I; Li, Min; Zhang, Songlin

    2017-01-01

    Invasive squamous cell carcinoma (SCC) of the cervix involves the progression of premalignant cervical intraepithelial neoplasia (CIN) and is associated with persistent human papillomavirus infection. Most CINs will regress, and the challenge is to identify the lesions likely to progress to invasive cancer. We evaluated Sirtuin 1 (SIRT1) expression in nonneoplastic cervix, CINs, and SCCs as a potential biomarker to predict disease progression. A total of 101 cases were selected including 29 CIN 1s, 32 CIN 2s, 16 CIN 3s, 2 microinvasive SCCs, and 22 invasive SCCs. Cervical nonneoplastic squamous epithelium showed weak positivity of SIRT1 in the basal layer. SIRT1 cytoplasmic overexpression was found in 13.8% of CIN 1s (4/29), 40.6% of CIN 2s (13/32), and 50% of CIN 3s (8/16), and it was statistically significant between CIN 1 and CIN 2/3 lesions (P=.01). All 24 cases of invasive and microinvasive SCC showed SIRT1 overexpression, with 25% (6/24) showing cytoplasmic staining only, 4.2% (1/24) showing nuclear staining only, and 70.8% (17/24) showing both nuclear and cytoplasmic staining. From CIN 1 to SCC, SIRT1 expression showed steady and statistically significant increase (CIN 1 versus CIN 2-3, P=.01; CIN 2-3 versus SCC, P=.0001). Thus, SIRT1 may serve as a potential biomarker for predicting the progression of CIN to invasive SCC. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Two-year clinical evaluation of three adhesive systems in non-carious cervical lesions

    PubMed Central

    ELİGUZELOGLU DALKILİC, Evrim; OMURLU, Huma

    2012-01-01

    Objectives Adhesive systems are continuously being introduced to Dentistry, unfortunately often without sufficient clinical validation. The aim of this study was to evaluate the clinical performance of cervical restorations done with three different adhesive systems. Material and methods 158 non-carious cervical lesions of 23 patients were restored with a nanofilled composite resin (Filtek Supreme, 3M/ESPE) combined with Single Bond (3M/ESPE, group SI), Clearfil SE (Kuraray Medical Inc., group CL) and Xeno III (De Trey Dentsply, group XE). In groups SI-B, CL-B and XE-B, the outer surface of the sclerotic dentin was removed by roughening with a diamond bur before application of the respective adhesive systems. In groups CL-BP and XE-BP, after removal of the outer surface of the sclerotic dentin with the bur, the remaining dentin was etched with 37% phosphoric acid and the self-etch adhesive systems Clearfil SE and Xeno III were applied, respectively. Lesions were evaluated at baseline, and restorations after 3 months, 1 year and 2 years using modified USPHS criteria. Results After 2 years, no significant difference was found between the retention rates of the groups (p >0.05). Although groups CL and SI showed significantly better marginal adaptation than group XE (p<0.05) at 2 years, no significant difference was found between the marginal adaptation of the groups SI-B, CL-B and XE-B (p>0.05). After 2 years no significant difference was observed among the marginal staining results of all groups (p>0.05). Conclusion Although all adhesive systems showed similar retention rates, Clearfil SE and Single Bond showed better marginal adaptation than Xeno III after 2 years of follow-up. PMID:22666836

  15. Diagnostic and Treatment Reproducibility of Cervical Intraepithelial Neoplasia / Squamous Intraepithelial Lesion and Factors Affecting the Diagnosis.

    PubMed

    Sağlam, Arzu; Usubütün, Alp; Dolgun, Anıl; Mutter, George L; Salman, M Coşkun; Kurtulan, Olcay; Akyol, Aytekin; Özkan, Eylem Akar; Baykara, Sema; Bülbül, Dilek; Calay, Zerrin; Eren, Funda; Gümürdülü, Derya; Haberal, Nihan; Ilvan, Şennur; Karaveli, Şeyda; Koyuncuoğlu, Meral; Müezzinoğlu, Bahar; Müftüoğlu, Kamil Hakan; Özen, Özlem; Özdemir, Necmettin; Peştereli, Elif; Ulukuş, Çağnur; Zekioğlu, Osman

    2017-01-01

    Inter-observer differences in the diagnosis of HPV related cervical lesions are problematic and response of gynecologists to these diagnostic entities is non-standardized. This study evaluated the diagnostic reproducibility of "cervical intraepithelial neoplasia" (CIN) and "squamous intraepithelial lesion" (SIL) diagnoses. 19 pathologists evaluated 66 cases once using H&E slides and once with immunohistochemical studies (p16, Ki-67 and Pro-ExC). Management response to diagnoses was evaluated amongst 12 gynecologists. Pathologists and gynecologists were also given a questionnaire about how additional information like smear results and age modify diagnosis and management. We show moderate interobserver diagnostic reproducibility amongst pathologists. The overall kappa value was 0.50 and 0.59 using the CIN and SIL classifications respectively. Impact of immunohistochemical evaluation on interpretation of cases differed and there was lack of statistically significant improvement of interobserver diagnostic reproducibility with the addition of immunohistochemistry. We saw that choice of treatment methods amongst gynecologists varied and overall concordance was only fair to moderate. The CIN2 diagnostic category was seen to have the lowest percentage agreement amongst both pathologists and gynecologists. We showed that pathologists had diagnostic "styles" and gynecologists had management "styles". In summary each pathologist had different diagnostic tendencies which were affected not only by histopathology and marker studies, but also by the patient management tendencies of the gynecologist that the pathologist worked with. The two-tiered modified Bethesda system improved diagnostic agreement. We concluded that immunohistochemistry should be used only to resolve problems in select cases and not for every case.

  16. [Epidemiologic characteristics in women with sterility and cervical lesions with and without human papilloma virus infection. Comparative study].

    PubMed

    Alvarez Fernández, J; Bustos López, H H; Villanueva Díaz, C; Zambrana Castañeda, M C; Coria Soto, I; Aranda Flores, C

    1998-04-01

    Human papilloma virus (HPV) infections frequently cause cervical lesions of different morphologies. We have previously reported a 53.5% pregnancy rate after treatment in a group of women with infertility associated to HPV infection of the cervix uteri. In that paper it was stated that a controlled study should be conducted in order to confirm this finding. Present work was aimed to find if there is any correlation between HPV infections of the cervix uteri and infertility in a retrospective design using an historical cohort of patients studied between 1991 and 1996 in our clinic. A total of 61 women attending the Infertility Clinic at the Instituto Nacional de Perinatología were included into two group. Group 1 (n = 45) included women with HPV lesions of the cervix and group II (n = 16) was formed by women with other type of cervical lesions who had no evidence of HPV infections on colposcopy. Cervico-vaginal citology, colposcopyc study and biopsy specimens were evaluated in all this medical records and the patients status (pregnant-not pregnant) at one year after treatment was registered. The mean duration time of infertility was 4.86 in group I and 3.5 in group II. Pregnancy rate was 16/45 (35.55%) in group I and 6/16 (37.5%) in group II. Seventy five percent of patients in group I and 66% in group II achieved a spontaneous pregnancy after specific treatment of cervical lesions whereas 25% and 33.3% required only ovarian stimulation with clomiphene or hMG. Pregnancies occurred approximately at 9 months after treatment in group I and at 7 months in group II. An association of cervical lesions and a tuboperitoneal factor (excluding endometriosis) was found on 53.57% of women in group I and on 46.66% of women in group II. Cervico-vaginal cytology was suspicious of HPV infection in less than 25% of cases. Present study emphasizes the need for a colposcopic study for the diagnosis of HPV infection in infertile women with cervical lesions even in cases with a negative

  17. Effect of oxalic acid pre-treatment in restorations of non-carious cervical lesions: A randomized clinical trial

    PubMed Central

    de Souza, André Mattos Brito; Colares, Regina Claudia Ramos; Mendonça, Juliano Satori; Rodrigues, Lidiany Karla Azevedo; Santiago, Sérgio Lima

    2014-01-01

    Context: Non-carious cervical lesions are usually associated with dentin hypersensitivity. The use of oxalic acid in restorations of these lesions could be beneficial in relieving pain. Aims: To evaluate the use of oxalic acid in restorations of non-carious cervical lesions. Settings and Design: A randomized clinical trial. Subjects and Methods: One operator placed 90 restorations in 20 volunteers of both sexes, with at least two lesions to be restored with the techniques: Control — Restoration with total-etch technique and Experimental — Restoration with pretreatment with oxalic acid followed by application of adhesive system. The restorative adhesive system used was XP Bond/Durafill. The restorations were directly assessed by two independent examiners using a modified United States Public Health Service (USPHS) method at baseline, 6 and 12 months, taking into account the following criteria: Retention (R), marginal integrity (MI), marginal discoloration (MD), postoperative sensitivity (S), caries (C), and anatomic form (AF). Statistical analysis used: The data were statistically analyzed using the Fisher exact and McNemar tests. The level of significance was set at 5%. Results: After 1 year, the results of restorations clinically satisfactory obtained for the control and experimental group respectively were: R (97% / 89%), MI (100% / 100%), MD (100% / 100%), S (100% / 100%), C (100% / 100%), and AF (100% / 100%). Conclusions: The use of oxalic acid as an agent of dentin pretreatment did not influence the clinical performance of restorations in non-carious cervical lesions after 1 year. PMID:25298641

  18. DLG1 polarity protein expression associates with the disease progress of low-grade cervical intraepithelial lesions.

    PubMed

    Cavatorta, Ana Laura; Di Gregorio, Alejandra; Bugnon Valdano, Marina; Marziali, Federico; Cabral, Mariela; Bottai, Hebe; Cittadini, Jorge; Nocito, Ana Lia; Gardiol, Daniela

    2017-02-01

    Human Discs large tumour suppressor (DLG1) participates in regulating cell polarity and proliferation, suggesting an important connection between epithelial organization and cellular growth control. However, it was demonstrated that DLG1 could acquire oncogenic attributes in some specific contexts. In this work, we evaluated the expression of DLG1 and its contribution to the progress of cervical lesions in order to investigate a potential role of this polarity protein in human oncogenic processes. We analyzed cervical biopsies from women with low-grade squamous intraepithelial lesion (LSIL) diagnosis (n=30), for DLG1 expression by immunohistochemistry. These results were correlated with the clinical monitoring of the patients during a 24-month follow-up period. Our data indicate that while all LSIL patients with a DLG1 staining pattern similar to normal tissues are significantly more likely to regress (n=23, Pattern I), all LSIL biopsy specimens showing a diffuse and intense DLG1 staining likely progress to high-grade lesions (n=4, Pattern II). Finally, all persistent LSIL analyzed showed an undetermined DLG1 staining, with a diffuse distribution without a strong intensity (n=3, Pattern III). We found a significant association between the expression pattern of DLG1 and the evolution of the lesion (p<0.00001). This work contributes to the knowledge of DLG1 biological functions, suggesting that its expression may have an important role in the progression of early dysplastic cervical lesions, giving prognostic information. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Effect of oxalic acid pre-treatment in restorations of non-carious cervical lesions: A randomized clinical trial.

    PubMed

    de Souza, André Mattos Brito; Colares, Regina Claudia Ramos; Mendonça, Juliano Satori; Rodrigues, Lidiany Karla Azevedo; Santiago, Sérgio Lima

    2014-09-01

    Non-carious cervical lesions are usually associated with dentin hypersensitivity. The use of oxalic acid in restorations of these lesions could be beneficial in relieving pain. To evaluate the use of oxalic acid in restorations of non-carious cervical lesions. A randomized clinical trial. One operator placed 90 restorations in 20 volunteers of both sexes, with at least two lesions to be restored with the techniques: Control - Restoration with total-etch technique and Experimental - Restoration with pretreatment with oxalic acid followed by application of adhesive system. The restorative adhesive system used was XP Bond/Durafill. The restorations were directly assessed by two independent examiners using a modified United States Public Health Service (USPHS) method at baseline, 6 and 12 months, taking into account the following criteria: Retention (R), marginal integrity (MI), marginal discoloration (MD), postoperative sensitivity (S), caries (C), and anatomic form (AF). The data were statistically analyzed using the Fisher exact and McNemar tests. The level of significance was set at 5%. After 1 year, the results of restorations clinically satisfactory obtained for the control and experimental group respectively were: R (97% / 89%), MI (100% / 100%), MD (100% / 100%), S (100% / 100%), C (100% / 100%), and AF (100% / 100%). The use of oxalic acid as an agent of dentin pretreatment did not influence the clinical performance of restorations in non-carious cervical lesions after 1 year.

  20. [The diagnosis of traumatic cervical lesions: a decade of evidence-based change].

    PubMed

    Núñez, D

    2006-01-01

    The growing awareness of the need for emergency centers specializing in the care of trauma patients, together with advances in diagnostic imaging technology, have led to the occasional indiscriminate use of diagnostic methods to the detriment of ordering diagnostic tests based on the risk of fracture and of the clinical examination itself. In many institutions, this practice is carried out without appropriate controls and without analyzing the risks and benefits of a particular clinical conduct. This is particularly true in cases of multiple trauma with suspected traumatic lesions of the cervical spine. For many years, radiological examination was based on plain-film radiography, with CT playing a complementary role. Over the last decade, since the introduction of helical CT, and more recently multidetector CT scanners, the diagnostic approach has undergone rapid, significant changes. This article summarizes the experience based on publications centered on establishing the diagnostic effectiveness of CT in comparison to plain-film radiography and the importance of recognizing risk factors when determining the diagnostic strategy. On the other hand, the importance of avoiding unnecessary tests and excessive radiation in providing appropriate and efficient medical care is stressed. In general, the evidence indicates that CT should be the first-line approach in high-risk patients and plain-film radiography should be reserved for the initial evaluation of patients with a low risk of traumatic lesions.

  1. Six-month clinical evaluation of XP BOND in noncarious cervical lesions.

    PubMed

    Blunck, Uwe; Knitter, Katharina; Jahn, Klaus-Roland

    2007-01-01

    To evaluate the 6-month clinical performance of the etch-and-rinse one-bottle adhesive system XP BOND, used in combination with the composite resin Ceram X duo for the restoration of Class V noncarious cervical lesions (NCCL). XP BOND was tested in a total of 40 patients who received two Class V Ceram X duo restorations, Adper Scotchbond 1 XT was used as a control. After cleaning the teeth, the surface of the NCCL was treated using a carbide bur in dentin and a 40-microm diamond bur in enamel with no retentive preparations. The lesions were filled with two increments of Ceram X duo after the application of the respective adhesive by a single operator according to manufacturer's instructions. After 6 months, the retention and the marginal integrity were evaluated. Thirty-eight of 40 patients were evaluated after 6 months by two clinicians according to modified USPHS criteria, and all restorations using XP BOND were still in place. In the control group (using Adper Scotchbond 1XT), one restoration was lost. The statistical evaluation (chi2 test) showed no significant differences in any of the criteria. No difference of marginal integrity was found between the two adhesive systems. XP BOND meets the ADA success criteria after 6 months.

  2. Visual inspection of the cervix with acetic acid for cervical intraepithelial lesions.

    PubMed

    Goel, A; Gandhi, G; Batra, S; Bhambhani, S; Zutshi, V; Sachdeva, P

    2005-01-01

    Evaluation of visual inspection of the cervix with acetic acid (VIA) for screening cervical intraepithelial neoplasia. In this prospective study, 400 women were screened using the Papanicolaou (PAP) smear, VIA and colposcopy. Those who had positive results with any of the screening methods underwent large loop excision of the transformation zone (LLETZ). The sensitivity and specificity of each of the screening methods was analyzed. The sensitivity of VIA (96.7%) was much higher than that of the Pap smear (50%), and almost as high as that of colposcopy (100%). The specificity of VIA (36.4%) was lower than that of the Pap smear (97%) and colposcopy (96.9%), resulting in high false-positive rates for VIA. Two cases of endocervical lesions were missed with VIA. Visual inspection of the cervix with acetic acid is very sensitive for ectocervical lesions. The advantages of the VIA method are its low cost and ease of use (it can be used by paramedical workers), its high sensitivity and its immediate results (it is possible to "see and treat" at the first visit). Its main limitation is a high rate of false-positive results, which may lead to overtreatment if a "see and treat" policy is applied.

  3. The three most common human papillomavirus oncogenic types and their integration state in Thai women with cervical precancerous lesions and carcinomas.

    PubMed

    Aromseree, Sirinart; Chaiwongkot, Arkom; Ekalaksananan, Tipaya; Kongyingyoes, Bunkerd; Patarapadungkit, Natcha; Pientong, Chamsai

    2014-11-01

    To understand the potential role in cervical cancer development of the three most common high-risk human papillomavirus (HR-HPVs) in Thai women, HPV genotypes and viral genome statuses in different cervical lesions were investigated. Cervical tissues consisting of no cervical intraepithelial neoplasia (84 cases), grade I cervical intraepithelial neoplasia (176 cases), grade II-III cervical intraepithelial neoplasia (91 cases), and squamous cell carcinoma (66 cases) were subjected for HPV genotyping by polymerase chain reaction (PCR) and reverse line blot hybridization assay and for HPV genome status determination by amplification of papillomavirus oncogene transcripts (APOT) assay. HPV prevalence was 28.6% in no cervical intraepithelial neoplasia, 40.3% in grade I cervical intraepithelial neoplasia, 70.3% in grade II-III cervical intraepithelial neoplasia and 86.4% in squamous cell carcinoma cases. The three most common HR-HPV types were HPV 16, 58, and 18 which were distributed in all cervical lesions. HPV physical statuses could be investigated in 4 no cervical intraepithelial neoplasias, 2 grade I cervical intraepithelial neoplasias, 28 grade II-III cervical intraepithelial neoplasias and 31 squamous cell carcinomas. The integrated-derived transcripts were found 3.6% in grade II-III cervical intraepithelial neoplasia and 48.4% in squamous cell carcinoma, whereas no viral genome integration was found in the group of no cervical intraepithelial neoplasia or grade I cervical intraepithelial neoplasia samples. The frequencies of HR-HPV integration in squamous cell carcinoma were found 40%, 100%, 20% of HPV 16, 18, and 58. This study indicates the oncogenic potential ability of the three most common HR-HPVs associated with cervical cancer progression. © 2014 Wiley Periodicals, Inc.

  4. Management guidelines for participation in collision activities with congenital, developmental, or post-injury lesions involving the cervical spine.

    PubMed

    Torg, J S; Ramsey-Emrhein, J A

    1997-01-01

    Conditions involving the cervical spine in the athlete requiring management decisions are numerous. The purpose of this paper is to present appropriate guidelines for return to collision activities in those with congenital, developmental, or post-injury lesions. Collision activities include boxing, football, ice hockey, lacrosse, rugby and wrestling. Information compiled from over 1200 cervical spine lesions documented by the National Football Head and Neck Injury Registry, an extensive literature review, as well as an understanding of injury mechanisms have resulted in reasonable management guidelines. Each of the congenital, developmental and post-traumatic conditions presented are identified as either no contraindication, relative contraindication, or an absolute contraindication on the basis of a variety of parameters. Conditions involved in the discussion include: odontoid anomalies, spina bifida occulta, atlanto-occipital fusion, K1ippel-Feil syndrome, cervical canal stenosis, spear tackler's spine; and traumatic conditions of the upper, middle and lower cervical spine including ligamentous injuries and fractures, intervertebral disc injuries and post-cervical spine fusion. It should be emphasized that the proposed guidelines should be used in the decision making process and in conjunction with other such factors as age, experience, ability of the individual, level of participation, position played, as well as the attitude and desires of the athlete and his parents, where applicable following an informed discussion of the problem with particular regard to potential risk.

  5. Associated factors with cervical pre-malignant lesions among the married fisher women community at Sadras, Tamil Nadu

    PubMed Central

    Ganesan, Sornam; Subbiah, Vasantha N.; Michael, Jothi Clara J.

    2015-01-01

    Objective: To identify the associated factors of cervical pre-malignant lesions among the married fisher women residing in the coastal areas of Sadras, Tamil Nadu. Methods: The study was conducted in five fishermen communities under Sadras, a coastal area in Tamil Nadu, India. Two hundred and fifty married fisher women residing in the area. Quantitative descriptive approach with a cross-sectional study design was used. Data were collected using a structured interview schedule for identifying the associated factors and Pap smear test was performed for identifying the pre-malignant cervical lesions among the married fisher women. Data were analyzed using descriptive and inferential statistics. Results: Among 250 women, about six (2.4%) of them presented with pre-cancerous lesions such as atypical squamous cell of undifferentiated significance (ASCUS) — five (2%) and mild dysplasia one (0.4%). Majority of the women, about 178 (71.2%) women, had abnormal cervical findings. Statistical analysis showed a significant association of risk factors such as advanced age, lack of education, low socioeconomic status, using tobacco, multiparity, premarital sex, extramarital relationship, using cloth as sanitary napkin, etc. Conclusion: The study findings clearly show the increased vulnerable state of the fisher women for acquiring cervical cancer as they had many risk factors contributing to the same. PMID:27981091

  6. Human papillomavirus types distribution in eastern Sicilian females with cervical lesions. A correlation with colposcopic and histological findings.

    PubMed

    Le Donne, Maria; Giuffrè, Giuseppe; Caruso, Carmela; Nicotina, Piero Antonio; Alibrandi, Angela; Scalisi, Rosalba; Simone, Angela; Chiofalo, Benito; Triolo, Onofrio

    2013-07-01

    To determine human papillomavirus (HPV) types distribution in cervical lesions in a Southern Italian female population in Messina and their relationship between HPV type and grade of colposcopic and histopathological abnormality, a total of 253 women aged 17-68 years, with previous cytological abnormalities, were included in this study. HPV-DNA testing, colposcopy and biopsy were performed. For each sample, cervical cells were collected by centrifugation and DNA was extracted, followed by a PCR-based HPV-DNA assay and reverse dot blot genotyping. HPV-16 was found the most common type (46.6 %) followed by HPV-31 (26.9 %), -6 (18.6 %), -58 (8.8 %), -18 (6.7 %), -66 (5.7 %), -52 and -53 (4.7 %). Out of 62 women with abnormal transformation zone (ATZ) area compatible with squamous intraepithelial lesion (SIL) or cervical cancer (CC), 64.5 % was found high risk (HR) HPV-positive. Moreover the severity of the colposcopic diagnosis was positively correlated with the higher HPV oncogenicity risk (HPV-16 P = 0.023; and HPV-53 P = 0.047). The HPV-16 was found the most prevalent type within each histological category: 66.7 %, 31.2 %, 44 % and 37.2 % of CC, high grade (H)SIL, low grade (L)SIL and chronic cervicitis respectively; followed by HPV-31 present in 25 %, 8 %, and 13.3 % of HSIL, LSIL and chronic cervicitis respectively. A higher HPV incidence than the rest of Italy was found, in agreement with that detected by other authors for the South of the country. These data provide further information about the types prevalence in women with cervical lesions living in Eastern Sicily, suggesting the introduction of new targeted vaccines against a wider spectrum of HPV.

  7. Impact of human papillomavirus coinfections on the risk of high-grade squamous intraepithelial lesion and cervical cancer.

    PubMed

    Carrillo-García, Adela; Ponce-de-León-Rosales, Sergio; Cantú-de-León, David; Fragoso-Ontiveros, Verónica; Martínez-Ramírez, Imelda; Orozco-Colín, Asunción; Mohar, Alejandro; Lizano, Marcela

    2014-09-01

    The molecular and epidemiologic effect of human papillomavirus (HPV) coinfections in the risk of developing cervical cancer is yet unclear. The aim of this study was to determine the frequency HPV coinfections at different stages of cervical lesions in the development of cervical cancer and the impact of HPV specific type interactions on high-grade squamous intraepithelial lesions (HSIL) and invasive cervical cancer (ICC) risk. HPV testing was performed in 931 cervical samples diagnosed as: negative for intraepithelial lesion or malignancy (NILM); low-grade squamous intraepithelial lesion (LSIL); HSIL; and ICC. For HPV detection and typing two sets of primers from the L1 region were used in the polymerase chain reaction method (PCR) (MY09/MY11/HMB01 and L1C1/L1C2.1/L1C2.2) and HPV type was determined by PCR product sequence. To look for multiple HPV infections, the E6 nested multiplex PCR method was performed in all DNA samples. Odds ratios were calculated as indexes of the strength of the association between the sample category (LSIL/NILM or ICC/HSIL) and the presence of a given viral combination. In HPV positive samples, coinfections are as common in ICC/HSIL as in LSIL/NILM (47.12% and 40.17%, respectively). There is an increased risk to ICC/HSIL when multiple high-risk HPV types are present. The coinfection of HPV68 with HPV16 increases the risk of ICC/HSIL (OR=14.54, P=0.012, after multivariate adjustment), related to the presence of HPV16 or HPV68 alone. These results sustain that specific HPV coinfections confer an increased risk to develop ICC/HSIL. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. Human papillomavirus type 56 polymorphism in Canadian women with and without cervical lesions.

    PubMed

    Rodrigues-Coutlée, Catherine; Archambault, Jacques; Money, Deborah; Ramanakumar, Agnihotram V; Raboud, Janet; Hankins, Catherine; Koushik, Anita; Richardson, Harriet; Brassard, Paul; Franco, Eduardo L; Coutlée, Francois

    2013-12-01

    The genomic diversity of high-risk human papillomaviruses (HPV) has been associated with viral persistence and HPV-induced lesions. Studies on HPV56 persistence are still pending. To assess the association between HPV56 polymorphism and HPV56 persistence and presence of high-grade cervical intraepithelial neoplasia (CIN2,3) or cancer. HPV56-positive cervical specimens from 204 women selected from a total of 4669 participants recruited in 5 epidemiological studies (parent studies) were further analyzed by PCR-sequencing of the long control region (LCR). Of the 81 women followed prospectively in cohort studies who could be classified, 34 had persistent and 47 had transient HPV56 infections. Variant HPV56-LCR-MTL-21 was detected more frequently in persistent infections (52.9%, 95% CI: 36.7-68.6%) than in transient infections (25.5%, 95% CI: 15.1-39.4). Considering only women recruited in a cohort of women infected or at high risk for HIV infection, infection with variant HPV56-LCR-MTL-21 (OR=4.4, 95% CI: 1.3-14.5) was significantly associated with HPV56 persistence controlling in multivariate analysis for high risk HPV detection and HIV infection. A variation at nucleotide 7800 in HPV56-LCR-MTL-21 resulted in the loss of a binding site for Elf-1 embedded in one of the E2 binding sites, a potential activator or repressor of expression of the HPV genome. HPV56 polymorphism was not associated with CIN2,3 or cancer in women enrolled in cross-sectional and case-control studies. Polymorphism in HPV56 may influence the risk that infections with this type will persist. Copyright © 2013 Elsevier B.V. All rights reserved.

  9. Analysis of gene status in cervical dysplastic lesions and squamous cell carcinoma using tissue microarrays.

    PubMed

    Costa, Carlota; Espinet, Blanca; Molina, Miguel A; Salgado, Rocio; Salido, Marta; Baró, Teresa; Fusté, Pere; Mancebo, Gemma; Carreras, Ramón; Solé, Francesc; Serrano, Sergi; Alameda, Francesc

    2009-07-01

    Cervical displasia are classified as CIN-I, CIN-II and CIN-III. It has been observed that in at least 60% of CIN-I and CIN-II, the pathology disappears spontaneously, while around 30% persist at 24 months, 10% progress to CIN-III and 1% develops as a SCC. The factors involved in the evolution of the pathology are not defined, although infection of HPV is a necessary condition, but not the only one. For this reason, the identification of genetic changes is an essential element for understanding the carcinogenic process. It can also serve as a helpful tool for identifying patients who may be susceptible to its evolution and treatment, from patients whose lesions could regress spontaneous and for whom periodic follow-ups would be enough. Fifty three cervical biopsies from patients with dysplasia and ISCC were included in the study. These biopsies were set into nine macroarrays. Eight genes and five proteins were examined in each samples (hTERT, PIK3CA, hTERC, MYC, CCND1, BCL2, ZNF217 and p16) by fluorescence in situ hybridization (FISH) and/or immunohistochemistry (IHC). The results reflected that the genetic alterations of PIK3CA, ZNF217 and CCND1 were associated with the evolution of normal tissue to CIN I, those of hTERC and ERBB with the evolution of LSIL to HSIL, those of hTERT and MYC with the evolution of CIN-II/CIN-III to ISCC, and those of BCL-2 with the inception of ISCC. With regards to proteins, the expression of MYC and CCND1 in the initial stages of the illness would help in the acquisition of the altered cellular phenotype.

  10. How mechanical stresses modulate enamel demineralization in non-carious cervical lesions?

    PubMed

    Leal, Noélia M S; Silva, Juscelino L; Benigno, Maria Ivone M; Bemerguy, Eliane A; Meira, Josete B C; Ballester, Rafael Y

    2017-02-01

    To introduce an experimental non-carious cervical lesion (NCCL) model for studying the influence of presence and type of stress (tension or compression) on acid effects involved in NCCL formation on the enamel near the cement-enamel junction (CEJ). 108 bovine incisors were cut into 18 × 3×3 mm(3) beams, with a notch in the cervical region to generate a standardized area of stress concentration. Half of the specimens were immersed in distilled water and the other half in acetic acid solution (pH 4.5) for 72h. Each group was divided into three subgroups. Two subgroups underwent 800gf static loading, with the specimen positioned in a bending jig with the buccocervical region under either tension or compression. The load was applied simultaneously to immersion (in water or in acid). The third subgroup was not subjected to loading. Transversal and longitudinal 0.05 mm plates of the specimens were analyzed under a light microscope (40, 100 and 200×) to measure the enamel demineralization depth and to assess the presence of cracks, fractures and gaps at the enamel-dentin junction. The demineralization depth data were submitted to ANOVA and Tukey's test at a 5% significance level. Enamel demineralization depth (μm) was higher under tension (158±19 in transversal sections and 229±32 in longitudinal sections) than under compression (transversal: 129±16 and longitudinal: 167±10) or unstressed condition (transversal: 138±21 and longitudinal: 187±21). Specimens immersed in acid and subjected to tensile stress presented enamel micro fractures and wider gaps in the dentin-enamel junction. Enamel demineralization was significantly higher in the presence of tensile stress, due to wider gaps between dentin and enamel, stress corrosion cracking and increased enamel permeability to acid. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Human Papillomavirus Genotype Distribution among Thai Women with High-Grade Cervical Intraepithelial Lesions and Invasive Cervical Cancer: a Literature Review.

    PubMed

    Kietpeerakool, Chumnan; Kleebkaow, Pilaiwan; Srisomboon, Jatupol

    2015-01-01

    Infection with high-risk human papillomavirus (HR-HPV) is an essential cause of cervical cancer. Because of substantial geographical variation in the HPV genotype distribution, data regarding HPV type-specific prevalence for a particular country are mandatory for providing baseline information to estimate effectiveness of currently implemented HPV-based cervical cancer prevention. Accordingly, this review was conducted to evaluate the HR-HPV genotype distribution among Thai women with precancerous cervical lesions i.e. cervical intraepithelial neoplasia grade 2-3 (CIN 2-3), adenocarcinoma in situ (AIS), and invasive cervical cancer by reviewing the available literature. The prevalence of HR-HPV infection among Thai women with CIN 2-3 ranged from 64.8% to 90.1% and the three most common genotypes were HPV 16 (38.5%), HPV 58 (20.0%), and HPV 18 (5.5%). There were high squamous cell carcinoma/CIN 2-3 prevalence ratios in women with CIN 2-3 infected with HPV 33 and HPV 58 (1.40 and 1.38, respectively), emphasizing the importance of these subtypes in the risk of progression to invasive cancer among Thai women. Data regarding the prevalence and genotype distribution of HR-HPV in Thai women with AIS remain unavailable. Interesting findings about the distribution of HPV genotype in cervical cancer among Thai women include: (1) a relatively high prevalence of HPV 52 and HPV 58 in invasive squamous cell carcinoma; (2) the prevalence of HPV 18-related adenocarcinoma is almost double thepreviously reported prevalence, and (3) 75% of neuroendocrine carcinomas are HPV18-positive when taking into account both single and multiple infections.

  12. Pregnancy Outcomes after Treatment for Cervical Cancer Precursor Lesions: An Observational Study.

    PubMed

    Weinmann, Sheila; Naleway, Allison; Swamy, Geeta; Krishnarajah, Girishanthy; Arondekar, Bhakti; Fernandez, Jovelle; Myers, Evan

    2017-01-01

    To examine whether surgical procedures involving the uterine cervix were associated with pregnancy outcomes, including preterm birth, low birth weight, cesarean delivery and pregnancy loss. Population-based observational study nested in retrospective matched cohort. Kaiser Permanente Northwest integrated health plan in Oregon/Washington, U.S.A. Female health plan members age 14-53 years with documented pregnancies from 1998-2009. Women with prior excisional and ablative cervical surgical procedures (N = 322) were compared to women unexposed to cervical procedures (N = 4,307) and, separately, to those having undergone only diagnostic/biopsy procedures (N = 847). Using log-linear regression models, we examined risk of adverse pregnancy outcomes in relation to prior excisional or ablative cervical surgical procedures. We stratified excisional procedures by excision thickness. We evaluated for confounding by age, body mass index, race, smoking history, previous preterm birth, and parity. We found a positive association between excisional treatment > = 1.0 cm and the outcomes preterm birth and low birth weight (preterm birth unadjusted risk ratio [RR] = 2.15, 95% confidence interval [CI] 1.16-3.98 for excisions ≥1.0 cm compared to unexposed women), particularly in women who delivered within one year of surgery (RR = 3.26, 95% CI 1.41-7.53). There was no clear association between excisional treatment and cesarean delivery, and treated women did not have a substantially higher risk of dysfunctional labor. Ablative treatment was not associated with low birth weight, preterm birth, or cesarean delivery but was associated with pregnancy loss (RR = 1.43, 95% CI 1.05-1.93 vs. unexposed women). Analyses using the diagnostic procedures comparison group produced similar results. Women with > = 1.0 cm excisional treatment had elevated risk of preterm birth and low birth weight when compared to unexposed women and women with cervical diagnostic procedures. This suggests that

  13. Pregnancy Outcomes after Treatment for Cervical Cancer Precursor Lesions: An Observational Study

    PubMed Central

    Naleway, Allison; Swamy, Geeta; Krishnarajah, Girishanthy; Arondekar, Bhakti; Fernandez, Jovelle; Myers, Evan

    2017-01-01

    Objective To examine whether surgical procedures involving the uterine cervix were associated with pregnancy outcomes, including preterm birth, low birth weight, cesarean delivery and pregnancy loss. Design Population-based observational study nested in retrospective matched cohort Setting Kaiser Permanente Northwest integrated health plan in Oregon/Washington, U.S.A. Population Female health plan members age 14–53 years with documented pregnancies from 1998–2009. Women with prior excisional and ablative cervical surgical procedures (N = 322) were compared to women unexposed to cervical procedures (N = 4,307) and, separately, to those having undergone only diagnostic/biopsy procedures (N = 847). Methods Using log-linear regression models, we examined risk of adverse pregnancy outcomes in relation to prior excisional or ablative cervical surgical procedures. We stratified excisional procedures by excision thickness. We evaluated for confounding by age, body mass index, race, smoking history, previous preterm birth, and parity. Results We found a positive association between excisional treatment > = 1.0 cm and the outcomes preterm birth and low birth weight (preterm birth unadjusted risk ratio [RR] = 2.15, 95% confidence interval [CI] 1.16–3.98 for excisions ≥1.0 cm compared to unexposed women), particularly in women who delivered within one year of surgery (RR = 3.26, 95% CI 1.41–7.53). There was no clear association between excisional treatment and cesarean delivery, and treated women did not have a substantially higher risk of dysfunctional labor. Ablative treatment was not associated with low birth weight, preterm birth, or cesarean delivery but was associated with pregnancy loss (RR = 1.43, 95% CI 1.05–1.93 vs. unexposed women). Analyses using the diagnostic procedures comparison group produced similar results. Conclusion Women with > = 1.0 cm excisional treatment had elevated risk of preterm birth and low birth weight when compared to unexposed

  14. Diagnostic criteria for mass lesions differentiating in electrical impedance mammography

    NASA Astrophysics Data System (ADS)

    A, Karpov; M, Korotkova

    2013-04-01

    The purpose of this research was to determine the diagnostic criteria for differentiating volumetric lesions in the mammary gland in electrical impedance mammography. The research was carried out utilizing the electrical impedance computer mammograph llMEIK v.5.6gg®, which enables to acquire images of 3-D conductivity distribution layers within mamma's tissues up to 5 cm depth. The weighted reciprocal projection method was employed to reconstruct the 3-D electric conductivity distribution of the examined organ. The results of 3,710 electrical impedance examinations were analyzed. The analysis of a volumetric lesion included assessment of its shape, contour, internal electrical structure and changes of the surrounding tissues. Moreover, mammary gland status was evaluated with the help of comparative and age-related electrical conductivity curves. The diagnostic chart is provided. Each criterion is measured in points. Using the numerical score for evaluation of mass and non-volumetric lesions within the mammary gland in electrical impedance mammography allowed comparing this information to BI-RADS categories developed by American College of Radiology experts. The article is illustrated with electrical impedance mammograms and tables.

  15. Effects of cyclic fatigue stress-biocorrosion on noncarious cervical lesions.

    PubMed

    Grippo, John O; Chaiyabutr, Yada; Kois, John C

    2013-08-01

    Although there is a high prevalence of noncarious cervical lesions (NCCLs), the etiology of these lesions remains contentious. To evaluate the combined effects of cyclic fatigue stress and biocorrosion activity on NCCLs. Extracted premolar teeth were allocated into four groups (N = 10). Two groups were cyclically fatigue loaded (100 N; 72 cycles per minute; 9,200 cycles) and placed in either hydrochloric acid gel (pH = 0.1) or orange juice (pH = 4). The other two groups were stored in identical chemical solutions without fatigue load. The buccal-lingual width of each tooth was measured before and after testing. The depth of biocorrosion, normalized by the percentage change in buccolingual width, normalized by time (hour) was calculated. The data were analyzed using a two-way analysis of variance and Tukey's HSD multiple comparison test (α = 0.05). Mean (SD) of the depth of biocorrosion values were as follows: teeth receiving fatigue loading with hydrochloric acid gel exposure (1.003%/hour [0.063]) revealed a significantly higher depth of biocorrosion than the fatigue-loaded group with orange juice exposure (0.511%/hour [0.281]) (p < 0.01). For the groups without fatigue loading, those with hydrochloric acid gel (0.022%/hour [0.006]) had a significantly higher depth of biocorrosion than the group with orange juice (0.009%/hour [0.004]) (p < 0.01). The cyclically fatigue-loaded teeth with hydrochloric acid gel had a significantly greater depth of biocorrosion than either group without fatigue loading (p < 0.001). Cyclic fatigue stress-acidic biocorrosion had a significant effect on the depth of the NCCLs. In order to manage the destructive NCCLs lesions properly, it is essential to understand the etiology of these lesions. The present study indicated that the combined mechanisms of cyclic fatigue stress and biocorrosion could contribute to the formation of NCCLs. © 2013 Wiley Periodicals, Inc.

  16. HPV genotype distribution in Brazilian women with and without cervical lesions: correlation to cytological data.

    PubMed

    Martins, Toni Ricardo; Mendes de Oliveira, Cristina; Rosa, Luciana Reis; de Campos Centrone, Cristiane; Rodrigues, Célia Luiza Regina; Villa, Luisa Lina; Levi, José Eduardo

    2016-08-12

    Human Papillomavirus (HPV) genotype distribution varies according to the method of assessment and population groups. This study analyzed type-specific HPV infections among women ranging from 14-95 years old, displaying normal and abnormal cytology, from São Paulo and Barretos cities, Brazil. Women found positive for High Risk-HPVs DNA by either the Hybrid Capture 2 (HC2) or Cobas HPV Test (n = 431) plus a random sample of 223 negative by both assays and 11 samples with indeterminate results, totalizing 665 samples, were submitted to HPV detection by the PapilloCheck test. Cytological distribution included 499 women with a cytological result of Negative for Intraepithelial Lesion or Malignancy and 166 with some abnormality as follows: 54 Atypical Squamous Cells of Undetermined Significance; 66 Low-Grade Squamous Intraepithelial Lesion; 43 High-Grade Squamous Intraepithelial Lesion and 3 (0.5 %) Invasive Cervical Cancer. From the 323 samples (48.6 %) that had detectable HPV-DNA by the PapilloCheck assay, 31 were HPV negative by the cobas HPV and HC2 assays. Out of these 31 samples, 14 were associated with HR-HPVs types while the remaining 17 harbored exclusively low-risk HPVs. In contrast, 49 samples positive by cobas HPV and HC 2 methods tested negative by the PapilloCheck assay (19.8 %). Overall, the most frequent HR-HPV type was HPV 16 (23.2 %), followed by 56 (21.0 %), 52 (8.7 %) and 31 (7.7 %) and the most frequent LR-HPV type was HPV 42 (12.1 %) followed by 6 (6.2 %). Among the HR-HPV types, HPV 56 and 16 were the most frequent types in NILM, found in 19.1 and 17.7 % of the patients respectively while in HSIL and ICC cases, HPV 16 was the predominant type, detected in 37.2 and 66.7 % of these samples. In the population studied, HPV 16 and 56 were the most frequently detected HR-HPV types. HPV 56 was found mainly in LSIL and NILM suggesting a low oncogenic potential. HPV 16 continues to be the most prevalent type in high-grade lesions whereas HPV

  17. [P16(INK4alpha)/Ki-67 immunocytochemical dual staining for detection of cervical lesions associated to papillomavirus infection].

    PubMed

    Toro de Méndez, Morelva; Ferrández Izquierdo, Antonio; Llombart-Bosch, Antonio

    2014-09-01

    We aimed to explore the expression pattern of p16(INK4alpha)/Ki-67 immunocytochemical dual-staining and to establish the potential clinical utility for early detection of cervical lesions. Liquid-based cytologies of cervical specimens of cervical cancer screening were processed for p16(INK4alpha)/Ki-67 immunocytochemical dual-staining using the CINtec Plus Kit. HPV testing was performed with the INNO-LiPA HPV genotyping Extra Reverse Hybridization Line Probe Assay kit. One hundred and fifteen cervical cytologies were analyzed with the following results: 11(9.6%) were negative for intraepithelial lesions or malignancy (NILM); 32 (27.8%) presented atypical squamous cells of undetermined significance (ASC-US); 62 (53.9%) exhibited low grade squamous intraepithelial lesions (LSIL) and 10 (8.7%) showed high grade squamous intraepithelial lesions (HSIL). No cases of cervical cancer were detected. The overall prevalence of DNA HPV detection was 81.7% (94/115). The following specific HPV genotypes were identified in 42 (45.0%) cases: HPV16 (26.2%), HPV51 (21.4%), HPV52 (14.3%) and HPV66 (7.1%). Viral sequences of an unknown single HPV were detected in 23.8% of the cases. A total of 42/115 (36.5%) were p16(IVK4alpha)/Ki-67 dual-staining-positive, being more frequent in HSIL (70.0%), decreasing in LSIL (44.0%), detected in a minority of ASC-US (25.0%) and negative in NILM cases (p < 0.001). 40/115 cases (34.8%) were positive for both oncogenic HPV and p16(INK4alpha)/Ki-67 dual-staining, including 6/32 (18.8%) ASC-US, 26/62 (42.0%) LSIL and 8/10 (80.0%) HSIL, which represent a strong association between positivity for HPV, p16(INK4alpha)/Ki-67 staining and severe cytological abnormalities (p < 0.001). This methodology could be used to detect unnoticed cervical lesions.

  18. Clinical features and factors associated with non-carious cervical lesions and dentin hypersensitivity.

    PubMed

    Yoshizaki, K T; Francisconi-Dos-Rios, L F; Sobral, M A P; Aranha, A C C; Mendes, F M; Scaramucci, T

    2017-02-01

    Determining the factors associated with NCCLs and DH in populations could guide the implementation of specific preventive measures. This study evaluated the clinical features and factors associated with non-carious cervical lesions (NCCLs) and dentin hypersensitivity (DH) in a Brazilian population. The participants were 118 patients at the Dentistry Clinic of our dental school. They completed an interview to obtain personal information and determine the possible factors associated with NCCLs and DH. Clinical examination was undertaken to record the NCCLs, shape of the lesion and certain occlusal factors. DH was diagnosed by air and probe tests. Data were analysed with the multilevel Poisson regression and prevalence ratios, and the respective 95% confidence intervals were calculated. The prevalence of NCCLs and DH among patients was 67·8% and 51·7%, respectively. Of a total number of 2902 teeth examined, 9·65% had NCCLs and 5·82% were sensitive to air. The most affected teeth for both conditions were the premolars. Most of the NCCLs were wedge-shaped and located in the maxilla. The factors associated with NCCLs and DH were age and presence of premature occlusal contacts. NCCLs were also significantly associated with consumption of wine and alcoholic beverages, and DH with consumption of acidic fruits and juices. NCCLs were a common finding, with higher frequency in more advanced age groups, the maxilla and premolars. A significant association occurred between NCCLs, premature contacts and consumption of wine and alcoholic beverages. DH was associated with NCCLs, premature contacts and with the consumption of acidic fruits and juices. © 2016 John Wiley & Sons Ltd.

  19. Spinal cord injury after blunt cervical spine trauma: correlation of soft-tissue damage and extension of lesion.

    PubMed

    Martínez-Pérez, R; Paredes, I; Cepeda, S; Ramos, A; Castaño-León, A M; García-Fuentes, C; Lobato, R D; Gómez, P A; Lagares, A

    2014-05-01

    In patients with spinal cord injury after blunt trauma, several studies have observed a correlation between neurologic impairment and radiologic findings. Few studies have been performed to correlate spinal cord injury with ligamentous injury. The purpose of this study was to retrospectively evaluate whether ligamentous injury or disk disruption after spinal cord injury correlates with lesion length. We retrospectively reviewed 108 patients diagnosed with traumatic spinal cord injury after cervical trauma between 1990-2011. Plain films, CT, and MR imaging were performed on patients and then reviewed for this study. MR imaging was performed within 96 hours after cervical trauma for all patients. Data regarding ligamentous injury, disk injury, and the extent of the spinal cord injury were collected from an adequate number of MR images. We evaluated anterior longitudinal ligaments, posterior longitudinal ligaments, and the ligamentum flavum. Length of lesion, disk disruption, and ligamentous injury association, as well as the extent of the spinal cord injury were statistically assessed by means of univariate analysis, with the use of nonparametric tests and multivariate analysis along with linear regression. There were significant differences in lesion length on T2-weighted images for anterior longitudinal ligaments, posterior longitudinal ligaments, and ligamentum flavum in the univariate analysis; however, when this was adjusted by age, level of injury, sex, and disruption of the soft tissue evaluated (disk, anterior longitudinal ligaments, posterior longitudinal ligaments, and ligamentum flavum) in a multivariable analysis, only ligamentum flavum showed a statistically significant association with lesion length. Furthermore, the number of ligaments affected had a positive correlation with the extension of the lesion. In cervical spine trauma, a specific pattern of ligamentous injury correlates with the length of the spinal cord lesion in MR imaging studies

  20. The performance of multimodal hyperspectral spectroscopy in the detection of precancerous cervical lesions

    NASA Astrophysics Data System (ADS)

    Trahmono; Lusiana, N.; Indarti, J.

    2017-08-01

    The aim of this study was to compare the performance of multimodal hyperspectral spectroscopy (MHS), which combines fluorescence and reflectance spectroscopy, with that of conventional laboratory-based screening tests, such as the Papanicolaou (Pap) smear test and human papilloma virus (HPV) DNA test, for detecting precancerous lesions of the cervix. The study utilized a cross-sectional design, and the kappa test was used in the analytical assessment. MHS scans were obtained from a sample of 70 consecutive patients, followed by sample collection for Pap and HPV DNA analysis and colposcopy referral, if indicated. Of the 70 patients evaluated, the results of cervical spectroscopy were normal in 38 (54.3%) patients, and they were abnormal in 32 (45.7%) patients. Based on the cytology results, 45 (64.3%) samples were normal, and 25 (35.7%) samples were abnormal. According to the results of the HPV DNA test, 47 (67.14%) samples were normal, and 17 (24.28%) samples were abnormal. Based on the results of the kappa test, the agreement between MHS and cytology was 0.793 (p < 0.001). The agreement between MHS and the HPV DNA test was 0.195 (p = 0.086), and the agreement between MHS and colposcopy was 0.479 (p < 0.001).

  1. Immunohistochemical Expression of VEGF and Podoplanin in Uterine Cervical Squamous Intraepithelial Lesions

    PubMed Central

    Belfort-Mattos, Patrícia Napoli; Focchi, Gustavo Rubino de Azevedo; Ribalta, Julisa Chamorro Lascasas; Megale De Lima, Tatiana; Nogueira Carvalho, Carmen Regina; Kesselring Tso, Fernanda; De Góis Speck, Neila Maria

    2016-01-01

    VEGF and podoplanin (PDPN) have been identified as angiogenesis and/or lymphangiogenesis regulators and might be essential to restrict tumor growth, progression, and metastasis. In the present study, we evaluate the association between the expression of these markers and CIN grade. Immunohistochemistry was performed in 234 uterine cervical samples using conventional histologic sections or TMA with the monoclonal antibodies to VEGF (C-1 clone) and podoplanin (D2-40 clone). Positive-staining rates of VEGF in 191 CIN specimens were significantly associated with histological grade (P < 0.001). Negative and/or focal immunostaining for PDPN were more frequent in CIN 3 (P = 0.016). We found that patients with CIN 3 more frequently had strong and more diffuse staining for VEGF and diminished staining for PDPN (P = 0.018). Strong and more diffuse VEGF immunoexpressions in CIN 2 and CIN 3 were detected when compared to CIN 1. Negative and/or focal PDPN immunoexpression appear to be more frequent in CIN 3. Moderate to strong VEGF expression may be a tendency among patients with high-grade lesions and diminished PDPN expression. PMID:27313335

  2. Clinical evaluation of resin composite and resin-modified glass ionomer cement in non-carious cervical lesions.

    PubMed

    Adeleke; Oginni, Ao

    2012-10-01

    The clinical performance of various tooth-coloured materials used to restore Non-Carious Cervical Lesions (NCCLs) has been evaluated. However, most of these evaluations were in western societies where soft diets requiring little mastication were common. The present study sets out to evaluate resin composite and RMGIC in the restoration of NCCLs among a Nigerian subpopulation group with fibrous diet requiring more rigorous mastication. The study included all adult patients that presented at the Dental Hospital, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria with non-carious cervical lesions over a period of six months. The teeth with non-carious cervical lesions in each patient were allocated into treatment with either resin composite or resin-modified glass ionomer cement by simple random sampling using ballots. The depth of the NCCLs was measured using a graduated flat ash periodontal probe. All the treatment was done by the first author according to the manufacturer's instructions. Patients were recalled and evaluated at 48- hours, 3- months, 6- months and 12- months using the USPHS criteria. Data analysis was done using SPSS version 15. The level of significance was put at 0.05. At the end of 12 months, 143 resin composite and 144 RMGIC restorations were evaluated, out of which 37 resin composite and 13 RMGIC restorations were dislodged, giving a retention rate of 74.1% and 91.0% respectively. The difference was statistically significant (p<0.05). For marginal discolouration, marginal adaptation, abrasion wear resistance, post operative sensitivity, and secondary caries, there were no statistically significant differences in the performance of resin composite and RMGIC. There was more retention failure of both resin composite and RMGIC restorations in NCCLs in mandibular teeth than in maxillary teeth. The differences were statistically significant (p<0.05). RMGIC demonstrated a higher retention rate in the restoration of non

  3. Human papillomavirus type distribution and HPV16 intratype diversity in southern Brazil in women with and without cervical lesions

    PubMed Central

    de Oliveira, Gisele R; Vieira, Valdimara C; Ávila, Emiliana C; Finger-Jardim, Fabiana; Caldeira, Thaís DM; Gatti, Fabiane AA; Gonçalves, Carla V; Oliveira, Sandro G; da Hora, Vanusa P; Soares, Marcelo A; de Martinez, Ana MB

    2017-01-01

    BACKGROUND Increasing evidence suggests that human papillomavirus (HPV) intratype variants (specific lineages and sublineages) are associated with pathogenesis and progression from HPV infection to persistence and the development of cervical cancer. OBJECTIVES This study aimed to verify the prevalence of HPV infection and distribution of HPV types and HPV16 variants in southern Brazil in women with normal cytology or intraepithelial lesions. METHODS HPV typing was determined by L1 gene sequencing. To identify HPV16 variants, the LCR and E6 regions were sequenced, and characteristic single nucleotide variants were identified. FINDINGS A total of 445 samples were studied, with 355 from cervical scrapes and 90 from cervical biopsies. HPV was detected in 24% and 91% of these samples, respectively. The most prevalent HPV types observed were 16 (cervical, 24%; biopsies, 57%) and 58 (cervical, 12%; biopsies, 12%). Seventy-five percent of the HPV16-positive samples were classified into lineages, with 88% defined as lineage A, 10% as lineage D, and 2% as lineage B. MAIN CONCLUSIONS This study identified a high frequency of European and North American HPV16 lineages, consistent with the genetic background of the human population in southern Brazil. PMID:28591310

  4. Impact of human papillomavirus (HPV) 16 and 18 vaccination on prevalent infections and rates of cervical lesions after excisional treatment.

    PubMed

    Hildesheim, Allan; Gonzalez, Paula; Kreimer, Aimee R; Wacholder, Sholom; Schussler, John; Rodriguez, Ana C; Porras, Carolina; Schiffman, Mark; Sidawy, Mary; Schiller, John T; Lowy, Douglas R; Herrero, Rolando

    2016-08-01

    Human papillomavirus vaccines prevent human papillomavirus infection and cervical precancers. The impact of vaccinating women with a current infection or after treatment for an human papillomavirus-associated lesion is not fully understood. To determine whether human papillomavirus-16/18 vaccination influences the outcome of infections present at vaccination and the rate of infection and disease after treatment of lesions. We included 1711 women (18-25 years) with carcinogenic human papillomavirus infection and 311 women of similar age who underwent treatment for cervical precancer and who participated in a community-based trial of the AS04-adjuvanted human papillomavirus-16/18 virus-like particle vaccine. Participants were randomized (human papillomavirus or hepatitis A vaccine) and offered 3 vaccinations over 6 months. Follow-up included annual visits (more frequently if clinically indicated), referral to colposcopy of high-grade and persistent low-grade lesions, treatment by loop electrosurgical excisional procedure when clinically indicated, and cytologic and virologic follow-up after treatment. Among women with human papillomavirus infection at the time of vaccination, we considered type-specific viral clearance, and development of cytologic (squamous intraepithelial lesions) and histologic (cervical intraepithelial neoplasia) lesions. Among treated women, we considered single-time and persistent human papillomavirus infection, squamous intraepithelial lesions, and cervical intraepithelial neoplasia 2 or greater. Outcomes associated with infections absent before treatment also were evaluated. Infection-level analyses were performed and vaccine efficacy estimated. Median follow-up was 56.7 months (women with human papillomavirus infection) and 27.3 months (treated women). There was no evidence of vaccine efficacy to increase clearance of human papillomavirus infections or decrease incidence of cytologic/histologic abnormalities associated with human

  5. Prevalence and risk factors of cervical squamous intraepithelial lesions among HIV-infected women in Dar es Salaam, Tanzania.

    PubMed

    Liu, Enju; McCree, Renicha; Mtisi, Expeditho; Fawzi, Wafaie W; Aris, Eric; Lema, Irene A; Hertzmark, Ellen; Chalamilla, Guerino; Li, Nan; Vermund, Sten H; Spiegelman, Donna

    2016-03-01

    To determine the prevalence and predictors of cervical squamous intraepithelial lesions (SIL) among HIV-infected women in Tanzania, a cross-sectional study was conducted among HIV-infected women at HIV care and treatment clinics. A Papanicolaou (Pap) smear was used as a screening tool for detection of cervical SIL. From December 2006 to August 2009, 1365 HIV-infected women received cervical screening. The median age was 35 (interquartile range [IQR]: 30-42) years, and the median CD4 + cell count was 164 (IQR: 80-257) cells/mm(3). The prevalence of cervical SIL was 8.7% (119/1365). In multivariate analysis, older age (≥50 versus 30-<40 years: prevalence ratio [PR], 2.36; 95% confidence interval [CI], 1.45-3.84, p for trend = 0.001), lower CD4 + cell counts (<100 versus ≥200 cells/mm(3): PR, 1.55; 95% CI, 1.01-2.36, p for trend = 0.03) and cervical inflammation (PR, 1.73; 95% CI, 1.16-2.60, p = 0.008) were associated with an increased risk of cervical SIL. Women with advanced WHO HIV disease stage (IV versus I/II: PR, 3.45; 95% CI, 1.35-8.85, p for trend = 0.01) had an increased risk for high-grade SIL. In resource-limited settings where it is not feasible to provide cervical cancer prevention services to all HIV-infected women, greater efforts should focus on scaling-up services among those who are older than 50 years, with lower CD4 cell counts and advanced HIV disease stage. © The Author(s) 2015.

  6. CCR2 and CCR5 genes polymorphisms in women with cervical lesions from Pernambuco, Northeast Region of Brazil: a case-control study

    PubMed Central

    dos Santos, Erinaldo Ubirajara Damasceno; de Lima, Géssica Dayane Cordeiro; Oliveira, Micheline de Lucena; Heráclio, Sandra de Andrade; da Silva, Hildson Dornelas Angelo; Crovella, Sergio; Maia, Maria de Mascena Diniz; de Souza/, Paulo Roberto Eleutério

    2016-01-01

    Polymorphisms in chemokine receptors play an important role in the progression of cervical intraepithelial neoplasia (CIN) to cervical cancer (CC). Our study examined the association of CCR2-64I (rs1799864) andCCR5-Δ32 (rs333) polymorphisms with susceptibility to develop cervical lesion (CIN and CC) in a Brazilian population. The genotyping of 139 women with cervical lesions and 151 women without cervical lesions for the CCR2-64I and CCR5-Δ32 polymorphisms were performed using polymerase chain reaction-restriction fragment length polymorphism. The individuals carrying heterozygous or homozygous genotypes (GA+AA) for CCR2-64I polymorphisms seem to be at lower risk for cervical lesion [odds ratio (OR) = 0.37, p = 0.0008)]. The same was observed for the A allele (OR = 0.39, p = 0.0002), while no association was detected (p > 0.05) with CCR5-Δ32 polymorphism. Regarding the human papillomavirus (HPV) type, patients carrying the CCR2-64Ipolymorphism were protected against infection by HPV type 16 (OR = 0.35, p = 0.0184). In summary, our study showed a protective effect ofCCR2-64I rs1799864 polymorphism against the development of cervical lesions (CIN and CC) and in the susceptibility of HPV 16 infection. PMID:26982176

  7. HPV Genotypes in High Grade Cervical Lesions and Invasive Cervical Carcinoma as Detected by Two Commercial DNA Assays, North Carolina, 2001–2006

    PubMed Central

    Hariri, Susan; Steinau, Martin; Rinas, Allen; Gargano, Julia W.; Ludema, Christina; Unger, Elizabeth R.; Carter, Alicia L.; Grant, Kathy L.; Bamberg, Melanie; McDermott, James E.; Markowitz, Lauri E.; Brewer, Noel T.; Smith, Jennifer S.

    2012-01-01

    Background HPV typing using formalin fixed paraffin embedded (FFPE) cervical tissue is used to evaluate HPV vaccine impact, but DNA yield and quality in FFPE specimens can negatively affect test results. This study aimed to evaluate 2 commercial assays for HPV detection and typing using FFPE cervical specimens. Methods Four large North Carolina pathology laboratories provided FFPE specimens from 299 women ages18 and older diagnosed with cervical disease from 2001 to 2006. For each woman, one diagnostic block was selected and unstained serial sections were prepared for DNA typing. Extracts from samples with residual lesion were used to detect and type HPV using parallel and serial testing algorithms with the Linear Array and LiPA HPV genotyping assays. Findings LA and LiPA concordance was 0.61 for detecting any high-risk (HR) and 0.20 for detecting any low-risk (LR) types, with significant differences in marginal proportions for HPV16, 51, 52, and any HR types. Discordant results were most often LiPA-positive, LA-negative. The parallel algorithm yielded the highest prevalence of any HPV type (95.7%). HR type prevalence was similar using parallel (93.1%) and serial (92.1%) approaches. HPV16, 33, and 52 prevalence was slightly lower using the serial algorithm, but the median number of HR types per woman (1) did not differ by algorithm. Using the serial algorithm, HPV DNA was detected in >85% of invasive and >95% of pre-invasive lesions. The most common type was HPV16, followed by 52, 18, 31, 33, and 35; HPV16/18 was detected in 56.5% of specimens. Multiple HPV types were more common in lower grade lesions. Conclusions We developed an efficient algorithm for testing and reporting results of two commercial assays for HPV detection and typing in FFPE specimens, and describe HPV type distribution in pre-invasive and invasive cervical lesions in a state-based sample prior to HPV vaccine introduction. PMID:22479516

  8. Large cerebellar mass lesion: A rare intracranial manifestation of blastomycosis.

    PubMed

    Munich, Stephan A; Johnson, Andrew K; Ahuja, Sumeet K; Venizelos, Alexander; Byrne, Richard W

    2013-01-01

    Blastomyces dermatitidis is a dimorphic fungus found endemically in the Mississippi and Ohio River basins and in the Midwestern and Canadian provinces that border the Great Lakes. Unlike other fungal infections, it most commonly affects immunocompetent hosts. Blastomycosis typically manifests as pulmonary infection, but may affect nearly any organ, including the skin, bone, and genitourinary system. Central nervous system (CNS) blastomycosis is rare, but potentially fatal manifestation of this disease. When it does occur, it most commonly presents as acute or chronic meningitis. We present a case of a patient who suffered intractable nausea and vomiting for several months before discovery of a large cerebellar blastomycoma causing mass effect and obstructive hydrocephalus. The enhancing lesion with unusual peripheral cystic structures is a unique radiographic appearance of CNS blastomycosis. We review this patient's purely intraparenchymal manifestation of CNS blastomycosis and describe the unique imaging characteristics encountered.

  9. Evaluation of Ki67, p16 and CK17 Markers in Differentiating Cervical Intraepithelial Neoplasia and Benign Lesions

    PubMed Central

    Sari Aslani, Fatemeh; Safaei, Akbar; Pourjabali, Masoumeh; Momtahan, Mozhdeh

    2013-01-01

    Background: Cervical intraepithelial neoplasia (CIN) is a premalignant lesion capable of progressing to cervical cancer. Despite the existing well-defined criteria, the histomorphologic diagnosis is subject to high rates of discordance among pathologists. The aim of this study was to evaluate Ki-67 (MIB-1), CK17 and p16 INK4a (p16) markers by immunohistochemical methods in differentiating CIN from benign cervical lesions. Methods: The present study reviewed and re-classified 77 cervical biopsies, originally diagnosed as 31 non-CIN, and 46 CIN, as 54 non-CIN, and 23 CIN based on at least two similar diagnoses. Immunostaining by Ki67, p16 and CK17 markers was performed on all cases and the results were compared with pervious and consensus diagnosis. Results: The overall agreement between pervious and consensus diagnosis was 67.5% (Kappa=0.39, P<0.001). The sensitivity and specificity of Ki67 immunostaining were 95.6% and 85.1% respectively, while for p16 the corresponding values were 91.3% and 98.1%. The overall agreement, for both p16 and Ki67, with consensus diagnosis were significant (P<0.001). The sensitivity and specificity of CK17 negative staining in CIN detection were 39.1% and 40.7% respectively. Conclusion: Ki67 and p16 markers are recommended as complementary tests for differentiating between dysplastic and non-dysplastic lesions. CK17 does not discriminate between immature metaplasia with and without dysplasia. PMID:23645953

  10. Characterization of genomic changes in the cervical pre-cancerous lesions and tumors induced by different types of human papillomaviruses.

    PubMed

    Grozdanov, Petar; Hadjidekova, Savina; Dimova, Ivanka; Nikolova, Ivanka; Toncheva, Draga; Ganchev, Gancho; Zlatkov, Victor; Galabov, Angel S

    2016-09-01

    Cervical carcinoma is the second most common malignancy among women in both incidence and mortality. Although much is known about the etiology and treatment of cervical cancer, the role of genetic alterations in the multistep pathway of cervical tumorigenesis is largely unknown. The aim of this study was to characterize the genomic changes in the cervical pre-cancerous lesions and tumors, induced by different types of human papillomaviruses. In this research was used the BlueGnome CytoChip oligo 2 × 105 K microarray for whole-genome oligo-array CGH. Microarray CGH analysis of 40 specimens was carried out-12 specimens from patients with early-stage squamous cell carcinomas; 19 specimens from patients with mild to moderate dysplasia and 9 with severe dysplasia. First we performed microarray CGH analysis of five DNA pools which contained the DNA from homogeneous groups of patients. The results revealed presence of micro chromosomal aberrations in chromosome region 14q11.2. According to the genome database these aberrations represent polymorphisms. Microarray analysis of DNA from 9 separate carcinoma lesions revealed a total of 26 aberrations in 14 chromosomes of nine patients. Our results showed the advantages of high-resolution chips in the clinical diagnosis of patients with cancerous and precancerous lesions caused by viral infection with HPV, but also highlight the need for extensive population studies revealing the molecular nature and clinical significance of different CNVs and the creation of detailed maps of variations in the Bulgarian population. This would facilitate extremely precise interpretation of specific genomic imbalances in the clinical aspect.

  11. Effects of non-carious cervical lesion size, occlusal loading and restoration on biomechanical behaviour of premolar teeth.

    PubMed

    Zeola, L F; Pereira, F A; Machado, A C; Reis, B R; Kaidonis, J; Xie, Z; Townsend, G C; Ranjitkar, S; Soares, P V

    2016-12-01

    Information on fracture biomechanics has implications in materials research and clinical practice. The aim of this study was to analyse the influence of non-carious cervical lesion (NCCL) size, restorative status and direction of occlusal loading on the biomechanical behaviour of mandibular premolars, using finite element analysis (FEA), strain gauge tests and fracture resistance tests. Ten buccal cusps were loaded on the outer and inner slopes to calculate the strain generated cervically. Data were collected for healthy teeth at baseline and progressively at three lesion depths (0.5 mm, 1.0 mm and 1.5 mm), followed by restoration with resin composite. The magnitude and distribution of von Mises stress and maximum principal stress were simulated at all stages using FEA, and fracture strength was also determined (n = 7 per group). There were significant effects of the lesion size and loading directions on stress, strain and fracture resistance (p < 0.05). Fracture resistance values decreased with increase in lesion size, but returned to baseline with restorations. Combined assessment of computer-based and experimental techniques provide an holistic approach to characterize the biomechanical behaviour of teeth with both unrestored and restored NCCLs. © 2016 Australian Dental Association.

  12. Interaction between susceptibility loci in cGAS-STING pathway, MHC gene and HPV infection on the risk of cervical precancerous lesions in Chinese population.

    PubMed

    Xiao, Di; Huang, Weihuang; Ou, Meiling; Guo, Congcong; Ye, Xingguang; Liu, Yang; Wang, Man; Zhang, Baohuan; Zhang, Na; Huang, Shiqi; Zang, Jiankun; Zhou, Zixing; Wen, Zihao; Zeng, Chengli; Wu, Chenfei; Huang, Chuican; Wei, Xiangcai; Yang, Guang; Jing, Chunxia

    2016-12-20

    Human papillomavirus (HPV) infection is a definite risk factor for cervical cancer. Nevertheless, only some infected individuals actually develop cervical cancer. The cGAS-STING pathway in innate immunity plays an important role in protecting against HPV infection. Chen et al. described that the rs2516448 SNP in the MHC locus may affect susceptibility to cervical cancer, a finding that we attempted to replicate in a Chinese population. To investigate the effects of cGAS, STING and MHC polymorphisms on susceptibility to cervical precancerous lesions, 9 SNPs were analyzed in 164 cervical precancerous lesion cases and 428 controls. Gene-gene and gene-environment interactions were also evaluated. We found a significantly decreased risk of cervical precancerous lesions for the GG genotype of rs311678 in the cGAS gene (ORadjusted = 0.40, 95% CI: 0.16-0.98). Moreover, MDR analysis identified a significant three-locus interaction model, involving HPV infection, age at menarche and rs311678 in cGAS. Additionally, a significant antagonistic interaction between HPV infection and rs311678 was found on an additive scale. In conclusion, our results indicate that the rs311678 polymorphism in the cGAS gene confers genetic susceptibility to cervical precancerous lesions. Moreover, the three-way gene-environment interactions further demonstrate that the rs311678 polymorphism in cGAS can significantly decrease the risk of HPV infection and the elder at menarche.

  13. Evaluation of p16, human papillomavirus capsid protein L1 and Ki-67 in cervical intraepithelial lesions: potential utility in diagnosis and prognosis.

    PubMed

    Alshenawy, Hanan AlSaeid

    2014-12-01

    Cervical dysplasia, a potentially precancerous lesion, has increased in young women. Detection of cervical dysplasia is important for reducing morbidity and mortality in cervical cancer. This study analyzes the immunohistochemical expression of p16, HPV L1 capsid protein and Ki-67 in cervical intraepithelial lesions, and correlates them with lesion grade to develop a set of markers for diagnosis and detect the prognosis of cervical cancer precursors. Seventy-five specimens were analyzed, including 15 cases of CIN 1, 28 cases of CIN 2, 20 cases of CIN 3, and 12 cervical squamous carcinomas, besides 10 normal cervical tissues. They were stained for p16, HPV L1 and Ki-67. Sensitivity, specificity, predictive values and accuracy were evaluated for each marker. p16 expression increased during progression from CIN 1 to carcinoma. HPV L1 positivity was detected in CIN 2 and decreased gradually as the CIN grade increased but disappeared in carcinoma. Strong Ki-67 expression was observed in high grades CIN and carcinoma. p16, HPV L1 and Ki-67 were sensitive but with variable specificity in detecting CIN lesions. p16, HPV L1 and Ki-67 are useful markers in establishing the risk of high-grade CIN. They complete each other to reach an accurate diagnosis and to detect the prognosis. Copyright © 2014 Elsevier GmbH. All rights reserved.

  14. Laminoplasty with lateral mass screw fixation for cervical spondylotic myelopathy in patients with athetoid cerebral palsy

    PubMed Central

    Zhou, Hua; Liu, Zhong-jun; Wang, Shao-bo; Pan, Sheng-fa; Yan, Ming; Zhang, Feng-shan; Sun, Yu

    2016-01-01

    Abstract Although several studies report various treatment solutions for cervical spondylotic myelopathy in patients with athetoid cerebral palsy, long-term follow-up studies are very rare. None of the reported treatment solutions represent a gold standard for this disease owing to the small number of cases and lack of long-term follow-up. This study aimed to evaluate the outcomes of laminoplasty with lateral mass screw fixation to treat cervical spondylotic myelopathy in patients with athetoid cerebral palsy from a single center. This retrospective study included 15 patients (9 male patients and 6 female patients) with athetoid cerebral palsy who underwent laminoplasty with lateral mass screw fixation for cervical spondylotic myelopathy at our hospital between March 2006 and June 2010. Demographic variables, radiographic parameters, and pre- and postoperative clinical outcomes determined by the modified Japanese Orthopedic Association (JOA), Neck Disability Index (NDI), and visual analog scale (VAS) scores were assessed. The mean follow-up time was 80.5 months. Developmental cervical spinal canal stenosis (P = 0.02) and cervical lordosis (P = 0.04) were significantly correlated with lower preoperative modified JOA scores. The mean modified JOA scores increased from 7.97 preoperatively to 12.1 postoperatively (P < 0.01). The mean VAS score decreased from 5.30 to 3.13 (P < 0.01), and the mean NDI score decreased from 31.73 to 19.93 (P < 0.01). There was a significant negative correlation between developmental cervical spinal canal stenosis and recovery rate of the modified JOA score (P = 0.01). Developmental cervical spinal canal stenosis is significantly related to neurological function in patients with athetoid cerebral palsy. Laminoplasty with lateral mass screw fixation is an effective treatment for cervical spondylotic myelopathy in patients with athetoid cerebral palsy and developmental cervical spinal canal stenosis. PMID:27684879

  15. Flowable composites for restoration of non-carious cervical lesions: Three-year results.

    PubMed

    May, Sabine; Cieplik, Fabian; Hiller, Karl-Anton; Buchalla, Wolfgang; Federlin, Marianne; Schmalz, Gottfried

    2017-03-01

    To evaluate the clinical performance of two flowable composites for restoring Class-V non-carious cervical lesions (NCCLs), one with novel (ND; N'Durance(®) Dimer Flow, Septodont) and one with modified conventional matrix composition (FS; Filtek™ Supreme XTE Flow, 3M-ESPE). The null hypothesis was that both flowable composites perform equally regarding clinical quality and survival. 50 patients received one ND and one FS restoration of NCCLs in premolars using Clearfil Protect Bond (Kuraray) as an adhesive. Restorations were evaluated by two examiners at baseline (BL), 18 and 36 months employing FDI criteria. Non-parametric statistical analyses and χ(2) tests were applied (α=0.05). 48 patients with both restorations under risk participated in the 36-mo recall. One patient terminated participation after the 18-mo recall. One ND restoration failed at the 18-mo recall (fracture). One FS restoration failed during clinical examination at the 36-mo recall (debonding). 95.8% of restorations each were rated clinically acceptable at 36-mo. No significant differences for all selected FDI criteria were recorded between ND and FS at each examination time point except for the criteria surface staining at 36-mo and marginal staining at 18-mo and 36-mo, where FS showed significantly better results. For each material, no significant differences over time were detected, except for loss of surface lustre for FS (BL to 18 months). Within the limitations of the study, the null hypothesis that materials perform equally could not be rejected. Both flowable composites performed equally regarding survival and similarly regarding clinical performance. Copyright © 2016 The Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

  16. DISTRIBUTION OF CARIOUS AND NON-CARIOUS CERVICAL LESIONS AND GINGIVAL RECESSION AT AGE RELATED ASPECTS.

    PubMed

    Mamaladze, M; Khutsishvili, L; Zarkua, E

    2016-07-01

    The current study aims at differentiating carious and/or non-carious diseases developed in Class 5 region and detecting the distribution rate at the age aspects. The study was conducted at the Dental Clinicand Educational-Research Center "Unident" LTD and Dental Clinic "Dens". 256 patients were involved in the study. All patients underwent a routine dental examination, while rentgenovisiography and CT were performed in case of need. For gathering the detailed medical history and integrated study of Class 5 defects, a special questionnaire/survey, providing detailed information on each patient, was developed. The conducted study revealed the following: The patients were divided into 3 age groups: 16-30 of ages (77 patients, I study group), 30-50 of ages (97 patients, II study group) and 50-70 of ages (82, III study group), respectively. In total 5802 teeth were examined. The subject of our interest was identification of intact and damaged teeth (affected with caries and non-carious diseases) in the above-mentioned contingent. It was found that carious disease of cervical zone of tooth (Class 5) most often was revealed in 30-50 age group (202 cases), which is 1.8-fold higher than the same index in the I study group (144) and 1.4-fold higher in the III study group (183), respectively; The highest rate of non-carious lesions (erosion, abrasion, abfraction) of dental neck was recorded in examined 50-70 age group (294 cases), which was 4.6 -fold higher than in the I study group (64) and 2.1 -fold higher in II study group (140), respectively; The lowest incidence of gingival recession was in the I study group (65 cases), which is 6.3 -fold lower than in the II study group (412) and 7.5-fold lower than - the III group (493).

  17. Retention of tooth-colored restorations in non-carious cervical lesions--a systematic review.

    PubMed

    Santos, Maria Jacinta Moraes Coelho; Ari, Nilgun; Steele, Shawn; Costella, John; Banting, David

    2014-01-01

    The aim of this review was to assess the effect of different adhesive systems and tooth preparation on the retention of tooth-colored restorative materials placed in non-carious cervical lesions (NCCLs). Randomized clinical trials with a minimum of 3 years of follow-up that evaluated the effectiveness of tooth-colored materials, adhesive systems, and preparation techniques for the restoration of NCCLs were selected. The Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE (OVID), the Latin American and Caribbean Health Sciences Literature database (LILACS), and Medline (OVID) electronic databases were searched from 1990 to 2013. Twenty-seven randomized clinical trials were included and reviewed. Meta-analysis was used to determine the relative risk of loss of tooth-colored NCCL restorations between different categories of adhesive systems. The effect of tooth preparation could not be similarly analyzed. The current best evidence indicates that a glass ionomer cement has a significantly lower risk of loss of a NCCL restoration compared to either a three-step etch-and-rinse or a two-step etch-and-rinse adhesive system; a three-step etch-and-rinse adhesive system has a significantly lower risk of loss of a NCCL restoration compared to a two-step etch-and-rinse adhesive system. No significant difference could be observed in the risk of loss of a tooth-colored NCCL restoration between a three-step etch-and-rinse adhesive system and either a two-step self-etch or a one-step self-etch adhesive system.

  18. Tooth-colored filling materials for the restoration of cervical lesions: a 24-month follow-up study.

    PubMed

    Folwaczny, M; Loher, C; Mehl, A; Kunzelmann, K H; Hinkel, R

    2000-01-01

    The recently developed resin-modified glass ionomer cements and the polyacid-modified composites are promising alternatives to conventional materials for restoring cervical defects. This clinical study evaluated the clinical condition of cervical fillings 24 months following placement. The study subjects were 197 cervical restorations placed on incisors, canines and premolars in 37 patients for restoration of erosion/non-carious lesions (69 cases), primary carious lesions (57 cases) and the replacement of deficient restorations (71 cases). The teeth were randomly divided into four groups for restoration with either Tetric (composite, Group A: n = 36), Dyract (compomer, Group B: n = 79), Fuji II LC (resin-modified glass ionomer cement, Group C: n = 51) or Photac-Fil (resin-modified glass ionomer cement, Group D: n = 31). The evaluation was done single-blind at baseline, 8 and 24 months after the placement of the fillings, according to a modified USPHS rating scale. The assessment criteria were color stability, anatomical form, surface texture, marginal integrity, marginal discoloration and loss of filling. Statistical analysis was completed using Pearson chi-square and Fisher's exact test at a significance level of 5% (p < 0.05). After the 24-month period, the composite restorations showed superior results. The compomer fillings demonstrated conditions that were only slightly worse. A substantial number of the resin-modified glass-ionomer fillings were evaluated with bravo or even charlie scores in respect to at least one of the criteria assessed.

  19. Differential role of gene hypermethylation in adenocarcinomas, squamous cell carcinomas and cervical intraepithelial lesions of the uterine cervix.

    PubMed

    Blanco-Luquin, Idoia; Guarch, Rosa; Ojer, Amaya; Pérez-Janices, Noemí; Martín-Sánchez, Esperanza; Maria-Ruiz, Sergio; Monreal-Santesteban, Iñaki; Blanco-Fernandez, Laura; Pernaut-Leza, Eduardo; Escors, David; Guerrero-Setas, David

    2015-09-01

    Cervical cancer is the third most common cancer in women worldwide. The hypermethylation of P16, TSLC-1 and TSP-1 genes was analyzed in squamous cell carcinomas (SCC), cervical intraepithelial lesions (CIN) and adenocarcinomas (ADC) of the uterine cervix (total 181 lesions). Additionally human papillomavirus (HPV) type, EPB41L3, RASSF1 and RASSF2 hypermethylation were tested in ADC and the results were compared with those obtained previously by our group in SCC. P16, TSLC-1 and TSP-1 hypermethylation was more frequent in SCCs than in CINs. These percentages and the corresponding ones for EPB41L3, RASSF1 and RASSF2 genes were also higher in SCCs than in ADCs, except for P16. The presence of HPV in ADCs was lower than reported previously in SCC and CIN. Patients with RASSF1A hypermethylation showed significantly longer disease-free survival (P = 0.015) and overall survival periods (P = 0.009) in ADC patients. To our knowledge, this is the first description of the EPB41L3 and RASSF2 hypermethylation in ADCs. These results suggest that the involvement of DNA hypermethylation in cervical cancer varies depending on the histological type, which might contribute to explaining the different prognosis of patients with these types of tumors.

  20. Comparative study of HPV16 integration in cervical lesions between ethnicities with high and low rates of infection with high-risk HPV and the correlation between integration rate and cervical neoplasia.

    PubMed

    Han, Lili; Maimaitiming, Tuerxunayi; Husaiyin, Sulaiya; Wang, Lin; Wusainahong, Kunduozi; Ma, Chunhua; Niyazi, Mayinuer

    2015-12-01

    The etiology of a high incidence of cervical cancer in populations with a low human papillomavirus (HPV) infection rate is unclear. The current study aimed to investigate the role of HPV16 DNA integration in cervical lesions in women of Han and Uygur ethnicity and to explore the association between viral integration and a high cervical cancer morbidity with a low HPV infection rate. DNA was extracted from the biopsy specimens of cervical lesions of 379 patients of Uygur ethnicity and 464 patients of Han ethnicity, and multiple quantitative polymerase chain reaction (qPCR) assays were performed to determine the copy numbers of the HPV16 E2 and E6 genes. The copy number of the HPV16 DNA was evaluated according to the E2/E6 ratio. Among these cases, 122 Uygur and 121 Han specimens were found to be HPV16 positive. In the two populations, the percentage of cases with HPV16 integration (the sum of integrated-type infection only or a mixture of free-and integrated-type infection) increased with the grade of the cervical lesions (P<0.001). Within groups with the same cervical lesion grade, no significant differences in HPV16 integration were found between women of Uygur and Han ethnicity (rank sum test, P>0.05). No significant differences in the distribution of the HPV16 integration rate according to lesion grade were found in either population (P>0.05). When the two subpopulations were considered as one sample population, the integration rate significantly increased with lesion grade (P=0.02). These results indicate that the integration rate of HPV16 E2 may serve as a molecular biological marker for the development of cervical lesions.

  1. Clinical evaluation of giomer- and resin-modified glass ionomer cement in class V noncarious cervical lesions: An in vivo study.

    PubMed

    Jyothi, Kn; Annapurna, S; Kumar, Anil S; Venugopal, P; Jayashankara, Cm

    2011-10-01

    To evaluate and compare the clinical performance of Giomer (Beautifil II) and RMGIC (Fuji II LC) in noncarious cervical lesions. Thirty-two subjects with one or two pairs of noncarious cervical lesions were included in the study. Each pair of lesion was restored with either giomer or RMGIC assigned randomly. Clinical evaluation of restorations was done using USPHS criteria. Data was formulated in a predesigned format and subjected to statistical analysis using the chi square test. Statistically significant difference was found between RMGIC and Giomer with respect to surface roughness with P value <0.001. Giomer showed superior surface finish compared to RMGIC. Both Giomer and RMGIC showed equal retention ability.

  2. Cervicitis

    MedlinePlus

    ... growth of normal bacteria in the vagina (bacterial vaginosis) can also cause cervicitis. ... a microscope (may show candidiasis , trichomoniasis , or bacterial vaginosis) Pap test Tests for gonorrhea or chlamydia Rarely, ...

  3. Clinical evaluation of different adhesives used in the restoration of non-carious cervical lesions: 24-month results.

    PubMed

    Tuncer, D; Yazici, A R; Özgünaltay, G; Dayangac, B

    2013-03-01

    The aim of this study was to compare after 24 months the clinical performance of cervical restorations placed with the use of an etch-and-rinse and an all-in-one adhesive. Twenty-four patients with at least one pair of non-carious cervical lesions participated in this study. One hundred and twenty-three cervical lesions were restored (62 etch-and-rinse adhesive, Solobond M; 61 all-in-one adhesive, Futurabond NR). A nanohybrid resin composite, Grandio, was used as the restorative material. Restorations were evaluated according to modified USPHS criteria by two independent examiners. The survival rates of the restorations were calculated by the Kaplan-Meier estimator and log-rank test. The restorations in each category were compared using the Pearson chi-square test, while the performance of restorations at the baseline and at each recall time was evaluated by McNemar's test (p < 0.05). The recall rate of patients was 100%. The retention rates were 82% and 75% at 6 months and 77% and 62% at 12 months for Solobond M and Futurabond NR, respectively. At the 24-month recall, the retention rate was 69% for Solobond M and 49% for Futurabond NR, and this difference was statistically significant (p < 0.05). No statistically significant difference was found for colour match, marginal staining, or marginal adaptation between the adhesives (p > 0.05). None of the restorations had secondary caries, loss of anatomical form, or surface texture changes. Cervical restorations placed with an etch-and-rinse adhesive showed higher retention than an all-in-one adhesive. © 2013 Australian Dental Association.

  4. Association between PD-L1 and HPV status and the prognostic value for HPV treatment in premalignant cervical lesion patients

    PubMed Central

    Yang-Chun, Feng; Zhen-Zhen, Cheng; Yan-Chun, Huang; Xiu-Min, Ma

    2017-01-01

    Abstract The difference of PD-L1 expression between only HPV-positive patients and premalignant cervical lesion patients did not be reported in present studies. And to test the PD-L1 expression in some cervical cell lesion studies using cervical exfoliated cells sample also was ignored. Meanwhile, the PD-L1 expression as a predictive biomarker still existed controversy. So in the study, first to compare the expression of PD-L1 between only HPV-positive patients and premalignant cervical lesion patients, then to research the association between PD-L1 and HPV status, lastly to explore the possible prognostic value for HPV treatment in premalignant cervical lesion patients. Cervical exfoliated cells samples of 54 premalignant cervical lesion patients with HPV16 infection were collected; meanwhile the cervical exfoliated cells samples from 20 healthy women without HPV infection and 20 patients with only HPV16 infection but cervical cytology normal were collected as 2 control groups. Flow-through hybridization and gene chip (FHGC) was used to detect the HPV type, the PD-L1 expression was tested by Flow cytometry analysis, the methylation-sensitive high-resolution melting (MS-HRM) was used to test the HPV16 L1 gene methylation. The 54 premalignant cervical lesion patients were followed up in 18 months to assess the prognostic value of PD-L1 for HPV treatment. The PD-L1 positive cell rate and mean fluorescence intensity of PD-L1 positive cell in premalignant cervical lesion patients with HPV16 infection were higher than 2 control groups. Mean fluorescence intensity of PD-L1 positive cell were increased in 54 cases when existing multiple HPV status and high HPV16-L1 gene methylation (L1 gene methylation more than 50%). High PD-L1 expression (PD-L1 positive cell rate more than 10%), high HPV16-L1 gene methylation, and multiple HPV infection status could prolong the time to clean HPV infection by Kaplan–Meier analysis. Multivariate Cox proportional hazards analysis also

  5. Local immunosuppression induced by high viral load of human papillomavirus: characterization of cellular phenotypes producing interleukin-10 in cervical neoplastic lesions

    PubMed Central

    Prata, Thiago Theodoro Martins; Bonin, Camila Mareti; Ferreira, Alda Maria Teixeira; Padovani, Cacilda Tezelli Junqueira; Fernandes, Carlos Eurico dos Santos; Machado, Ana Paula; Tozetti, Inês Aparecida

    2015-01-01

    A specific immune response to human papillomavirus (HPV) in the cervical microenvironment plays a key role in eradicating infection and eliminating mutated cells. However, high-risk HPVs modulate immune cells to create an immunosuppressive microenvironment, and induce these immune cells to produce interleukin 10 (IL-10). This production of IL-10, in conjunction with HPV infection, contributes to the appearance of cervical neoplastic lesions. We sought to characterize the IL-10-producing cellular phenotype, and investigate the influence of host and HPV factors upon the induction of an immunosuppressive microenvironment. Immunohistochemical analysis demonstrated an increase in IL-10 production by keratinocytes, macrophages and Langerhans cells in high-grade cervical lesions and cervical cancer. This increase was more pronounced in patients older than 30 years, and was also correlated with high viral load, and infection with a single HPV type, particularly high-risk HPVs. Our results indicate the existence of a highly immunosuppressive microenvironment composed of different IL-10-producing cellular phenotypes in cervical cancer samples, and samples classified as high-grade cervical lesions (cervical intraepithelial neoplasia stages II and III). The immunosuppressive microenvironment that developed for these different cellular phenotypes favours viral persistence and neoplastic progression. PMID:26059395

  6. Local immunosuppression induced by high viral load of human papillomavirus: characterization of cellular phenotypes producing interleukin-10 in cervical neoplastic lesions.

    PubMed

    Prata, Thiago Theodoro Martins; Bonin, Camila Mareti; Ferreira, Alda Maria Teixeira; Padovani, Cacilda Tezelli Junqueira; Fernandes, Carlos Eurico dos Santos; Machado, Ana Paula; Tozetti, Inês Aparecida

    2015-09-01

    A specific immune response to human papillomavirus (HPV) in the cervical microenvironment plays a key role in eradicating infection and eliminating mutated cells. However, high-risk HPVs modulate immune cells to create an immunosuppressive microenvironment, and induce these immune cells to produce interleukin 10 (IL-10). This production of IL-10, in conjunction with HPV infection, contributes to the appearance of cervical neoplastic lesions. We sought to characterize the IL-10-producing cellular phenotype, and investigate the influence of host and HPV factors upon the induction of an immunosuppressive microenvironment. Immunohistochemical analysis demonstrated an increase in IL-10 production by keratinocytes, macrophages and Langerhans cells in high-grade cervical lesions and cervical cancer. This increase was more pronounced in patients older than 30 years, and was also correlated with high viral load, and infection with a single HPV type, particularly high-risk HPVs. Our results indicate the existence of a highly immunosuppressive microenvironment composed of different IL-10-producing cellular phenotypes in cervical cancer samples, and samples classified as high-grade cervical lesions (cervical intraepithelial neoplasia stages II and III). The immunosuppressive microenvironment that developed for these different cellular phenotypes favours viral persistence and neoplastic progression. © 2015 John Wiley & Sons Ltd.

  7. Human papillomavirus prevalence and type-distribution in women with cervical lesions: a cross-sectional study in Sri Lanka.

    PubMed

    Karunaratne, Kanishka; Ihalagama, Himali; Rohitha, Saman; Molijn, Anco; Gopala, Kusuma; Schmidt, Johannes E; Chen, Jing; Datta, Sanjoy; Mehta, Shailesh

    2014-02-21

    Cervical cancer ranks second among all cancers reported in Sri Lankan women. This study assessed the prevalence and type-distribution of human papillomavirus (HPV) among Sri Lankan women with invasive cervical cancer (ICC) and pre-cancerous lesions. 114 women aged 21 years and above, hospitalized in the National Cancer Institute, Sri Lanka with a diagnosis of ICC or cervical intraepithelial neoplasia (CIN) 2/3 were prospectively enrolled between October 2009 and September 2010 (110430/NCT01221987). The cervical biopsy or excision specimens collected during routine clinical procedures were subjected to histopathological review. DNA was extracted from samples with a confirmed histological diagnosis and was amplified using polymerase chain reaction and HPV DNA was detected using Enzyme Immuno Assay. HPV positive samples were typed using reverse hybridization Line Probe Assay. Of the cervical samples collected, 93.0% (106/114) had a histologically confirmed diagnosis of either ICC (98/106) or CIN 2/3 (8/106). Among all ICC cases, squamous cell carcinoma was diagnosed in the majority of women (81.6% [80/98]). HPV prevalence among ICC cases was 84.7% (83/98). The HPV types most commonly detected in ICC cases with single HPV infection (98.8% [82/83]) were HPV-16 (67.3%) and HPV-18 (9.2%). Infection with multiple HPV types was recorded in a single case (co-infection of HPV-16 and HPV-59). HPV was prevalent in most women with ICC in Sri Lanka; HPV-16 and HPV-18 were the predominantly detected HPV types. An effective prophylactic vaccine against the most prevalent HPV types may help to reduce the burden of ICC disease.

  8. Differential Gene Expression Landscape of Co-Existing Cervical Pre-Cancer Lesions Using RNA-seq

    PubMed Central

    Royse, Kathryn E.; Zhi, Degui; Conner, Michael G.; Clodfelder-Miller, Buffie; Srinivasasainagendra, Vinodh; Vaughan, Laura Kelly; Skibola, Christine F.; Crossman, David K.; Levy, Shawn; Shrestha, Sadeep

    2014-01-01

    Genetic changes occurring in different stages of pre-cancer lesions reflect causal events initiating and promoting the progression to cancer. Co-existing pre-cancerous lesions including low- and high-grade squamous intraepithelial lesion (LGSIL and HGSIL), and adjacent “normal” cervical epithelium from six formalin-fixed paraffin-embedded samples were selected. Tissues from these 18 samples were isolated using laser-capture microdissection, RNA was extracted and sequenced. RNA-sequencing generated 2.4 billion raw reads in 18 samples, of which ~50.1% mapped to known and annotated genes in the human genome. There were 40 genes up-regulated and 3 down-regulated (normal to LGSIL) in at least one-third of the sample pairs (same direction and FDR p < 0.05) including S100A7 and KLK6. Previous studies have shown that S110A7 and KLK7 are up-regulated in several other cancers, whereas CCL18, CFTR, and SLC6A14, also differentially expressed in two samples, are up-regulated specifically in cervical cancer. These differentially expressed genes in normal to LGSIL progression were enriched in pathways related to epithelial cell differentiation, keratinocyte differentiation, peptidase, and extracellular activities. In progression from LGSIL to HGSIL, two genes were up-regulated and five down-regulated in at least two samples. Further investigations using co-existing samples, which account for all internal confounders, will provide insights to better understand progression of cervical pre-cancer. PMID:25505737

  9. p16(INK4a) immunostaining as an alternative to histology review for reliable grading of cervical intraepithelial lesions.

    PubMed

    Dijkstra, Maaike G; Heideman, Daniëlle A M; de Roy, Sabine C; Rozendaal, Lawrence; Berkhof, Johannes; van Krimpen, Kees; van Groningen, Krijn; Snijders, Peter J F; Meijer, Chris J L M; van Kemenade, Folkert J

    2010-11-01

    Histomorphological grading of cervical intraepithelial neoplasia (CIN) is crucial for clinical management. CIN grading is however subjective and affected by substantial rates of discordance among pathologists, which may lead to overtreatment. To minimise this problem, a histology review of CIN lesions by a consensus panel of pathologists is often used. Diffuse strong p16(INK4a) immunostaining has been proposed to aid the identification of true high-grade cervical lesions (ie, CIN2/3). To assess the value of additional interpretation of p16(INK4a) immunostains for making a more reproducible diagnosis of CIN2/3 lesions. The authors used a series of 406 biopsies of cervical lesions, with known HPV status, stained for both H&E- and p16(INK4a). First, in a randomly selected set of 49 biopsies, we examined the effect of additional interpretation of p16(INK4a) immunostained slides, on the agreement of CIN diagnosis among three pathologists. Second, the full series of samples was used to assess the accuracy of p16(INK4a)-supported lesion grading by a single pathologist, by evaluating the degree of diagnostic agreement with the consensus diagnosis of expert pathologists based on H&E-stained sections only. The study shows that the interobserver agreement between three pathologists for the routine H&E-based diagnosis ranged from fair (weighted kappa 0.44 (95% CI 0.19 to 0.64)) to moderate (weighted kappa 0.66 (95% CI 0.47 to 0.79)). The concordance increased substantially for p16(INK4a)-supported grading (mean weighted kappa 0.80 (95% CI 0.66 to 0.89)). Furthermore, an almost perfect agreement was found between the p16(INK4a)-supported diagnosis of a single pathologist and the consensus diagnosis of an expert pathology panel (kappa 0.88 (95% CI 0.85 to 0.89)). These data demonstrate that additive use of p16(INK4a) immunohistochemistry significantly improves the accuracy of grading CIN lesions by a single pathologist, equalling an expert consensus diagnosis. Hence, the authors

  10. Retrocochlear mass lesion in mid-frequency sudden deafness.

    PubMed

    Lin, Yi-Tsen; Young, Yi-Ho

    2008-01-01

    This study retrospectively reviewed all cases of mid-frequency sudden deafness to understand the clinical significance of this hallmark finding. Retrospective study. From 1992 to 2006, a total of 556 patients with sudden deafness were experienced. Based on the audiographic configuration, these patients were classified into: flat-type group, 272 cases; high-frequency group, 146 cases; low-frequency group, 70 cases; mid-frequency group, 30 cases; and unclassified group, 38 cases. All patients underwent a battery of audiovestibular function testing. Among 556 sudden deafness patients, 17 patients (3%) were proved to have a retrocochlear tumor, including mid-frequency group (10), high-frequency group (4), flat-type group (2), and low-frequency group (1). Thus, the mid-frequency group had significantly higher (33%) association with a retrocochlear tumor than other groups. One-third of the patients with mid-frequency sudden deafness harbor a true retrocochlear mass lesion; hence, MR imaging is mandatory in such cases.

  11. 3-year clinical effectiveness of one-step adhesives in non-carious cervical lesions.

    PubMed

    Moretto, S G; Russo, E M A; Carvalho, R C R; De Munck, J; Van Landuyt, K; Peumans, M; Van Meerbeek, B; Cardoso, M V

    2013-08-01

    Despite representing an important component of current dental adhesives, HEMA has been said to negatively influence the long-term stability of adhesion to dentine and enamel. The aim of this randomised clinical trial was to evaluate the 3-year clinical performance of two one-step self-etch adhesives. Thirty patients had 175 non-carious cervical lesions restored with composite (Gradia Direct Anterior, GC) using either the HEMA-rich adhesive Clearfil Tri-S Bond (C3S; Kuraray) or the HEMA-free adhesive G-Bond (GB; GC). The restorations were evaluated by two examiners at baseline, 6, 12, 24 and 36 months regarding retention, caries recurrence, marginal integrity and discoloration and post-operative sensitivity. The data were statistically analysed with GEE and McNemar tests (p<0.05). The recall rate at 6 and 12 months was 100% and decreased to 96.7% at 24 and 36 months. At 3 years, the retention rate was 93.8% for C3S and 98.8% for GB (p=0.14). A pairwise comparison showed no significant differences between the two adhesives for all the parameters evaluated, irrespective of the recall (p>0.05). After 3 years, both adhesives presented an increase in the percentage of clinically acceptable marginal discoloration (C3S: 32.9% and GB: 26.8%) normally associated to clinically acceptable marginal defects (C3S: 35.8% and GB: 26.5%). Only 1 dentine margin of a GB restoration presented a severe marginal defect (1.2%) and 1 C3S restoration presented caries recurrence. The overall 3-year clinical success rate was 92.6% for C3S and 97.6% for GB (p=0.16). Both one-step self-etch adhesives presented an equally favourable clinical effectiveness at 3 years. HEMA is a monomer frequently present in dental adhesives in order to increase their wettability and hydrophilicity. However, this monomer negatively influences hydrolytic stability and durability of the adhesive interface complex. In this 3-year clinical trial no significant difference in bonding effectiveness was noticed between a

  12. Psychological predictors of the effectiveness of radiofrequency lesioning of the cervical spinal dorsal ganglion (RF-DRG).

    PubMed

    Samwel, H; Slappendel, R; Crul, B J; Voerman, V F

    2000-01-01

    In this study, 54 patients suffering from chronic cervicobrachialgia (mean pain duration 7 years) were treated with radiofrequency lesioning of the cervical spinal dorsal root ganglion (RF-DRG). The aim of the study was to investigate whether psychological variables would be predictive for the changes in pain intensity after medical treatment. The following psychological aspects were measured: pain cognitions, negative self-efficacy and catastrophizing, physical and psychosocial dysfunction, and overall distress. The level of catastrophizing before treatment appeared to predict 10% of the changes in pain intensity after treatment. Changes in pain intensity after RF-DRG were positively correlated with changes in psychosocial dysfunction and negative self-efficacy.

  13. Analysis of cytosine-adenine repeats in P1 promoter region of IGF-1 gene in peripheral blood cells and cervical tissue samples of females with cervical intraepithelial lesions and squamous cervical cancer.

    PubMed

    Kwasniewski, Wojciech; Gozdzicka-Jozefiak, Anna; Kotarska, Maria; Polak, Grzegorz; Barczynski, Bartlomiej; Broniarczyk, Justyna; Nowak, Witold; Wolun-Cholewa, Maria; Kwasniewska, Anna; Kotarski, Jan

    2015-02-01

    High oncogenic risk human papillomaviruses (HPVs) are closely associated with cancer of the cervix. However, HPV infection alone may not be sufficient to cause cervical cancer, and other factors or cofactors may have a cumulative effect on the risk of progression from cervical HPV infection to cancer. The present study investigates the cytosine‑adenine (CA) repeat polymorphism in the P1 promoter region of the insulin‑like growth factor‑1 (IGF‑1) gene among cervical precancerous and cancer patients and healthy control females. The association between these polymorphisms, tissue and blood serum levels of IGF‑1, and cervical cancer risk and progression is evaluated. The material for analysis consisted of blood cells and postoperative tissues from patients diagnosed with low‑grade squamous intraepithelial lesions (L‑SILs), high‑grade squamous intraepithelial lesions (H‑SILs) and invasive cervical cancer (ICC). A polymerase chain reaction amplification and the sequencing of DNA were used for the identification of (CA)n repeats in the IGF‑1 P1 region and detection of HPV DNA. The blood serum concentration of IGF was determined by enzyme‑linked immunosorbent assay. The identification of the IGF‑1 protein in the cervical tissues was performed by immunohistochemical analysis. The range of the length of the CA repeats in the study DNA was 11 to 21. However, the most common allele length and genotype in the control and study patients from serum and tissues was 19 CA repeats and a homozygous genotype of CA19/19. Statistically significant differences in the concentration of IGF‑1 in the blood serum were observed between H‑SILs and controls, only (p=0.047). However, the concentration of IGF‑1 in the group of females with CA19/19, CA19<19 and CA19>19 was significantly higher in the group of patients with H‑SIL (P=0.041) and ICC (P=0.048) in comparison with the control group. An association was detected between CA repeat length <19 and/or >19, IGF

  14. Analysis of cytosine-adenine repeats in P1 promoter region of IGF-1 gene in peripheral blood cells and cervical tissue samples of females with cervical intraepithelial lesions and squamous cervical cancer

    PubMed Central

    KWASNIEWSKI, WOJCIECH; GOZDZICKA-JOZEFIAK, ANNA; KOTARSKA, MARIA; POLAK, GRZEGORZ; BARCZYNSKI, BARTLOMIEJ; BRONIARCZYK, JUSTYNA; NOWAK, WITOLD; WOLUN-CHOLEWA, MARIA; KWASNIEWSKA, ANNA; KOTARSKI, JAN

    2015-01-01

    High oncogenic risk human papillomaviruses (HPVs) are closely associated with cancer of the cervix. However, HPV infection alone may not be sufficient to cause cervical cancer, and other factors or cofactors may have a cumulative effect on the risk of progression from cervical HPV infection to cancer. The present study investigates the cytosine-adenine (CA) repeat polymorphism in the P1 promoter region of the insulin-like growth factor-1 (IGF-1) gene among cervical precancerous and cancer patients and healthy control females. The association between these polymorphisms, tissue and blood serum levels of IGF-1, and cervical cancer risk and progression is evaluated. The material for analysis consisted of blood cells and postoperative tissues from patients diagnosed with low-grade squamous intraepithelial lesions (L-SILs), high-grade squamous intraepithelial lesions (H-SILs) and invasive cervical cancer (ICC). A polymerase chain reaction amplification and the sequencing of DNA were used for the identification of (CA)n repeats in the IGF-1 P1 region and detection of HPV DNA. The blood serum concentration of IGF was determined by enzyme-linked immunosorbent assay. The identification of the IGF-1 protein in the cervical tissues was performed by immunohistochemical analysis. The range of the length of the CA repeats in the study DNA was 11 to 21. However, the most common allele length and genotype in the control and study patients from serum and tissues was 19 CA repeats and a homozygous genotype of CA19/19. Statistically significant differences in the concentration of IGF-1 in the blood serum were observed between H-SILs and controls, only (p=0.047). However, the concentration of IGF-1 in the group of females with CA19/19, CA19<19 and CA19>19 was significantly higher in the group of patients with H-SIL (P=0.041) and ICC (P=0.048) in comparison with the control group. An association was detected between CA repeat length <19 and/or >19, IGF concentration in blood serum and

  15. Diagnostic accuracy of diffusion-weighted MRI for differentiation of cervical cancer and benign cervical lesions at 3.0T: Comparison with routine MRI and dynamic contrast-enhanced MRI.

    PubMed

    Kuang, Fei; Yan, Zhiping; Li, Huili; Feng, Hao

    2015-10-01

    To compare the diagnostic accuracy of routine magnetic resonance imaging (MRI) (T1 WI and T2 WI), diffusion-weighted MRI (DWI), and DCE-MRI (dynamic contrast-enhanced MRI) at 3.0T for differentiation of cervical cancer and benign cervical lesions. A cohort of 75 cervical cancer patients, 26 cervical leiomyoma patients, 22 patients with cervical polyps consecutively underwent pelvic MRI scanning on a 3T MR unit. Two radiologists independently evaluated images at three imaging settings; routine MRI alone, DWI combined with routine MRI (DWI+routine MRI), and DCE-MRI. The apparent diffusion coefficients (ADCs) were calculated from b 0, 600 s/mm(2) and b 0, 1000 s/mm(2). DWI+routine MRI was significantly better than routine MRI and obtained high accuracy (0.95); the diagnostic performance was not significantly different between DWI+routine MRI and DCE-MRI. Reader agreement was excellent for both DWI+routine MRI (κ, 0.90) and DCE-MRI (κ, 0.92). The ADCs of cervical cancer were significantly lower than those of benign cervical lesions at both ADC maps (P = 0.0001). The diagnostic accuracy was not different at both ADC maps (P = 0.375). For differentiation of cervical cancer and benign cervical lesions, unenhanced MRI with combined diffusion-weighted and routine MRI (DWI+routine MRI) at 3T can provide accurate information and may be preferable to DCE. © 2015 Wiley Periodicals, Inc.

  16. [Low rate of oropharyngeal human papillomavirus infection among women with cervical lesion. Preliminary results from the South-Eastern Hungarian population].

    PubMed

    Vanya, Melinda; Jakó, Mária; Terhes, Gabriella; Szakács, László; Kaiser, László; Deák, Judit; Bártfai, György

    2016-01-10

    Although the natural history of cervical and oral human papillomavirus infection has been intensively investigated in the past years, the ability of this virus to infect oral and genital mucosae in the same individual and its potential to co-infect both cervical and oral mucosa are still unclear. The aim of the authors was to assess the presence of oropharyngeal human papillomavirus infection in women with cervical lesions in the South-Eastern Hungarian population. The total of 103 women have been included in the study between March 1, 2013 and January 1, 2015. Brushing was used to collect cells from the oropharyngeal mucosa. Human papillomavirus DNA was detected using polymerase chain reaction, and Amplicor line blot test was used for genotyping. Oropharyngeal human papillomavirus infection was detected in 2 cases (3%). The detected genotypes were 31, 40/61 and 73 in the oropharyngeal region. The results indicate that in women with cervical lesions oropharyngeal human papillomavirus infection rarely occurs.

  17. Mass media campaign improves cervical screening across all socio-economic groups.

    PubMed

    Anderson, Jenny O; Mullins, Robyn M; Siahpush, Mohammad; Spittal, Matthew J; Wakefield, Melanie

    2009-10-01

    Low socio-economic status (SES) has been associated with lower cervical screening rates. Mass media is one known strategy that can increase cervical screening participation. This study sought to determine whether a mass media campaign conducted in Victoria, Australia, in 2005 was effective in encouraging women across all SES groups to screen. Data were obtained from the Victorian Cervical Cytology Registry for each Pap test registered during 2005 and categorized into SES quintiles using the Index of Socio-Economic Advantage/Disadvantage. Negative binomial regression was used to determine the impact of the campaign on the weekly number of Pap tests and whether the media campaign had a differential effect by SES, after adjusting for the number of workdays per week, age group and time since previous test. Cervical screening increased 27% during the campaign period and was equally effective in encouraging screening across all SES groups, including low-SES women. Mass media campaigns can prompt increased rates of cervical screening among all women, not just those from more advantaged areas. Combining media with additional strategies targeted at low-SES women may help lessen the underlying differences in screening rates across SES.

  18. Selective enamel etching in cervical lesions for self-etch adhesives: A systematic review and meta-analysis.

    PubMed

    Szesz, Anna; Parreiras, Sibelli; Reis, Alessandra; Loguercio, Alessandro

    2016-10-01

    To identify if selective etching of enamel (SEE) margins improves the retention rates and marginal discoloration of cervical composite restorations in non-carious cervical lesions (NCCLs) of adult patients. MEDLINE, Scopus, Web of Science, LILACS, BBO Library, Cochrane Library and SIGLE were searched without restrictions, as well as IADR abstracts and gray literature via trial registries. Dissertations and theses were searched using the ProQuest Dissertations and Periódicos Capes Theses databases. We included randomized clinical trials that compared the clinical effectiveness of SEE using the self-etch adhesive for direct composite resin restorations in NCCLs in the permanent dentition. After removal of duplicates, 2689 articles were identified. Following screening of abstracts, 10 studies remained in the qualitative synthesis. Seven were considered to be at "low" risk of bias. The report of the studies varied from 1 to 5 years. Except for one-year follow-up, there was a significantly lower marginal discoloration and marginal adaptation during all follow-up periods. Significantly less loss of retention of restorations at the 3-year follow-up was observed with the selective enamel etching technique. Selective enamel prior to application of self-etch adhesive systems in NCCLs might improve clinical performance of resin-composite cervical restorations, although further long-term research is required to confirm this. Selective enamel etching prior to application of self-etch adhesive systems in NCCLs can produce composite restorations with higher longevity. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Quality of life in women with cervical precursor lesions and cancer: a prospective, 6-month, hospital-based study in China

    PubMed Central

    Zhao, Zhi-Mei; Pan, Xiong-Fei; Lv, Si-Han; Xie, Yao; Zhang, Shao-Kai; Qiao, You-Lin; Qi, Xiao-Rong; Yang, Chun-Xia; Zhao, Fang-Hui

    2014-01-01

    The overall survival of patients with cervical cancer has improved due to detection at an early stage and availability of comprehensive treatments in China. As patients' lives prolonged, it is important to understand their health-related quality of life (QoL) during and after treatment. We used the EQ-5D questionnaire to assess QoL of 194 patients with cervical lesions at Sichuan University West China Second Hospital between May 2010 and January 2011. Patients were surveyed before primary treatment and at 1, 3, and 6 months after primary treatment. Results showed a consistent decline in EQ-5D scores in the spectrum of cervical lesions at each time point after treatment (all P < 0.05). For patients with precursor lesions, there was an increasing trend along the timeline of treatment (P < 0.01). For patients with early-stage cervical cancer, EQ-5D scores declined in the first month (P = 0.01) and gradually increased to higher levels at 6 months post-treatment than those before treatment (P < 0.01). EQ-5D scores followed a similar trend in patients with advanced cervical cancer (P = 0.04), though they did not statistically rebound after 6 months (0.84 ± 0.19 vs. 0.86 ± 0.11, P = 0.62). Regarding advanced cervical cancer, EQ-5D scores for women above 40 years of age appeared to recover more rapidly and reached higher levels than those for women below 40 years (P = 0.03). Caution and extra care are recommended in the early period of cervical cancer treatment given the slight deterioration in the QoL, and in particular, for younger cervical cancer patients. Our study implies that health care providers may need to improve the health-related QoL of cervical cancer patients. PMID:24698497

  20. Evaluation of the association of NKG2C copy number variations with susceptibility to human papillomavirus-induced cervical lesions.

    PubMed

    Vilchez, José R; Torres-Moreno, Daniel; Martínez-Senac, María M; Trujillo-Santos, Javier; Conesa-Zamora, Pablo

    2013-10-01

    Squamous intraepithelial lesions (SIL) and cervical cancer are primary due to suboptimal host-dependent immune response against human papillomavirus (HPV). Natural killer cells (NK) are innate-immune response components against virus and tumors. We studied whether the null allele of NKG2C NK cell receptor could be associated with low-grade (LSIL) to high-grade SIL (HSIL) transition or likelihood of HPV infection. Eight-hundred and sixty-seven subjects (263 LSIL, 309 HSIL and 295 controls) were genotyped for NKG2C using a novel multiplex PCR protocol. HPV genotype information was obtained from the cases. NKG2C genotype distributions in LSIL were WT/WT: 69.2%, WT/null: 26.2% and null/null: 4.6%; whereas in HSIL were WT/WT: 65.4%, WT/null: 28.5% and null/null: 6.1% and no statistical differences were observed (LSIL vs. HSIL p=0.541; LSIL vs. controls p=0.230; HSIL vs. controls p=0.624) nor when restricting to HPV positive, HR-HPV nor co-infection. This study demonstrates that NKG2Cnull does not seem to constitute a risk factor for HPV-induced cervical lesions. Copyright © 2013 American Society for Histocompatibility and Immunogenetics. Published by Elsevier Inc. All rights reserved.

  1. Vaginal Infections of Albanian women Infected with HPV and their impact in intraepithelial cervical lesions evidenced by Pap test

    PubMed Central

    Kone, Elsa S; Balili, Avenir D; Paparisto, Piro D; Ceka, Xheladin R; Petrela, Elizana D

    2017-01-01

    Background: Cervical cytology is the best single method for large screening of the population in identifying precancerous lesions of the uterine cervix. Aim: To estimate the frequency of human papillomavirus (HPV) positivity in a group of Albanian women, the prevalence of vaginal coinfections, and the relationship of coinfections with HPV, as well as their role in metaplasia or cervical intraepithelial lesions (CIN). Materials and Methods: In this retrospective study, 2075 vaginal smears were examined. The Papanicolaou stain was used for all slides. The New Bethesda System 2001 was used for the interpretations of the smears. Data analysis was completed using the Statistical Package for the Social Sciences version 19.0. Results: Prevalence of HPV positivity was 43.9% with an average age of 35.48 ± 9.27 years. Candida coinfection resulted in 57.8% of HPV positive women with a significant relationship between them. Gardnerella coinfection resulted in 36 (23%), mixed flora in 34 (8%), and Trichomonas vaginalis in 50% of HPV positive woman. Among the women with positive HPV, 19% had CIN, 8% had metaplasia, and 1% had metaplasia and CIN; 9% of the women with HPV had CIN1 and one of the coinfections. Conclusions: There is a strong relationship between CIN1 and HPV positivity as well as between CIN1 and coinfections. HPV infection is a major factor contributing to metaplasia, and bacterial coinfections in HPV positive women have a statistically significant impact in the development of metaplasia. PMID:28182076

  2. A non-variable L1-peptide displays high sensitivity and specificity for detecting women having human papillomavirus-associated cervical lesions.

    PubMed

    Urquiza, Mauricio; Guevara, Tatiana; Sanchez, Ricardo; Vanegas, Magnolia; Patarroyo, Manuel E

    2008-06-01

    Anti-human papillomavirus (HPV) antibody detection is promising technique for detecting women at risk of suffering cervical cancer, since potentially oncogenic, persistent, long-term HPV-infections elicit an antibody response which is rarely detected in transitory HPV-infection patients. We have identified a non-variable C-terminus L1-peptide, belonging to an alpha-helix surface exposed on L1-protein, specifically recognized by antibodies from HPV-associated cervical lesion patients. This peptide tested against 313 sera presented higher reactivity with antibodies from cervical cancer (OD mean 0.43+/-0.13) or cervical lesion patients (OD mean 0.41+/-0.17) than antibodies from normal cytology patients (OD mean 0.17+/-0.03). High-risk HPV-infected patients presented higher antibody reactivity (OD mean 0.36+/-0.17) than high-risk HPV-non-infected patients (OD mean 0.22+/-0.11). This peptide showed 88.36% sensitivity, 99.39% specificity and 94.21% correct classification of high risk-HPV cervical lesion or cervical cancer patients. This peptide should be taken into account for designing serological screening or diagnostic tests for use in a clinical scenario.

  3. Increased detection of clue cells in smears from cervical intraepithelial lesions with reduced expression of COX-2.

    PubMed

    Figueiredo, Priscila Garcia; Sarian, Luis Otávio; Tambascia, Julia Kawamura; Simões, José Antônio; Rabelo-Santos, Silvia Helena; Discacciati, Michelle Garcia; Derchain, Sophie

    2008-10-01

    The relation between the detection of clue cells in cervical smears of women with CIN and the expression of COX-2 in these lesions were determined. Samples from 228 women, treated due to CIN and who underwent cervical conization, were obtained. Hybrid Capture II and Pap smear samples were collected immediately before performing conization. Pathological diagnoses were 11 (5%) normal cervix, 35 (15%) CIN1, 31 (14%) CIN2, and 151 (66%) CIN3. COX-2 immunoreactivity grading on the pathological specimens was based on the German ImmunoReactive score. In cervical smears, 20 fields (40x) were examined, each of them with a minimum count of 10 epithelial cells. When 20% or more of clue cells were detected the sample was considered positive for clue cells. The prevalence of clue cells was similar across histological strata (P = 0.42). Although the expression of COX-2 did not differ in lesions with varying severities (P = 0.24), there was a negative association between the expression of COX-2 and the presence of clue cells in Pap smear (OR = 0.4; 95% CI = 0.2-0.9): only 12% of women with moderate and strong expression of COX-2 had clue cells in their smears, contrasted to 22% of those with negative and weak expression of COX-2. HPV infection was associated in a borderline manner to the expression of COX-2 (P = 0.04; OR = 2.3 95% CI = 1.0-5.4). The reduced expression of COX-2 in CIN specimens may suggest that clue cells interfere with the inflammatory component of the carcinogenic process that lead to CIN.

  4. DNA methylation in human papillomavirus-infected cervical cells is elevated in high-grade squamous intraepithelial lesions and cancer

    PubMed Central

    Lee, Ki-Heon; So, Kyeong A; Hong, Sung Ran; Hwang, Chang-Sun; Kee, Mee-Kyung; Rhee, Jee Eun; Kang, Chun; Hur, Soo Young; Park, Jong Sup

    2016-01-01

    Objective DNA methylation has been shown to be a potential biomarker for early cancer detection. The aim of this study was to evaluate DNA methylation profiles according to liquid-based Pap (LBP) test results and to assess their diagnostic value in a Korean population. Methods A total of 205 patients with various Papanicolaou test results were enrolled to this study (negative, 26; atypical squamous cells of undetermined significance, 39; low grade squamous intraepithelial lesion, 44; high grade squamous intraepithelial lesion (HSIL), 48; and cancer, 48). DNA methylation analysis of four genes, ADCYAP1, PAX1, MAL, and CADM1, was performed on residual cervical cells from LBP samples using a quantitative bisulfite pyrosequencing method. To evaluate the diagnostic performance of the four methylated genes for cancer detection, receiver operating characteristic (ROC) curves were drawn. Sensitivities and specificities were also tested at cutoffs determined from the ROC curves. Results Cervical cancer cells showed dramatically increased methylation levels for the four genes analyzed. ADCYAP1 and PAX1 also trended toward elevated methylation levels in HSIL samples, although the levels were much lower than those in cancer cells. The sensitivities of methylated ADCYAP1, PAX1, MAL, and CADM1 for the detection of cancer were 79.2%, 75.0%, 70.8%, and 52.1%, and the specificities were 92.0%, 94.0%, 94.7%, and 94.0%, respectively. Methylated ADCYAP1 and PAX1 demonstrated relatively better discriminatory ability than did methylated MAL and CADM1 (area under the curves 0.911 and 0.916 vs. 0.854 and 0.756, respectively). Conclusion DNA methylation status, especially in the ADCYAP1 and PAX1 genes, showed relatively good specificity, ranging from 90% to 94%. The possible additive and complementary roles of DNA methylation testing with respect to conventional cervical cancer screening programs will need to be validated in prospective population-based studies. PMID:26768780

  5. Cervicitis

    MedlinePlus

    ... uterine lining and the fallopian tubes, resulting in pelvic inflammatory disease (PID), an infection of the female reproductive organs that can cause fertility problems if left untreated. Cervicitis can also ... incidentally during a routine pelvic exam and Pap test and may not require ...

  6. Epidemiology of Cervical Squamous Intraepithelial Lesions in HIV Infected Women in Kenya: a cross-Sectional Study.

    PubMed

    Memiah, Peter; Makokha, Violet; Mbuthia, Wangeci; Kiiru, Grace Wanjiku; Agbor, Solomon; Odhiambo, Francesca; Ojoo, Sylvia; Mbizo, Justice; Muhula, Samuel; Mahasi, Gabriel; Biadgilign, Sibhatu

    2015-03-01

    Cervical cancer is the second most common cancer among women worldwide. Infection with the human immunodeficiency virus (HIV) and its related immunosuppression are associated with an increased risk of prevalent, incident, and persistent squamous intraepithelial lesions (SILs) of the cervix. The objective of the study was to describe the prevalence and predictors of high-risk HPV and cervical cancer to support the need for strengthening cervical cancer screening programs for HIV infected women in Kenya. A cross sectional study was conducted in a hospital in Central Kenya, Kiambu district. The study population constituted of HIV positive women attending the ART treatment clinic. A total of 715 HIV positive women initiated on Antiretroviral Therapy (ART) were enrolled in this study. About 359 (52.1%) were less than 40 years of age and 644 (90.3%) of the patients were widowed. About 642 (92.6%) of the HIV infected women were in follow-up period of ≥ 1 year. The outcome/prognosis of the patients undergoing ICC was 3 cured, 5 good and 4 poor respectively. In a multivariable ordinal logistic regression analysis showed that for a one-unit decrease of CD4, we expect 1.23 log odds of increasing the severity of cervical cancer (B = 1.23, P < 0.0 15), given that all of the other variables in the model are held constant. In conclusion screening of all HIV infected women, who are under HIV care and treatment, enrolling patients on HAART with higher CD4 counts is recommended to see the net effect of HAART response.

  7. Mapping of HPV transcripts in four human cervical lesions using RNAseq suggests quantitative rearrangements during carcinogenic progression.

    PubMed

    Chen, Jinmiao; Xue, Yuezhen; Poidinger, Michael; Lim, Thimothy; Chew, Sung Hock; Pang, Chai Ling; Abastado, Jean-Pierre; Thierry, Françoise

    2014-08-01

    Two classes of Human papillomaviruses (HPV) infect the anogenital track: high risk viruses that are associated with risk of cervical cancer and low risk types that drive development of benign lesions, such as condylomas. In the present study, we established quantitative transcriptional maps of the viral genome in clinical lesions associated with high risk HPV16 or low risk HPV6b. Marked qualitative and quantitative changes in the HPV16 transcriptome were associated with progression from low to high grade lesions. Specific transcripts encoding essential regulatory proteins such as E7, E2, E1^E4 and E5 were identified. We also identified intrinsic differences between the HPV6b-associated condyloma transcript map and that of the HPV16-associated low grade CIN specifically regarding promoter usage. Characterization and quantification of HPV transcripts in patient samples thus establish the impact of viral transcriptional regulation on the status of HPV-associated lesions and may therefore help in defining new biologically-relevant prognosis markers. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. Chlamydia infection in patients with and without cervical intra-epithelial lesions tested by real-time PCR vs. direct immunofluorescence.

    PubMed

    Oliveira, Micheline de Lucena; Amorim, Melania Maria Ramos de; Souza, Paulo Roberto Eleutério de; Albuquerque, Lúcia Cristina Bezerra de; Brandão, Lucas André Cavalcanti; Guimarães, Rafael Lima

    2008-08-01

    This study compares the detection rates of Chlamydia trachomatis by two techniques, direct immunofluorescence (IMF) and real time polymerase chain reaction (PCR), in patients with and without intra-epithelial cervical lesions (SIL) in Recife. We conducted a transversal study involving 35 women with SIL and 35 without SIL attended at Ambulatório Especializado da Mulher, Recife, Brazil. They were tested for Chlamydia trachomatis using two techniques, direct IMF or real time PCR. The rates of Chlamydia trachomatis detection were compared and the association with intra-epithelial cervical lesions was determined using the chi-square test at a 5% level of significance. Concordance between the tests was evaluated using kappa. The global prevalence of Chlamydia infection was 47.1% by direct IMF and 58.6% by real time PCR. A significant association was observed between Chlamydia diagnosis and presence of intra-epithelial cervical lesions, with about 80% positive results by direct IMF and 77.1% by real time PCR. However, the detected rate of infection with Chlamydia trachomatis was significantly greater in patients without intra-epithelial cervical lesions tested by real time PCR (40%) when compared to direct IMF (14.3%). The concordance between the tests was weak, with a kappa coefficient of 0.4. Both real time PCR and direct IMF detected elevated rates of Chlamydia infection in patients with intra-epithelial cervical lesions (80%) but the tests were discordant when patients without cervical lesions were tested, possibly because sensitivity of real time PCR is greater.

  9. Are treatments for cervical precancerous lesions in less-developed countries safe enough to promote scaling-up of cervical screening programs? A systematic review

    PubMed Central

    2010-01-01

    Background Since the mid-1990s, there have been growing efforts to prevent cervical cancer in less-developed countries through the development of innovative screening approaches such as visual inspection of the cervix associated with same day management of cervical lesions with cryotherapy or loop electrosurgical excision procedure (LEEP). In the past, promising cancer screening interventions have been widely promoted despite incomplete evidence, only to become the subject of intense controversies about ensuing net health benefit. Because the efficacy and effectiveness of the new protocols for global cervical cancer screening have not been well characterized yet, and as a contribution to the evaluation of the balance between the benefits and risks of these protocols, we reviewed the literature on the safety of cryotherapy and LEEP for cervical intraepithelial neoplasia (CIN) in low- and middle-income countries. Methods We searched 12 databases (Medline, Google Scholar, Scopus, Cochrane Library, Web of Science, OCLC, PAIS International Database, WHO Global Health Library, CINAHL, Science.gov, NYAM Grey Literature Report, and POPLINE) for original research published between January 1995 and April 2009. Both peer-reviewed publications and items of "grey" literature were retrieved; no language restriction was applied. We calculated the median (minimum, maximum) reported rate for each harm considered. Because of limitations and heterogeneity in the data, no formal meta-analysis was performed. Results The search identified 32 articles that reported safety data from 24 cryotherapy and LEEP studies. The combined sample consisted of 6,902 women treated by cryotherapy and 4,524 women treated by LEEP. Most studies were conducted in reference or research settings in Asia and Africa. Short-term harms of cryotherapy and LEEP appeared to be similar to those described in the literature from high-income countries. Information was sparse on HIV-related harms and long

  10. Are treatments for cervical precancerous lesions in less-developed countries safe enough to promote scaling-up of cervical screening programs? A systematic review.

    PubMed

    Chamot, Eric; Kristensen, Sibylle; Stringer, Jeffrey S A; Mwanahamuntu, Mulindi H

    2010-04-01

    Since the mid-1990 s, there have been growing efforts to prevent cervical cancer in less-developed countries through the development of innovative screening approaches such as visual inspection of the cervix associated with same day management of cervical lesions with cryotherapy or loop electrosurgical excision procedure (LEEP). In the past, promising cancer screening interventions have been widely promoted despite incomplete evidence, only to become the subject of intense controversies about ensuing net health benefit. Because the efficacy and effectiveness of the new protocols for global cervical cancer screening have not been well characterized yet, and as a contribution to the evaluation of the balance between the benefits and risks of these protocols, we reviewed the literature on the safety of cryotherapy and LEEP for cervical intraepithelial neoplasia (CIN) in low- and middle-income countries. We searched 12 databases (Medline, Google Scholar, Scopus, Cochrane Library, Web of Science, OCLC, PAIS International Database, WHO Global Health Library, CINAHL, Science.gov, NYAM Grey Literature Report, and POPLINE) for original research published between January 1995 and April 2009. Both peer-reviewed publications and items of "grey" literature were retrieved; no language restriction was applied. We calculated the median (minimum, maximum) reported rate for each harm considered. Because of limitations and heterogeneity in the data, no formal meta-analysis was performed. The search identified 32 articles that reported safety data from 24 cryotherapy and LEEP studies. The combined sample consisted of 6,902 women treated by cryotherapy and 4,524 women treated by LEEP. Most studies were conducted in reference or research settings in Asia and Africa. Short-term harms of cryotherapy and LEEP appeared to be similar to those described in the literature from high-income countries. Information was sparse on HIV-related harms and long-term reproductive outcomes of treatment

  11. [Double traumatic cervical spine lesion (odontoid fracture and spinal cord injury) and Klippel-Feil syndrome].

    PubMed

    Graillon, T; Pech-Gourg, G; Adetchessi, T; Metellus, P; Dufour, H; Fuentes, S

    2012-12-01

    Klippel-Feil syndrome (KFS) is defined as a congenital fusion of at least two cervical vertebrae. Patients with KFS are known to be at high risk for spinal cord injury in case of cervical trauma even with weak kinetic. We report the case of a patient with C4-C5 and C6-C7 congenital fusion, harbouring C5-C6 post-traumatic spinal cord injury, associated with an odontoid fracture type 2 of Anderson and D'Alonzo classification following a motorbike accident.

  12. Endoscopic ultrasound-guided techniques for diagnosing pancreatic mass lesions: Can we do better?

    PubMed Central

    Storm, Andrew C; Lee, Linda S

    2016-01-01

    The diagnostic approach to a possible pancreatic mass lesion relies first upon various non-invasive imaging modalities, including computed tomography, ultrasound, and magnetic resonance imaging techniques. Once a suspect lesion has been identified, tissue acquisition for characterization of the lesion is often paramount in developing an individualized therapeutic approach. Given the high prevalence and mortality associated with pancreatic cancer, an ideal approach to diagnosing pancreatic mass lesions would be safe, highly sensitive, and reproducible across various practice settings. Tools, in addition to radiologic imaging, currently employed in the initial evaluation of a patient with a pancreatic mass lesion include serum tumor markers, endoscopic retrograde cholangiopancreatography, and endoscopic ultrasound-guided fine needle aspiration (EUS-FNA). EUS-FNA has grown to become the gold standard in tissue diagnosis of pancreatic lesions. PMID:27818584

  13. Effects of Lateral Mass Screw Rod Fixation to the Stability of Cervical Spine after Laminectomy

    NASA Astrophysics Data System (ADS)

    Rosli, Ruwaida; Kashani, Jamal; Kadir, Mohammed Rafiq Abdul

    There are many cases of injury in the cervical spine due to degenerative disorder, trauma or instability. This condition may produce pressure on the spinal cord or on the nerve coming from the spine. The aim of this study was, to analyze the stabilization of the cervical spine after undergoing laminectomy via computational simulation. For that purpose, a three-dimensional finite element (FE) model for the multilevel cervical spine segment (C1-C7) was developed using computed tomography (CT) data. There are various decompression techniques that can be applied to overcome the injury. Usually, decompression procedures will create an unstable spine. Therefore, in these situations, the spine is often surgically restabilized by using fusion and instrumentation. In this study, a lateral mass screw-rod fixation was created to stabilize the cervical spine after laminectomy. Material properties of the titanium alloy were assigned on the implants. The requirements moments and boundary conditions were applied on simulated implanted bone. Result showed that the bone without implant has a higher flexion and extension angle in comparison to the bone with implant under applied 1Nm moment. The bone without implant has maximum stress distribution at the vertebrae and ligaments. However, the bone with implant has maximum stress distribution at the screws and rods. Overall, the lateral mass screw-rod fixation provides stability to the cervical spine after undergoing laminectomy.

  14. Migration of fishbone following penetration of the cervical esophagus presenting as a thyroid mass.

    PubMed

    Bendet, E; Horowitz, Z; Heyman, Z; Faibel, M; Kronenberg, J

    1992-01-01

    Fishbones are among the commonest foreign bodies lodged in the cervical esophagus. A small percentage of them will penetrate the esophageal wall and will be found either intra- or extraluminally. Migration of esophageal foreign bodies to the thyroid gland, and presentation as a mass, is extremely rare. We present such a case and review the relevant literature.

  15. A regional registration method to find corresponding mass lesions in temporal mammogram pairs

    SciTech Connect

    Timp, Sheila; Engeland, Saskia van; Karssemeijer, Nico

    2005-08-15

    In this paper we develop an automatic regional registration method to find corresponding masses on prior and current mammograms. The method contains three steps. In the first, we globally align both images. Then, for each mass lesion on the current view, we define a search area on the prior view, which is likely to contain the same mass lesion. Third, at each location in this search area we calculate a registration measure to quantify how well this location matches the mass lesion on the current view. Finally we select the best location. To determine the performance of our method we compare it to several other registration methods. On a dataset of 389 temporal mass pairs our method correctly links 82% of prior and current mass lesions, whereas other methods achieve at most 72%.

  16. Metastatic lesion of the cervical spine secondary to an extraocular sebaceous carcinoma.

    PubMed

    Antuña, S A; Méndez, J G; Cincunegui, J A; López-Fanjul, J C

    1996-12-01

    A case of cervical spine metastasis from an extraocular sebaceous carcinoma of the scalp is presented. Anterior decompression and fusion were performed and resulted in complete relief of symptoms. Postoperatively the primary tumor behaved in a very aggressive manner, with visceral metastases leading to the death of the patient in a few weeks.

  17. Distribution of Carcinogenic Human Papillomavirus Genotypes and Association to Cervical Lesions among Women in Fez (Morocco)

    PubMed Central

    Souho, Tiatou; El Fatemi, Hinde; Karim, Safae; El Rhazi, Karima; Bouchikhi, Chahrazed; Banani, Abdelaziz; Melhouf, Moulay Abdelilah; Benlemlih, Mohamed; Bennani, Bahia

    2016-01-01

    Objectives To determine the distribution of cervical high-risk human papillomavirus genotypes and their association to cellular abnormalities in women from Fez and its neighborhood. Methods Women attending the Hassan II University Hospital for cervical pap smears were recruited after an informed consent. Interviews and two cervical samples were performed for each woman. Cervical samples were used for cytological analysis and HPV DNA detection. HPV was typed using a method based on multiplex PCR with fluorescently labeled specific primers followed by capillary electrophoresis. The study was approved by the ethics committee of the Faculty of Medicine and Pharmacy of Fez. Results The HPV prevalence in the studied population was 43.1% and the most prevalent types were HPV 53 (23 cases); HPV 16 (20 cases); HPV 35 (18 cases); HPV 51 (10 cases) and HPV 56 (7 cases). From the 619 confirmed pap smears, 20% were abnormal. The cytological abnormalities were significantly associated to HPV infection, women age, number of pregnancies and parity (p < 0.05). Conclusion More attention should be given to HPV in Morocco because it represents an important public health concern. The distribution of carcinogenic HPV types in the studied population is different from the data in other regions but epidemiological studies in other Moroccan regions are required. PMID:26731415

  18. Blunt craniocervical artery injury in cervical spine lesions: the value of CT angiography.

    PubMed

    Fleck, Steffen Kristian; Langner, Soenke; Baldauf, Joerg; Kirsch, Michael; Rosenstengel, Christian; Schroeder, Henry W

    2010-10-01

    The awareness of traumatic craniocervical artery injuries has increased over the last years, and the detection rate varies in published trauma series. These injuries are often associated with cervical spinal and cranial trauma. The purpose of this prospective study was to determine the frequency and injury characteristics of blunt traumatic cervical artery injuries in patients suffering from cervical spine injuries by using a standardized CT angiography (CTA) protocol of the craniocervical vessels. Over a period of 32 months (February 2006 to September 2008), we prospectively evaluated 53 patients with osseous cervical spine injuries. Of these, 41 patients were screened for blunt craniocervical vessel injuries using CT angiography in 718 consecutive patients requiring a whole-body trauma CT due to the mechanism of their injury and injury patterns. All examinations were performed using a 16-row multi-slice computed tomography (Sensation 16, Siemens, Erlangen, Germany). Initially, a scan of the neurocranium angulated in orbito-meatal orientation was acquired. Then, a CT angiography of the craniocervical vessels with 40 ml of iodinated contrast agent (flow 4 ml/s; 40 ml saline flush, flow 4 ml/s) was performed starting at the level of Th2 up to the roof of the lateral ventricles. The scan was started using bolus tracking. Finally, a contrast-enhanced spiral thoraco-abdominal scan was performed with a delay of 20 s after administering a second contrast bolus of 60 ml. Besides, 11 patients with already detected isolated cervical spine injury, who were not initially involved in the whole-body trauma imaging protocol, underwent a secondary CT angiography with 60 ml of contrast agent (flow 4 ml/s; 40 ml saline flush, flow 4 ml/s), starting at the level of Th2 up to the roof of the lateral ventricles. The craniocervical vessels were analyzed in the source images, with the use of maximum-intensity projections and curved multi-planar reconstructions. Alternatively, a duplex

  19. Sonography of Abdominal Wall Masses and Masslike Lesions: Correlation With Computed Tomography and Magnetic Resonance Imaging.

    PubMed

    Ahn, Sung Eun; Park, Seong Jin; Moon, Sung Kyoung; Lee, Dong Ho; Lim, Joo Won

    2016-01-01

    Sonography is usually regarded as a first-line imaging modality for masses and masslike lesions in the abdominal wall. A dynamic study focusing on a painful area or palpable mass and the possibility of ultrasound-guided aspiration or biopsy are the major advantages of sonography. On the other hand, cross-sectional imaging clearly shows anatomy of the abdominal wall; thereby, it is valuable for diagnosing and evaluating the extent of diseases. Cross-sectional imaging can help differentiate neoplastic lesions from non-neoplastic lesions. This pictorial essay focuses on sonographic findings of abdominal wall lesions compared with computed tomographic and magnetic resonance imaging findings.

  20. Characterization of Single-Nucleotide Polymorphisms in the Tumor Necrosis Factor α Promoter Region and in Lymphotoxin α in Squamous Intraepithelial Lesions, Precursors of Cervical Cancer1

    PubMed Central

    Nieves-Ramirez, Miriam Enriqueta; Partida-Rodriguez, Oswaldo; Alegre-Crespo, Pedro Eduardo; Tapia-Lugo, Maria del Carmen; Perez-Rodriguez, Martha Esthela

    2011-01-01

    Development of cervical cancer is a long process of abnormal cancerous cell growth in the cervix and is primarily the result of infection with specific high-risk types of human papillomavirus (HPV). The cytokines tumor necrosis factor α (TNFα) and lymphotoxin α (LTA) have an important role in all stages of cervical cancer and have the ability to induce the regression or promote the development of human tumors. Biologically important single-nucleotide polymorphisms (SNPs) occur within the TNFα and LTA genes. Therefore, the purpose of this study was to investigate the SNPs in the TNFα promoter region (-163, -238, -244, -308, -376, -857, -863, and -1031) and in the first intron of LTA (+252) in women with precursor lesions of cervical cancer. Overall, we studied 396 women from Mexico City. A total of 191 patients with HPV infection and precursor cervical lesions were subdivided in two groups: those with low-grade squamous intraepithelial lesions (n = 132) and those with high-grade squamous intraepithelial lesions (n = 59). Women (n = 205) negative for HPV and without cervical lesions were also included in the study. DNA was extracted from peripheral white blood cells and from cervical samples, and detection of biallelic polymorphisms of TNFα and LTA was performed using the polymerase chain reaction-sequence-specific oligonucleotide probe and restriction fragment length polymorphism techniques, respectively. We demonstrated that risk is associated with the genotype G/A (odds ratio = 2.48) and that protection is associated with the genotype G/G of SNP TNFα -376 (odds ratio = 0.37). PMID:22190997

  1. Efficacy in treatment of cervical HRHPV infection by combination of beta interferon, and herbal therapy in woman with different cervical lesions.

    PubMed

    Iljazović, Ermina; Ljuca, Dzenita; Sahimpasić, Ademir; Avdić, Silvija

    2006-11-01

    Cervical dysplasia, a premalignant lesion that can progress to cervical cancer, is caused primarily by a sexually transmitted infection with an oncogenic strain of the human papillomavirus (HPV). The HPV infections are treated through destroying the clinical lesions: laser, cryotherapy, podophyllin... The hope is that by causing local tissue inflammation that the body will be stimulated to mount an antibody response and thereby prevent recurrence. In contrast to other prevention approaches, vaccines can reduce susceptibility in uninfected partners by stimulating the immune system. Aloe vera has also been reported to retard tumour growth and stimulate the immune response to viruses. A list of possible actions of propolis includes: antibacterial, antifungal, antiviral, antioxidant, anticarcinogenic, antithrombotic and immunomodulatory. Research on the possible role of some B vitamins in preventing cancer began in the last few decades, but however this complex have an influence on immune status. The aim of our study is to try to treat the HPV infection as confirmed cause of neoplastic transformation with some herbal therapy and interferon and to try define the guidelines in the management of the HPV positive patients. Goal of this paper is to search for evidence of efficacy of any treatment for HPV infection of the cervix mostly in woman with no concomitant CIN. Fifty five woman affected by HPV genital infection were enrolled in the study from September 2005 to April 2006. Patients were classified according to the results of the HPV testing prior and after the therapy. Patients were randomized into two groups: the first group was HPV positive woman treated with other than recommended therapy (n=20), (control group); the second group was pharmacologically treated with intravaginal administration of an interferon and aloe vera-propolis in recommended scheme (n=35) with treatment of the possible fungal or bacterial genital infection prior to the specific therapy. The

  2. Stabilization of subaxial cervical spines by lateral mass screw fixation with modified Magerl's technique.

    PubMed

    Wu, Jau-Ching; Huang, Wen-Cheng; Chen, Yu-Chun; Shih, Yang-Hsin; Cheng, Henrich

    2008-12-01

    There are various techniques in lateral mass screw placement in the cervical spine currently available, including the Roy-Camille, Magerl, Anderson, and An techniques. Each has different entrance points and trajectories for screw insertion, and some even have different methods for different level of the subaxial cervical spine. The potential risk of vascular and neurologic injury varies with different techniques and different levels of the cervical spine. We proposed a modified technique with a universal method of screw placement suitable for stabilization of every level of the subaxial cervical spines, from C3 to C7. We have applied this modified technique on a large series of patients and obtained satisfactory results. A retrospective study was conducted of the charts, records, and clinical follow-up of 115 patients who received internal fixation with lateral mass screws and rods in the Department of Neurosurgery of Taipei Veterans General Hospital (Taipei, Taiwan) from 2004 to 2006. All patients received lateral mass screw placement in various levels of the subaxial cervical spines. The clinical and radiologic follow-up were carefully evaluated and analyzed. All 115 patients with different pathological situations requiring stabilization received instrumentations with polyaxial screws and rod systems, in which 673 screws in total were used in various levels of the cervical spine between C3 and C7: 129 screws in C3, 115 in C4, 193 in C5, 101 in C6, and 135 in C7. The most often used screw length was 16 mm (385/673, 57%). Good bony fusion was observed in all patients except 1 (99.1%). The mean follow-up period was 14 months (4-35 months). No neurologic or vascular injury was noted clinically. Follow-up radiologic examinations found that the screw placements were well positioned. Based on our experience, lateral mass fixation of subaxial cervical spines with our modified technique is safe and effective. This technique of lateral mass screw placement yielded good

  3. Dysregulation of microRNA expression in human cervical preneoplastic and neoplastic lesions.

    PubMed

    Galamb, Ádám; Benczik, Márta; Zinner, Balázs; Vígh, Eszter; Baghy, Kornélia; Jeney, Csaba; Kiss, András; Lendvai, Gábor; Sobel, Gábor

    2015-07-01

    Data discussed in recent reviews demonstrated that dysregulation of microRNA (miRNA) expression profiles occurs during cervical carcinogenesis and characteristic up- or downregulation of certain miRNAs might be used as biomarkers. The majority of altered miRNAs, however were found to be inconsistent upon comparison with cancerous and normal cervical epithelia in the discussed studies due to several reasons. The results obtained in this present review suggest the need for further investigations on miRNAs on larger sample sizes in order to indicate sensitivity and specificity by means of well defined, "unified" methods. In addition, obtaining further data on the clinical course and outcome of patients in comparison to the dysregulation of miRNA expression profile could turn miRNAs into prognostic and/or progression markers. Inhibition of overexpressed miRNAs, as suggested by some authors, might even serve as target for cancer therapy.

  4. Cervical Pre-Phrenic Interneurons in the Normal and Lesioned Spinal Cord of the Adult Rat

    PubMed Central

    Lane, Michael A.; White, Todd E.; Coutts, Marcella A.; Jones, Alex L.; Sandhu, Milapjit S.; Bloom, David C.; Bolser, Donald C.; Yates, Bill J.; Fuller, David D.; Reier, Paul J.

    2008-01-01

    While monosynaptic bulbospinal projections to phrenic motoneurons have been extensively described, little is known about the organization of phrenic premotor neurons in the adult rat spinal cord. As interneurons may play an important role in normal breathing and recovery following spinal cord injury, the present study has used anterograde and transneuronal retrograde tracing to study their distribution and synaptic relations. Exclusive unilateral, first-order labeling of the phrenic motoneuron pool with pseudorabies virus demonstrated a substantial number of second-order, bilaterally-distributed cervical interneurons predominantly in the dorsal horn and around the central canal. Combined transneuronal and anterograde tracing revealed ventral respiratory column projections to pre-phrenic interneurons suggesting some propriospinal relays exist between medullary neurons and the phrenic nucleus. Dual-labeling studies with pseudorabies virus recombinants also showed pre-phrenic interneurons integrated with either contralateral phrenic or intercostal motoneuron pools. The stability of interneuronal pseudorabies virus labeling patterns following lateral cervical hemisection was then addressed. Except for fewer infected contralateral interneurons at the level of the central canal, the number and distribution of phrenic-associated interneurons was not significantly altered two weeks post-hemisection (i.e. when the earliest post-injury recovery of phrenic activity has been reported). These results demonstrate a heterogeneous population of phrenic-related interneurons. Their connectivity and relative stability after cervical hemisection raises speculation for potentially diverse roles in modulating phrenic function normally and post-injury. PMID:18924146

  5. Non-mass-like lesions on breast ultrasonography: a systematic review.

    PubMed

    Uematsu, Takayoshi

    2012-10-01

    This article reviews various non-mass-like ultrasonography (US) findings of the breast and the sonographic-pathologic correlation with Doppler techniques, elastography, and MRI. High-resolution US allows for identification of small, clinically occult non-mass-like US findings. Ductal carcinoma in situ and invasive lobular carcinoma usually manifest as a non-mass-like lesion on US. It is useful to classify non-mass-like lesions on US in a similar manner to the classification of non-mass-like enhancement on MRI.

  6. Huge Neck Masses Causing Respiratory Distress in Neonates: Two Cases of Congenital Cervical Teratoma.

    PubMed

    Gezer, Hasan Özkan; Oğuzkurt, Pelin; Temiz, Abdulkerim; Bolat, Filiz Aka; Hiçsönmez, Akgün

    2016-12-01

    Congenital cervical teratomas are rare and usually large enough to cause respiratory distress in the neonatal period. We present two cases of congenital huge cystic neck masses in which distinguishing cervical cystic hygroma and congenital cystic teratoma was not possible through radiologic imaging techniques. Experience with the first case, which was initially diagnosed and treated as cystic hygroma by injection sclerotherapy, led to early suspicion and surgery in the second case. The masses were excised completely and histopathologic diagnoses were congenital teratoma in both patients. Our aim is to review congenital huge neck masses causing respiratory distress in early neonatal life to highlight this dilemma briefly with these interesting cases. Copyright © 2014. Published by Elsevier B.V.

  7. An Evaluation by Midwives and Gynecologists of Treatability of Cervical Lesions by Cryotherapy Among Human Papillomavirus–Positive Women

    PubMed Central

    Gage, Julia C.; Rodriguez, Ana Cecilia; Schiffman, Mark; Adadevoh, Sydney; Alvarez Larraondo, Manuel J.; Chumworathayi, Bandit; Lejarza, Sandra Vargas; Araya, Luis Villegas; Garcia, Francisco; Budihas, Scott R.; Long, Rodney; Katki, Hormuzd A.; Herrero, Rolando; Burk, Robert D.; Jeronimo, Jose

    2010-01-01

    Objectives To estimate efficacy of a visual triage of human papillomavirus (HPV)– positive women to either immediate cryotherapy or referral if not treatable (eg, invasive cancer, large precancers). Methods We evaluated visual triage in the HPV-positive women aged 25 to 55 years from the 10,000-woman Guanacaste Cohort Study (n = 552). Twelve Peruvian midwives and 5 international gynecologists assessed treatability by cryotherapy using digitized high-resolution cervical images taken at enrollment. The reference standard of treatability was determined by 2 lead gynecologists from the entire 7-year follow-up of the women. Women diagnosed with histologic cervical intraepithelial neoplasia grade 2 or worse or 5-year persistence of carcinogenic HPV infection were defined as needing treatment. Results Midwives and gynecologists judged 30.8% and 41.2% of women not treatable by cryotherapy, respectively (P < 0.01). Among 149 women needing treatment, midwives and gynecologists correctly identified 57.5% and 63.8% (P = 0.07 for difference) of 71 women judged not treatable by the lead gynecologists and 77.6% and 59.7% (P < 0.01 for difference) of 78 women judged treatable by cryotherapy. The proportion of women judged not treatable by a reviewer varied widely and ranged from 18.6%to 61.1%. Interrater agreement was poor with mean pairwise overall agreement of 71.4% and 66.3% and κ ’s of 0.33 and 0.30 for midwives and gynecologists, respectively. Conclusions In future “screen-and-treat” cervical cancer prevention programs using HPV testing and cryotherapy, practitioners will visually triage HPV-positive women. The suboptimal performance of visual triage suggests that screen-and-treat programs using cryotherapy might be insufficient for treating precancerous lesions. Improved, low-technology triage methods and/or improved safe and low-technology treatment options are needed. PMID:19509579

  8. Feasibility of fine-needle aspiration biopsy and its applications in superficial cervical lesion biopsies

    PubMed Central

    Xu, Dong; Xu, Hai-Miao; Li, Ming-Kui; Chen, Li-Yu; Wang, Li-Jing

    2014-01-01

    The aim of the study was to investigate the feasibility and value of clinical application of fine-needle aspiration histological biopsy via ultrasound-guided thyroid nodule and enlarged cervical lymph node fine-needle aspiration histological biopsy. Fine-needle aspiration cytological and histological biopsies and surgical treatments were performed on 982 patients with thyroid nodule and 1435 patients with enlarged cervical lymph nodes. A comparative study of the histological and cytological examination results and post-surgical etiology results was subsequently conducted. Among the 982 thyroid nodule patients, the acquisition rates were 89.8% (882/982) for fine-needle aspiration histological biopsy and 96.2% (945/982) for cytological biopsy, while among the 1435 patients with enlarged cervical lymph nodes, the acquisition rate for fine-needle aspiration cytological biopsy was slightly higher than that for histological biopsy, with values of 95.7% (1374/1435) and 91.4% (1312/1435), respectively. For the thyroid nodule patients, when the acquired histological and cytological biopsy results were compared with the post-surgical etiology results, the sensitivity, specificity, and accuracy of the histological results were 98.5%, 100%, and 98.9%, respectively, whereas those of the cytological results were 86.8%, 82.9%, and 85.6%, respectively; the differences between the 2 biopsy methods were statistically significant (P < 0.05). For the patients with enlarged cervical lymph nodes, when the acquired histological and cytological biopsy results were compared with the post-surgical etiology results, the sensitivity, specificity, and accuracy of the histological results were 96.3%, 99.8%, and 97.6%, respectively, whereas the those of the cytological results were 76.8%, 92.1%, and 82.2%, respectively; again, the differences between the 2 methods were statistically significant (P < 0.05). In conclusion, Fine-needle aspiration histological biopsy is a reliable and highly

  9. Is screen-and-treat approach suited for screening and management of precancerous cervical lesions in Sub-Saharan Africa?

    PubMed

    Fokom-Domgue, Joël; Vassilakos, Pierre; Petignat, Patrick

    2014-08-01

    The World Health Organization guidelines for screening and management of cervical precancerous lesions updated in 2013 made an emphasis on the use of the 'screen-and-treat' approach for cervical cancer prevention. In order to facilitate scaling-up in low income settings, most of these screen-and-treat strategies do not involve confirmatory biopsy. This yields a certain rate of overtreatment. In other words, a majority of people undergoing screen-and-treat intervention who are treated does not necessarily benefit from the treatment. Therefore, the issue of potential short term and long term complications of the recommended treatment procedures (cryotherapy and Loop Electrosurgical Excision Procedure) arises. This question has seldom been studied in resource poor countries, particularly in Sub-Saharan Africa where Human Immunodeficiency Virus infection is rampant in an epidemic fashion and where the procreative capacities are socially rewarding for women. We draw the attention of the scientific community and policy makers to the fact that the lack of evidence supporting the safety of these treatment procedures in African populations may have an impact on the acceptability of these strategies and therefore on the effectiveness of screening programs. Copyright © 2014 Elsevier Inc. All rights reserved.

  10. Metabonomic signature analysis of cervical carcinoma and precancerous lesions in women by 1H NMR spectroscopy

    PubMed Central

    HASIM, AYSHAMGUL; ALI, MAYINUER; MAMTIMIN, BATUR; MA, JUN-QI; LI, QIAO-ZHI; ABUDULA, ABULIZI

    2012-01-01

    1H nuclear magnetic resonance (NMR)-based metabonomics has been used to characterize the metabolic profiles of cervical intraepithelial neoplasia (CIN) and cervical squamous cell carcinoma (CSCC). Principal component analysis (PCA) and orthogonal partial least-squares discriminant analysis (OPLS-DA) were used to model the systematic variation related to patients with CIN or CSCC with healthy controls. Potential metabolic biomarkers were identified using database comparisons, and the one-way analysis of variance (ANOVA) test was used to examine the significance of the metabolites. Compared with plasma obtained from the healthy controls, plasma from patients with CIN had higher levels of very-low density lipoprotein (VLDL), acetone, unsaturated lipid and carnitine, together with lower levels of creatine, lactate, isoleucine, leucine, valine, alanine, glutamine, histidine, glycine, acetylcysteine, myo-inositol, choline and glycoprotein. Plasma from patients with CSCC had higher levels of acetate and formate, together with lower levels of creatine, lactate, isoleucine, leucine, valine, alanine, glutamine, histidine and tyrosine compared with the plasma of the healthy controls. In addition, compared with the plasma of patients with CIN, the plasma of CSCC patients had higher levels of acetate, formate, lactate, isoleucine, leucine, valine, alanine, glutamine, histidine, tyrosine, acetylcysteine, myo-inositol, glycoprotein, α-glucose and β-glucose, together with lower levels of acetone, unsaturated lipid and carnitine. Moreover, the profiles showed high feasibility and specificity by statistical analysis with OPLS-DA compared to the Thinprep cytology test (TCT) by setting the histopathological outcome as standard. The metabolic profile obtained for cervical cancer is significant, even for the precancerous disease. This suggests a systemic metabolic response to cancer, which may be used to identify potential early diagnostic biomarkers of the cancer and to establish

  11. Major sequence variants in E7 gene of human papillomavirus type 16 from cervical cancerous and noncancerous lesions of Korean women.

    PubMed

    Song, Y S; Kee, S H; Kim, J W; Park, N H; Kang, S B; Chang, W H; Lee, H P

    1997-08-01

    Geographic specificity of nucleotide sequence variations in the coding and noncoding regions of HPV 16 genome has been reported. Little has been known, however, regarding whether these naturally occurring sequence variations of HPV 16 may result in marked differences in biological properties, such as oncogenic potential. This study was performed to identify sequence variants in the HPV 16 E7 gene derived from Korean women with cervical cancerous and noncancerous lesions, and to assess the association between the sequence variant and the cervical cancer. We examined E7 variants of HPV 16 in a total of 157 patients with no cervical disease (NCD, n = 87) or cervical neoplasia (cervical intraepithelial neoplasia 3, n = 21; cervical carcinoma, n = 49), using the nested polymerase chain reaction (PCR) and the PCR-directed sequencing methods with outer consensus and inner type-specific primers. Forty-two (NCD, n = 9; CIN 3, n = 6; cervical carcinoma, n = 27) of 157 cervical samples contained HPV 16 E7 DNA, but only 8 had prototype sequences. Four variants of the HPV 16 E7 gene were identified. The variant with a single nucleotide change at position 647 (A --> G, Asn --> Ser) was found in about 60% of DNA samples with HPV 16. The second most common variant, found in 16.7% of cases, had three silent mutations at positions 732 (T --> C), 789 (T --> C), and 795 (T --> G). Two other variants were detected, one in a patient with cervical cancer and the other in a patient with no cervical disease. One had a single nucleotide change at position 666 (G --> A) and the other had one silent mutation at position 796 (T --> C). The most common variant in Korea has a change of nucleotide affecting the predicted amino acid related with high antigenicity and binding to retinoblastoma protein. There was a statistically significant trend for this variant to be more frequently detected in cancerous lesions of the uterine cervix than in noncancerous lesions. These data suggest that naturally

  12. Use of a portable diathermy machine for LEEP without colposcopy during see-and-treat management of VIA-positive cervical lesions in resource-poor settings.

    PubMed

    Chigbu, Chibuike O; Onyebuchi, Azubuike K

    2014-05-01

    To compare the effectiveness of cryotherapy and loop electrosurgical excision procedure without colposcopy (visual LEEP) in treating cervical lesions detected through visual inspection with acetic acid (VIA). In rural southeast Nigeria, women with VIA-positive lesions who were eligible for ablative treatment were selected to undergo immediate cryotherapy with nitrous oxide. Women with VIA-positive lesions who were not eligible for ablative treatment were selected to undergo visual LEEP at the same visit. A portable diathermy machine was used for LEEP. Participants were re-evaluated 6 months later using VIA. The main outcome measures included persistent VIA positivity at 6 months, duration of procedure, second clinic visits for complications, and patient acceptability. In total, 304 women completed the study. Persistent VIA-positivity rates, duration of procedure, second clinic visits for complications, and patient acceptability were similar in the 2 groups. Visual LEEP and cryotherapy have similar efficacy and patient acceptability in see-and-treat management of VIA-positive cervical lesions. In see-and-treat VIA-based cervical cancer prevention programs in low-resource countries, visual LEEP can be used to treat women who do not meet the criteria for ablative treatment. This would increase the treatment coverage of women with VIA-positive lesions and improve program efficiency. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  13. Orbital masses: CT and MRI of common vascular lesions, benign tumors, and malignancies

    PubMed Central

    Khan, Sarah N.; Sepahdari, Ali R.

    2012-01-01

    A wide variety of space occupying lesions may be encountered in the orbit. CT and MR imaging frequently help confirm the presence of a mass and define its extent. Characteristic imaging features may help distinguish among lesions that have overlapping clinical presentations. This review focuses on some of the common orbital masses. Common vascular lesions that are reviewed include: capillary (infantile) hemangioma, cavernous hemangioma (solitary encapsulated venous-lymphatic malformation), and lymphangioma (venous-lymphatic malformation). Benign tumors that are reviewed include: optic nerve sheath meningioma, schwannoma, and neurofibroma. Malignancies that are reviewed include: lymphoma, metastasis, rhabdomyosarcoma, and optic glioma. Key imaging features that guide radiological diagnosis are discussed and illustrated. PMID:23961022

  14. Clinical evaluation of giomer- and resin-modified glass ionomer cement in class V noncarious cervical lesions: An in vivo study

    PubMed Central

    Jyothi, KN; Annapurna, S; Kumar, Anil S; Venugopal, P; Jayashankara, CM

    2011-01-01

    Objectives: To evaluate and compare the clinical performance of Giomer (Beautifil II) and RMGIC (Fuji II LC) in noncarious cervical lesions. Materials and Methods: Thirty-two subjects with one or two pairs of noncarious cervical lesions were included in the study. Each pair of lesion was restored with either giomer or RMGIC assigned randomly. Clinical evaluation of restorations was done using USPHS criteria. Data was formulated in a predesigned format and subjected to statistical analysis using the chi square test. Results: Statistically significant difference was found between RMGIC and Giomer with respect to surface roughness with P value <0.001. Conclusion: Giomer showed superior surface finish compared to RMGIC. Both Giomer and RMGIC showed equal retention ability. PMID:22144814

  15. [Frequency of cervical epithelial lesions reported in the Regional Laboratory of Exfoliative Cytology in Jalisco].

    PubMed

    González-López, Sergio; Martínez-Silva, María G; Hernández-Hernández, Dulce M; Aguilar-Lemarroy, Adriana; Jave-Suárez, Luis Felipe

    2015-01-01

    The Official Mexican Norm for the prevention, treatment and control of Cervical Cancer (CC) indicates that the Papanicolau (Pap) is the procedure for the detection of this neoplasia; therefore, it is of interest to know the prevalence of suspected cases by this technique in Mexican population. In this study, we show the diagnosed cases in the State of Jalisco, México. A retrospective study was made to the samples that arrived for their analysis to the Laboratorio Regional de Citología Exfoliativa (LARCE), of the Instituto Mexicano del Seguro Social (IMSS) in Guadalajara, Jalisco. We considered all cases from January 2010 to December 2012. We analyzed 188 095 cases, from which 5.3 % had a diagnosis of low dysplasia, 0.18 % of moderated dysplasia and 0.05 % of high dysplasia. Microinvasive and invasive cancer showed a low frequency (0.03 %). The frequency of abnormal findings identified by vaginal cervical cytology is relatively low. The number of inadequate and limited samples for cytological assessment is high; there is a high proportion of women attending for the first time in life to cytology evaluation in older age groups.

  16. Association between cervical lesion grade and micronucleus frequency in the Papanicolaou test.

    PubMed

    Bueno, Caroline Tanski; Dornelles da Silva, Cláudia Maria; Barcellos, Regina Bones; da Silva, Juliana; Dos Santos, Carla Rossana; Menezes, João Evangelista Sampaio; Menezes, Honório Sampaio; Rossetti, Maria Lucia Rosa

    2014-09-01

    The aim of this study was to evaluate the association between the frequency of micronuclei (MN) and the cellular changes detected in the conventional Papanicolaou test. One hundred and seventy-four Papanicolaou test smears with cellular changes were examined. MN screening was done in cytopathological smears by counting 1,000 cervical cells in a light microscope. MN frequencies were significantly higher in the group with cellular changes compared to the control group (p < 0.001). The mean MN frequencies were 0.95 ± 1.12 (mean ± SD) in the control group (n = 223), 2.98 ± 1.20 in individuals with atypical squamous cells of undetermined significance (ASC-US) (n = 50), 4.04 ± 1.45 in cervical intraepithelial neoplasia (CIN) I (n = 52), 5.97 ± 1.83 in CIN II (n = 30), 7.29 ± 1.55 in CIN III (n = 17) and 8.64 ± 1.55 in invasive cancer (n = 25). These findings suggest that MN monitoring should be included as an additional criterion for the early detection of cytogenetic damage in routine examinations. This monitoring should be done in the same smear as used for cytopathological examination. More specific and systematic studies are necessary to confirm this proposal.

  17. Association between cervical lesion grade and micronucleus frequency in the Papanicolaou test

    PubMed Central

    Bueno, Caroline Tanski; Dornelles da Silva, Cláudia Maria; Barcellos, Regina Bones; da Silva, Juliana; dos Santos, Carla Rossana; Menezes, João Evangelista Sampaio; Menezes, Honório Sampaio; Rossetti, Maria Lucia Rosa

    2014-01-01

    The aim of this study was to evaluate the association between the frequency of micronuclei (MN) and the cellular changes detected in the conventional Papanicolaou test. One hundred and seventy-four Papanicolaou test smears with cellular changes were examined. MN screening was done in cytopathological smears by counting 1,000 cervical cells in a light microscope. MN frequencies were significantly higher in the group with cellular changes compared to the control group (p < 0.001). The mean MN frequencies were 0.95 ± 1.12 (mean ± SD) in the control group (n = 223), 2.98 ± 1.20 in individuals with atypical squamous cells of undetermined significance (ASC-US) (n = 50), 4.04 ± 1.45 in cervical intraepithelial neoplasia (CIN) I (n = 52), 5.97 ± 1.83 in CIN II (n = 30), 7.29 ± 1.55 in CIN III (n = 17) and 8.64 ± 1.55 in invasive cancer (n = 25). These findings suggest that MN monitoring should be included as an additional criterion for the early detection of cytogenetic damage in routine examinations. This monitoring should be done in the same smear as used for cytopathological examination. More specific and systematic studies are necessary to confirm this proposal. PMID:25249771

  18. Chemical Interaction Analysis of an Adhesive Containing 10-Methacryloyloxydecyl Dihydrogen Phosphate (10-MDP) With the Dentin in Noncarious Cervical Lesions.

    PubMed

    Oliveira, Bmb; Ulbaldini, Alm; Sato, F; Baesso, M L; Bento, A C; Andrade, Lhc; Lima, S M; Pascotto, R C

    2017-02-03

    The purpose of this study was to evaluate the chemical bonds of a self-etch 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP) adhesive to natural noncarious cervical lesions (NCCLs) and compare them with those occurring in sclerotic dentin in artificially prepared defects (APDs). Four human teeth with natural NCCLs on the buccal surface were selected. Artificial defects matching the natural lesions were prepared on the lingual surface of the same teeth serving as control. Micro-Raman (MR) spectroscopy was used to quantify mineral content in natural NCCLs and in APDs. Fourier transform infrared-photoacoustic spectroscopy (FTIR-PAS) readouts were taken before and after adhesive application to analyze the protein matrix/mineral (M:M) ratio and chemical interactions between 10-MDP adhesive and dentin. The MR and FTIR-PAS spectra collected from natural NCCLs demonstrated a larger area of the band (961 cm(-1), PO4) and lower M:M ratio, respectively, characterizing a hypermineralized dentin, compared with APDs. FTIR-PAS demonstrated emergence of a peak (1179 cm(-1), P=O) in spectra after adhesive treatment, demonstrating a more intense chemical interaction in natural NCCLs. The results demonstrated that chemical bonding of 10-MDP adhesive to natural NCCLs is more intense, due to the hypermineralized surface, and suggest that it is unnecessary to remove the hypermineralized layer with burs, as this may decrease the chemical bonding potential of 10-MDP.

  19. The prevalence and morphological types of non-carious cervical lesions (NCCL) in a contemporary sample of people.

    PubMed

    Igarashi, Yuriko; Yoshida, Satoru; Kanazawa, Eisaku

    2017-03-08

    Non-carious cervical lesions (NCCLs) were examined in 6541 extracted human teeth and classified based on the morphology of the lesions. As a result, NCCLs were found on 38.7% of teeth (41.6% on maxillary teeth and 36.0% on mandibular teeth), and were most frequent on canines and first premolars. According to the new method of classification, the morphology of NCCLs was classified both by the surface contour (SC) and by the cross-sectional contour (CC). Three types of NCCLs appeared to be dominant. The causes of these NCCLs were discussed based on their morphologies, positions where these NCCLs were frequently found, and the results of previous studies. NCCLs with a horizontal oval SC and a round CC (Type I), which were frequent on the labial surfaces of maxillary canines and buccal surfaces of maxillary first premolars, may be associated with wear by friction and chemical degradation. NCCLs with a vertical oval SC and a round CC (Type II), which were frequent on the lingual surfaces of mandibular incisors and canines, might be mainly related to chemical degradation. NCCLs with a horizontal oval SC and a wedge shape CC (Type III), which were extensively found on the buccal surfaces of maxillary premolars, had formed most probably due to wear by friction and microstructural loss by stress. This new method can classify the morphology of NCCLs more precisely and deduce the mechanisms of the formation of NCCLs more clearly than former methods.

  20. γH2Ax Expression as a Potential Biomarker Differentiating between Low and High Grade Cervical Squamous Intraepithelial Lesions (SIL) and High Risk HPV Related SIL

    PubMed Central

    Kefala, Maria; Kottaridi, Christine; Spathis, Aris; Gouloumi, Alina-Roxani; Pouliakis, Abraham; Pappas, Asimakis; Sioulas, Vasileios; Chrelias, Charalambos; Karakitsos, Petros; Panayiotides, Ioannis

    2017-01-01

    Background γH2AX is a protein biomarker for double-stranded DNA breakage; its expression was studied in cervical squamous intraepithelial lesions and carcinomas. Methods Immunostaining for phospho-γH2AX was performed in sections from histologically confirmed cervical SIL and carcinomas, as well as from normal cervices used as controls. In total, 275 cases were included in the study: 112 low grade SIL (LGSIL), 99 high grade SIL (HGSIL), 24 squamous cell carcinoma (SCC), 12 adenocarcinoma and 28 cervical specimens with no essential lesions. Correlation of histological grading, high risk vs. low risk HPV virus presence, activated vs. non-activated status (by high risk HPV mRNA expression) and γH2AX expression in both basal and surface segments of the squamous epithelium was performed. Results Gradual increase of both basal and surface γH2AX expression was noted up from normal cervices to LGSIL harboring a low risk HPV type, to LGSIL harboring a high risk virus at a non-activated state (p<0.05). Thereafter, both basal and surface γH2AX expression dropped in LGSIL harboring a high risk virus at an activated state and in HGSIL. Conclusions γH2AX could serve as a potential biomarker discriminating between LGSIL and HGSIL, as well as between LGSIL harboring high risk HPV at an activated state. PMID:28118377

  1. Human papillomavirus-specific genotypes in cervical lesions of women referred for smears with atypical glandular cells or adenocarcinoma in situ.

    PubMed

    Rabelo-Santos, Silvia Helena; Derchain, Sophie Françoise Mauricette; Villa, Luísa Lina; Costa, Maria Cecília; Sarian, Luis Otávio Zanatta; do Amaral Westin, Maria Cristina; Kornegay, Janet; Zeferino, Luiz Carlos

    2009-05-01

    This study was designed to analyze whether specific human papillomavirus (HPV) genotypes may predict histologic outcomes in women with glandular abnormalities in their cervical smears. Of the 160 women included, 111 were diagnosed with atypical glandular cells, 35 had both atypical glandular cells and high-grade squamous intraepithelial lesions, whereas 14 women had AIS, in 1 case associated with high-grade squamous intraepithelial lesions. All women underwent colposcopic examinations and biopsy was performed in 129/160 (80.6%). Thirty-one women (19.3%) were considered negative for neoplasia and scheduled for follow-up. All specimens were tested for 27 HPV genotypes by Roche's polymerase chain reaction-reverse line blot assay. Histologic diagnoses were either cervical intraepithelial neoplasia or invasive carcinoma in 75 (58%) women, and negative for neoplasia in 54 (42%). The overall prevalence of HPV was 43%. HPV 16 was the most prevalent type followed by HPV 18. HPV 16 was significantly associated with squamous and glandular neoplasia and HPV 18 with glandular neoplasia. In women with cervical intraepithelial neoplasia 2 or 3, 11 different HPV genotypes were found, whereas in those who had invasive glandular or invasive carcinoma HPV 16 and HPV 18 were found predominantly. The detection of HPV 16 in women with glandular abnormalities in cervical smears did not help differentiating squamous from glandular lesions. However, the detection of HPV 53 in abnormal smears can predict squamous neoplasia, whereas HPV 18 can predict glandular neoplasia as histologic diagnoses.

  2. Biomechanical evaluation of DTRAX® posterior cervical cage stabilization with and without lateral mass fixation

    PubMed Central

    Voronov, Leonard I; Siemionow, Krzysztof B; Havey, Robert M; Carandang, Gerard; Patwardhan, Avinash G

    2016-01-01

    Introduction Lateral mass screw (LMS) fixation with plates or rods is the current standard procedure for posterior cervical fusion. Recently, implants placed between the facet joints have become available as an alternative to LMS or transfacet screws for patients with cervical spondylotic radiculopathy. The purpose of this study was to evaluate the biomechanical stability of the DTRAX® cervical cage for single- and two-level fusion and compare this to the stability achieved with LMS fixation with rods in a two-level construct. Methods Six cadaveric cervical spine (C3–C7) specimens were tested in flexion–extension, lateral bending, and axial rotation to ±1.5 Nm moment without preload (0 N) in the following conditions: 1) intact (C3–C7), 2) LMS and rods at C4–C5 and C5–C6, 3) removal of all rods (LMS retained) and placement of bilateral posterior cages at C5–C6, 4) bilateral posterior cages at C4–C5 and C5–C6 (without LMS and rods), and 5) C4–C5 and C5–C6 bilateral posterior cages at C4–C5 and C5–C6 with rods reinserted. Results Bilateral posterior cervical cages significantly reduced range of motion in all tested directions in both single- and multilevel constructs (P<0.05). Similar stability was achieved with bilateral posterior cages and LMS in a two-level construct: 0.6°±0.3° vs 1.2°±0.4° in flexion–extension (P=0.001), (5.0°±2.6° vs 3.1°±1.3°) in lateral bending (P=0.053), (1.3°±1.0° vs 2.2°±0.9°) in axial rotation (P=0.091) for posterior cages and LMS, respectively. Posterior cages, when placed as an adjunct to LMS, further reduced range of motion in a multilevel construct (P<0.05). Conclusion Bilateral posterior cages provide similar cervical segmental stability compared with a LMS and rod construct and may be an alternative surgical option for select patients. Furthermore, supplementation of a lateral mass construct with posterior cages increases cervical spine stability in single- and multilevel conditions. PMID

  3. Human papillomavirus 16 non-European variants are preferentially associated with high-grade cervical lesions.

    PubMed

    Freitas, Luciana Bueno; Chen, Zigui; Muqui, Elaine Freire; Boldrini, Neide Aparecida Tosato; Miranda, Angélica Espinosa; Spano, Liliana Cruz; Burk, Robert D

    2014-01-01

    HPV16 accounts for 50-70% of cervical cancer cases worldwide. Characterization of HPV16 variants previously indicated that they differ in risks for viral persistence, progression to cervical precancer and malignant cancer. The aim of this study was to examine the association of severity of disease with HPV16 variants identified in specimens (n = 281) obtained from a Cervical Pathology and Colposcopy outpatient clinic in the University Hospital of Espírito Santo State, Southeastern Brazil, from April 2010 to November 2011. All cytologic and histologic diagnoses were determined prior to definitive treatment. The DNA was isolated using QIAamp DNA Mini Kit and HPV was detected by amplification with PGMY09/11 primers and positive samples were genotyped by RFLP analyses and reverse line blot. The genomes of the HPV16 positive samples were sequenced, from which variant lineages were determined. Chi2 statistics was performed to test the association of HPV16 variants between case and control groups. The prevalence of HR-HPV types in

  4. Prevalence of type-specific oncogenic human papillomavirus infection assessed by HPV E6/E7 mRNA among women with high-grade cervical lesions.

    PubMed

    Wang, Hye-Young; Park, Sunyoung; Lee, Dongsup; Kim, Sunghyun; Kim, Geehyuk; Park, Kwang Hwa; Lee, Hyeyoung

    2015-08-01

    Human papillomavirus (HPV) infection is a major cause of premalignant dysplasia and cervical cancer. There are no data on the prevalence of genotype-specific HPV infection assessed by HPV E6/E7 mRNA in women representative of the Korean population across a broad age range. A total of 630 women aged 17-90 years were enrolled in this study. ThinPrep liquid-based cytology samples were evaluated using the CervicGen HPV RT-qDx assay, which detects 16 high-risk (HR) HPV genotypes (set 1: HPV 16, 31, 33, 35, 52, and 58; set 2: HPV 18, 39, 45, 51, 59, and 68; and set 3: HPV 53, 56, 66, and 69). The overall prevalence of HPV infection was 33.2% (n=209), and oncogenic high-risk HPV was detected in 75.9% (n=107) of 141 women with high-grade cervical lesions. HPV 16 was the most common HPV genotype among women with high-grade cervical lesions and histologically confirmed cervical intraepithelial neoplasia grade 2 and above (CIN2+) in the Republic of Korea (41.6%). Among women aged over 30 years, 182/329 (55%) had invasive cervical cancer and 135 (74%) of these were infected with oncogenic HR-HPV types (in particular 25% with HPV 16). Among patients diagnosed with CIN2+, the positivity rate of HR-HPV was the highest in women aged 40-49 years. These results suggest that the determination of specific HPV genotypes is very important for evaluating the potential impact of preventive measures, including the use of prophylactic vaccines, on reducing the burden of cervical cancer. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  5. Dose-mass inverse optimization for minimally moving thoracic lesions.

    PubMed

    Mihaylov, I B; Moros, E G

    2015-05-21

    In the past decade, several different radiotherapy treatment plan evaluation and optimization schemes have been proposed as viable approaches, aiming for dose escalation or an increase of healthy tissue sparing. In particular, it has been argued that dose-mass plan evaluation and treatment plan optimization might be viable alternatives to the standard of care, which is realized through dose-volume evaluation and optimization. The purpose of this investigation is to apply dose-mass optimization to a cohort of lung cancer patients and compare the achievable healthy tissue sparing to that one achievable through dose-volume optimization. Fourteen non-small cell lung cancer (NSCLC) patient plans were studied retrospectively. The range of tumor motion was less than 0.5 cm and motion management in the treatment planning process was not considered. For each case, dose-volume (DV)-based and dose-mass (DM)-based optimization was performed. Nine-field step-and-shoot IMRT was used, with all of the optimization parameters kept the same between DV and DM optimizations. Commonly used dosimetric indices (DIs) such as dose to 1% the spinal cord volume, dose to 50% of the esophageal volume, and doses to 20 and 30% of healthy lung volumes were used for cross-comparison. Similarly, mass-based indices (MIs), such as doses to 20 and 30% of healthy lung masses, 1% of spinal cord mass, and 33% of heart mass, were also tallied. Statistical equivalence tests were performed to quantify the findings for the entire patient cohort. Both DV and DM plans for each case were normalized such that 95% of the planning target volume received the prescribed dose. DM optimization resulted in more organs at risk (OAR) sparing than DV optimization. The average sparing of cord, heart, and esophagus was 23, 4, and 6%, respectively. For the majority of the DIs, DM optimization resulted in lower lung doses. On average, the doses to 20 and 30% of healthy lung were lower by approximately 3 and 4%, whereas lung

  6. Dose-mass inverse optimization for minimally moving thoracic lesions

    NASA Astrophysics Data System (ADS)

    Mihaylov, I. B.; Moros, E. G.

    2015-05-01

    In the past decade, several different radiotherapy treatment plan evaluation and optimization schemes have been proposed as viable approaches, aiming for dose escalation or an increase of healthy tissue sparing. In particular, it has been argued that dose-mass plan evaluation and treatment plan optimization might be viable alternatives to the standard of care, which is realized through dose-volume evaluation and optimization. The purpose of this investigation is to apply dose-mass optimization to a cohort of lung cancer patients and compare the achievable healthy tissue sparing to that one achievable through dose-volume optimization. Fourteen non-small cell lung cancer (NSCLC) patient plans were studied retrospectively. The range of tumor motion was less than 0.5 cm and motion management in the treatment planning process was not considered. For each case, dose-volume (DV)-based and dose-mass (DM)-based optimization was performed. Nine-field step-and-shoot IMRT was used, with all of the optimization parameters kept the same between DV and DM optimizations. Commonly used dosimetric indices (DIs) such as dose to 1% the spinal cord volume, dose to 50% of the esophageal volume, and doses to 20 and 30% of healthy lung volumes were used for cross-comparison. Similarly, mass-based indices (MIs), such as doses to 20 and 30% of healthy lung masses, 1% of spinal cord mass, and 33% of heart mass, were also tallied. Statistical equivalence tests were performed to quantify the findings for the entire patient cohort. Both DV and DM plans for each case were normalized such that 95% of the planning target volume received the prescribed dose. DM optimization resulted in more organs at risk (OAR) sparing than DV optimization. The average sparing of cord, heart, and esophagus was 23, 4, and 6%, respectively. For the majority of the DIs, DM optimization resulted in lower lung doses. On average, the doses to 20 and 30% of healthy lung were lower by approximately 3 and 4%, whereas lung

  7. [Expression of TREM-1 in patients with invasive cervical cancer and precursor lesions].

    PubMed

    Anaya-Prado, Roberto; Norzgaray-Ibarra, Fabiola Geovanna; Bravo-Cuéllar, Alejandro; Pérez-Avila, Carlos Eduardo; Schadegg-Peña, Daniel; Anaya-Fernández, Michelle M

    2015-01-01

    Introducción: se ha demostrado que la glicoproteína TREM-1 pertenece a la superfamilia de las inmunoglobulinas que induce la secreción de varias citocinas proinflamatorias. El objetivo de este trabajo fue medir la expresión de TREM-1 en pacientes con cáncer cervical. Métodos: en este estudio transversal analítico incluimos 4 grupos de pacientes: GI: mujeres con lesión intraepitelial (LI) escamosa de bajo grado (n = 15 p/g); GII: pacientes con LI escamosa de alto grado (n = 9 p/g); GIII: pacientes con cáncer cervical invasor (n = 9 p/g), y GIV: pacientes sanas (n = 15 p/g). En todas las pacientes se midió la expresión de TREM-1 y el Índice Medio de Fluorescencia (IMF) en neutrófilos y monocitos, así como los niveles de leucocitos, neutrófilos y monocitos. Usamos t de Student para muestras independientes. Para estas mismas variables, aplicamos prueba de suma de rangos de Mann-Whitney, ANOVA y Turkey. Para las variables cualitativas se utilizó la prueba de Chi cuadrada. Resultados: los porcentaje de expresión de TREM-1 en neutrófilos y monocitos, además del IMF en neutrófilos en los 4 grupos, no fue significativamente diferente. El IMF de TREM-1 en monocitos fue significativamente diferente al comparar el grupo II y grupo III frente al grupo IV (p < 0.02). Tampoco hubo diferencia significativa al comparar los valores promedio de leucocitos, neutrófilos y monocitos en los diferentes grupos. Conclusión: este estudio documenta una mayor expresión de TREM-1 en monocitos de pacientes con cáncer avanzado.

  8. Role of endoscopic ultrasound-guided fine needle aspiration in the diagnosis of mass lesions

    PubMed Central

    Han, Chaoqun; Lin, Rong; Zhang, Qin; Liu, Jun; Ding, Zhen; Hou, Xiaohua

    2016-01-01

    Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is an accurate technique for sampling the pancreas and mediastinum; however, limited data are available for other mass lesions. The aim of this study was to explore the value of EUS-FNA in the differential diagnosis of all mass lesions. Data from patients who underwent EUS-FNA for the diagnosis of mass lesions, including pancreatic, mediastinal, celiac and retroperitoneal lesions were retrospectively analyzed. The accuracy was calculated by comparing the results of FNA with the results of pathological examination or follow-up surveillances in non-operated cases. A total of 150 cases were included. The location of the mass varied from the pancreas (n=62) to the mediastinum (n=29), gastrointestinal tract (n=36), celiac cavity and retroperitoneum (n=23). The sensitivity and Youdens index of EUS-FNA in the diagnosis of all lesions were 92.97% and 0.93 respectively. The accuracy of diagnosis of pancreatic, mediastinal, gastrointestinal, celiac and retroperitoneal lesions was 85.48, 89.66, 83.33 and 78.23%, respectively. Masses were categorized into parenchymal organs (n=66), luminal organs (n=36) and enlarged lymph nodes (n=33). Lesions in parenchymal organs were likely to be bigger than those in luminal organs (P=0.03) and enlarged lymph nodes (P=0.01). For solid and cystic masses, which constituted 63.3 and 14.7% of the total masses, no significant difference in diagnostic accuracy was observed (P=0.56); however, lesion sizes were significantly different between these two groups (P=0.04) and the majority of cystic masses were identified in women (P=0.03). Malignant lesions were more common in older (P=0.01) and male (P=0.03) patients. In conclusion, EUS-FNA is an effective tool in the diagnosis of unexplained mass lesions; it influences the management of patients by enabling the appropriate treatment to be identified. PMID:27446324

  9. Prevalence of human papillomavirus in archival samples obtained from patients with cervical pre-malignant and malignant lesions from Northeast Brazil

    PubMed Central

    2010-01-01

    Background Human Papillomavirus (HPV) is considered as a necessary, but not sufficient, cause of cervical cancer. In this study, we aimed to assess the prevalence of HPV in a series of pre-malignant and malignant cervical lesion cases, to identify the virus genotypes, and to assess their distribution pattern according to lesion type, age range, and other considered variables. The samples were submitted to histopathological revision examination and analysed by polymerase chain reaction (PCR) for the presence of HPV DNA, followed by HPV typing by dot blot hybridisation. Findings Of the analysed samples, 53.7% showed pre-malignant cervical lesions, and 46.3% presented with cervical cancer. Most cancer samples (84.1%) were classified as invasive carcinoma. The mean age of these cancer patients was 47.3 years. The overall HPV prevalence was 82.4% in patients with pre-malignant lesions and 92.0% in the cancer patients. HPV 16 was the most prevalent type, followed by HPV 18 and 58, including both single and double infections. Double infection was detected in 11.6% of the samples, and the most common combination was HPV 16+18. Conclusions Cervical cancer appears to occur in women in a lower age range in the studied area, compared to the situation in other Brazilian regions. Furthermore, among the patients with CIN 3 and those with cancer, we observed a higher proportion of married women, women with more than one sexual partner, smokers, and individuals with less than an elementary education, relative to their counterparts. Findings The overall HPV prevalence was 82.4% in patients with pre-malignant lesions and 92.0% in the cervical cancer patients from Northeast Brazil. HPV 16 was the most prevalent type, followed by HPV 18 and 58. The most common double infection was HPV 16+18. Cervical cancer appears to occur in women in a lower age range in the Northeast Brazil. Among the patients with CIN 3 and those with cancer, we observed a higher proportion of married women, women

  10. Detection rates of precancerous and cancerous cervical lesions within one screening round of primary human papillomavirus DNA testing: prospective randomised trial in Finland

    PubMed Central

    Nieminen, Pekka; Lönnberg, Stefan; Malila, Nea; Hakama, Matti; Pokhrel, Arun; Laurila, Pekka; Tarkkanen, Jussi; Anttila, Ahti

    2012-01-01

    Objective To compare the detection rates of precancerous and cancerous cervical lesions by human papillomavirus (HPV) DNA testing and by conventional cytology screening. Design Prospective randomised trial. Two cohorts were followed over one screening round of five years, screened initially by primary HPV DNA testing or by primary Pap test. Setting Population based programme for cervical cancer screening in Finland. Participants Women aged 25-65 years invited for screening in 2003-07 (101 678 in HPV arm; 101 747 in conventional cytology arm). Intervention Women were randomly allocated (1:1) to primary HPV DNA screening followed by cytology triage if they had positive results, or to primary cytology screening. Screening method was disclosed at the screening visit. Trial personnel involved were aware of all test results. Main outcome measures Cumulative detection rates of cervical intraepithelial neoplasia (CIN), adenocarcinoma in situ (AIS), and invasive cervical cancer before the second screening (after five years) or before 31 December 2008. Lesions detected at screening and during the five year interval were included. Results 1010 and 701 precancerous or cancerous lesions were detected during an average follow-up of 3.6 years in the HPV and cytology arms, respectively. Among invited women, the hazard ratio was 1.53 (95% confidence interval l.28 to 1.84) for CIN grade 1, 1.54 (1.33 to 1.78) for CIN 2, 1.32 (1.09 to 1.59) for CIN 3 or AIS, and 0.81 (0.48 to 1.37) for cervical cancer. In 25-34 year old participants, the cumulative hazard (or cumulative detection rate) was 0.0057 (0.0045 to 0.0072) for HPV screening versus 0.0046 (0.0035 to 0.0059) for conventional screening; corresponding data for women aged 35 years and older were 0.0022 (0.0019 to 0.0026) and 0.0017 (0.0014 to 0.0021), respectively. Conclusions Primary HPV DNA screening detects more cervical lesions than primary cytology within one screening round of five years. Even if the detection rate of

  11. Immunoexpression of HPV 16/18 E6 and E7 oncoproteins in high-grade cervical squamous intraepithelial lesions in HIV-positive women.

    PubMed

    Rodrigues, L C; Speck, N M de Gois; Focchi, G R de Azevedo; Schimidt, M A; Marques, R M; Ribalta, J C Lascasas

    2016-02-19

    The aim of this study was to assess the immunoexpression of human papillomavirus genotypes 16 and 18 (E6 and E7) oncoproteins in cervical high-grade squamous intraepithelial lesions (HSIL) of human immunodeficiency virus (HIV)-positive women. These results were also compared to the persistence and/or recurrence of lesions after loop electrosurgical excision procedure. Cervical samples from 158 patients were divided into three groups according to the presence or absence of HSIL in women who were or were not HIV-positive. By using the tissue microarray technique, immunohistochemistry was performed to analyze the expression of HPV 16/18 E6 and E7 oncoproteins. Cervical samples from 95 HIV-positive women and 63 HIV-negative women were studied. A statistically significant difference was found in the immunoexpression of E6 and E7 oncoproteins in samples from HIV-positive women with HSIL and that of women with non-neoplastic tissue (P < 0.001). There was also a statistically significant correlation between the immunoexpression of E6 (P = 0.012) and E7 (P < 0.001) oncoproteins in lesion persistence among HIV-positive women. Within the limitations of this study, the immunoexpression of HPV 16/18 E6 and E7 oncoproteins may have prognostic value regarding lesion persistence in HIV-positive women.

  12. A portrait of single and multiple HPV type infections in Brazilian women of different age strata with squamous or glandular cervical lesions

    PubMed Central

    2014-01-01

    Background Cervical cancer ranks third in prevalence and fourth as cause of death in women worldwide. In Brazil, 17,540 women were diagnosed in 2012 with the disease. Persistent infection with high-risk HPV types is a necessary condition for the development of pre-invasive and invasive cervical neoplasia. Currently, over 100 HPV types have been identified, but HPV16 and 18 are recognized as the mayor culprits in cervical carcinogenesis. Our objective was to assess the relationships between single- (ST) and multiple-type (MT) HPV infections with patients’ age and lesion pathological status. Methods 328 patients with either squamous or glandular intraepithelial or invasive cervical lesion were selected. All subjects were tested for HPV genotypes with reverse hybridization for 21 high- (hr-HPV) and 16 low-risk (lr-HPV) probes. Prevalence of ST and MT HPV infections was compared across histological types and age strata. Results 287 (87%) women had at least one HPV type detected and 149 (52%) had MT infections. The most prevalent HPV type was HPV16, present in 142 cases (49% of all HPV-positive cases), followed by HPV58, 52, 31, 35 and 33. HPV18, in single or multiple infections, occurred in 23 cases (8% of hr-HPV cases). Almost all glandular lesions were associated with HPV16 and 18 alone. Multiple infections were significantly more prevalent in squamous than in glandular lesion for HPV16 and 18 (P = 0.04 and 0.03 respectively). The prevalence of MT infections followed a bimodal distribution; peaking in women younger 29 years and in those aged 50 to 59. Conclusions Our data indicate that prevention strategies for pre-invasive and invasive squamous lesions should be focused on HPV16 and a few alpha-9 HPV types. It is clear to us that in young women, prophylaxis must cover a large amalgam of HPV types beyond classic HPV16 and 18. PMID:24751127

  13. A portrait of single and multiple HPV type infections in Brazilian women of different age strata with squamous or glandular cervical lesions.

    PubMed

    Resende, Leandro Santos de Araújo; Rabelo-Santos, Sílvia Helena; Sarian, Luís Otávio; Figueiredo Alves, Rosane Ribeiro; Ribeiro, Andréa Alves; Zeferino, Luiz Carlos; Derchain, Sophie

    2014-04-22

    Cervical cancer ranks third in prevalence and fourth as cause of death in women worldwide. In Brazil, 17,540 women were diagnosed in 2012 with the disease. Persistent infection with high-risk HPV types is a necessary condition for the development of pre-invasive and invasive cervical neoplasia. Currently, over 100 HPV types have been identified, but HPV16 and 18 are recognized as the mayor culprits in cervical carcinogenesis. Our objective was to assess the relationships between single- (ST) and multiple-type (MT) HPV infections with patients' age and lesion pathological status. 328 patients with either squamous or glandular intraepithelial or invasive cervical lesion were selected. All subjects were tested for HPV genotypes with reverse hybridization for 21 high- (hr-HPV) and 16 low-risk (lr-HPV) probes. Prevalence of ST and MT HPV infections was compared across histological types and age strata. 287 (87%) women had at least one HPV type detected and 149 (52%) had MT infections. The most prevalent HPV type was HPV16, present in 142 cases (49% of all HPV-positive cases), followed by HPV58, 52, 31, 35 and 33. HPV18, in single or multiple infections, occurred in 23 cases (8% of hr-HPV cases). Almost all glandular lesions were associated with HPV16 and 18 alone. Multiple infections were significantly more prevalent in squamous than in glandular lesion for HPV16 and 18 (P = 0.04 and 0.03 respectively). The prevalence of MT infections followed a bimodal distribution; peaking in women younger 29 years and in those aged 50 to 59. Our data indicate that prevention strategies for pre-invasive and invasive squamous lesions should be focused on HPV16 and a few alpha-9 HPV types. It is clear to us that in young women, prophylaxis must cover a large amalgam of HPV types beyond classic HPV16 and 18.

  14. The reporting of cervical cancer in the mass media: a study of UK newspapers.

    PubMed

    Bell, L; Seale, C

    2011-05-01

    Cervical cancer disproportionately affects those in lower socio-economic groups. Mass media, including newspapers, are an important source of information about disease and how to prevent it. An analysis of UK national newspaper content between 2000 and 2009 is reported, assessing the extent to which information is provided about early signs and symptoms, risk factors and ways of preventing cervical cancer. The messages in newspapers targeted at readers in lower socio-economic groups are compared with the messages in other newspapers, and the impact of reporting the illness and death of the reality TV star, Jade Goody, on the level of medical information contained in articles is assessed. Tabloid or 'popular' newspapers are found to provide more information about early signs and symptoms, and no less information about risk factors, when compared with broadsheets or 'serious' papers. This is due to their greater use of personal stories of people with cervical cancer. The Jade Goody story was associated with an increase in information about early signs and symptoms, and about screening, but not (with the exception of the role played by social deprivation) about risk factors. Suggestions about how to approach public education via an entertainment format in mass media are made.

  15. Extensive brain masses and cavitary lung lesions associated with toxoplasmosis and acquired immunodeficiency syndrome.

    PubMed

    Ayoade, Folusakin; Todd, John; Al-Delfi, Firas; King, John

    2017-10-01

    Toxoplasmosis is an important cause of enhancing brain lesions in patients with acquired immunodeficiency syndrome (AIDS), and it is typically associated with low CD4-lymphocyte counts. Extensive toxoplasma encephalitis when the CD4-lymphocyte count is above 100 cells/µl is unusual. Cavitary lung lesions are also not typically associated with toxoplasmosis. Here, we present a case of toxoplasmosis associated with extensive brain masses and cavitary lung lesions, both of which improved with directed toxoplasmosis therapy, in an AIDS patient with a CD4 cell count of 120 cells/µl.

  16. P16 and Ki-67 expression improves the diagnostic accuracy of cervical lesions but not predict persistent high risk human papillomavirus infection with CIN1

    PubMed Central

    Zhong, Pingping; Li, Jifeng; Gu, Yiqun; Liu, Yu; Wang, Aichun; Sun, Yunfei; Lu, Lijuan

    2015-01-01

    Objective: To determine the association between the expression of p16 and Ki-67 and cervical lesions, and to evaluate the role of p16 and Ki-67 as prognostic markers for persistent high risk human papillomavirus (hr-HPV) infection. Methods: Totally 1,154 cases of cervical biopsies were enrolled, 331 cases with negative for dysplasia (NEG), 462 with cervical intraepithelial neoplasia 1 (CIN1), 176 with CIN2, 163 with CIN3 and 22 with cervical squamous cell carcinoma (SCC). Furthermore, 283 women with CIN1 were recruited into 12-month follow-up, and HPV specific gene detection by polymerase chain reaction was used to detect hr-HPV of cervical secretions at 6-month-interval for 12-month follow-up period. 40 women were infected with persistent hr-HPV, 182 with transient infection and 61 unfected with hr-HPV. The expression of p16 and Ki-67 were evaluated by immunohistochemical method. The immunostaining results of p16 and Ki-67 were classified into four categories: negative, 1+, 2+ and 3+. Results: There was significant increase in the expression of p16 (P < 0.001) and Ki-67 (P < 0.001) from NEG to SCC. The expression of Ki-67 (P < 0.001) but not p16 (P = 0.254) significantly increased in CIN2, CIN3. Ratio of p16 (P = 0.215) and Ki-67 (P = 0.495) positivity were not correlated with persistent hr-HPV infection. Conclusion: P16 and Ki-67 can improve the diagnostic accuracy of cervical lesions but can not predict persistent hr-HPV infection with CIN1. PMID:26045807

  17. P16 and Ki-67 expression improves the diagnostic accuracy of cervical lesions but not predict persistent high risk human papillomavirus infection with CIN1.

    PubMed

    Zhong, Pingping; Li, Jifeng; Gu, Yiqun; Liu, Yu; Wang, Aichun; Sun, Yunfei; Lu, Lijuan

    2015-01-01

    To determine the association between the expression of p16 and Ki-67 and cervical lesions, and to evaluate the role of p16 and Ki-67 as prognostic markers for persistent high risk human papillomavirus (hr-HPV) infection. Totally 1,154 cases of cervical biopsies were enrolled, 331 cases with negative for dysplasia (NEG), 462 with cervical intraepithelial neoplasia 1 (CIN1), 176 with CIN2, 163 with CIN3 and 22 with cervical squamous cell carcinoma (SCC). Furthermore, 283 women with CIN1 were recruited into 12-month follow-up, and HPV specific gene detection by polymerase chain reaction was used to detect hr-HPV of cervical secretions at 6-month-interval for 12-month follow-up period. 40 women were infected with persistent hr-HPV, 182 with transient infection and 61 unfected with hr-HPV. The expression of p16 and Ki-67 were evaluated by immunohistochemical method. The immunostaining results of p16 and Ki-67 were classified into four categories: negative, 1+, 2+ and 3+. There was significant increase in the expression of p16 (P<0.001) and Ki-67 (P<0.001) from NEG to SCC. The expression of Ki-67 (P<0.001) but not p16 (P=0.254) significantly increased in CIN2, CIN3. Ratio of p16 (P=0.215) and Ki-67 (P=0.495) positivity were not correlated with persistent hr-HPV infection. P16 and Ki-67 can improve the diagnostic accuracy of cervical lesions but can not predict persistent hr-HPV infection with CIN1.

  18. Scintigraphic diagnosis of hepatic hemangioma: its role in the management of hepatic mass lesions

    SciTech Connect

    Moinuddin, M.; Allison, J.R.; Montgomery, J.H.; Rockett, J.F.; McMurray, J.M.

    1985-08-01

    Hepatic cavernous hemangiomas are benign tumors of the liver that are often an incidental finding. They are usually asymptomatic but may cause symptoms when traumatized, may bleed spontaneously, or may produce pain by virtue of their large size and mass effect. A retrospective analysis of the clinical presentation, liver function tests, and diagnostic imaging procedures in 20 patients with hepatic hemangiomas is presented and the literature is reviewed. The 20 patients had 27 mass lesions as seen on liver scintigraphy, computed tomography, or sonography. Technetium-99m-labeled red blood cell flow studies and blood pool scintigrams showed delayed filling of the mass lesions, diagnostic of hemangiomas. This finding was not encountered in any other type of lesion. A new diagnostic algorithm is proposed in which flood-flow and blood-pool scintigraphy play a more prominent role in the diagnostic workup.

  19. Prognostic value of human papillomavirus 16/18 genotyping in low-grade cervical lesions preceded by mildly abnormal cytology.

    PubMed

    Ye, Jing; Cheng, Bei; Cheng, Yi-Fan; Yao, Ye-Li; Xie, Xing; Lu, Wei-Guo; Cheng, Xiao-Dong

    Histological low-grade squamous intraepithelial lesion/cervical intraepithelial neoplasia grade 1 (LSIL/CIN1) preceded by normal or mildly abnormal cytology is recommended for conservative follow-up, with no separated management. In this study, we assessed the triage value of human papillomavirus (HPV) 16/18 genotyping in 273 patients with LSIL/CIN1. HPV16/18 genotyping was performed at baseline and follow-up was at 6-monthly intervals for up to 2 years. At each follow-up, women positive for cytology or high-risk HPV (hrHPV) were referred for colposcopy. Enrollment cytology, HPV16/18 genotyping, and questionnaire-obtained factors were linked to the 2-year cumulative progression rate. Univariate and multivariate analyses were performed taking into account time-to-event with Cox proportional hazard regression. The results showed that 190 cases (69.6%) regressed, 37 (13.6%) persisted, and 46 (16.8%) progressed. HPV16/18 positivity (hazard ratio (HR), 2.708; 95% confidence interval (CI), 1.432-5.121; P=0.002) is significantly associated with higher 2-year cumulative progression rate. Sub-analysis by enrollment cytology and age restricted the positive association among patients preceded by mildly abnormal cytology and aged 30 years or older. Immediate treatment is a rational recommendation for the high-risk subgroup, when good compliance is not assured.

  20. Brainstem lesion in benign paroxysmal vertigo children: Evaluated by a combined ocular and cervical vestibular-evoked myogenic potential test.

    PubMed

    Lin, Kuei-You; Hsu, Ying-Shuo; Young, Yi-Ho

    2010-05-01

    This study utilized a combined ocular vestibular-evoked myogenic potential (oVEMP) and cervical VEMP (cVEMP) test in children with benign paroxysmal vertigo (BPV) to investigate whether the upper or lower brainstem is more frequently affected in BPV children. Fifteen BPV children aged 4-14 years, and 15 age- and sex-matched healthy children were enrolled. All subjects underwent pure tone audiometry, stabilometry, and a combined oVEMP and cVEMP test using acoustic stimulation. All BPV patients displayed normal hearing and clear oVEMPs. However, 11 (73%) of 15 BPV patients had delayed cVEMPs, showing significant difference when compared with 100% normal cVEMPs in healthy children. The sway path and sway area in stabilometry were significantly different between BPV and healthy children, regardless of whether their eyes were open or closed. However, neither the sway path nor sway area correlated significantly with cVEMP results. Normal oVEMPs in BPV children indicate an intact vestibulo-ocular reflex pathway, which travels through the upper brainstem. In contrast, delayed cVEMPs in BPV children reflect a retrolabyrinthine lesion along the sacculo-collic reflex pathway, which descends via the lower brainstem. Hence, the lower brainstem is more frequently affected than the upper brainstem in children with BPV. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

  1. Prognostic value of human papillomavirus 16/18 genotyping in low-grade cervical lesions preceded by mildly abnormal cytology*

    PubMed Central

    Ye, Jing; Cheng, Bei; Cheng, Yi-fan; Yao, Ye-li; Xie, Xing; Lu, Wei-guo; Cheng, Xiao-dong

    2017-01-01

    Histological low-grade squamous intraepithelial lesion/cervical intraepithelial neoplasia grade 1 (LSIL/CIN1) preceded by normal or mildly abnormal cytology is recommended for conservative follow-up, with no separated management. In this study, we assessed the triage value of human papillomavirus (HPV) 16/18 genotyping in 273 patients with LSIL/CIN1. HPV16/18 genotyping was performed at baseline and follow-up was at 6-monthly intervals for up to 2 years. At each follow-up, women positive for cytology or high-risk HPV (hrHPV) were referred for colposcopy. Enrollment cytology, HPV16/18 genotyping, and questionnaire-obtained factors were linked to the 2-year cumulative progression rate. Univariate and multivariate analyses were performed taking into account time-to-event with Cox proportional hazard regression. The results showed that 190 cases (69.6%) regressed, 37 (13.6%) persisted, and 46 (16.8%) progressed. HPV16/18 positivity (hazard ratio (HR), 2.708; 95% confidence interval (CI), 1.432–5.121; P=0.002) is significantly associated with higher 2-year cumulative progression rate. Sub-analysis by enrollment cytology and age restricted the positive association among patients preceded by mildly abnormal cytology and aged 30 years or older. Immediate treatment is a rational recommendation for the high-risk subgroup, when good compliance is not assured. PMID:28271660

  2. A 24-month follow-up of flowable resin composite as an intermediate layer in non-carious cervical lesions.

    PubMed

    Reis, Alessandra; Loguercio, Alessandro D

    2006-01-01

    This study compared the clinical performance of a microhybrid resin composite to lined Class V restorations or to those restorations without a flowable resin composite over a 24-month period. Nineteen patients with at least 2 pairs of equivalent cervical erosion/attrition/abfraction lesions, under occlusion, were enrolled in this study. A total of 74 restorations were placed, half for each group (Single-Bond + Filtek-Flow + Filtek Z250 or Single-Bond + Filtek Z250). According to the manufacturers' instructions, 2 calibrated operators placed all restorations. Two other independent examiners evaluated the restorations at baseline and after 24 months, according to the USPHS criteria and modified criteria for color match. The classic alpha score was divided into A1 for "not detectable" and A2 for "slightly discernible" filling. Statistical analysis was conducted using Fisher's exact test (alpha=0.05). For each group, 8 restorations were lost after 24 months (retention rate of 89.2%). All the restorations showed a trend toward dark yellowing after 24 months (color match A2).

  3. Four-year randomized clinical trial of oxalic acid pretreatment in restorations of non-carious cervical lesions.

    PubMed

    Albuquerque, Nadine Luísa Guimarães; de Souza, André Mattos Brito; de Moraes, Maria Denise Rodrigues; Mendonça, Juliano Sartori; Rodrigues, Lidiany Karla Azevedo; Santiago, Sérgio Lima

    2016-03-01

    The aim of this study was to evaluate the efficiency of oxalic acid (BisBlock) on restorations of non-carious cervical lesions. One operator placed 90 restorations randomly divided into two groups in 20 patients under cotton rolls isolation: Control Group-two-step etch-and-rinse adhesive technique; and Experimental Group-two-step etch-and-rinse adhesive technique with oxalic acid pretreatment after acid-etched dentin. The restorative adhesive system used was XP Bond/Durafill. The restorations were directly assessed by two independent examiners, using the modified United States Public Health Service (USPHS) criteria at the baseline and 4 years. Data were statistically analyzed using the Fisher and McNemar tests (p < 0.05). Fifteen patients (75%) were available for recall after 4 years. The McNemar test detected significant differences within the Experimental Group between the baseline and 4-year evaluations for retention (p < 0.05). For the Control Group, there was no significant difference (p > 0.05) between the periods. The Fisher test showed no statistically significant difference between the groups for all other criteria (p > 0.05). After 4 years of service, the use of oxalic acid did not influence the clinical performance of restorations when it was used under composite resin restorations.

  4. Comparison of self-collected vaginal, vulvar and urine samples with physician-collected cervical samples for human papillomavirus testing to detect high-grade squamous intraepithelial lesions

    PubMed Central

    Sellors, John W.; Lorincz, Attila T.; Mahony, James B.; Mielzynska, Iwona; Lytwyn, Alice; Roth, Paula; Howard, Michelle; Chong, Sylvia; Daya, Dean; Chapman, William; Chernesky, Max

    2000-01-01

    Background Certain types of human papillomavirus (HPV) in cervical samples are strongly associated with squamous intraepithelial lesions (SIL) and invasive cervical carcinoma. We determined and compared the test characteristics of testing for HPV with samples obtained by patients and with samples obtained by their physicians. Methods In a consecutive series of women referred to a colposcopy clinic at a teaching hospital because of abnormalities on cervical cytologic screening, 200 agreed to collect vulvar, vaginal and urine samples for HPV testing. The physician then collected cervical samples for HPV testing, and colposcopy, with biopsy as indicated, was performed. Presence of HPV was evaluated using the hybrid capture II assay (Digene Corp., Silver Spring, Md.) with a probe cocktail for 13 carcinogenic types. Cervical specimens were also tested for HPV by polymerase chain reaction and hybridization with type-specific probes. Cervical smears for cytologic examination were obtained from all women. Results High-grade lesions (high-grade squamous intraepithelial lesions [HSIL], equivalent to cervical intraepithelial neoplasia [CIN] grade 2 or 3, and adenocarcinoma) were found in 58 (29.0%) of the 200 women. Carcinogenic types of HPV were detected in the self-collected vaginal samples of 50 (86.2%) of these 58 women, in the self-collected vulvar samples of 36 (62.1%) and in the self-collected urine samples of 26 (44.8%). Carcinogenic types of HPV were detected in the cervical samples collected by physicians for 57 (98.3%) of these 58 women. The remaining 142 women (71.0%) had normal findings or low-grade squamous intraepithelial lesions (LSIL, CIN grade 1). Test results were negative or noncarcinogenic types of HPV were detected in the self-collected vaginal samples of 76 (53.5%) of these 142 women, in the self-collected vulvar samples of 89 (62.7%) and in the self-collected urine samples of 99 (69.7%). The sensitivity for self-collected samples ranged from 44.8% to

  5. Significance of p53-binding protein 1 nuclear foci in uterine cervical lesions: endogenous DNA double strand breaks and genomic instability during carcinogenesis

    PubMed Central

    Matsuda, Katsuya; Miura, Shiro; Kurashige, Tomomi; Suzuki, Keiji; Kondo, Hisayoshi; Ihara, Makoto; Nakajima, Hisayoshi; Masuzaki, Hideaki; Nakashima, Masahiro

    2011-01-01

    Aims A defective DNA damage response can result in genomic instability (GIN) and lead to transformation to cancer. As p53-binding protein 1 (53BP1) localizes at the sites of DNA double strand breaks (DSBs) and rapidly forms nuclear foci (NF), the presence of 53BP1 NF can be considered to be an indicator of endogenous DSBs reflecting GIN. Our aim was to analyse the presence of DSBs by immunofluorescence for 53BP1 expression in a series of cervical lesions, to evaluate the significance of GIN during carcinogenesis. Methods and results A total of 80 archival cervical tissue samples, including 11 normal, 16 cervical intraepithelial neoplasia (CIN)1, 15 CIN2, 24 CIN3 and 14 squamous cell carcinoma samples, were analysed for 53BP1 NF, human papillomavirus (HPV) infection, and p16INK4a overexpression. The number of 53BP1 NF in cervical cells appeared to increase with progression during carcinogenesis. The distribution of 53BP1 NF was similar to that of the punctate HPV signals as determined by in-situ hybridization and also to p16INK4a overexpression in CIN, suggesting an association with viral infection and replication stress. Conclusions Immunofluorescence analysis of 53BP1 expression can be a useful tool with which to estimate the level of GIN. During cervical carcinogenesis, GIN may allow further accumulation of genomic alterations, causing progression to invasive cancer. PMID:22034884

  6. Reduction in HPV 16/18-associated high grade cervical lesions following HPV vaccine introduction in the United States - 2008-2012.

    PubMed

    Hariri, Susan; Bennett, Nancy M; Niccolai, Linda M; Schafer, Sean; Park, Ina U; Bloch, Karen C; Unger, Elizabeth R; Whitney, Erin; Julian, Pamela; Scahill, Mary W; Abdullah, Nasreen; Levine, Diane; Johnson, Michelle L; Steinau, Martin; Markowitz, Lauri E

    2015-03-24

    Prevention of pre-invasive cervical lesions is an important benefit of HPV vaccines, but demonstrating impact on these lesions is impeded by changes in cervical cancer screening. Monitoring vaccine-types associated with lesions can help distinguish vaccine impact from screening effects. We examined trends in prevalence of HPV 16/18 types detected in cervical intraepithelial neoplasia 2, 3, and adenocarcinoma in situ (CIN2+) among women diagnosed with CIN2+ from 2008 to 2012 by vaccination status. We estimated vaccine effectiveness against HPV 16/18-attributable CIN2+ among women who received ≥1 dose by increasing time intervals between date of first vaccination and the screening test that led to detection of CIN2+ lesion. Data are from a population-based sentinel surveillance system to monitor HPV vaccine impact on type-specific CIN2+ among adult female residents of five catchment areas in California, Connecticut, New York, Oregon, and Tennessee. Vaccination and cervical cancer screening information was retrieved. Archived diagnostic specimens were obtained from reporting laboratories for HPV DNA typing. From 2008 to 2012, prevalence of HPV 16/18 in CIN2+ lesions statistically significantly decreased from 53.6% to 28.4% among women who received at least one dose (Ptrend<.001) but not among unvaccinated women (57.1% vs 52.5%; Ptrend=.08) or women with unknown vaccination status (55.0% vs 50.5%; Ptrend=.71). Estimated vaccine effectiveness for prevention of HPV 16/18-attributable CIN2+ was 21% (95% CI: 1-37), 49% (95% CI: 28-64), and 72% (95% CI: 45-86) in women who initiated vaccination 25-36 months, 37-48 months, and >48 months prior to the screening test that led to CIN2+ diagnosis. Population-based data from the United States indicate significant reductions in CIN2+ lesions attributable to types targeted by the vaccines and increasing HPV vaccine effectiveness with increasing interval between first vaccination and earliest detection of cervical disease

  7. Human papillomavirus infections in Mexican women with normal cytology, precancerous lesions, and cervical cancer: type-specific prevalence and HPV coinfections.

    PubMed

    Aguilar-Lemarroy, Adriana; Vallejo-Ruiz, Verónica; Cortés-Gutiérrez, Elva I; Salgado-Bernabé, Manuel Eduardo; Ramos-González, Norma Patricia; Ortega-Cervantes, Laura; Arias-Flores, Rafael; Medina-Díaz, Irma M; Hernández-Garza, Fernando; Santos-López, Gerardo; Piña-Sánchez, Patricia

    2015-05-01

    The prevalence and genotype distribution of human papillomavirus (HPV) provides the basis for designing HPV prevention programs. The prevalence rates of type-specific HPV and coinfections in samples of Mexican women were investigated in 822 women aged 18-87 years. HPV detection was performed using a Linear Array™ genotyping test. HPV infection was found in 12.4% of controls, 46.3% of those with cervical intraepithelial neoplasia 1, and 100% of those with cervical intraepithelial neoplasia 3 or cervical cancer. HPV 16 was the most prevalent type in all diagnosis groups. The HPV types most frequently found in cervical cancers were 16, 18, 45, 52, 58, and 39; HPV types 16, 62, 51, 84, 18, 53, and CP6108 were the most prevalent in control women. Considering HPV-positive samples only, coinfections occurred most often in controls (63%) and were less frequent in those with cervical cancer (26%). The most frequent viral types in coinfections with HPV 16 in control women were HPV 62, 51, and 84; in women with cervical cancers, HPV 18, 39, and 70 were most common. In conclusion, in addition to HPV types 16 and 18, types 45, 39, 58, 52, and 71 were found in cervical cancers in Mexican women (78%); among them, only 65% were attributable to HPV types 16 and 18. Therefore, it is necessary to consider these viral types in the design of new vaccines, and to determine whether certain HPV types coinfecting with HPV 16 in precursor lesions determine tumor progression or regression.

  8. A Comparison of 3 Ways of Conventional Pap Smear, Liquid-Based Cytology and Colposcopy vs Cervical Biopsy for Early Diagnosis of Premalignant Lesions or Cervical Cancer in Women with Abnormal Conventional Pap Test.

    PubMed

    Karimi-Zarchi, Mojgan; Peighmbari, Fateme; Karimi, Neda; Rohi, Mitra; Chiti, Zohre

    2013-12-01

    The most cost effective method of prevention and detection of cervical cancer is the Pap smear. In abnormal Pap smear, colposcopy, endocervical curettage and biopsy will be done. Gold standard method in detecting cervical lesion is biopsy. Now in two ways conventional Pap smear and liquid base are routine diagnostic technique in Iran and given easily and cost-effectiveness of this method in the detection of cervical lesions to determine the sensitivity the objective of this study was compare three methods of Pap smear and colposcopy in detection of any lesion to gold standard biopsy in the positive ASC cases who referred to gynecologic Oncology Clinic of shahid Sadoughi University of Medical Science. This study is a descriptive analytic in 2009-2010 years on 150 cases of patients with Atypical Squamose Cell (ASC) results in previous pap smear ,conventional pap smear, liquid based pap smear, colposcopy and cervical biopsy had been done for all patient and finally data were analyzed with chi-square statistical test on spss ver 16 saftware. Average age of patients in this study was, 42 ± 9.9 year and reason for referring patients in 35.4% of cases was due to follow-up of abnormal results of previous Pap smear, in 30% bleeding, 12% Pain and 2.6% percent of cases was checking-up. In final results of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy any of the methods conventional and liquid based Pap smear and colposcopy were compared with cervical biopsy as a gold standard. The conventional Pap smear method had a sensitivity 51%, specificity 66.6%, PPV 96%, NPV was 8% and accuracy was 92%, about the liquid base Pap smear method, sensitivity was 55.3%, specificity was 77.7%, PPV was 97.5%, NPV was 10% and accuracy was 56/6%. About the colposcopy, sensitivity was70/9 % specificity 44/4%, PPV was 95.2%, NPV was 8/8% and accuracy was 69.3%. The relationship between sensitivity results of conventional Pap smear and

  9. Diagnostic accuracy of high-risk HPV genotyping in women with high-grade cervical lesions: evidence for improving the cervical cancer screening strategy in China.

    PubMed

    Xu, Huihui; Lin, Aifen; Shao, Xiujuan; Shi, Weiwu; Zhang, Yang; Yan, Weihua

    2016-12-13

    Currently, clinical data for primary HPV screening alone are lacking in China. Here, we evaluate cervical cancer screening with primary HPV genotyping, as well as possible future screening strategy. Overall, high-risk HPV (hrHPV) prevalence was 18.2% among hospital-based population in Taizhou area. For cervical intraepithelial neoplasia 2 or worse (CIN2+), the sensitivity of primary hrHPV genotyping strategy and current cervical cancer screening strategy were 93.5%, and 71.1%, respectively; whereas the specificity was 17.5%, and 62.4%, respectively. Current cervical screening strategy had slightly higher positive predictive values (28.4%) for CIN2+ than hrHPV genotyping strategy (21.9%), whereas primary hrHPV genotyping strategy demonstrated higher negative predictive values (94.7%) than current cervical screening strategy (91.1%). Compared to HPV35/39/45/51/56/59/66/68 genotypes, the odds ratios (OR) for CIN2+ in HPV16/18/31/33/52/58 infection women were 3.2 (95% confidence interval [CI] 2.3-4.1). Primary hrHPV genotyping strategy provides a better predictive value than HPV16/18 genotyping alone in guiding the clinical management of the current cervical cancer screening. HPV testing without adjunctive cytology may be sufficiently sensitive for primary cervical cancer screening.

  10. Diagnostic accuracy of high-risk HPV genotyping in women with high-grade cervical lesions: evidence for improving the cervical cancer screening strategy in China

    PubMed Central

    Xu, Huihui; Lin, Aifen; Shao, Xiujuan; Shi, Weiwu; Zhang, Yang; Yan, Weihua

    2016-01-01

    Currently, clinical data for primary HPV screening alone are lacking in China. Here, we evaluate cervical cancer screening with primary HPV genotyping, as well as possible future screening strategy. Overall, high-risk HPV (hrHPV) prevalence was 18.2% among hospital-based population in Taizhou area. For cervical intraepithelial neoplasia 2 or worse (CIN2+), the sensitivity of primary hrHPV genotyping strategy and current cervical cancer screening strategy were 93.5%, and 71.1%, respectively; whereas the specificity was 17.5%, and 62.4%, respectively. Current cervical screening strategy had slightly higher positive predictive values (28.4%) for CIN2+ than hrHPV genotyping strategy (21.9%), whereas primary hrHPV genotyping strategy demonstrated higher negative predictive values (94.7%) than current cervical screening strategy (91.1%). Compared to HPV35/39/45/51/56/59/66/68 genotypes, the odds ratios (OR) for CIN2+ in HPV16/18/31/33/52/58 infection women were 3.2 (95% confidence interval [CI] 2.3-4.1). Primary hrHPV genotyping strategy provides a better predictive value than HPV16/18 genotyping alone in guiding the clinical management of the current cervical cancer screening. HPV testing without adjunctive cytology may be sufficiently sensitive for primary cervical cancer screening. PMID:27626178

  11. Prevalence and Genetic Variability in Capsid L1 Gene of Rare Human Papillomaviruses (HPV) Found in Cervical Lesions of Women from North-East Brazil

    PubMed Central

    Gurgel, Ana Pavla Almeida Diniz; Chagas, Bárbara Simas; do Amaral, Carolina Maria Medeiros; Albuquerque, Eugênia Maria Bezerra; Serra, Ivi Gonçalves Soares Santos; Silva Neto, Jacinto da Costa; Muniz, Maria Tereza Cartaxo; de Freitas, Antonio Carlos

    2013-01-01

    The aim of this study was to examine the prevalence and genetic variability of the capsid L1 gene of rare HPV genotypes that were found in the cervical lesions of women from North-East Brazil. A total number of 263 patients were included in this study. HPV detection was performed using PCR followed by direct sequencing of MY09/11, as well as type-specific PCR to detect the Alpha-9 species. Epitope prediction was performed to determine whether or not the genetic variants are inserted in B-cell and T-cell epitopes. The prevalence of rare HPV types in cervical lesions was found to be 9.47%. The rare HPV genotypes that were detected were HPV-53, 54, 56, 61, 62, 66, 70, and 81. The genetic variability in the L1 gene of rare HPV types involved thirty nucleotide changes, eight of which were detected for the first time in this study. Moreover, some of these variants are embedded in B-cell or T-cell epitope regions. The results of this research suggest that rare HPV types might be involved in cervical lesions and some of these variants can be found in B-cell and T-cell epitopes. Data on the prevalence and variability of rare HPV types will assist in clarifying the role of these viruses in carcinogenesis. PMID:23865057

  12. Prevalence and genetic variability in capsid L1 gene of rare human papillomaviruses (HPV) found in cervical lesions of women from North-East Brazil.

    PubMed

    Gurgel, Ana Pavla Almeida Diniz; Chagas, Bárbara Simas; do Amaral, Carolina Maria Medeiros; Albuquerque, Eugênia Maria Bezerra; Serra, Ivi Gonçalves Soares Santos; Silva Neto, Jacinto da Costa; Muniz, Maria Tereza Cartaxo; de Freitas, Antonio Carlos

    2013-01-01

    The aim of this study was to examine the prevalence and genetic variability of the capsid L1 gene of rare HPV genotypes that were found in the cervical lesions of women from North-East Brazil. A total number of 263 patients were included in this study. HPV detection was performed using PCR followed by direct sequencing of MY09/11, as well as type-specific PCR to detect the Alpha-9 species. Epitope prediction was performed to determine whether or not the genetic variants are inserted in B-cell and T-cell epitopes. The prevalence of rare HPV types in cervical lesions was found to be 9.47%. The rare HPV genotypes that were detected were HPV-53, 54, 56, 61, 62, 66, 70, and 81. The genetic variability in the L1 gene of rare HPV types involved thirty nucleotide changes, eight of which were detected for the first time in this study. Moreover, some of these variants are embedded in B-cell or T-cell epitope regions. The results of this research suggest that rare HPV types might be involved in cervical lesions and some of these variants can be found in B-cell and T-cell epitopes. Data on the prevalence and variability of rare HPV types will assist in clarifying the role of these viruses in carcinogenesis.

  13. Bilateral ectopic cervical thymus presenting as a neck mass: Ultrasound and magnetic resonance imaging.

    PubMed

    Tanrivermis Sayit, Asli; Elmali, Muzaffer; Hashimov, Jalal; Ceyhan Bilgici, Meltem; Dağdemir, Ayhan

    2016-09-01

    Ectopic cervical thymus (ECT) is a rare cause of neck mass in the pediatric age group. It is extremely uncommon in infants. Overall more than 100 cases have been reported in the literature, though fewer than 10% involved infants. Furthermore, ECT is usually unilateral and more frequently seen in men than in women. Ultrasound (US) is the preferred initial imaging modality, especially in pediatric neck masses given its wide availability, low cost and lack of radiation exposure. US can show the location, extension, and echotexture of the ECT. Magnetic resonance imaging (MRI) can be performed to verify the diagnosis and confirm communication between the ECT and the mediastinal thymus. Diffusion restriction can aid diagnosis when seen in a neck mass similar to that in the mediastinal thymus. Herein is described a case of bilateral ECT in a 2-month-old boy with associated US and MRI findings. © 2016 Japan Pediatric Society.

  14. Implementation of mass media community health education: the Forsyth County Cervical Cancer Prevention Project.

    PubMed

    Dignan, M; Bahnson, J; Sharp, P; Beal, P; Smith, M; Michielutte, R

    1991-09-01

    The Forsyth County Cervical Cancer Prevention Project (FCP) is a community-based health education project funded by the National Cancer Institute. The target population includes around 25 000 black women age 18 and older who reside in Forsyth County, North Carolina. The overall goal of the program is to prevent mortality from cervical cancer by promoting Pap smears and return for follow-up care when needed. Based on the principles of social marketing, a plan to reach the target population with mass media educational messages through electronic and print channels was developed. Guided by marketing objectives, the target population was divided into relatively discrete segments. The segments included church attenders, patients in waiting rooms of public and selected health providers, female students at local colleges, shoppers, viewers of radio and television, newspaper readers, and business owners and managers. Introduction of the program was based on strategies developed for reaching the target population in each segment with television, radio and print mass media messages. Qualitative assessment of the mass media developed by the program indicated that all forms of communication helped to increase awareness of the program.

  15. Compressibility of thyroid masses: a sonographic sign differentiating benign from malignant lesions?

    PubMed

    Seo, Young Lan; Yoon, Dae Young; Yoon, Soo Jeong; Lim, Kyoung Ja; Yun, Eun Joo; Choi, Chul Soon; Bae, Sang Hoon

    2012-02-01

    The purpose of this study was to assess the manual compressibility of thyroid masses with an ultrasound probe and to determine whether this ultrasound feature can be used to differentiate benign from malignant thyroid lesions. We prospectively compared images obtained during compression with an ultrasound probe and noncompressed ultrasound images of 180 pathologically proven thyroid masses (51 malignant, 129 benign) smaller than 2 cm in 169 patients (127 women, 42 men; mean age, 51.2 years). The size (anteroposterior and transverse dimensions) and shape (ratio of anteroposterior to transverse dimension) of the selected lesions were measured on both noncompressed and compressed ultrasound images at a computer workstation, and the compressibility (anteroposterior-to-transverse ratio on noncompressed images minus anteroposterior-to-transverse ratio on compressed images) was calculated. Compressibility was analyzed to determine its association with histopathologic results (benign versus malignant) and the characteristics of the thyroid mass (involved lobe, location in lobe, halo, and composition). The area under the receiver operating characteristic curve was used as an indicator of performance. The mean anteroposterior-to-transverse ratio of a thyroid mass on compressed ultrasound images was significantly lower than that on noncompressed images (0.78 ± 0.28 vs 0.92 ± 0.30; p < 0.001). The compressibility of masses was greater for benign than for malignant lesions (0.19 ± 0.16 vs 0.05 ± 0.12; p < 0.001). No statistically significant association was identified between compressibility and other characteristics of a lesion. The area under the receiver operating characteristic curve for compressibility of thyroid masses was 0.78. On the basis of a cutoff value for malignancy of compressibility less than 0.10, the sensitivity, specificity, and accuracy were 72.5%, 72.9%, and 72.8%. Compressibility with an ultrasound probe is a useful criterion for differentiating benign

  16. AN UPWARD TREND IN DNA P16INK4A METHYLATION PATTERN AND HIGH RISK HPV INFECTION ACCORDING TO THE SEVERITY OF THE CERVICAL LESION

    PubMed Central

    Carestiato, Fernanda Nahoum; Afonso, Larissa Alves; Moysés, Natalia; Almeida, Gutemberg Leão; Velarde, Luis Guillermo Coca; Cavalcanti, Silvia Maria Baeta

    2013-01-01

    SUMMARY High-risk human papillomavirus (hr-HPV) infection is necessary but not sufficient for cervical cancer development. Recently, P16INK4A gene silencing through hypermethylation has been proposed as an important cofactor in cervical carcinogenesis due to its tumor suppressor function. We aimed to investigate P16INK4A methylation status in normal and neoplastic epithelia and evaluate an association with HPV infection and genotype. This cross-sectional study was performed with 141 cervical samples from patients attending Hospital Moncorvo Filho, Rio de Janeiro. HPV detection and genotyping were performed through PCR and P16INK4A methylation by nested-methylation specific PCR (MSP). HPV frequency was 62.4% (88/141). The most common HPV were HPV16 (37%), HPV18 (16.3%) and HPV33/45(15.2%). An upward trend was observed concerning P16INK4A methylation and lesion degree: normal epithelia (10.7%), low grade lesions (22.9%), high grade (57.1%) and carcinoma (93.1%) (p < 0.0001). A multivariate analysis was performed to evaluate an association between methylation, age, tobacco exposure, HPV infection and genotyping. A correlation was found concerning methylation with HPV infection (p < 0.0001), hr-HPV (p = 0.01), HSIL (p < 0.0007) and malignant lesions (p < 0.0001). Since viral infection and epigenetic alterations are related to cervical carcinoma, we suggest that P16INK4A methylation profile maybe thoroughly investigated as a biomarker to identify patients at risk of cancer. PMID:24037287

  17. Histopathologic extent of cervical intraepithelial neoplasia 3 lesions in the atypical squamous cells of undetermined significance low-grade squamous intraepithelial lesion triage study: implications for subject safety and lead-time bias.

    PubMed

    Sherman, Mark E; Wang, Sophia S; Tarone, Robert; Rich, Laurie; Schiffman, Mark

    2003-04-01

    Cervical intraepithelial neoplasia 3 (CIN3) is the precursor of mostsquamous carcinomas and serves as a surrogate end point. However, small CIN3 lesions are rarely associated with concurrent invasion. We hypothesized that aggressive follow-up for cytology of atypical squamous cells of undetermined significance (ASCUS) or low-grade squamous intraepithelial lesion (LSIL) leads predominantly to detection of smaller CIN3 lesions than those usually associated with cancer. We assessed this hypothesis in a masked histopathologic review of 330 CIN3 lesions in the ASCUS LSILTriage Study, focusing on ASCUS referrals. ASCUS referrals underwent randomized management [colposcopy for repeat cytology of high-grade squamous intraepithelial lesion (HSIL), colposcopy for oncogenic human papillomavirus (HPV) detection or repeat HSIL, or immediate colposcopy]; then all were followed with repeat cytology for 2 years, followed by colposcopy and aggressive treatment. We assessed all CIN3 lesions qualitatively and measured 39 of them. CIN3 lesions were overwhelmingly small. Compared with enrollment, lesions found at follow-up or exit involved fewer tissue fragments (P < 0.01) and showed less diffuse gland involvement (P = 0.03). CIN3 lesions found postenrollment after HPV testing involved the fewest tissue fragments [versus immediate colposcopy (P = 0.04) or repeat cytology of HSIL (P = 0.02)], and none showed diffuse gland involvement. The median distal-proximal length was 6.5 mm (median replacement of total epithelium = 5%) in the 39 measured cases. We conclude that CIN3 lesions underlying ASCUS or LSIL generally lack features associated with invasion, particularly if managed using HPV testing, suggesting that aggressive management leads to early detection of CIN3 but probably prevents relatively few cancers in screened populations.

  18. Expression of E6, p53 and p21 proteins and physical state of HPV16 in cervical cytologies with and without low grade lesions

    PubMed Central

    Tagle, Diana K Jiménez; Sotelo, Daniel Hernández; Illades-Aguiar, Berenice; Leyva-Vazquez, Marco A; Alfaro, Eugenia Flores; Coronel, Yaneth Castro; Hernández, Oscar del Moral; Romero, Luz del Carmen Alarcón

    2014-01-01

    The aim of this study was to determine the correlation between expression of HPV16 E6, p53 and p21 proteins and the physical state of HPV16 in cervical cytologies without squamous intraepithelial lesions (Non-SIL) and with low grade squamous intraepithelial lesions (LSIL), both with HPV16 infection. 101 liquid-based cytological samples were analyzed. 50 samples were without squamous intraepithelial lesions (Non-IL) and 51 samples of low grade squamous intraepithelial lesions (LSIL), both with HPV16 infection. HPV16 infection was determined by PCR-RFLP, and the physical state of HPV16 by in situ hybridization with tyramide-amplification. The expression of E6, p53 and p21 proteins was evaluated by immunocytochemistry. The expression of HPV16 E6 protein was significantly higher in LSIL that in Non-SIL samples (p=0.006). We found a significant correlation between E6 expression and the physical state of HPV16 in Non-SIL (p=0.049). Our results suggest that high expression of E6 in LSIL is an early event of cervical carcinogenesis and perhaps can be used as an early marker. PMID:24482706

  19. Stress analysis of occlusal forces in canine teeth and their role in the development of non-carious cervical lesions: abfraction.

    PubMed

    Romeed, Shihab A; Malik, Raheel; Dunne, Stephen M

    2012-01-01

    Non-carious cervical tooth lesions for many decades were attributed to the effects of abrasion and erosion mainly through toothbrush trauma, abrasive toothpaste, and erosive acids. However, though the above may be involved, more recently a biomechanical theory for the formation of these lesions has arisen, and the term abfraction was coined. The aim of this study was to investigate the biomechanics of abfraction lesions in upper canine teeth under axial and lateral loading conditions using a three-dimensional finite element analysis. An extracted human upper canine tooth was scanned by μCT machine (Skyscan, Belgium). These μCT scans were segmented, reconstructed, and meshed using ScanIP (Simpleware, Exeter, UK) to create a three-dimensional finite element model. A 100 N load was applied axially at the incisal edge and laterally at 45° midpalatally to the long axis of the canine tooth. Separately, 200 N axial and non-axial loads were applied simultaneously to the tooth. It was found that stresses were concentrated at the CEJ in all scenarios. Lateral loading produced maximum stresses greater than axial loading, and pulp tissues, however, experienced minimum levels of stresses. This study has contributed towards the understanding of the aetiology of non-carious cervical lesions which is a key in their clinical management.

  20. Expression of E6, p53 and p21 proteins and physical state of HPV16 in cervical cytologies with and without low grade lesions.

    PubMed

    Tagle, Diana K Jiménez; Sotelo, Daniel Hernández; Illades-Aguiar, Berenice; Leyva-Vazquez, Marco A; Alfaro, Eugenia Flores; Coronel, Yaneth Castro; Hernández, Oscar Del Moral; Romero, Luz Del Carmen Alarcón

    2014-01-01

    The aim of this study was to determine the correlation between expression of HPV16 E6, p53 and p21 proteins and the physical state of HPV16 in cervical cytologies without squamous intraepithelial lesions (Non-SIL) and with low grade squamous intraepithelial lesions (LSIL), both with HPV16 infection. 101 liquid-based cytological samples were analyzed. 50 samples were without squamous intraepithelial lesions (Non-IL) and 51 samples of low grade squamous intraepithelial lesions (LSIL), both with HPV16 infection. HPV16 infection was determined by PCR-RFLP, and the physical state of HPV16 by in situ hybridization with tyramide-amplification. The expression of E6, p53 and p21 proteins was evaluated by immunocytochemistry. The expression of HPV16 E6 protein was significantly higher in LSIL that in Non-SIL samples (p=0.006). We found a significant correlation between E6 expression and the physical state of HPV16 in Non-SIL (p=0.049). Our results suggest that high expression of E6 in LSIL is an early event of cervical carcinogenesis and perhaps can be used as an early marker.

  1. Up-regulation of lipocalin 2 is associated with high-risk human papillomavirus and grade of cervical lesion at baseline but does not predict outcomes of infections or incident cervical intraepithelial neoplasia.

    PubMed

    Syrjänen, Stina; Naud, Paulo; Sarian, Luis; Derchain, Sophie; Roteli-Martins, Cecilia; Tatti, Silvio; Branca, Margerita; Erzen, Mojca; Hammes, Luciano S; Costa, Silvano; Longatto-Filho, Adhemar; Syrjänen, Kari

    2010-07-01

    Our objective was to assess whether neutrophil gelatinase-associated lipocalin (NGAL)/lipocalin 2 (LCN2) expression in cervical human papillomavirus (HPV) lesions has implications on the outcome of HPV infections or disease progression. Cervical biopsy specimens from 225 women in the Latin American Screening study were analyzed for NGAL/LCN2 expression using immunohistochemical analysis, to assess associations with cervical intraepithelial neoplasia (CIN) grade, high-risk HPV, and in predicting outcomes of high-risk (HR)-HPV infections. Expression of NGAL/LCN2 increased with lesion grade (odds ratio [OR], 3.86; 95% confidence interval [CI], 1.53-9.71; P = .001). Up-regulation was also related to HR-HPV detection (OR, 2.21; 95% CI, 1.15-4.24; P = .016) and showed a linear relationship to HR-HPV load (P = .002). NGAL/LCN2 expression was of no value in predicting the outcomes of HR-HPV infections or the surrogate end points (incident CIN 1+ and CIN 2+) of progressive disease. Because the SV40 large T antigen is a powerful up-regulator of this lipocalin, up-regulation of NGAL/LCN2 in CIN is probably induced by HR-HPV E6 oncoprotein, most likely by eliminating its normal transcription repression exerted by wild-type p53.

  2. Non-carious cervical lesions (NCCLs) in a random sampling community population and the association of NCCLs with occlusive wear.

    PubMed

    Yang, J; Cai, D; Wang, F; He, D; Ma, L; Jin, Y; Que, K

    2016-12-01

    This study investigated the prevalence, risk factors and association of occlusive wear with non-carious cervical lesions (NCCLs) in the general Chinese population. A total of 1320 subjects were recruited, and multistage and random sampling methods of survey spots were performed. All age groups comprised similar numbers of participants and equal numbers of males and females. Each subject completed a structured interview, and all teeth of each subject were examined by a practitioner to determine NCCLs and occlusive wear. Binary logistic regression was conducted by analysing the association of risk factors with the occurrence of NCCLs. Bivariate correlation analysis was performed by determining the association of NCCLs dimension or depth with the range of occlusive wear facets. Clinical assessment showed that the overall prevalence of subjects diagnosed with NCCLs was 63%. The proportion of subjects or teeth with NCCLs significantly increased with age. Pre-molars were the most commonly affected teeth. Single variables and interactive effects of variables associated with the occurrence of NCCLs include the following: age group, intensity of toothbrushing, frequency of fresh fruit consumption and interactive effect between intensity of toothbrushing and frequency of fresh fruit consumption. A weak positive correlation of the grading index was found between NCCLs dimension, size or depth and range of occlusive wear facets. This study reported the higher prevalence of NCCLs in the general Chinese population. Implementation of a combined strategy to reduce risk factors of NCCLs could be more effective than individual techniques; meanwhile, the occurrence of NCCL could be related to the wear degree of occlusive defects in the population studied. © 2016 John Wiley & Sons Ltd.

  3. Prevalence and risk factors of non-carious cervical lesions related to occupational exposure to acid mists.

    PubMed

    Bomfim, Rafael Aiello; Crosato, Edgard; Mazzilli, Luiz Eugênio Nigro; Frias, Antonio Carlos

    2015-01-01

    This study evaluates the prevalence and risk factors of non-carious cervical lesions (NCCLs) in a Brazilian population of workers exposed and non-exposed to acid mists and chemical products. One hundred workers (46 exposed and 54 non-exposed) were evaluated in a Centro de Referência em Saúde do Trabalhador - CEREST (Worker's Health Reference Center). The workers responded to questionnaires regarding their personal information and about alcohol consumption and tobacco use. A clinical examination was conducted to evaluate the presence of NCCLs, according to WHO parameters. Statistical analyses were performed by unconditional logistic regression and multiple linear regression, with the critical level of p < 0.05. NCCLs were significantly associated with age groups (18-34, 35-44, 45-68 years). The unconditional logistic regression showed that the presence of NCCLs was better explained by age group (OR = 4.04; CI 95% 1.77-9.22) and occupational exposure to acid mists and chemical products (OR = 3.84; CI 95% 1.10-13.49), whereas the linear multiple regression revealed that NCCLs were better explained by years of smoking (p = 0.01) and age group (p = 0.04). The prevalence of NCCLs in the study population was particularly high (76.84%), and the risk factors for NCCLs were age, exposure to acid mists and smoking habit. Controlling risk factors through preventive and educative measures, allied to the use of personal protective equipment to prevent the occupational exposure to acid mists, may contribute to minimizing the prevalence of NCCLs.

  4. Different patterns of p16 immunoreactivity in cervical biopsies: correlation to lesion grade and HPV detection, with a review of the literature.

    PubMed

    Kostopoulou, E; Samara, M; Kollia, P; Zacharouli, K; Mademtzis, I; Daponte, A; Messinis, I E; Koukoulis, G

    2011-01-01

    p16 is one extensively studied marker in gynecological pathology. However, its routine application in the diagnosis of squamous intraepithelial lesions of the uterine cervix may present difficulties for the general pathologist. The aim of the present study was to examine a series of 100 cervical biopsies/LEEP specimens, with detailed HPV-typing, for patterns of p16 immunoreactivity and possible correlations with morphology and HPV types. Four patterns of immunopositivity were recognized, according to the distribution of positively stained cells, and these correlated to lesion grade. A review of the pertinent literature concerning p16 immunoreactivity in squamous intraepithelial lesions and nonneoplastic epithelia of the uterine cervix is included in an effort to summarize the existing data and the remaining questions at both the practical and theoretical level.

  5. Immunohistochemical expression of p16(INK4a) is predictive of HR-HPV infection in cervical low-grade lesions.

    PubMed

    Benevolo, Maria; Mottolese, Marcella; Marandino, Ferdinando; Vocaturo, Giuseppe; Sindico, Roberto; Piperno, Giulia; Mariani, Luciano; Sperduti, Isabella; Canalini, Paola; Donnorso, Raffaele P; Vocaturo, Amina

    2006-03-01

    The p16(INK4a) is a cyclin-dependent kinase inhibitor that decelerates the cell cycle by inactivating the cyclin-dependent kinases involved in the phosphorylation of the retinoblastoma protein (RB). Expression of E6 and E7 oncogenes of high-risk (HR) human papillomavirus (HPV), affecting the RB-p16 pathway, leads to p16 upregulation. Although it is widely reported that p16 is overexpressed in a high percentage of preneoplastic lesions and in almost all carcinomas of the uterine cervix, protein upregulation and its correlation with HPV infection in low-grade lesions is still being debated. In this study, we investigated in parallel, p16 expression and HPV infection in 100 cervical biopsies (17 normal tissues, 54 CIN1, 10 CIN2, 11 CIN3, eight invasive squamous cancers). Results obtained demonstrated that none of the 17 normal cervical tissues, evaluated by immunohistochemistry, presented p16 positivity whereas, starting from CIN1 (31%) to CIN2 (90%), CIN3 (100%) and carcinomas (100%), a constant and significant increase of protein overexpression (P<0.0001) was observed. In addition, p16 overexpression consistently showed elevated sensitivity (84%) and specificity (98%) in detecting HR-HPV infection with a high positive predictive value (97%) and negative predictive value (86%). Of interest, 93% of the p16-positive CIN1 were also HR-HPV infected. Our findings confirmed that p16 overexpression is associated to high-grade precancerous lesions and cervical carcinomas, and further demonstrated that immunohistochemical evaluation of p16 may be a useful biomarker in identifying HR-HPV-infected low-grade lesions.

  6. High-Grade Cervical Intraepithelial Neoplasia Detected by Colposcopy-Directed or Random Biopsy Relative to Age, Cytology, Human Papillomavirus 16, and Lesion Size.

    PubMed

    Chen, Qing; Du, Hui; Pretorius, Robert G; Wang, Chun; Yang, Bin; Wang, Guixiang; Tang, Jinlong; Belinson, Jerome L; Wu, Ruifang

    2016-07-01

    The aim of the study was to determine whether p16 positive/cervical intraepithelial neoplasia (CIN) 2, 3, and cancer (p16 + CIN 2/3+) detected by colposcopy-directed or random biopsy differ by age, referral cytology, human papillomavirus (HPV) 16, and lesion size. Data from the Shenzhen Cervical Cancer Screening Trial II where, at colposcopy, women who had directed and random cervical biopsies were reviewed to find women with CIN 2, 3, or cancer; 227 such women identified had their paraffin-embedded tissue blocks recut, reviewed, and then immune stained for p16. Data were analyzed by χ, Fisher exact test, and linear regression. After histopathologic review and p16 staining of CIN 2, 175 women were diagnosed with p16 + CIN 2/3+. When compared with those diagnosed by colposcopy-directed biopsy (n = 138), those diagnosed by random biopsy (n = 37) were more likely to have Cytology-Lo (cytology of negative, atypical squamous cells of undetermined significance, or low-grade squamous intraepithelial lesion; p = .07), less likely to have HPV 16 (p = .041), more likely to be 51 years or older (p = .022), and more likely to have 1 quadrant lesions (p < .001). Logistic regression analysis showed p16 + CIN 2/3+ diagnosed by random biopsy was predicted by 1 quadrant lesions (p < .0001) and age of 51 years or older (p = .03) but not by Cytology-Lo (p = .71) nor HPV 16 (p = .26). Women with p16 + CIN 2/3+ diagnosed by random biopsy are older and less likely to have HPV 16; hence, CIN diagnosed by random biopsy may not be as virulent as CIN diagnosed by colposcopy-directed biopsy. Regardless, we advise that CIN diagnosed by random biopsy be viewed like CIN diagnosed by colposcopy-directed biopsy.

  7. Oral infection by the Human Papilloma Virus in women with cervical lesions at a prison in São Paulo, Brazil.

    PubMed

    Zonta, Marco Antonio; Monteiro, Jussimara; Santos Jr, Gildo; Pignatari, Antonio Carlos Campos

    2012-04-01

    Carcinoma of the head and neck is the 6th cause of death by cancer in the world. In recent decades the human papillomavirus (HPV) has been implicated in the etiology of this disease. To characterize the types of HPV detected in the oral mucosa in women with cytological abnormalities suggesting intraepithelial squamous lesions in the uterine cervix. Four-hundred-nine cervical-vaginal and oral pap-smears of women interned in a Female Prison in São Paulo were examined. The relationship between cervical and oral lesion was analyzed by PCR/RFLP and DNA sequencing. Of 27 (6.67%) specimens showing cervical cytological abnormalities suggesting LSIL and HSIL, 22 (81.48%) had oncogenic high-risk HPV infection, of which HPV 59 was the most prevalent. Three (11.1%) samples showed cytological changes suggesting mild dysplasia in the oral cavity. Our study suggests an association between carcinoma of the oral cavity and HPV infection, regardless of the virus type.

  8. Cervical Injury Risk Resulting From Rotary Wing Impact: Assessment of Injury Based Upon Aviator Size, Helmet Mass Properties and Impact Severity

    DTIC Science & Technology

    2004-10-21

    NAWCADPAX/TR-2004/86 CERVICAL INJURY RISK RESULTING FROM ROTARY WING IMPACT: ASSESSMENT OF INJURY BASED UPON AVIATOR SIZE, HELMET MASS...DEPARTMENT OF THE NAVY NAVAL AIR WARFARE CENTER AIRCRAFT DIVISION PATUXENT RIVER, MARYLAND NAWCADPAX/TR-2004/86 21 October 2004 CERVICAL ... Cervical Injury Risk Resulting From Rotary Wing Impact: Assessment of Injury Based Upon Aviator Size, Helmet Mass Properties and Impact Severity 5b

  9. Seizure syndrome as a first manifestation of solitary tumor-like mass lesion of PACNS

    PubMed Central

    Zhu, De-Sheng; Yang, Xiao-Li; Lv, Hui-Hui; Bai, Chen-Guang; Yang, Pang-Pan; Li, Ze-Zhi; Hao, Yong; Zhang, Ying; Guan, Yang-Tai

    2017-01-01

    Abstract Rationale: Primary angiitis of the central nervous system (PACNS) is an inflammatory disease involving cerebrovascular and parenchymal, and solitary tumor-like mass lesion of PACNS (TLML-PACNS) is frequently misdiagnosed as neoplastic or other inflammatory diseases. However, seizure syndrome as a first manifestation of TLML-PACNS has rarely reported before. Patient concerns: Here, we report 2 cases of seizure syndrome, which was the first sign that presented prior to the diagnosis of TLML-PACNS by brain biopsy. Diagnoses: A mass lesion in the white and gray matters was detected by magnetic resonance imaging. The pathology for leptomeningeal lesion biopsy observed a transmural inflammation of the artery, with T lymphocyte infiltration. Patients were diagnosed with PACNS and epileptic seizure by biopsy and electroencephalogram. Interventions: Patients were treated with glucocorticoid pulse therapy for 3 days, and subsequently oral prednisone was continued, in combination with immunosuppressant. Outcomes: Luckily, both two patients were improved after treatment, and only mild cognitive impairment remained without adverse event. Lessons: Patient with mass lesion in CNS, which is similar to tumor, presented with seizure, headache, or cerebrovascular events without any other risk factors for stroke or tumor, should be considered the feasible with the disease of TLML-PACNS. PMID:28248859

  10. Small lesion size measured by colposcopy may predict absence of cervical intraepithelial neoplasia in a large loop excision of the transformation zone specimen.

    PubMed

    Munmany, M; Marimon, L; Cardona, M; Nonell, R; Juiz, M; Astudillo, R; Ordi, J; Torné, A; Del Pino, M

    2017-02-01

    To evaluate whether colposcopic measurement of the lesion size at diagnosis and/or human papillomavirus (HPV) genotyping can predict the absence of dysplasia in a large loop excision of the transformation zone (LLETZ) specimen in women treated for squamous intraepithelial lesions/cervical intraepithelial neoplasia (SIL/CIN). Prospective observational study. Tertiary university hospital. A cohort of 116 women who underwent LLETZ because of biopsy-proven low-grade SIL/CIN that had persisted for 2 years, or because of a high-grade SIL/CIN diagnosed in the referral visit and squamocolumnar junction completely visible (types 1 or 2, according to the International Federation of Cervical Pathology and Colposcopy, IFCPC). After LLETZ the women were classified by histology into the study group (absence of SIL/CIN in the surgical specimen, 28/116, 24.1%) and the control group (SIL/CIN in the LLETZ specimen, 88/116, 75.9%). The size of the lesion determined in the diagnostic colposcopy and the HPV genotype were evaluated in all women. The lesion size was significantly smaller in the study group (25.7 ± 37.8 versus 84.5 ± 81.7 mm(2) ; P < 0.001). A lesion size of ≤12 mm(2) and HPV types other than 16 or 18 were associated with an absence of SIL/CIN in the LLETZ specimen (P < 0.001 and P = 0.016, respectively). On multivariate analysis only a lesion size of ≤12 mm(2) predicted the absence of SIL/CIN (odds ratio, OR 10.6; 95% confidence interval, 95% CI 3.6-30.6; P < 0.001). A lesion size of ≤12 mm(2) had a specificity of 90.9% (95% CI 83.0-95.3%) and a negative predictive value of 86.0% (95% CI 77.5-91.6%) to predict the absence of SIL/CIN in the surgical specimen. Small lesion size in diagnostic colposcopy could predict the absence of SIL/CIN in the LLETZ specimen. Colposcopy measurement of lesion size prior to LLETZ may avoid unnecessary treatment. Small lesion size in colposcopic evaluation might predict the absence of SIL/CIN in an LLETZ specimen. © 2016 Royal

  11. p16(INK4a) as a complementary marker of high-grade intraepithelial lesions of the uterine cervix. I: Experience with squamous lesions in 189 consecutive cervical biopsies.

    PubMed

    Dray, Michael; Russell, Peter; Dalrymple, Chris; Wallman, Neil; Angus, George; Leong, Adelyn; Carter, Jonathan; Cheerala, Bharathi

    2005-04-01

    To test the usefulness of p16(INK4a) immunostaining for improving the diagnostic accuracy of cervical punch biopsies referred to a routine laboratory setting during the investigation of women with abnormal Papanicolaou smears. A total of 188 consecutive and unselected colposcopically directed cervical biopsies and a single contemporaneous cervical polyp were accessioned prospectively over a 3-month period, step-serially sectioned and examined by H&E and immunostained for p16(INK4a). The clinical context, results of concurrent Papanicolaou smears/ThinPrep slides and Digene hybrid capture tests for high-risk human papillomavirus (HPV) subtypes, as well as follow-up cervical smears/ThinPrep, biopsies and loop excisions of transformation zones or cone biopsies were all correlated with the morphological and immunohistochemical findings. Seventy-seven biopsies (40.7%) displayed a high-grade squamous intraepithelial lesion (HGSIL; cervical intraepithelial neoplasia [CIN] 2-3), 27 (14.3%) showed a low grade squamous intraepithelial lesion (HPV +/- CIN1) and 85 (45%) showed a range of non-dysplastic (inflammatory or reactive) changes. Diffuse strong parabasal immunostaining for p16(INK4a), suggestive of integrated high-risk HPV DNA into the host genome, was observed in 81 biopsies (42.9%, including the cervical polyp) and correlated (>90%) with HGSIL in the H&E sections. Only one case revealed irreconcilable discordance between the histological features and this strong parabasal immunostaining pattern. Focal and weaker midzonal or superficial p16(INK4a) immunostaining, suggestive of episomal HPV infection, was noted in 19 biopsies (10%) and these biopsies exhibited a range of histological changes but predominantly low grade squamous intraepithelial lesion (LGSIL). No staining of the squamous epithelium was seen in 89 biopsies (47.1%). Again, only one case revealed irreconcilable discordance between the histological features and this negative immunostaining pattern. On

  12. Lateral mass screw stimulation thresholds in posterior cervical instrumentation surgery: a predictor of medial deviation.

    PubMed

    Wilson, Bayard; Curtis, Erik; Hirshman, Brian; Oygar, Ahmet; Chen, Karen; Gabel, Brandon C; Vaida, Florin; Allison, David W; Ciacci, Joseph D

    2017-03-01

    OBJECTIVE Normative data exists for stimulus-evoked pedicle screw electromyography (EMG) current thresholds in the lumbar spine, and is routinely referenced during spine surgeries to detect a screw breach, prevent injury of neural elements, and ensure the most biomechanically sound instrumentation construct. To date, similar normative data for cervical lateral mass screws is limited, thus the utility of lateral mass screw testing remains unclear. To address this disparity, in this study the authors describe cumulative lateral mass screw stimulation threshold data in patients undergoing posterior cervical instrumentation with lateral mass screws. These data are correlated with screw placement on postoperative imaging, and a novel correlation is discovered with direct clinical implications. METHODS Using a ball-tip probe, 154 lateral mass screws in 21 patients were electrically tested intraoperatively. In each case, for each screw, the lowest (or threshold) current at which the first polyphasic stimulus-evoked EMG response was reproducibly observed by a neurophysiologist was recorded. All patients underwent postoperative CT. Screw position within the lateral mass was first measured in the axial and sagittal planes for each lateral mass screw using the CT images. Screw placement was also evaluated by 2 independent physicians, blinded to current threshold data, on a binary scale of acceptability. The predictive capacity of screw EMG threshold data was evaluated via multivariable regression analyses and receiver operating characteristic (ROC) analyses. Predictive capacity was examined with respect to screw position within the lateral mass, as well as screw acceptability. RESULTS Lateral mass screw EMG thresholds did not appear to differ significantly for screws considered "acceptable" versus "unacceptable" according to the radiographic criteria. Accordingly, ROC analysis confirmed that EMG current threshold data were of minimal utility in predicting screw radiographic

  13. Increased Ki-67 proliferative index and absence of P16INK4 in CIN-HPV related pathogenic pathways different from cervical squamous intraepithelial lesion.

    PubMed

    Kuo, K-T; Chang, H-C; Hsiao, C-H; Lin, M-C

    2006-07-01

    It is generally assumed that similar pathways are involved in human papillomavirus (HPV) induced pathogenesis of cervical squamous intraepithelial lesions (SILs) and cancers and a subset of conjunctival intraepithelial neoplasm (CIN)-that the malignancies or pre-cancerous lesions arise through HPV oncoproteins E6 and E7, which disrupt the pathways of p53 and the product of the retinoblastoma (Rb) gene and, in turn, increase the protein product of gene p16INK4 through the mechanism of positive feedback. Several cell cycle molecules are detected to test this hypothesis. Nine cases of CIN and eight non-CIN cases were analysed for the expression of Ki-67, pRb, p53, and p16INK4 via immunohistochemistry. Nine cases of cervical high grade squamous intraepithelial lesion (HSIL), and 10 cases of cervical low grade squamous intraepithelial lesion (LSIL) were included for stain control of p16INK4a, and comparison of p16INK4a expression to CIN cases. A nested polymerase chain reaction and a genechip HPV typing were used to detect HPV infection and types in the CIN and non-CIN samples HPV positivity was demonstrated in all of the CIN lesions but in none of the non-CIN lesions. The Ki-67 proliferative index (Ki-67 PI) was statistically higher in the CIN group than the non-CIN group; however, there were no differences of expression of pRb and p53 between the two groups and no expression of p16INK4 in all cases. All nine cases of HSIL, and seven out of 10 cases of LSIL used for stain control were immunoreactive for p16INK4a. There were statistically significant differences in overexpression of p16INK4a between the CINs and SILs The Ki-67 proliferative index may be a sensitive marker for CIN lesions and these results, with significant differences in overexpression of p16INK4a between CINs and SILs, may provide new evidence that HPV related mucosal dysplasia in different anatomical locations may lead to dissimilar molecular pathways.

  14. Papanicolaou test in the detection of high-grade cervical lesions: a re-evaluation based on cytohistologic non-correlation rates in 356 concurrently obtained samples.

    PubMed

    Carns, Bhavini; Fadare, Oluwole

    2008-01-01

    Studies evaluating the routine Papanicolaou (Pap) test have traditionally used as the reference gold standard, the diagnoses on the follow-up histologic samples. Since the latter are typically obtained days to weeks after the Pap test, the accuracy of the resultant comparison may be affected by interim factors, such as regression of human papillomavirus, new lesion acquisitions or colposcopy-associated variability. A subset of our clinicians have routinely obtained cervical cytology samples immediately prior to their colposcopic procedures, which presented a unique opportunity to re-evaluate the test performance of liquid-based cervical cytology in detecting the most clinically significant lesions (i.e. cervical intraepithelial neoplasia 2 or worse: CIN2+), using as gold standard, diagnoses on cervical biopsies that were essentially obtained simultaneously. For each patient, cytohistologic non-correlation between the Pap test and biopsy was considered to be present when either modality displayed a high-grade squamous intraepithelial lesion (HGSIL)/CIN2+ while the other displayed a less severe lesion. Therefore, HGSIL/CIN2+ was present in both the Pap test and biopsy in true positives, and absent in both modalities in true negatives. In false positives, the Pap test showed HGSIL while the biopsy showed less than a CIN2+. In false negatives, Pap tests displaying less than a HGSIL were associated with biopsies displaying CIN2+. Combinations associated with "atypical" interpretations were excluded. A cytohistologic non-correlation was present in 17 (4.8%) of the 356 combinations reviewed. The non-correlation was attributed, by virtue of having the less severe interpretation, to the Pap test in all 17 cases. There were 17, 322, 0, and 17 true positives, true negatives, false positives and false negatives respectively. The sensitivity, specificity, positive predictive value and negative predictive value of the Pap test, at a diagnostic threshold of HGSIL, in identifying

  15. Magnetic resonance imaging of Whipple's disease confined to the CNS presenting with multiple intracerebral mass lesions.

    PubMed

    Poureisa, Masoud; Daghighi, Mohammad Hossein; Esmaili, Haidar; Mazaheri-Khameneh, Ramin

    2015-01-01

    We report a patient diagnosed with Whipple's disease (WD) who presented only with neurological symptoms. Neuroimaging (MRI) showed lesions with marked mass effect similar to infiltrative tumors, which were hypersignal on long TR and hyposignal on short TR images, located in several areas of the brain. In serial controls, lesions resolved with gliosis and atrophic changes as well as migration of active infiltrative-like lesions to new areas. MR findings of the brain WD are discussed, which confirmed by stereotactic brain biopsy. Familiarity with the range of possible MR imaging appearances of WD enables the radiologist to place WD more effectively on the differential diagnosis which motivates the clinician to consider both the diagnosis and early initiation of treatment; so, this may significantly impact outcome. Moreover, repeated MR investigations may serve as a valuable method to evaluate efficacy of treatment and long term follow-up of WD involving the CNS.

  16. A method for mass candidate detection and an application to liver lesion detection

    NASA Astrophysics Data System (ADS)

    Costa, Maria J.; Tsymbal, Alexey; Nguatem, William; Suehling, Michael; Zhou, S. Kevin; Comaniciu, Dorin

    2011-03-01

    Detection and segmentation of abnormal masses within organs in Computed Tomography (CT) images of patients is of practical importance in computer-aided diagnosis (CAD), treatment planning, and analysis of normal as well as pathological regions. For intervention planning e.g. in radiotherapy the detection of abnormal masses is essential for patient diagnosis, personalized treatment choice and follow-up. The unpredictable nature of disease often makes the detection of the presence, appearance, shape, size and number of abnormal masses a challenging task, which is particularly tedious when performed by hand. Moreover, in cases in which the imaging protocol specifies the administration of a contrast agent, the contrast agent phases at which the patient images are acquired have a dramatic influence on the shape and appearance of the diseased masses. In this paper we propose a method to automatically detect candidate lesions (CLs) in 3D CTs of liver lesions. We introduce a novel multilevel candidate generation method that proves clearly advantageous in a comparative study with a state of the art approach. A learning-based selection module and a candidate fusion module are then introduced to reduce both redundancy and the false positive rate. The proposed workflow is applied to the detection of both hyperdense and hypodense hepatic lesions in all contrast agent phases, with resulting sensitivities of 89.7% and 92% and positive predictive values of 82.6% and 87.6% respectively.

  17. Frequency and type-distribution of human papillomavirus from paraffin-embedded blocks of high grade cervical intraepithelial neoplasia lesions in Thailand.

    PubMed

    Swangvaree, Sukumarn Sanersak; Kongkaew, Phon; Ngamkham, Jarunya

    2013-01-01

    Cervical cancer is the most important female gynecological cancer, the second leading cause of cancer mortality in women worldwide and the second most common cancer in Thai women. The major cause of cervical cancer is persistent infection of human papillomavirus (HPV), leading to abnormal epithelial lesions, with progression to precancerous and invasive cancer. This study was conducted to investigate the frequency and type distribution of HPV in Thai women who had abnormal cytology. HPV detection from FFPE confirmed abnormal of high grade cervical intraepithelial lesions were for SPF-10-Innogenic Line Probe Assay. HPV-positivity was detected in 320/355 cases (90.14%) and HPV-negativity in 35/355 (9.86%). HPV-positive was found 147/320 cases (41.4%) of single infection, whereas 173/320 cases (48.7%) showed the multiple HPV infection. The most common seven types were HPV-16, -52, -18, -11, -51, -31 and -33, in that order. HPV 16 and 18, the important oncogenic HPV type, were observed in 64.8% of HSIL cases. Interestingly, a high proportion of multiple infections was found in this study and more than ten types could be detected in one case. Therefore, HPV infection screening program in women is essential, particularly in Thailand. Effective primary and secondary prevention campaigns that reinforce HPV screening for HPV detection and typing may be decrease the incidence and mortality of cervical cancer in the future and may lead to significantly improve the quality of life in Thai women.

  18. Analysis of Sensitivity, Specificity, and Positive and Negative Predictive Values of Smear and Colposcopy in Diagnosis of Premalignant and Malignant Cervical Lesions

    PubMed Central

    Barut, Mert Ulaş; Kale, Ahmet; Kuyumcuoğlu, Umur; Bozkurt, Murat; Ağaçayak, Elif; Özekinci, Server; Gul, Talip

    2015-01-01

    Background This study aimed to examine the positive and negative predictive value in the diagnosis of premalignant and malignant lesions of cervical colposcopy, the sensitivity and specificity of smear, and to evaluate the correlation with histopathology of abnormal cytology and colposcopy. Material/Methods The criteria for inclusion of patients with unhealthy cervix in the study were: Erosion, Chronic cervicitis, and Healed lacerations, Hypertrophied cervix, bleeding on touch, suspicious growth/ulcer/polyp on the cervix, and abnormal discharges from the cervix. Women with frank carcinoma cervix, pregnant females, patients with bleeding per vaginum at the time of examination, and those who had used vaginal medications, vaginal contraceptives or douches in the last 48 h of examination were excluded from the study. Demographic analysis was performed for 450 patients who were admitted to the clinic. Sensitivity, specificity, positive predictive value and negative predictive values of patients to identify cervical pathologies of smear and colposcopy were histopathologically calculated. The statistical software package SPSS 15.0 (SPSS Inc., Chicago, IL, USA) and Spearman‘s and Chi-Square tests were used for statistical analysis. Results Sensitivity, specificity, PPD and NDP of smear were 0.57%, 0.76%, 0.26%, 0.92% respectively. Sensitivity, specificity, PPD and NDP of colposcopy were 0.92%, 0.67%, 0.52%, 0.96% respectively. A statistically significant correlation was found between abnormal cytology and histopathology, and abnormal colposcopy finding and histopathology. Conclusions Women with clinical diagnosis of unhealthy cervix should be evaluated by cytology to detect any premalignant or malignant lesions. It was concluded that Pap smear, colposcopy and histopathology should be collectively evaluated to evaluate cervical findings in low socio-economic regions. PMID:26655816

  19. Analysis of Sensitivity, Specificity, and Positive and Negative Predictive Values of Smear and Colposcopy in Diagnosis of Premalignant and Malignant Cervical Lesions.

    PubMed

    Barut, Mert Ulaş; Kale, Ahmet; Kuyumcuoğlu, Umur; Bozkurt, Murat; Ağaçayak, Elif; Özekinci, Server; Gül, Talip

    2015-12-10

    BACKGROUND This study aimed to examine the positive and negative predictive value in the diagnosis of premalignant and malignant lesions of cervical colposcopy, the sensitivity and specificity of smear, and to evaluate the correlation with histopathology of abnormal cytology and colposcopy. MATERIAL AND METHODS The criteria for inclusion of patients with unhealthy cervix in the study were: Erosion, Chronic cervicitis, and Healed lacerations, Hypertrophied cervix, bleeding on touch, suspicious growth/ulcer/polyp on the cervix, and abnormal discharges from the cervix. Women with frank carcinoma cervix, pregnant females, patients with bleeding per vaginum at the time of examination, and those who had used vaginal medications, vaginal contraceptives or douches in the last 48 h of examination were excluded from the study. Demographic analysis was performed for 450 patients who were admitted to the clinic. Sensitivity, specificity, positive predictive value and negative predictive values of patients to identify cervical pathologies of smear and colposcopy were histopathologically calculated. The statistical software package SPSS 15.0 (SPSS Inc., Chicago, IL, USA) and Spearman's and Chi-Square tests were used for statistical analysis. RESULTS Sensitivity, specificity, PPD and NDP of smear were 0.57%, 0.76%, 0.26%, 0.92% respectively. Sensitivity, specificity, PPD and NDP of colposcopy were 0.92%, 0.67%, 0.52%, 0.96% respectively. A statistically significant correlation was found between abnormal cytology and histopathology, and abnormal colposcopy finding and histopathology. CONCLUSIONS Women with clinical diagnosis of unhealthy cervix should be evaluated by cytology to detect any premalignant or malignant lesions. It was concluded that Pap smear, colposcopy and histopathology should be collectively evaluated to evaluate cervical findings in low socio-economic regions.

  20. Simultaneous detection of human papillomavirus integration and c-MYC gene amplification in cervical lesions: an emerging marker for the risk to progression.

    PubMed

    Gimenes, Fabrícia; Souza, Raquel Pantarotto; de Abreu, André Luelsdorf Pimenta; Pereira, Monalisa Wolski; Consolaro, Marcia Edilaine Lopes; da Silva, Vânia Ramos Sela

    2016-04-01

    The persistence of high-risk oncogenic human papillomavirus (HR-HPV) infection and its integration into the host genome are key steps in the induction of malignant alterations. c-MYC chromosome region is a frequent localization for HPV insertion that has been observed in chromosome band 8q24 by fluorescence in situ hybridization (FISH). We report the HPV viral integration and amplification patterns of the c-MYC gene in cytological smears with FISH as a potential biomarker for the progression of squamous intraepithelial lesions (SIL). HPV detection and genotyping by polymerase chain reaction (PCR) and FISH analysis by "Vysis Cervical FISH Probe" kit (ABBOTT Molecular Inc.) were performed in 37 cervical samples including 8 NILM, 7 ASC-US, 7 LSIL, 3 ASC-H, 7 HSIL and 5 SCC. The results show concordance between FISH and PCR techniques for HPV detection. The majority of the samples contained HR-HPV, the majority being -16 and -18 genotypes. HPV integration as determined by FISH was most frequent in high-risk lesions. The c-MYC gene amplification was found only in HPV-positive samples and was detected primarily in high-risk lesions and in cells with an integrated form of HPV. HPV integration and c-MYC gene amplification detected by FISH could be an important biomarker for use in clinical practice to determine SIL with a risk of progression.

  1. Antenatal hemorrhage of a cervical lymphatic malformation presenting as a draining neck mass: An unusual presentation.

    PubMed

    Haricharan, R N; Nawaz, M; Bettolli, M; Ferretti, E

    2014-01-01

    Lymphatic malformations in the neck can present as large fetal neck masses causing airway obstructions with potential perinatal demise and can pose a therapeutic challenge. We present a rare case of prenatally diagnosed large fetal neck mass with features of lymphatic malformation with intralesional hemorrhage of uncertain origin. Postnatal evaluation showed a complex cystic-solid lesion eroding through the skin with an open wound that made it clinically hard to differentiate from a teratoma. Given that malignancy could not be completely ruled out, surgery was favored. Final pathology showed a complex lymphatic malformation with intralesional hemorrhage, despite having no associated capillary, venous or arterial malformations.

  2. Evaluation of the p16 and Ki-67 Biomarkers as Predictors of the Recurrence of Premalignant Cervical Cancer Lesions after LEEP Conization.

    PubMed

    Leite, Paulo Macêdo de Oliveira; Tafuri, Luciene; Costa, Maria Zélia de Oliveira; Lima, Maria Inês de Miranda; Simões, Renata Toscano

    2017-06-01

    Objective To evaluate the expressions of biomarkers p16 and Ki-67 in low-grade (LG) or high-grade (HG) lesions, and to relate them to risk factors and the recurrence of these lesions. Methods A retrospective case-control study of 86 patients with LG and HG lesions who underwent a loop electrosurgical excision procedure (LEEP) between 1999 and 2004. The control group was composed of 69 women with no recurrence, and the study group, of 17 patients with recurrence. All patients were followed-up over a two-year period after surgery, and screened every six months, including cytology and colposcopy. Biopsy samples collected from LEEP were submitted to immunohistochemical analysis for p16 and Ki-67. The statistical analysis was performed using the Statistical Package for the Social Sciences software (SPSS, IBM-SPSS, Inc., Chicago, IL, US), with a significant p ​​< 0.05. Results The biomarkers p16 and Ki-67, separately or combined, showed no relation to recurrence on the total analysis. However, evaluating specifically HG lesions, the positive expression (2+ and 3+) of p16/Ki-67 was associated with recurrence (0.010). In addition, p16 isolated was also more expressive in HG lesions (2+ and 3 + , p = 0.018), but it was unrelated to recurrence. Conclusion Proteins p16 and Ki-67, both isolated and combined, are not reliable primary markers for the recurrence of cervical lesions in the majority of LG lesions. However, analyzing only the group with prior diagnosis of HG lesions, the expressions of p16 and of p16/Ki-67 were associated with recurrence, and they may be useful in monitoring these cases. Thieme-Revinter Publicações Ltda Rio de Janeiro, Brazil.

  3. Association of Different MRI BIRADS Descriptors With Malignancy in Non Mass-Like Breast Lesions

    PubMed Central

    Gity, Masoumeh; Ghazi Moghadam, Koosha; Jalali, Amir Hossein; Shakiba, Madjid

    2014-01-01

    Background: Several studies on the diagnostic efficacy of MRI has not real consensus for the accuracy of MRI characteristics in non mass like breast lesions, and the number of malignant lesions in different studies is insufficient. Objectives: In this study we aimed to analyze the diagnostic role of MRI BIRADS features for diagnosis of malignancy in non mass like breast lesions. Patients and Methods: All patients with positive findings (BIRADS 3, 4, 5), which had either biopsy proved pathology or follow-up MRI data at least for 12 months were included in the study. Finally, 213 breasts MRI that showed non mass like enhancing lesions among our patients were assessed in study. One experienced breast radiologist who was unaware of any clinical information or the histopathologic diagnosis evaluated all images retrospectively. The morphologic parameters evaluated consisted of distribution modifiers and pattern of internal enhancement. The kinetic enhancement parameters were assessed as showing washout, plateau, or persistent patterns. In the enhancement kinetic analysis, thew most worrisome curve type in each lesion was considered for interpretation, if it was more than 2% enhancement. We have evaluated the visual findings by comparison of the signal intensity on the first and third dynamic series. Data for the study were extracted from the breast MRI database and analyzed using SPSS version 16 statistical software. Results: Totally 188 patients had 213 non mass like lesions. Mean age of the patients was 44.9 ± 8.3 years (24-63). Totally 46 of lesions were malignant (21.6%). The most common BIRADS score was 4 (116; 54.5%). The most prevalent feature of distribution, internal enhancement and curve type were focal (59.2%), clumped (27.2%) and washout (34.3%). Distribution of different subgroups of MR BIRADS features was different among benign and malignant lesions (All Pvalues < 0.05). Regarding association with malignancy, odds ratio of lesions with segmental or ductal

  4. Association of Different MRI BIRADS Descriptors With Malignancy in Non Mass-Like Breast Lesions.

    PubMed

    Gity, Masoumeh; Ghazi Moghadam, Koosha; Jalali, Amir Hossein; Shakiba, Madjid

    2014-12-01

    Several studies on the diagnostic efficacy of MRI has not real consensus for the accuracy of MRI characteristics in non mass like breast lesions, and the number of malignant lesions in different studies is insufficient. In this study we aimed to analyze the diagnostic role of MRI BIRADS features for diagnosis of malignancy in non mass like breast lesions. All patients with positive findings (BIRADS 3, 4, 5), which had either biopsy proved pathology or follow-up MRI data at least for 12 months were included in the study. Finally, 213 breasts MRI that showed non mass like enhancing lesions among our patients were assessed in study. One experienced breast radiologist who was unaware of any clinical information or the histopathologic diagnosis evaluated all images retrospectively. The morphologic parameters evaluated consisted of distribution modifiers and pattern of internal enhancement. The kinetic enhancement parameters were assessed as showing washout, plateau, or persistent patterns. In the enhancement kinetic analysis, thew most worrisome curve type in each lesion was considered for interpretation, if it was more than 2% enhancement. We have evaluated the visual findings by comparison of the signal intensity on the first and third dynamic series. Data for the study were extracted from the breast MRI database and analyzed using SPSS version 16 statistical software. Totally 188 patients had 213 non mass like lesions. Mean age of the patients was 44.9 ± 8.3 years (24-63). Totally 46 of lesions were malignant (21.6%). The most common BIRADS score was 4 (116; 54.5%). The most prevalent feature of distribution, internal enhancement and curve type were focal (59.2%), clumped (27.2%) and washout (34.3%). Distribution of different subgroups of MR BIRADS features was different among benign and malignant lesions (All Pvalues < 0.05). Regarding association with malignancy, odds ratio of lesions with segmental or ductal linear distribution was 3.4 (95% CI = 1.7-6.8), Clumped

  5. [A case of an intracerebral mass lesion consisting of traumatic granulation tissue].

    PubMed

    Wanibuchi, M; Uede, T; Ishiguro, M; Tatewaki, K; Kurokawa, Y; Yoshida, Y

    1994-10-01

    We reported a rare case of an intracerebral granulomatous lesion accompanying severe edema formation in the healing stage of traumatic brain contusions. A 44-year-old male patient came to our outpatient clinic due to progressing headache and nausea. Upon computed tomographic examination, a low density mass with strong surrounding edema was detected at the right frontal base. Magnetic resonance images revealed a high intensity mass on both T1- and T2-weighted images at the right frontal base. Upon intravenous injection of a contrast agent, this lesion exhibited multifocal marginal contrast enhancement. Two additional small enhanced mass lesions were detected at the tip of the right temporal lobe and the medial portion of the left temporal lobe. We tentatively diagnosed it as a right frontal brain tumor and attempted the total removal of the right frontal mass. Unexpectedly, pathological diagnosis was intracerebral granulation tissue associated with accumulation of hemosiderin-laden macrophages and capillary wall thickening. In addition, there was no reactive gliosis. We speculated on the pathogenesis of intracerebral granulation tissue as follows. Since the patient was a heavy drinker and often fell down when he was drunk, it is likely that he might be suffering from intracerebral hematomas due to traumatic contusions. This assumption may be supported by the fact that an old subdural hematoma was observed during the operation and the radiological examination revealed multiple lesions. The gathering and proliferation of mesenchymal cells possibly derived from blood circulation probably began at the site of the damaged brain tissue, thus forming intracerebral granulation tissue.(ABSTRACT TRUNCATED AT 250 WORDS)

  6. Outcome of surgical decompression of spinal mass lesions in non-Hodgkin's lymphoma and plasmacytoma.

    PubMed

    Hong, Bujung; Hermann, Elvis J; Reuter, Christoph; Brandis, Almuth; Krauss, Joachim K

    2013-12-01

    Surgical treatment for spinal mass lesions due to non-Hodgkin's lymphoma (NHL) or plasmacytoma is necessary only in rare instances. The purpose of this study was to investigate long-term outcome and quality of life of surgery combined with postoperative chemotherapy or radiochemotherapy. The data of patients, who underwent spinal surgery for mass lesions in a 10-year periods were reviewed, identifying 10 patients with a histopathological diagnosis of NHL or plasmacytoma. Functional outcome were assessed by the Karnofsky Performance Score (KPS), quality of life by the Short Form-36 (SF-36) Health Survey Questionnaire, and pain by the Visual Analog Scale (VAS). Clinical presentations included pain (n=10), paresis (n=5), and sensory deficits (n=5). Surgical treatment included removal of the mass lesion (total, n=5; subtotal, n=5) for decompression, interbody fusion (n=3), and corporectomy followed by stabilization (n=1). Histopathological findings revealed NHL in five patients and plasmacytoma/multiple myeloma in five other patients. Postoperatively, all patients underwent chemotherapy or radiochemotherapy. Mean follow-up time was 38 months. At the last follow-up, 2 patients had succumbed to progression of disease. Pain intensity remained significantly reduced as compared to preoperatively (p=0.049). The KPS was 90-100% in five patients still alive, 70% in two, and 60% in one. SF-36 subscores were lower as compared to age-matched healthy controls. This retrospective study shows that surgical decompression of spinal mass lesions is a valuable option in selected patients with NHL or plasmacytoma to improve neurological deficits and control pain. Long-term outcome after postoperative adjuvant therapy confirms prolonged stability of quality of life. Copyright © 2013 Elsevier B.V. All rights reserved.

  7. Triage of Women with Low-Grade Cervical Lesions - HPV mRNA Testing versus Repeat Cytology

    PubMed Central

    Sørbye, Sveinung Wergeland; Arbyn, Marc; Fismen, Silje; Gutteberg, Tore Jarl; Mortensen, Elin Synnøve

    2011-01-01

    Background In Norway, women with low-grade squamous intraepithelial lesions (LSIL) are followed up after six months in order to decide whether they should undergo further follow-up or be referred back to the screening interval of three years. A high specificity and positive predictive value (PPV) of the triage test is important to avoid unnecessary diagnostic and therapeutic procedures. Materials and Methods At the University Hospital of North Norway, repeat cytology and the HPV mRNA test PreTect HPV-Proofer, detecting E6/E7 mRNA from HPV types 16, 18, 31, 33 and 45, are used in triage of women with ASC-US and LSIL. In this study, women with LSIL cytology in the period 2005–2008 were included (n = 522). Two triage methods were evaluated in two separate groups: repeat cytology only (n = 225) and HPV mRNA testing in addition to repeat cytology (n = 297). Histologically confirmed cervical intraepithelial neoplasia of grade 2 or worse (CIN2+) was used as the study endpoint. Results Of 522 women with LSIL, 207 had biopsies and 125 of them had CIN2+. The sensitivity and specificity of repeat cytology (ASC-US or worse) were 85.7% (95% confidence interval (CI): 72.1, 92.2) and 54.4 % (95% CI: 46.9, 61.9), respectively. The sensitivity and specificity of the HPV mRNA test were 94.2% (95% CI: 88.7, 99.7) and 86.0% (95% CI: 81.5, 90.5), respectively. The PPV of repeat cytology was 38.4% (95% CI: 29.9, 46.9) compared to 67.0% (95% CI: 57.7, 76.4) of the HPV mRNA test. Conclusion HPV mRNA testing was more sensitive and specific than repeat cytology in triage of women with LSIL cytology. In addition, the HPV mRNA test showed higher PPV. These data indicate that the HPV mRNA test is a better triage test for women with LSIL than repeat cytology. PMID:21918682

  8. Papanicolau smear chances to be diagnostic for cervical squamous intraepithelial lesions (SIL) with or without detectable HPV DNA at in situ hybridization analysis.

    PubMed

    Sopracordevole, F; Cadorin, L; Muffato, G; De Benetti, L; Parin, A

    1993-01-01

    The Authors have correlated 39 cervical diagnostic biopsies for squamous intraepithelial lesions (SILs) with correspective Papanicolau smears (PS), with relation to the presence or the absence of HPV of oncogenic type (HPV-one) detected by in situ hybridization (ISH). Agreement between cytological and histological diagnosis was present in 14 of 16 cases with detectable HPV-one and only in 12 of 23 cases without detectable HPV-one at ISH. The importance of the HPV type in the SILs with relation to the diagnostic accuracy of Papanicolaou smears has been discussed.

  9. Benign liver masses and lesions in children: 53 cases over 12 years.

    PubMed

    Kochin, Israel N; Miloh, Tamir A; Arnon, Ronen; Iyer, Kishore R; Suchy, Frederick J; Kerkar, Nanda

    2011-09-01

    Primary liver masses in children may require intervention because of symptoms or concern about malignant transformation. To review the management and outcome of benign liver masses in children. We conducted a retrospective chart review of children with liver masses referred to our institution during the period 1997-2009. Benign liver masses were identified in 53 children. Sixteen of these children (30%) had hemangioma/infantile hepatic hemangioendothelioma (IHH) and 15 (28%) had focal nodular hyperplasia. The remainder had 6 cysts, 4 hamartomas, 3 nodular regenerative hyperplasia, 2 adenomas, 2 vascular malformations, and one each of polyarteritis nodosa, granuloma, hepatic hematoma, lymphangioma, and infarction. Median age at presentation was 6 years, and 30 (57%) were female. Masses were initially noticed on imaging studies performed for unrelated symptoms in 33 children (62%), laboratory abnormalities consistent with liver disease in 11 (21%), and palpable abdominal masses in 9 (17%). Diagnosis was made based on characteristic radiographic findings in 31 (58%), but histopathological examination was required for the remaining 22 (42%). Of the 53 children, 27 (51%) were under observation while 17 (32%) had masses resected. Medications targeting masses were used in 9 (17%) and liver transplantation was performed in 4 (8%). The only death (2%) occurred in a child with multifocal IHH unresponsive to medical management and prior to liver transplant availability. IHH and focal nodular hyperplasia were the most common lesions. The majority of benign lesions were found incidentally and diagnosed radiologically. Expectant management was sufficient in most children after diagnosis, although surgical intervention including liver transplant was occasionally necessary.

  10. Prevalence characteristics of high-risk human papillomaviruses in women living in Shanghai with cervical precancerous lesions and cancer.

    PubMed

    Gu, Ying; Ma, Chenyun; Zou, Jue; Zhu, Yi; Yang, Rong; Xu, Yan; Zhang, Yu

    2016-04-26

    A complete understanding of the natural history of infection with high-risk human papillomaviruses (HPVs) in cervical cancer requires data from regional and ethnic studies. The prevalence of high-risk HPVs was evaluated retrospectively in 2040 patients with cervicitis, 239 with cervical intraepithelial neoplasia grade 1 (CIN1), 242 with CIN2/3, and 42 patients with invasive squamous cell carcinoma (SCC) based on data from patients who visited our hospital between May 2013 and May 2015. The rates of high-risk HPV infection in patients with cervicitis, CIN1, CIN2/3, and invasive SCC were 40.8%, 74.9%, 70.2%, and 83.3%, respectively. The three most dominant HPV genotypes were HPV16, 58, and 52. HPV16 and HPV58 positivity in cervicitis, CIN1, CIN2/3, and SCC patients were 20.9% and 16.4%, 19.0% and 20.1%, 44.1% and 23.5%, and 60.0% and 31.4%, respectively. Compared to cervicitis, the odds ratios (ORs) for CIN2/3 in HPV16- and HPV58-positive patients were 2.99 (95% confidence interval [CI]: 1.32-4.33) and 1.56 (1.11-3.21), respectively; for SCC, the corresponding values were 5.68 (2.31-7.893) and 2.33 (1.41-3.87). Further identifying of carcinogenic HPVs and a fully aware of regional differences in HPV genotype distribution are tasks of top priority for cervical cancer control and prevention.

  11. Differentiating between endocervical glandular neoplasia and high grade squamous intraepithelial lesions in endocervical crypts: cytological features in ThinPrep and SurePath cervical cytology samples.

    PubMed

    Thiryayi, Sakinah A; Marshall, Janet; Rana, Durgesh N

    2009-05-01

    A recent audit at our institution revealed a higher number of cases diagnosed as endocervical glandular neoplasia on ThinPrep (TP) cervical cytology samples (9 cases) as opposed to SurePath (SP) (1 case), which on histology showed only high-grade cervical intraepithelial neoplasia (CIN) with endocervical crypt involvement (CI). We attempted to ascertain the reasons for this finding by reviewing the available slides of these cases, as well as slides of cases diagnosed as glandular neoplasia on cytology and histology; cases diagnosed as high-grade squamous intraepithelial lesions (HSIL) on cytology which had CIN with CI on histology and cases with mixed glandular and squamous abnormalities diagnosed both cytologically and histologically. Single neoplastic glandular cells and short pseudostratified strips were more prevalent in SP than TP with the cell clusters in glandular neoplasia 3-4 cells thick, in contrast to the dense crowded centre of cell groups in HSIL with CI. The cells at the periphery of groups can be misleading. Cases with HSIL and glandular neoplasia have a combination of the features of each entity in isolation. The diagnosis of glandular neoplasia remains challenging and conversion from conventional to liquid based cervical cytology requires a period of learning and adaptation, which can be facilitated by local audit and review of the cytology slides in cases with a cytology-histology mismatch. (c) 2009 Wiley-Liss, Inc.

  12. Cervical pneumatocyst.

    PubMed

    Hoover, Jason M; Wenger, Doris E; Eckel, Laurence J; Krauss, William E

    2011-09-01

    The authors present the case of a 56-year-old right hand-dominant woman who was referred for chronic neck pain and a second opinion regarding a cervical lesion. The patient's pain was localized to the subaxial spine in the midline. She reported a subjective sense of intermittent left arm weakness manifesting as difficulty manipulating small objects with her hands and fingers. She also reported paresthesias and numbness in the left hand. Physical and neurological examinations demonstrated no abnormal findings except for a positive Tinel sign over the left median nerve at the wrist. Electromyography demonstrated bilateral carpal tunnel syndrome with no cervical radiculopathy. Cervical spine imaging demonstrated multilevel degenerative disc disease and a pneumatocyst of the C-5 vertebral body. The alignment of the cervical spine was normal. A review of the patient's cervical imaging studies obtained in 1995, 2007, 2008, and 2010 demonstrated that the pneumatocyst was not present in 1995 but was present in 2007. The lesion had not changed in appearance since 2007. At an outside institution, multilevel fusion of the cervical spine was recommended to treat the pneumatocyst prior to evaluation at the authors' institution. The authors, however, did not think that the pneumatocyst was the cause of the patient's neck pain, and cervical pneumatocysts typically have a benign course. As such, the authors recommended conservative management and repeated MR imaging in 6 months. Splinting was used to treat the patient's carpal tunnel syndrome.

  13. [Immigration from countries with a strong migratory pressure and participation in cervical cancer screening program in the Local Health Unit 2, Umbria Region. Impact on the probability of high-grade lesions and cervical cancer].

    PubMed

    Vallesi, Giuseppe; Bietta, Carla; Marri, Maria; Petrella, Marco

    2012-01-01

    to measure the risk of having serious lesions and cervical cancer for immigrant women, by evaluating the impact of their lack of participation in the previous rounds. retrospective study. archive of the screening programme of Local Health Unit 2, Umbria. People subjected to the study: those adhering to the last round (2008- 2010) and belonging to an age group potentially capable of participating in all the previous rounds (1999-2007). positivity to Pap test; lesions that require colposcopy (AGCH,AGCUS,ASCH, HSIL); tumours (squamous cell carcinomas and adenocarcinomas). 1.7% of the women were positive to the Pap test, 0.7% presented lesions with the immediate need for colposcopy, and 0.039% were diagnosed with cancer. The percentage of women who resulted either positive to the Pap test, or presenting lesions requiring colposcopy or with cancer, is significantly higher among those who come from poor countries. Furthermore, participation in previous rounds has proven to be protective with reference to the above-mentioned markers. the independent weight of several risk factors has emerged and consequently the need to promote with particular commitment the participation in screening of women coming from poor countries.

  14. Deletion of the FHIT gene in neoplastic and invasive cervical lesions is related to high-risk HPV infection but is independent of histopathological features.

    PubMed

    Butler, D; Collins, C; Mabruk, M; Barry Walsh, C; Leader, M B; Kay, E W

    2000-12-01

    The fragile histidine triad (FHIT) gene encompasses the common chromosomal fragile site FRA3B. Human papilloma virus (HPV), which is the main aetiological agent in cervical cancers, has been found to be able to integrate its genes into the chromosome 3 fragile site of cultured cells, deleting a piece of DNA which includes the FHIT gene. Eighty-six microdissected archival cervical LLETZ biopsies comprising cases of cervical intraepithelial neoplasia (CIN) 1 (n=27), CIN3 (n=30) and microinvasive carcinoma (n=29) were evaluated for HPV infection and FHIT gene loss of heterozygosity (LOH). FHIT gene LOH was detected by polymerase chain reaction (PCR) using fluorescently labelled intragenic microsatellite markers D3S1300 and D3S4103. PCR products were analysed on a semi-automated DNA sequencer using Fragment Manager(trade mark) software to determine allele loss. The HPV status of the lesions was determined by PCR using generic and type-specific primers in conjunction with restriction endonuclease digestion. The results were analysed using Epi-Info and SPSS-PC statistical analysis software. Haematoxylin and eosin-stained sections from the 86 cases were profiled for six histopathological features, some of which have been previously shown to be associated with microinvasive cancer. FHIT gene LOH was found in 36% of CIN1 cases, 52% of CIN3 cases and 73% of microinvasive cases (p=0.029). HPV 16 DNA was found in 68% of CIN3 cases and 93% of microinvasive cases (p<0.001). The second most prevalent HPV type found was HPV 31, which was present in only four lesions, three of which had FHIT gene LOH. When FHIT gene LOH was evaluated versus HPV 16 and 31 infection using the chi-square test, a statistically significant relationship was found (p=0.014). FHIT gene LOH was found to be independent of the histopathological features evaluated. The finding of a statistically significant relationship between FHIT gene LOH and oncogenic HPV infection suggests a link between the integration

  15. "Ovarian vascular pedicle" sign revealing organ of origin of a pelvic mass lesion on helical CT.

    PubMed

    Lee, Jong Hwa; Jeong, Yoong Ki; Park, Ji Kang; Hwang, Jae Choel

    2003-07-01

    We evaluated the "ovarian vascular pedicle" sign as a way of differentiating ovarian from subserosal uterine lesions on single-detector helical CT. We prospectively evaluated 131 patients who had a pelvic mass suspected of originating in the ovary or subserosal zone of the uterus and had undergone helical CT before surgery. A total of 108 ovarian lesions and 23 subserosal uterine myomas were confirmed. CT images were analyzed prospectively by consensus of two radiologists who thoroughly evaluated the retrograde tracing of the gonadal veins to the ovary or pelvic mass. To assess the value of analyzing the ovarian vascular pedicle sign in identifying the organ of origin of a pelvic mass, we compared statistical proportions for the frequencies of the sign in ovarian tumors and subserosal uterine myomas by performing the chi-square test. The probabilities for the presence of the ovarian vascular pedicle sign as a positive finding for a pelvic mass of ovarian origin were calculated. The presence of the ovarian vascular pedicle sign was identified in 92% (99/108) of ovarian masses and in 13% (3/23) of subserosal uterine myomas. The sign was statistically significant (p < 0.01) for differentiating a mass of ovarian origin from a mass of subserosal uterine origin. When the ovarian vascular pedicle sign on helical CT confirmed the ovarian origin, the sensitivity, specificity, positive predictive value and negative predictive value, and diagnostic accuracy were 92% (99/108), 87% (20/23), 97% (99/102), 69% (20/29), and 91% (119/131), respectively. The presence of the ovarian vascular pedicle sign on helical CT is valuable for confirming the ovarian origin of a pelvic tumor and for differentiating an ovarian tumor from subserosal uterine myoma.

  16. Increased HPV L1 gene methylation and multiple infection status lead to the difference of cervical epithelial cell lesion in different ethnic women of Xinjiang, China

    PubMed Central

    Yang-chun, Feng; Yuan, Zhang; Cheng-ming, Liu; Yan-chun, Huang; Xiu-min, Ma

    2017-01-01

    Abstract Human papillomavirus (HPV) L1 gene methylation deeply involved in the progression and heterogeneity of cervical cell epithelial lesions. The DNA ploidy also represented the early lesions of cervical cell, and it was associated with different HPV infection status in different ethnic women. So, the research was to explore whether it was possible that HPV L1 gene methylation and HPV infection status as the risk factors to lead to the differences of cervical epithelial cells’ lesions in different ethnics women. The flow-through hybridization and gene chip for HPV genotypes test, general characteristics, and cervical exfoliated cell samples were collected from 94 Uygur and 79 Han women with HPV-16 infection. The cases were divided into the single HPV-16 (sHPV-16) infection group and multiple HPV-16 (mHPV-16) infection group in each ethnic women. The DNA ploidy was analyzed by flow cytometry, and the methylation-sensitive high resolution melting (MS-HRM) was used to test the HPV-16 L1 gene methylation, the results of methylation was segmented into mild methylation, moderate methylation, and severe methylation groups. Multifactor logistic analysis explored the relation between DNA heteroploid and HPV-16 infection status, HPV-16 L1 gene methylation in different ethnic women. The higher proportion of mHPV-16 infection in Uygur than Han women (61.7% vs 38.0%). L1 gene methylation had statistic difference between single and mHPV-16 infection under the same ethnic women. The proportion of DNA heteroploid had statistic difference between different HPV-16 infection status or different L1 gene methylation grades in Han or Uygur women. Both L1 gene methylation and HPV infection status were the risk factors of DNA heteroploid. Compared to the sHPV-16 infection, the odds ratio (OR) of mHPV-16 infection were 4.409 (CI: 1.398–13.910) and 3.279 (CI: 1.069–10.060) in Han and Uygur women. Compared the mild L1 gene methylation, the OR of moderate L1 gene methylation were 3

  17. Associations of P16INK4a promoter hypermethylation with squamous intra-epithelial lesion, cervical cancer and their clinicopathological features: a meta-analysis

    PubMed Central

    Cui, Ning-hua; Zhang, Shuai; Wang, Chen; Zheng, Fang

    2017-01-01

    To assess the associations of P16INK4a methylation status with low-grade squamous intra-epithelial lesion (LSIL), high-grade squamous intra-epithelial lesion (HSIL), cervical cancer (CC) and their clinicopathological features, a meta-analysis with 29 eligible studies was conducted. Pooled odds ratios (ORs) with their 95% confidence intervals (CIs) were estimated to assess the strength of the associations. Heterogeneity, sensitivity of pooled results and publication bias were also evaluated. Overall, there was an increasing trend of P16INK4a hypermethylation rates among LSIL (21.4%), HSIL (30.9%) and CC (35.0%) specimens. P16INK4a hypermethylation was significantly associated with the increased risk of LSIL, HSIL and CC, with the pooled ORs of 3.26 (95% CI: 1.86-5.71), 5.80 (95% CI: 3.80-8.84) and 12.17 (95% CI: 5.86-25.27), respectively. A significant association was also found between P16INK4a hypermethylation and smoking habit (OR = 3.88, 95% CI: 2.13-7.08). Taken together, meta-analysis results support P16INK4a hypermethylation as an epigenetic marker for the progression of cervical carcinogenesis. PMID:27669738

  18. Detection of Human Papilloma Virus (HPV) in oral mucosa of women with cervical lesions and their relation to oral sex practices

    PubMed Central

    2010-01-01

    Background Previous studies have either investigated the relationship of HPV with oral cancer or the prevalence of HPV on the oral cavity. The purpose of this investigation was to study the prevalence of HPV in oral cavity of women with oral sex practices and cervical lesions. Methods Forty six (46) non-smokers and non-alcoholic patients attended the "Clínica de Displasias" of "Ciudad Juarez" were sampled. This population had a CIN diagnosis sometime between the previous six months. On previous consent they filled out a questionnaire related to their oral sex practices. Afterwards one swab from cheeks and another from palate/gum were taken; PCR was used to determine generic HPV, HPV16 and HPV18. Results Seventy two percent (72%) of the patients stated to have oral sex practices regularly which all of them were positive to HPV either in oral mucus, palate/gum or both. The total of the given results showed that 35% had HPV16; among those distributed in 26% with regular oral sex practices and 9% stated as never practiced oral sex. An association was found between oral HPV16 positivity and progression to cervical CIN advanced lesions. On the other hand HPV18 was not detected. The frequency of HPV16 was higher in buccal mucosa (23%) versus palate/gum (16%). Conclusions This study suggests that buccal HPV16 infection is associated with CIN progression. PMID:21129222

  19. MALDI imaging mass spectrometry analysis-A new approach for protein mapping in multiple sclerosis brain lesions.

    PubMed

    Maccarrone, Giuseppina; Nischwitz, Sandra; Deininger, Sören-Oliver; Hornung, Joachim; König, Fatima Barbara; Stadelmann, Christine; Turck, Christoph W; Weber, Frank

    2017-03-15

    Multiple sclerosis is a disease of the central nervous system characterized by recurrent inflammatory demyelinating lesions in the early disease stage. Lesion formation and mechanisms leading to lesion remyelination are not fully understood. Matrix Assisted Laser Desorption Ionisation Mass Spectrometry imaging (MALDI-IMS) is a technology which analyses proteins and peptides in tissue, preserves their spatial localization, and generates molecular maps within the tissue section. In a pilot study we employed MALDI imaging mass spectrometry to profile and identify peptides and proteins expressed in normal-appearing white matter, grey matter and multiple sclerosis brain lesions with different extents of remyelination. The unsupervised clustering analysis of the mass spectra generated images which reflected the tissue section morphology in luxol fast blue stain and in myelin basic protein immunohistochemistry. Lesions with low remyelination extent were defined by compounds with molecular weight smaller than 5300Da, while more completely remyelinated lesions showed compounds with molecular weights greater than 15,200Da. An in-depth analysis of the mass spectra enabled the detection of cortical lesions which were not seen by routine luxol fast blue histology. An ion mass, mainly distributed at the rim of multiple sclerosis lesions, was identified by liquid chromatography and tandem mass spectrometry as thymosin beta-4, a protein known to be involved in cell migration and in restorative processes. The ion mass of thymosin beta-4 was profiled by MALDI imaging mass spectrometry in brain slides of 12 multiple sclerosis patients and validated by immunohistochemical analysis. In summary, our results demonstrate the ability of the MALDI-IMS technology to map proteins within the brain parenchyma and multiple sclerosis lesions and to identify potential markers involved in multiple sclerosis pathogenesis and/or remyelination. Copyright © 2016 Elsevier B.V. All rights reserved.

  20. Schwannomatosis of Cervical Vagus Nerve

    PubMed Central

    Sasi, M. P.

    2016-01-01

    Cervical vagal schwannoma is a rare entity among lesions presenting as a neck mass. They are usually slow-growing benign lesions closely associated with the vagus nerve. They are usually solitary and asymptomatic. Multiple schwannomas occurring in patients without neurofibromatosis (NF) are rare and have recently been referred to as schwannomatosis. Here, we present a case of a neck mass that had imaging features suggestive of vagal schwannoma and was operated upon. Intraoperatively, it was discovered to be a case of multiple vagal cervical schwannoma, all directly related to the right vagus nerve, and could be resected from the nerve in toto preserving the function of the vagus nerve. Final HPR confirmed our pre-op suspicion of vagal schwannomatosis. PMID:27807496

  1. Association of human papillomavirus, Neisseria gonorrhoeae and Chlamydia trachomatis co-infections on the risk of high-grade squamous intraepithelial cervical lesion

    PubMed Central

    de Abreu, André LP; Malaguti, Natália; Souza, Raquel P; Uchimura, Nelson S; Ferreira, Érika C; Pereira, Monalisa W; Carvalho, Maria DB; Pelloso, Sandra M; Bonini, Marcelo G; Gimenes, Fabrícia; Consolaro, Marcia EL

    2016-01-01

    The link between high-risk human Papillomavirus (HR-HPV) and other sexually transmitted diseases (STDs) in the risk of developing cervical cancer still unclear. Thus, in this report we investigated the rates of co-infections between HPV and other important non-HPV STDs in different cervical findings using a multiplex polymerase chain reaction (M-PCR) to simultaneously detect Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Trichomonas vaginalis, HSV-1 and -2, and Treponema pallidum. A total of 838 women aged 18 to 68 years were screened using Papanicolaou smears for cervical abnormalities, HPV and non-HPV STDs using PCR and M-PCR methods. A total of 614 (73.3%) of the women had normal cytology (NILM) and 224 (26.7%) women exhibited abnormal cytology (≥ ASC-US). HPV-DNA prevalence was 33.9%, and HPV-16 was the most prevalent genotype in women with NILM and ≥ ASC-US cytology. Non-HPV STDs were detected in 30.4% women and T. vaginalis was the most prevalent one (11.6%). A higher increased risk of ≥ ASC-US and HSIL occurred in co-infections of HR-HPV with C. trachomatis and N. gonorrhoeae. Co-infections of HPV-DNA and HR-HPV with HSV-2 exhibited a similar increased risk but only with ≥ ASC-US. Co-infections of HPV-DNA and HR-HPV with T. vaginalis demonstrated a similar increased risk of ≥ ASC-US and HSIL. We found that C. trachomatis and N. gonorrhoeae were the primary pathogens associated with HR-HPV for the increased risk for all grades of cervical abnormalities but mainly for HSIL, suggesting a possible synergistic action in cervical lesions progression. Our results reinforce the hypothesis that some non-HPV STDs might play a role as co-factors in HPV-mediated cervical carcinogenesis. These data improve our understanding of the etiology of SCC and may also be useful for disease prevention. PMID:27429850

  2. Association of human papillomavirus, Neisseria gonorrhoeae and Chlamydia trachomatis co-infections on the risk of high-grade squamous intraepithelial cervical lesion.

    PubMed

    de Abreu, André Lp; Malaguti, Natália; Souza, Raquel P; Uchimura, Nelson S; Ferreira, Érika C; Pereira, Monalisa W; Carvalho, Maria Db; Pelloso, Sandra M; Bonini, Marcelo G; Gimenes, Fabrícia; Consolaro, Marcia El

    2016-01-01

    The link between high-risk human Papillomavirus (HR-HPV) and other sexually transmitted diseases (STDs) in the risk of developing cervical cancer still unclear. Thus, in this report we investigated the rates of co-infections between HPV and other important non-HPV STDs in different cervical findings using a multiplex polymerase chain reaction (M-PCR) to simultaneously detect Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Trichomonas vaginalis, HSV-1 and -2, and Treponema pallidum. A total of 838 women aged 18 to 68 years were screened using Papanicolaou smears for cervical abnormalities, HPV and non-HPV STDs using PCR and M-PCR methods. A total of 614 (73.3%) of the women had normal cytology (NILM) and 224 (26.7%) women exhibited abnormal cytology (≥ ASC-US). HPV-DNA prevalence was 33.9%, and HPV-16 was the most prevalent genotype in women with NILM and ≥ ASC-US cytology. Non-HPV STDs were detected in 30.4% women and T. vaginalis was the most prevalent one (11.6%). A higher increased risk of ≥ ASC-US and HSIL occurred in co-infections of HR-HPV with C. trachomatis and N. gonorrhoeae. Co-infections of HPV-DNA and HR-HPV with HSV-2 exhibited a similar increased risk but only with ≥ ASC-US. Co-infections of HPV-DNA and HR-HPV with T. vaginalis demonstrated a similar increased risk of ≥ ASC-US and HSIL. We found that C. trachomatis and N. gonorrhoeae were the primary pathogens associated with HR-HPV for the increased risk for all grades of cervical abnormalities but mainly for HSIL, suggesting a possible synergistic action in cervical lesions progression. Our results reinforce the hypothesis that some non-HPV STDs might play a role as co-factors in HPV-mediated cervical carcinogenesis. These data improve our understanding of the etiology of SCC and may also be useful for disease prevention.

  3. Limiting factors for cytopathological diagnosis of high-grade squamous intraepithelial lesions: a cytohistological correlation between findings in cervical smears and loop electrical excision procedure.

    PubMed

    Pinto AP, Alvaro P; Tuon, Felipe F B; Torres, Luiz Fernando Bleggi; Collaço, Luiz Martins

    2002-01-01

    The present study sought possible factors leading to the cytological diagnosis of atypical squamous cells of uncertain significance (ASCUS) in cases of high-grade squamous intraepithelial lesions (HSIL). Based on retrospective histopathological analysis of loop electrical excision procedure (LEEP) products that diagnosed HSIL, two study groups were randomly selected. The first was consisted of cases with two consecutive Papanicolaou (Pap) smears with the diagnosis of ASCUS. The second (control) group was represented by cases diagnosed as HSIL by cytology. From the Pap smears diagnosed as ASCUS, the sampling limitations was different from control group (P < 0.05). The median size of the largest lesion in each case with ASCUS was 2.66 mm (+/- 1.71 mm). In the control group, the median size of the largest lesion was 5.15 mm (+/-2.58 mm) (P < 0.05). The size of the lesion and sample limitations led patients with cervical intraepithelial neoplasms to be diagnosed as ASCUS for two consecutive times, after a 6-mo period. Copyright 2002 Wiley-Liss, Inc.

  4. Risk of progression of early cervical lesions is associated with integration and persistence of HPV-16 and expression of E6, Ki-67, and telomerase

    PubMed Central

    Vega-Peña, Arianna; Illades-Aguiar, Berenice; Flores-Alfaro, Eugenia; López-Bayghen, Esther; Leyva-Vázquez, Marco Antonio; Castañeda-Saucedo, Eduardo; Alarcón-Romero, Luz Del Carmen

    2013-01-01

    Background: Low-grade squamous intraepithelial lesions (LSIL) are the earliest lesions of the uterine cervix, the persistence and integration of high-risk human papillomavirus (HR-HPV) as type 16, which promotes the development of more aggressive lesions. Aim: To select more aggressive lesions with tendency to progress to invasive cervical cancer. Materials and Methods: A total of 75 cytological specimens in liquid base (Liqui-PREP) were analyzed: 25 specimens were with no signs of SIL (NSIL) and without HPV; 25 NSIL with HPV-16, and 25 with both LSIL and HPV-16. The expression of Ki-67, telomerase, and viral E6 was evaluated by immunocytochemistry; and the detection of viral DNA was done by polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLPs) for genotyping or sequencing of HPV-16. The physical state of HPV-16 was evaluated by in situ hybridization with amplification with tyramide. Results: Of the total group, 58.6% had LSIL associated with persistence and of these 59.3% was associated with integrated state of HPV as intense expression of E6, Ki-67 (P = 0.013, P = 0.055) has except for the expression of telomerase present a non-significant association (P<0.341). Conclusions: Overexpression of E6 and Ki-67 is associated with the integration of HPV-16, favoring viral persistence, and increasing the risk of progression in women with NSIL and LSIL. PMID:24648664

  5. Huge right ventricular mass lesion associated with genital malignant tumor: a case report.

    PubMed

    Higashi, Masaya; Hodatsu, Akihiko; Uchiyama, Katsuharu; Tada, Hayato; Mori, Mika; Ohira, Miho; Hayashi, Kenshi; Kawashiri, Masa-Aki

    2017-10-03

    Primary heart tumors are rare, whereas metastatic heart tumors occur more frequently. We report a case of a 75-year-old Japanese woman who had metastatic heart tumors of the right ventricle. Although she initially received antibiotic therapy following a diagnosis of pneumonia and pleuritis, her symptoms worsened, and she developed dyspnea and bilateral lower limb edema. Echocardiography showed a huge mass lesion occupying the entire right ventricle. Because the patient's tumor markers were elevated, we used computed tomography to search for the primary lesion, which was located in the vagina or the uterus. Histology demonstrated the presence of basaloid squamous cell carcinoma in the vaginal tissue. Chemotherapy with paclitaxel and carboplatin was initiated. These data suggest that the tumor in the right ventricle metastasized from the genital organs.

  6. Rhabdoid meningioma presenting with subependymal and diffuse meningeal involvement but no mass lesion.

    PubMed

    Ahmad, Kate E; Al-Jahdhami, Suad; Ahmad, Omar

    2010-12-01

    Rhabdoid meningiomas are rare, aggressive tumours of the meninges that have a generally poor prognosis. We report a 49-year-old man with a background history of sarcoidosis who presented with nausea and vomiting. Imaging showed generalised leptomeningeal and subependymal enhancement suggestive of chronic meningitis. He had multiple lumbar punctures and a brain biopsy, none of which led to a pathological diagnosis. He died within months, and a postmortem examination was performed. At this stage, a diagnosis of rhabdoid meningioma was made. The clinical and radiological presentation of rhabdoid meningioma as a diffuse leptomeningeal process without a mass lesion is unique. All other published cases of rhabdoid meningioma have been of a discrete lesion. This highlights the importance of a tissue diagnosis in patients where the imaging is non-specific. A brief review of rhabdoid meningioma follows. Crown Copyright © 2010. Published by Elsevier Ltd. All rights reserved.

  7. Early Parenteral Nutrition in Patients with Biliopancreatic Mass Lesions, a Prospective, Randomized Intervention Trial

    PubMed Central

    Krüger, Janine; Meffert, Peter J.; Vogt, Lena J.; Gärtner, Simone; Steveling, Antje; Kraft, Matthias; Mayerle, Julia; Lerch, Markus M.; Aghdassi, Ali A.

    2016-01-01

    Purpose Patients with biliopancreatic tumors frequently suffer from weight loss and cachexia. The in-hospital work-up to differentiate between benign and malignant biliopancreatic lesions requires repeated pre-interventional fasting periods that can aggravate this problem. We conducted a randomized intervention study to test whether routine in-hospital peripheral intravenous nutrition on fasting days (1000 ml/24 h, 700 kcal) has a beneficial effect on body weight and body composition. Material and Methods 168 patients were screened and 100 enrolled in the trial, all undergoing in-hospital work-up for biliopancreatic mass lesions and randomized to either intravenous nutrition or control. Primary endpoint was weight loss at time of hospital discharge; secondary endpoints were parameters determined by bioelectric impedance analysis and quality of life recorded by the EORTC questionnaire. Results Within three months prior to hospital admission patients had a median self-reported loss of 4.0 kg (25*th: -10.0 kg and 75*th* percentile: 0.0kg) of body weight. On a multivariate analysis nutritional intervention increased body weight by 1.7 kg (95% CI: 0.204; 3.210, p = 0.027), particularly in patients with malignant lesions (2.7 kg (95% CI: 0.71; 4.76, p < 0.01). Conclusions In a hospital setting, patients with suspected biliopancreatic mass lesions stabilized their body weight when receiving parenteral nutrition in fasting periods even when no total parenteral nutrition was required. Analysis showed that this effect was greatest in patients with malignant tumors. Further studies will be necessary to see whether patient outcome is affected as well. Trial Registration ClinicalTrials.gov NCT02670265 PMID:27861546

  8. Clinical evaluation of an all-in-one adhesive in non-carious cervical lesions with different degrees of dentin sclerosis.

    PubMed

    Ritter, André V; Heymann, Harald O; Swift, Edward J; Sturdevant, John R; Wilder, Aldridge D

    2008-01-01

    This randomized clinical trial compared the performance of an all-in-one adhesive (iBond) applied in sclerotic and non-sclerotic non-carious cervical lesions with that of a three-step etch-prime-bond adhesive (Gluma Solid Bond, SB). One-hundred and five lesions were randomly assigned to four groups according to adhesive, sclerosis scale and technique: 1) SB applied to lesions with sclerosis scale 1 and 2 (n=26); 2) iBond applied to lesions with sclerosis scale 1 and 2 (n=28); 3) iBond applied to lesions with sclerosis scale 3 and 4 (n=25) and 4) iBond applied with prior acid-etching to lesions with sclerosis scale 3 and 4 (n=26). A microfilled composite (Durafill VS) was used as the restorative material. The restorations were evaluated for retention, color match, marginal adaptation, anatomic form, cavosurface margin discoloration, secondary caries, pre- and post-operative sensitivity, surface texture and fracture at insertion (baseline), 6, 18 months and at 3 years using modified USPHS evaluation criteria (Alfa=excellent; Bravo=clinically acceptable; Charlie=clinically unacceptable). There was a high percentage of Bravo scores for marginal adaptation (4%-32%) and marginal discoloration (18%-60%) in Groups 2, 3 and 4, but all groups had <5% Charlie scores at 6 months and <10% Charlie scores at 18 months for retention and marginal discoloration, respectively. However, it should be noted that 13% of the restorations in Group 4 were not retained at three years.

  9. Clinical significance of CK7, HPV-L1, and koilocytosis for patients with cervical low-grade squamous intraepithelial lesions: a retrospective analysis.

    PubMed

    Cao, Lanqing; Sun, Ping-Li; Yao, Min; Chen, Shifan; Gao, Hongwen

    2017-07-01

    Most cervical low-grade squamous intraepithelial lesions (LSILs) do not progress to high-grade squamous intraepithelial lesions (HSILs); however, reliable biomarkers that predict LSIL progression are lacking. We investigated the association of cytokeratin 7 (CK7), human papillomavirus-L1 capsid protein (HPV-L1), and koilocytosis with clinical outcomes of patients with LSIL. CK7, HPV-L1, Ki67, and p16-INK4A expression was determined in 72 cervical LSIL and 28 HSIL biopsy samples; koilocytosis was evaluated by reviewing biopsy slides. Fifty patients with LSIL received follow-up. CK7, HPV-L1, and koilocytosis were detected in 48.6%, 44.4%, and 52.0% of LSIL tissues and in 78.6%, 10.7%, and 64.3% of HSIL tissues, respectively. Lesion grade was correlated directly with CK7 expression (P=.007) and inversely with HPV-L1 expression (P=.004). CK7 expression in LSILs was correlated inversely with HPV-L1 expression and directly with p16-INK4A and Ki67 status. Furthermore, koilocytosis was significantly associated with HPV-L1 and p16-INK4A expression. Progression to cervical intraepithelial lesions of grades ≥2 occurred in 34% of cases. CK7 negativity and HPV-L1 positivity were significantly associated with lower HSIL progression rates. HPV-L1-positive and CK7-negative LSILs showed significantly lower progression rates compared with HPV-L1-negative and CK7-positive LSILs (6.3% v-positive cases showed a significantly lower progression rate (17.6%) compared with nonkoilocytic and HPV-L1-negative cases (50%). CK7-negative, HPV-L1-positive, and koilocytic LSILs showed a progression rate of 7.7%. Koilocytosis and p16-INK4A were not significantly associated with clinical outcomes. Hence, evaluating HPV-L1, CK7, and koilocytosis profiles combined may be more reliable for LSIL prognostication. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Isolated primary intracerebral mycetoma: presenting as a mass lesion in a patient with prostate cancer and multiple myeloma.

    PubMed

    Prabhakaran, Shyam; Gutin, Philip H; Holodny, Andrei; Raizer, Jeffrey J

    2005-01-01

    We report a patient with a history of prostate cancer and multiple myeloma, with a solitary indolent intracerebral mass lesion without any constitutional symptoms and minimal neurologic symptoms. The radiographic appearance of the lesion was that of a tumor but resection revealed a mycetoma, consistent with Aspergillus. A brief review of the literature discusses the rarity, presentation, diagnosis, and management of primary intracerebral mycetomas.

  11. Representation of lesion similarity by use of multidimensional scaling for breast masses on mammograms.

    PubMed

    Muramatsu, Chisako; Nishimura, Kohei; Endo, Tokiko; Oiwa, Mikinao; Shiraiwa, Misaki; Doi, Kunio; Fujita, Hiroshi

    2013-08-01

    Presentation of similar reference images can be useful for diagnosis of new lesions. A similarity map which can visually present the overview of the relationship between the lesions with different types may provide the supplemental information to the reference images. A new method for constructing the similarity map by multidimensional scaling (MDS) for breast masses on mammograms was investigated. Nine pathologic types were included; three regions of interests each from the nine groups were employed in this study. Subjective similarity ratings by expert readers were obtained for all possible 351 pairs of masses. Using the average ratings, MDS similarity map was created. Each axis of the MDS configuration was fitted by the linear model with 13 image features to reconstruct the similarity map. Dissimilarity based on the distance in the reconstructed space was determined and compared with the subjective rating. The MDS map consistently represented the similarity between cysts and fibroadenomas, invasive lobular carcinomas and scirrhous carcinomas, and ductal carcinomas in situ, solid-tubular carcinomas, and papillotubular carcinomas with the experts' data. The correlation between the average subjective ratings and the dissimilarities based on the distance in the reconstructed feature space was much greater (-0.87) than that of the dissimilarities based on the distance in the conventional feature space (-0.65). The new similarity map by MDS can be useful for visualizing the relationship between breast masses with different pathologic types. It has potential usefulness in selecting the similarity measures and providing the supplemental information.

  12. Brain and skull lesions resulting from use of percussive bolt, cervical dislocation by stretching, cervical dislocation by crushing and blunt trauma in turkeys.

    PubMed

    Erasmus, M A; Turner, P V; Nykamp, S G; Widowski, T M

    2010-11-27

    Three experiments were conducted to assess brain damage resulting from percussive bolt shooting and cervical dislocation by crushing (neck crushing) in turkey hens (mean [se] bodyweight 11.4 [0.1] kg); percussive bolt shooting and blunt trauma in turkey toms (13.1 [0.2] kg); and percussive bolt shooting, blunt trauma and cervical dislocation by stretching (neck stretching) in broiler turkeys (3.9 [0.3] kg). Brain and skull damage were assessed using macroscopic and microscopic evaluations and CT. Macroscopic subcutaneous haemorrhage was significantly greater with the percussive bolt in all three experiments (hens P=0.01, toms P=0.02, broilers P=0.0003), and skull fractures were more severe for toms (P<0.0001) and broilers (P=0.03) killed with the percussive bolt versus blunt trauma. In a subsample of turkeys, microscopic brain damage was present in all turkeys killed by percussive bolt shooting (five hens, 10 toms and four broilers) and blunt trauma (nine toms and three broilers), but only in one of four turkeys killed by neck crushing and one of four turkeys killed by neck stretching. Percussive bolt shooting and blunt trauma most likely caused death by directly disrupting brain function, whereas neck stretching and neck crushing probably resulted in death from cerebral hypoxia and ischaemia.

  13. Targeting immune response with therapeutic vaccines in premalignant lesions and cervical cancer: hope or reality from clinical studies

    PubMed Central

    Vici, P; Pizzuti, L; Mariani, L; Zampa, G; Santini, D; Di Lauro, L; Gamucci, T; Natoli, C; Marchetti, P; Barba, M; Maugeri-Saccà, M; Sergi, D; Tomao, F; Vizza, E; Di Filippo, S; Paolini, F; Curzio, G; Corrado, G; Michelotti, A; Sanguineti, G; Giordano, A; De Maria, R; Venuti, A

    2016-01-01

    ABSTRACT Human papillomavirus (HPV) is widely known as a cause of cervical cancer (CC) and cervical intraepithelial neoplasia (CIN). HPVs related to cancer express two main oncogenes, i.e. E6 and E7, considered as tumorigenic genes; their integration into the host genome results in the abnormal regulation of cell cycle control. Due to their peculiarities, these oncogenes represent an excellent target for cancer immunotherapy. In this work the authors highlight the potential use of therapeutic vaccines as safe and effective pharmacological tools in cervical disease, focusing on vaccines that have reached the clinical trial phase. Many therapeutic HPV vaccines have been tested in clinical trials with promising results. Adoptive T-cell therapy showed clinical activity in a phase II trial involving advanced CC patients. A phase II randomized trial showed clinical activity of a nucleic acid-based vaccine in HPV16 or HPV18 positive CIN. Several trials involving peptide-protein-based vaccines and live-vector based vaccines demonstrated that these approaches are effective in CIN as well as in advanced CC patients. HPV therapeutic vaccines must be regarded as a therapeutic option in cervical disease. The synergic combination of HPV therapeutic vaccines with radiotherapy, chemotherapy, immunomodulators or immune checkpoint inhibitors opens a new and interesting scenario in this disease. PMID:27063030

  14. [Prevalence of human papillomavirus infection and risk of cervical cancer or precancerous lesions in 15 years follow up: a prospective cohort study].

    PubMed

    Zhang, Q; Hu, S Y; Feng, R M; Dong, L; Chen, F; Zhang, X; Pan, Q J; Ma, J F; Shi, S D; Zhao, F H; Qiao, Y L

    2016-10-23

    Objective: To evaluate the 15 years changing trends of prevalence of high risk HPV (HR-HPV) infection and the risks of cervical cancer and precancerous lesions (CIN2+ ) among a Chinese rural population. Methods: The screening cohort with 1 997 women aged 35 to 45 years old was built in 1999 in Xiangyuan County, Shanxi province (SPOCCS-I) and followed up by cytology and HR-HPV testing in the years of 2005, 2010, and 2014. The changes of HR-HPV prevalence and the risks of cervical precancerous lesions with CIN2+ as the endpoints were analyzed during the past 15 years. Results: The detection rates of HPV infection and CIN2+ were 15.7%-22.3% and 1.1%-4.3% for the baseline visit and the other 3 follow-ups, respectively. The cumulative risk of CIN2+ in HR-HPV positive women at baseline was significantly higher than HR-HPV negative women (P<0.01) during the 15-year follow-up. The risk of CIN2+ in the four-times HPV positive group was 40.0%, while the group with four-times negative HPV results was 0.6% (Adjusted RR = 55.0, 95% CI: 11.3 to 268.4). Conclusions: The prevalence of HR-HPV infection and CIN2+ lesions were high in Xiangyuan county during the 15 years. HR-HPV positivity elevated the risk of CIN2+ compared to women whose HR-HPV test was negative. The risks of CIN2+ incidence in 6 years were low among women with negative HR-HPV test. The risk of CIN2+ increased with the numbers of HPV infection events. The screening interval could be extended to 5-6 years.

  15. Progression and Regression of Cervical Pap Test Lesions in an Urban AIDS Clinic in the Combined Antiretroviral Therapy Era: A Longitudinal, Retrospective Study

    PubMed Central

    Tadros, Talaat; Herring-Bailey, Gina; Birdsong, George; Mosunjac, Marina; Flowers, Lisa; Nguyen, Minh Ly

    2015-01-01

    Abstract Our objective was to evaluate the progression and regression of cervical dysplasia in human immunodeficiency virus (HIV)-positive women during the late antiretroviral era. Risk factors as well as outcomes after treatment of cancerous or precancerous lesions were examined. This is a longitudinal retrospective review of cervical Pap tests performed on HIV-infected women with an intact cervix between 2004 and 2011. Subjects needed over two Pap tests for at least 2 years of follow-up. Progression was defined as those who developed a squamous intraepithelial lesion (SIL), atypical glandular cells (AGC), had low-grade SIL (LSIL) followed by atypical squamous cells-cannot exclude high-grade SIL (ASC-H) or high-grade SIL (HSIL), or cancer. Regression was defined as an initial SIL with two or more subsequent normal Pap tests. Persistence was defined as having an SIL without progression or regression. High-risk human papillomavirus (HPV) testing started in 2006 on atypical squamous cells of undetermined significance (ASCUS) Pap tests. AGC at enrollment were excluded from progression analysis. Of 1,445 screened, 383 patients had over two Pap tests for a 2-year period. Of those, 309 had an intact cervix. The median age was 40 years and CD4+ cell count was 277 cells/mL. Four had AGC at enrollment. A quarter had persistently normal Pap tests, 64 (31%) regressed, and 50 (24%) progressed. Four developed cancer. The only risk factor associated with progression was CD4 count. In those with treated lesions, 24 (59%) had negative Pap tests at the end of follow-up. More studies are needed to evaluate follow-up strategies of LSIL patients, potentially combined with HPV testing. Guidelines for HIV-seropositive women who are in care, have improved CD4, and have persistently negative Pap tests could likely lengthen the follow-up interval. PMID:25693769

  16. MMP9 is protective against lethal inflammatory mass lesions in the mouse colon

    PubMed Central

    Hald, Andreas; Rønø, Birgitte; Melander, Maria C.; Ding, Ming; Holck, Susanne; Lund, Leif R.

    2011-01-01

    SUMMARY The family of matrix metalloproteinases (MMPs) is responsible for extracellular matrix degradation during physiological and pathophysiological tissue remodeling processes such as embryogenesis, tissue repair and cancer progression. Despite these important roles of MMPs, inhibition or ablation of individual members of the MMP family in animal models have been shown to have little effect. It has been speculated that this results from a functional overlap between individual MMPs and (as-yet-unclassified) functional overlaps between MMPs and other protease systems. We here present genetic data showing that concomitant ablation of MMP9 (gelatinase B) and the serine protease plasmin results in lethal inflammatory mass lesions in the colon. These lesions possessed several histological attributes that are characteristic of mucosal prolapse seen in humans, and they were found to be associated with splenomegaly, enlarged mesenteric lymph nodes, decreased thymus size and altered populations of circulating immune cells. A time-course study provided evidence that the massive lymphoid hyperplasia and reactive changes were secondary to discrete fibrinous lesions also observed in mice only deficient for plasminogen (Plg), the zymogen for plasmin. These data demonstrate a non-appreciated vital protective role for MMP9 in the absence of Plg. PMID:21123624

  17. Pre-vaccination type-specific HPV prevalence in confirmed cervical high grade lesions in the Māori and non-Māori populations in New Zealand.

    PubMed

    Kang, Yoon-Jung; Lewis, Hazel; Smith, Megan A; Simonella, Leonardo; Neal, Harold; Bromhead, Collette; Canfell, Karen

    2015-08-22

    New Zealand initiated HPV vaccination in 2008, and has attained 3-dose coverage of ~50 % in 12-13 year old girls. Due to the success of program initiatives in Māori girls, higher coverage rates of ~60 % have been achieved in this group. We have previously reported a benchmark overall pre-vaccination prevalence of oncogenic HPV infection in high grade cervical lesions in New Zealand. The current extended analysis provides separate pre-vaccination benchmark prevalence for Māori and non-Māori women. The National Cervical Screening Programme Register (NCSP-R) was used to identify any woman aged 20-69 years of age with an index high grade cytology report from 2009-2011. Extended recruitment was performed until 2012 in clinics with a high proportion of Māori women. Ethnicity status was based on self-reported information by participating women through phone contact supplemented by recordings on the study questionnaire (the NCSP-R was not used to extract ethnicity status). A total of 730 women consented to participate and had a valid HPV test result; 418 of these had histologically-confirmed cervical intraepithelial neoplasia (CIN) 2/3 lesions (149 Māori, 269 non-Māori). The prevalence of any cervical oncogenic HPV infection, HPV16, and HPV18 was calculated in women with CIN2/3. In confirmed CIN2/3, the prevalence of any oncogenic HPV, HPV16 and HPV18 was 96 % (95 % CI:91-99 %), 54 % (95 % CI:46-63 %), 11 % (95 % CI:7-18 %) in Māori and 96 % (95 % CI:93-98 %), 54 % (95 % CI:48-60 %), 11 % (95 % CI:7-15 %) in non-Māori women, respectively. Age-specific patterns of infection for HPV16/18 in confirmed CIN2/3 differed between the two groups (Pinteraction = 0.02), with a lower prevalence in younger vs. older Māori women (57 % in 20-29 years vs 75 % in 40-69 years) but a higher prevalence in younger vs. older non-Māori women (70 % in 20-29 years vs 49 % in 40-69 years); the difference in the age-specific patterns of infection for HPV16/18 was not significant either

  18. A Man with Pancreatic Head Mass Lesion on Endoscopic Ultrasound and Granuloma on Cytopathology

    PubMed Central

    Rad, Neda; Heidarnezhad, Arash; Soheili, Setareh; Mohammad-Alizadeh, Amir Houshang; Nikmanesh, Arash

    2016-01-01

    Primary pancreatic lymphoma is an unlikely malignancy accounting for less than 0.5% of pancreatic tumors. Clinical presentation is often nonspecific and may be clinically misdiagnosed as pancreatic adenocarcinoma. Here we present an Iranian case of primary pancreatic lymphoma in a 47-year-old male suffering from jaundice and 20% weight loss. Endoscopic ultrasound revealed a mixed echoic mass lesion at the head of pancreas. The patient underwent endoscopic ultrasound-guided fine needle aspiration of solid pancreatic mass and histopathologic diagnosis revealed granuloma. Computed tomography-guided core needle biopsy was performed and eventually histological examination showed granuloma that was coherent with the diagnosis of primary pancreatic lymphoma. Primary pancreatic lymphoma is a rare entity presenting with nonspecific symptoms, laboratory and radiological findings. Computed tomography results in combination with clinical and radiological studies generally provide guidance for appropriate investigation. PMID:28100998

  19. Association of the plasma and tissue riboflavin levels with C20orf54 expression in cervical lesions and its relationship to HPV16 infection.

    PubMed

    Aili, Aixingzi; Hasim, Ayshamgul; Kelimu, Alimujiang; Guo, Xia; Mamtimin, Batur; Abudula, Abuliz; Upur, Halmurat

    2013-01-01

    Riboflavin deficiency can cause a variety of metabolic problems that lead to skin and mucosal disorders. Limited evidence suggests that high intake of riboflavin may reduce overall risks of cancer. However, association of this deficiency with cervical cancer and precancerous lesions are still not definitively known. In this study, we characterized the relationship between plasma and tissue riboflavin levels and C20orf54 protein expression in patients with cervical intraepithelial neoplasia (CIN) and cervical squamous cell carcinoma (CSCC) as well as the relationship of these levels with human papillomavirus virus 16, 18 (HPV16/18) infections. High-performance liquid chromatography (HPLC) was used to measure blood riboflavin levels in patients with CIN and CSCC, and an enzyme-linked immunosorbent assay (ELISA) was used to determine tissue riboflavin levels in patients with CSCC and matched normal mucous epithelia. The expression of C20orf54 in fresh CSCC and matched tissues were detected by qRT-PCR and western blot, respectively. And it was further confirmed by immunohistochemistry (IHC) with formalin-fixed, paraffin-embedded CIN and CSCC. An HPV genotyping chip was used to analyze HPV infection and typing. The results showed that patients with CIN and CSCC had decreased plasma riboflavin levels as compared with normal controls. There was also significantly decreased riboflavin in tissues from CSCC patients, when compared with normal cervical epithelia. C20orf54 expression were significantly up-regulated in CSCC compared to matched control on both mRNA and protein level. Tissue riboflavin levels were significantly lower in HPV16/18 positive tissue compared with HPV16/18-negative tissue, and an inverse association was found between tissue riboflavin levels and C20orf54 mRNA and protein expression in CSCC. Additionally, C20orf54 was significantly correlated with tumor stages. In conclusion, C20orf54 tend to play a protective role in Uyghur cervical carcinogenesis of

  20. Association of the Plasma and Tissue Riboflavin Levels with C20orf54 Expression in Cervical Lesions and Its Relationship to HPV16 Infection

    PubMed Central

    Kelimu, Alimujiang; Guo, Xia; Mamtimin, Batur; Abudula, Abuliz; Upur, Halmurat

    2013-01-01

    Riboflavin deficiency can cause a variety of metabolic problems that lead to skin and mucosal disorders. Limited evidence suggests that high intake of riboflavin may reduce overall risks of cancer. However, association of this deficiency with cervical cancer and precancerous lesions are still not definitively known. In this study, we characterized the relationship between plasma and tissue riboflavin levels and C20orf54 protein expression in patients with cervical intraepithelial neoplasia (CIN) and cervical squamous cell carcinoma (CSCC) as well as the relationship of these levels with human papillomavirus virus 16, 18 (HPV16/18) infections. High-performance liquid chromatography (HPLC) was used to measure blood riboflavin levels in patients with CIN and CSCC, and an enzyme-linked immunosorbent assay (ELISA) was used to determine tissue riboflavin levels in patients with CSCC and matched normal mucous epithelia. The expression of C20orf54 in fresh CSCC and matched tissues were detected by qRT-PCR and western blot, respectively. And it was further confirmed by immunohistochemistry (IHC) with formalin-fixed, paraffin-embedded CIN and CSCC. An HPV genotyping chip was used to analyze HPV infection and typing. The results showed that patients with CIN and CSCC had decreased plasma riboflavin levels as compared with normal controls. There was also significantly decreased riboflavin in tissues from CSCC patients, when compared with normal cervical epithelia. C20orf54 expression were significantly up-regulated in CSCC compared to matched control on both mRNA and protein level. Tissue riboflavin levels were significantly lower in HPV16/18 positive tissue compared with HPV16/18-negative tissue, and an inverse association was found between tissue riboflavin levels and C20orf54 mRNA and protein expression in CSCC. Additionally, C20orf54 was significantly correlated with tumor stages. In conclusion, C20orf54 tend to play a protective role in Uyghur cervical carcinogenesis of

  1. Physical state and expression of HPV DNA in benign and dysplastic cervical tissue: different levels of viral integration are correlated with lesion grade.

    PubMed

    Hudelist, Gernot; Manavi, Mahmood; Pischinger, Kerstin I D; Watkins-Riedel, Thomas; Singer, Christian F; Kubista, E; Czerwenka, Klaus F

    2004-03-01

    Human papillomavirus (HPV) infection is the most important event in the malignant transformation of human cervical epithelium. Several high-risk (HR-)HPV subtypes have been identified, which lead to CIN and subsequently to invasive carcinoma. The reason for this phenomenon is still unknown, but it seems to be related to the physical state of HPV DNA. Digene HC II test was used to identify HR- and/or low-risk (LR-)HPV infections in cervical swabs of 275 women attending our clinic for routine cytological screening and/or colposcopy because of an abnormal Pap smear comprising low-grade squamous intraepithelial lesions (LGSIL) and high-grade SIL (HGSIL). Specific HR (16, 18, 31, 33, 52b, 58) and LR (6, 11) subtypes were characterized in cervical biopsies of 10 women with benign cellular changes and of 68 women with CIN I-III by the PCR-restriction enzyme method. The physical state of HPV DNA (episomal, mixed and integrated form) was analyzed by bi-dimensional (2D)-gel electrophoresis. In addition, mRNA expression of E6/E7 genes was analyzed by RT-PCR. Furthermore, the relative virus load was determined in nine selected cases. The physical state and transcriptional activity of HPV DNA were then correlated to histopathological results. LR-HPV infection [27 cases (9.8%)] and HR-HPV infection [121 cases (44%)] of cervical swabs were clearly correlated to the degree of SIL. Further HPV typing in cervical biopsies of 78 women showed that HPV6 and 11 were restricted to benign cellular changes, CIN I and II, whereas HPV16 and 18 were observed predominantly in CIN III/CIS (P=0.01). No clear distribution pattern was observed for HPV31, 33, 52b and 58. Expression of HPV E6 and E7 transcripts was uniformly correlated with the different physical state of HPV DNA. Analyzing the physical state of these HPV subtypes, HPV6 and 11 could only be detected as an episomal form, independent of SIL grade. In normal epithelium and in CIN I and II, HPV16 and 18 were exclusively found in the

  2. [A case of Sjögren syndrome with subacute combined degeneration-like posterior column lesion on cervical MRI].

    PubMed

    Hongo, Yu; Onoue, Hiroyuki; Takeshima, Shinichi; Kamakura, Keiko; Kaida, Ken-Ichi

    2012-01-01

    We report a case of a 67 year-old man with bilateral sensory ataxia of the upper extremities. He was diagnosed as having ANCA-related angitis and Sjögren syndrome at age 60. On admission to our hospital at age 67, he presented with severe sensory ataxia in his upper extremities, while his lower extremity neurological symptoms were limited to the absence of tendon reflexes. Cervical MRI showed an increased T2 signal intensity in an area limited to the bilateral cuneate fasciculus. Serum levels of vitamin B12 and folic acid were normal. Plasma homocysteine, serum and urine methylmalonic acid were also normal. Eight-week intramuscular administration of vitamin B12 did not improve either his disorder or the MRI findings. His sensory ataxia might be attributed to Sjögren syndrome-associated ganglionopathy at the cervical level, and the MRI findings might reflect centripetal Wallerian degeneration in the cuneate fasciculus. Gracilis fasciculus are well-known as vulnerable regions in Sjögren-associated myelopathy, whereas cervical myelopathy, limited to cuneate fascicules, can emerge as Sjögren-associated disorders.

  3. Participation and risk of high grade cytological lesions among immigrants and Italian-born women in an organized cervical cancer screening program in Central Italy.

    PubMed

    Visioli, Carmen Beatriz; Crocetti, Emanuele; Zappa, Marco; Iossa, Anna; Andersson, Karin Louise; Bulgaresi, Paolo; Alfieri, Antonia; Amunni, Gianni

    2015-06-01

    Few studies analyzed the risk for high-grade squamous intraepithelial lesions or worse (HSIL+) among immigrants and natives attending organized cervical cancer (CC) screening programs (SP). We evaluated participation and diagnosis of HSIL+ by country of birth with logistic models. Overall 540,779 invitation letters were delivered to target women of Florence SP in three screening rounds (years 2000-2002, 2003-2005, 2006-2008). The probability of attending screening was lower for immigrants than natives, but the difference decreased from 35% (1st round) to 20% (2nd-3rd round) for women born in high migration pressure (HMP) countries. The risk of HSIL+ was double than natives for HMP-born women from countries with high prevalence of human papillomavirus, even adjusting for age and previous history of Pap test. This is an important public health problem due to an increasing proportion over time of immigrant women with a lower attendance and greater risk for CC.

  4. Effectiveness on oral pain of 808-nm diode laser used prior to composite restoration for symptomatic non-carious cervical lesions unresponsive to desensitizing agents.

    PubMed

    Femiano, Felice; Femiano, Rossella; Lanza, Alessandro; Lanza, Michele; Perillo, Letizia

    2017-01-01

    This study compares sensitivity reduction after dental restoration with and without prior diode laser (DL) irradiation for cervical dentine hypersensitivity (CDH) from non-carious cervical lesions (NCCLs) unresponsive to desensitizing agents. Eighty-eight teeth of 28 subjects (21 females; age 23-64 years), with CDH from NCCL were included in this study. NCCLs of each oral quadrant were randomized in two groups (study group (SG)) to estimate the sensitivity reduction after dental restoration (SG-1) compared with the DL irradiation used prior to restoration placement (SG-2). The subjects were asked to rate the sensitivity experienced during air stimulation using a visual analog scale before (baseline), immediately after, and at 6 and 12 months from restoration. The outcomes showed a significant reduction of discomfort compared to baseline for NCCLs of SG-2 with the decrease of 78.5, 78.9, and 78.1 % immediately and at 6 and 12 months after restoration, respectively; in comparison with the decrease of 70.1, 67, and 65.3 % for NCCLs of SG-1 immediately and at 6 and 12 months after restoration, respectively; and compared to baseline. The DL irradiation prior to dental restoration can further improve the painful symptomatology of CDH from NCCL unresponsive to desensitizing agents.

  5. Optimal area of lateral mass mini-screws implanted in plated cervical laminoplasty: a radiography anatomy study.

    PubMed

    Chen, Hua; Li, Huibo; Deng, Yuxiao; Rong, Xin; Gong, Quan; Li, Tao; Song, Yueming; Liu, Hao

    2017-04-01

    Lateral mass mini-screws used in plated cervical laminoplasty might penetrate into facet joints. The objective is to observe this complication incidence and to identify the optimal areas for 5- and 7-mm-long mini-screws to implant on lateral mass. 47 patients who underwent plated cervical laminoplasty were included. The optimal area for mini-screws implanting was set according to pre-operative 3D CT reconstruction data. Then, each posterior-lateral mass surface was divided into three regions: 7-mm region, 5-mm region, and dangerous area. The mini-screw implanted region was recorded. Post-operative CT images were used to identify whether the mini-screws penetrated into facet joints. 235 mini-plates and 470 lateral mass mini-screws were used in the study. 117 (24.9%) mini-screws penetrated 88 (37.4%) facet joints. The 5-mm-long mini-screw optimal area occupied the upper 72, 65, 65, 64, and 65 % area of the posterior-lateral mass surface for C3-7, while the 7-mm-long mini-screw optimal area encompassed the upper 54, 39, 40, 33, and 32 %. Only 7-mm-long mini-screws were used to fix the plate to the lateral mass. 4 of 240 mini-screws in 7-mm region, 67 of the 179 mini-screws in 5-mm region, and 46 of the 51 mini-screws in dangerous region penetrated into the facet joint. The differences in the rate of facet joint penetration related to region were statistically significant (P < 0.001). The facet joint destruction by mini-screws was not a rare complication in plated cervical laminoplasty. The optimal areas we proposed may help guide the mini-screw implantation positions.

  6. Head position and impact direction in whiplash injuries: associations with MRI-verified lesions of ligaments and membranes in the upper cervical spine.

    PubMed

    Kaale, Bertel Rune; Krakenes, Jostein; Albrektsen, Grethe; Wester, Knut

    2005-11-01

    In the present study, we compared magnetic resonance imaging (MRI) findings of soft tissue structures in the upper cervical spine between whiplash-associated disorder (WAD) patients and population-based control persons, and examined whether MRI-verified abnormalities in WAD patients were related to accident-related factors hypothesized to be of importance for severity of injury. A total of 92 whiplash patients and 30 control persons, randomly drawn, were included. Information on the accident-related factors (i.e., head position and impact direction) was obtained by a questionnaire that was answered within 1 week after the accident. The MRI examination was performed 2-9 (mean 6) years after the accident. Focus was on MRI abnormalities of the alar and the transverse ligaments, and the tectorial and posterior atlanto-occipital membranes, graded 0-3. For all neck structures, the whiplash patients had more high-grade lesions (grade 2 or 3) than the control persons (Chi-square test, p < 0.055). An abnormal alar ligament was most common (66.3% graded 2 or 3). Whiplash patients who had been sitting with their head/neck turned to one side at the moment of collision more often had high-grade lesions of the alar and transverse ligaments (p < 0.001, p = 0.040, respectively). Severe injuries to the transverse ligament and the posterior atlanto-occipital membrane were more common in front than in rear end collisions (p < 0.001, p = 0.001, respectively). In conclusion, the difference in MRI-verified lesions between WAD patients and control persons, and in particular the association with head position and impact direction at time of accident, indicate that these lesions are caused by the whiplash trauma.

  7. A quantification strategy for missing bone mass in case of osteolytic bone lesions

    SciTech Connect

    Fränzle, Andrea Giske, Kristina; Bretschi, Maren; Bäuerle, Tobias; Hillengass, Jens; Bendl, Rolf

    2013-12-15

    Purpose: Most of the patients who died of breast cancer have developed bone metastases. To understand the pathogenesis of bone metastases and to analyze treatment response of different bone remodeling therapies, preclinical animal models are examined. In breast cancer, bone metastases are often bone destructive. To assess treatment response of bone remodeling therapies, the volumes of these lesions have to be determined during the therapy process. The manual delineation of missing structures, especially if large parts are missing, is very time-consuming and not reproducible. Reproducibility is highly important to have comparable results during the therapy process. Therefore, a computerized approach is needed. Also for the preclinical research, a reproducible measurement of the lesions is essential. Here, the authors present an automated segmentation method for the measurement of missing bone mass in a preclinical rat model with bone metastases in the hind leg bones based on 3D CT scans. Methods: The affected bone structure is compared to a healthy model. Since in this preclinical rat trial the metastasis only occurs on the right hind legs, which is assured by using vessel clips, the authors use the left body side as a healthy model. The left femur is segmented with a statistical shape model which is initialised using the automatically segmented medullary cavity. The left tibia and fibula are segmented using volume growing starting at the tibia medullary cavity and stopping at the femur boundary. Masked images of both segmentations are mirrored along the median plane and transferred manually to the position of the affected bone by rigid registration. Affected bone and healthy model are compared based on their gray values. If the gray value of a voxel indicates bone mass in the healthy model and no bone in the affected bone, this voxel is considered to be osteolytic. Results: The lesion segmentations complete the missing bone structures in a reasonable way. The mean

  8. Vaccines against cervical cancer.

    PubMed

    Jansen, Kathrin U

    2004-11-01

    Cervical cancer and precancerous lesions of the genital tract are a major threat to women's health worldwide. Although the introduction of screening tests to detect cervical cancer and its precursor lesions has reduced overall cervical cancer rates in the developed world, the approach was largely unsuccessful for developing countries, primarily due to a lack of appropriate infrastructures and high costs. Annually, 470,000 cervical cancer cases are diagnosed worldwide, of which 80% occur in developing countries. Despite advances in treatment of cervical cancer, approximately half of the women afflicted with the disease will die. Over 20 years of dedicated research has provided conclusive evidence that a subset of human papillomaviruses are the aetiological agents for cervical cancer. Finding a viral origin for this disease provided the basis to fight cervical cancer using prophylactic or therapeutic vaccination. Both vaccine approaches are reviewed here, with an emphasis on recent clinical data.

  9. [PREVALENCE OF NON-CARIOUS CERVICAL LESIONS AND ABFRACTIONS OF DENTAL HARD TISSUES IN AN ADULT IN DIFFERENT AGES].

    PubMed

    Iordanishvili, A K; Chernyj, D A; Jankovskij, V V; Orlov, A K; Drobkova, K O

    2015-01-01

    The article is devoted to gerontostomatological and gender-specific prevalence of non-carious lesions of the hard tissue of teeth in adults. The paper presents data of epidemiological study on prevalence of non-carious lesions of dental hard tissues (high abrasion, erosion, wedge-shaped defects, hyperesthesia). Allocated to four age groups: young adults surveyed--from 22 to 39 years; middle ages--from 40 to 59 years; older--from 60 to 74 years of age; senile age--from 75 to 87 years. To determine the frequency of occurrence of different forms of non-carious lesions of the hard tissue of teeth we have used the following: general scientific and special methods: poll, dental examination, groupings, statistical and mathematical methods of processing sample. We have ranked low incidence of non-carious lesions of the hard tissue of the teeth in the sample surveyed: high abrasion, erosion, wedge-shaped defects of solid tissues, hyperesthesia. The features of clinical course of non-carious lesions have been determined. In particular a rare combined lesion of the teeth with advanced erasibility, wedge defects and erosion has been noted. Significant combination of the pathological processes of the hard tissue of teeth with their hyperesthesia has been found. Features of different forms of non-carious lesions of the hard tissue of teeth in different age periods of life have been determined. Noted that older people, due to non-carious esions of the hard tissue of teeth were more likely to require medical intervention aimed at addressing the ncreased sensitivity and loss of hard tissue of teeth by dental therapeutic activities or dental prosthetics.

  10. Detection of Cervical Cancer Biomarker Patterns in Blood Plasma and Urine by Differential Scanning Calorimetry and Mass Spectrometry

    PubMed Central

    Garbett, Nichola C.; Merchant, Michael L.; Helm, C. William; Jenson, Alfred B.; Klein, Jon B.; Chaires, Jonathan B.

    2014-01-01

    Improved methods for the accurate identification of both the presence and severity of cervical intraepithelial neoplasia (CIN) and extent of spread of invasive carcinomas of the cervix (IC) are needed. Differential scanning calorimetry (DSC) has recently been shown to detect specific changes in the thermal behavior of blood plasma proteins in several diseases. This methodology is being explored to provide a complementary approach for screening of cervical disease. The present study evaluated the utility of DSC in differentiating between healthy controls, increasing severity of CIN and early and advanced IC. Significant discrimination was apparent relative to the extent of disease with no clear effect of demographic factors such as age, ethnicity, smoking status and parity. Of most clinical relevance, there was strong differentiation of CIN from healthy controls and IC, and amongst patients with IC between FIGO Stage I and advanced cancer. The observed disease-specific changes in DSC profiles (thermograms) were hypothesized to reflect differential expression of disease biomarkers that subsequently bound to and affected the thermal behavior of the most abundant plasma proteins. The effect of interacting biomarkers can be inferred from the modulation of thermograms but cannot be directly identified by DSC. To investigate the nature of the proposed interactions, mass spectrometry (MS) analyses were employed. Quantitative assessment of the low molecular weight protein fragments of plasma and urine samples revealed a small list of peptides whose abundance was correlated with the extent of cervical disease, with the most striking plasma peptidome data supporting the interactome theory of peptide portioning to abundant plasma proteins. The combined DSC and MS approach in this study was successful in identifying unique biomarker signatures for cervical cancer and demonstrated the utility of DSC plasma profiles as a complementary diagnostic tool to evaluate cervical cancer

  11. Detection of cervical cancer biomarker patterns in blood plasma and urine by differential scanning calorimetry and mass spectrometry.

    PubMed

    Garbett, Nichola C; Merchant, Michael L; Helm, C William; Jenson, Alfred B; Klein, Jon B; Chaires, Jonathan B

    2014-01-01

    Improved methods for the accurate identification of both the presence and severity of cervical intraepithelial neoplasia (CIN) and extent of spread of invasive carcinomas of the cervix (IC) are needed. Differential scanning calorimetry (DSC) has recently been shown to detect specific changes in the thermal behavior of blood plasma proteins in several diseases. This methodology is being explored to provide a complementary approach for screening of cervical disease. The present study evaluated the utility of DSC in differentiating between healthy controls, increasing severity of CIN and early and advanced IC. Significant discrimination was apparent relative to the extent of disease with no clear effect of demographic factors such as age, ethnicity, smoking status and parity. Of most clinical relevance, there was strong differentiation of CIN from healthy controls and IC, and amongst patients with IC between FIGO Stage I and advanced cancer. The observed disease-specific changes in DSC profiles (thermograms) were hypothesized to reflect differential expression of disease biomarkers that subsequently bound to and affected the thermal behavior of the most abundant plasma proteins. The effect of interacting biomarkers can be inferred from the modulation of thermograms but cannot be directly identified by DSC. To investigate the nature of the proposed interactions, mass spectrometry (MS) analyses were employed. Quantitative assessment of the low molecular weight protein fragments of plasma and urine samples revealed a small list of peptides whose abundance was correlated with the extent of cervical disease, with the most striking plasma peptidome data supporting the interactome theory of peptide portioning to abundant plasma proteins. The combined DSC and MS approach in this study was successful in identifying unique biomarker signatures for cervical cancer and demonstrated the utility of DSC plasma profiles as a complementary diagnostic tool to evaluate cervical cancer

  12. Non-mass breast lesions on ultrasound: final outcomes and predictors of malignancy.

    PubMed

    Park, Jong Won; Ko, Kyung Hee; Kim, Eun-Kyung; Kuzmiak, Cherie M; Jung, Hae Kyoung

    2017-09-01

    Background Breast cancer can present as non-mass lesions (NMLs) on ultrasound. However, knowledge of and understanding about NMLs are scarce. Purpose To retrospectively investigate the final outcomes of sonographic breast NMLs and determine the clinical and radiologic variables associated with malignancy Material and Methods In our radiologic database of breast ultrasound examinations between 2011 and 2014, we found 119 women with 121 NMLs with available histopathologic or sonographic follow-up (over 2 years) data. We collected the clinical variables (patient's age, symptoms, and mammographic density) and histopathologic data as well as radiologic variables (mammographic and ultrasound findings) after retrospective review by two radiologists, the authors of the current paper, in consensus. We classified the ultrasound findings according to distribution (focal, linear or segmental, and regional) and associated features (calcification, architectural distortion, and ductal changes) and analyzed the associations between variables and malignancy using the t test and χ(2) test. Results Of the 121 NMLs, 88 (72.7%) were benign and 33 (27.3%) were malignant. Ductal carcinoma in situ (DCIS) (17/33, 51.5%) and invasive ductal cancer with or without DCIS (13/33, 39.4%) comprised the main malignancies, and malignancy was significantly associated with palpability ( P = 0.000). Mammographic findings and sonographic distribution and associated features were significantly different between benign and malignant lesions ( P = 0.000, P = 0.004, and P = 0.001, respectively). Malignant lesions showed more frequent calcifications combined with asymmetry ( P = 0.000) on mammography and linear-segmental distributions ( P = 0.001) and associated calcifications ( P = 0.019) or architectural distortions ( P = 0.015) on ultrasound. Conclusion Breast NMLs on ultrasound showed high risk of malignancy. Symptoms and mammographic and ultrasound findings can be

  13. The SNP at −592 of human IL-10 gene is associated with serum IL-10 levels and increased risk for human papillomavirus cervical lesion development

    PubMed Central

    2012-01-01

    Background Women with Human Papilloma Virus (HPV) persistence are characterized by high levels of IL-10 at cervix. We have determined whether polymorphisms of IL-10 gene promoter might be associated with increased risk of squamous intraepithelial cervical lesions (SICL) and whether exist significative differences of IL-10 mRNA expression at cervix and systemic and serum IL-10 protein between SICL cases and non-Cervical Lesions (NCL). Methods Peripheral blood samples from SICL (n = 204) and NCL (n = 166) were used to detect IL-10 promoter polymorphisms at loci -592A/C (rs1800872), -819C/T (rs1800871), -1082A/G (rs1800896), -1352A/G (rs1800893), by allelic discrimination and to evaluate serum IL-10 protein. Cervical epithelial scrapings from NCL and biopsies from SICLs were used for HPV-typing and to evaluate IL-10 mRNA expression level. The systemic and local IL-10 mRNA expression levels were measured by real time-PCR. Genotypic and allelic frequencies of the selected polymorphisms were analyzed by logistic regression, adjusting by age and HPV-genotype, to determine the association with SICL. Results No significant differences were found between genotype frequencies at loci −819, -1082, and −1352. Individuals carrying at least one copy of risk allele A of polymorphism −592 had a two-fold increased risk of developing SICL [adjusted odds ratio (OR), 2.02 (95% CI, 1.26-3.25), p = 0.003], compared to NCL. The IL-10 mRNA expression and serum IL-10 protein, were significantly higher in SICL cases (p < 0.01), being higher in patients carrying the risk allele A. Conclusions The −592 polymorphism is associated with increased risk of SICL and can serve as a marker of genetic susceptibility to SICL among Mexican women. According to IL-10 levels found in SICL, IL-10 can be relevant factor for viral persistence and progression disease. PMID:23148667

  14. Loss of Dependence on Continued Expression of the Human Papillomavirus 16 E7 Oncogene in Cervical Cancers and Precancerous Lesions Arising in Fanconi Anemia Pathway-Deficient Mice.

    PubMed

    Park, Soyeong; Park, Jung Wook; Pitot, Henry C; Lambert, Paul F

    2016-05-17

    Fanconi anemia (FA) is a rare genetic disorder caused by defects in DNA damage repair. FA patients often develop squamous cell carcinoma (SCC) at sites where high-risk human papillomaviruses (HPVs) are known to cause cancer, including the cervix. However, SCCs found in human FA patients are often HPV negative, even though the majority of female FA patients with anogenital cancers had preexisting HPV-positive dysplasia. We hypothesize that HPVs contribute to the development of SCCs in FA patients but that the continued expression of HPV oncogenes is not required for the maintenance of the cancer state because FA deficiency leads to an accumulation of mutations in cellular genes that render the cancer no longer dependent upon viral oncogenes. We tested this hypothesis, making use of Bi-L E7 transgenic mice in which we temporally controlled expression of HPV16 E7, the dominant viral oncogene in HPV-associated cancers. As seen before, the persistence of cervical neoplastic disease was highly dependent upon the continued expression of HPV16 E7 in FA-sufficient mice. However, in mice with FA deficiency, cervical cancers persisted in a large fraction of the mice after HPV16 E7 expression was turned off, indicating that these cancers had escaped from their dependency on E7. Furthermore, the severity of precancerous lesions also failed to be reduced significantly in the mice with FA deficiency upon turning off expression of E7. These findings confirm our hypothesis and may explain the fact that, while FA patients have a high frequency of infections by HPVs and HPV-induced precancerous lesions, the cancers are frequently HPV negative. IMPORTANCE  : Fanconi anemia (FA) patients are at high risk for developing squamous cell carcinoma (SCC) at sites where high-risk human papillomaviruses (HPVs) frequently cause cancer. Yet these SCCs are often HPV negative. FA patients have a genetic defect in their capacity to repair damaged DNA. HPV oncogenes cause an accumulation of DNA

  15. Loss of Dependence on Continued Expression of the Human Papillomavirus 16 E7 Oncogene in Cervical Cancers and Precancerous Lesions Arising in Fanconi Anemia Pathway-Deficient Mice

    PubMed Central

    Park, Soyeong; Park, Jung Wook; Pitot, Henry C.

    2016-01-01

    ABSTRACT   Fanconi anemia (FA) is a rare genetic disorder caused by defects in DNA damage repair. FA patients often develop squamous cell carcinoma (SCC) at sites where high-risk human papillomaviruses (HPVs) are known to cause cancer, including the cervix. However, SCCs found in human FA patients are often HPV negative, even though the majority of female FA patients with anogenital cancers had preexisting HPV-positive dysplasia. We hypothesize that HPVs contribute to the development of SCCs in FA patients but that the continued expression of HPV oncogenes is not required for the maintenance of the cancer state because FA deficiency leads to an accumulation of mutations in cellular genes that render the cancer no longer dependent upon viral oncogenes. We tested this hypothesis, making use of Bi-L E7 transgenic mice in which we temporally controlled expression of HPV16 E7, the dominant viral oncogene in HPV-associated cancers. As seen before, the persistence of cervical neoplastic disease was highly dependent upon the continued expression of HPV16 E7 in FA-sufficient mice. However, in mice with FA deficiency, cervical cancers persisted in a large fraction of the mice after HPV16 E7 expression was turned off, indicating that these cancers had escaped from their dependency on E7. Furthermore, the severity of precancerous lesions also failed to be reduced significantly in the mice with FA deficiency upon turning off expression of E7. These findings confirm our hypothesis and may explain the fact that, while FA patients have a high frequency of infections by HPVs and HPV-induced precancerous lesions, the cancers are frequently HPV negative. Importance   Fanconi anemia (FA) patients are at high risk for developing squamous cell carcinoma (SCC) at sites where high-risk human papillomaviruses (HPVs) frequently cause cancer. Yet these SCCs are often HPV negative. FA patients have a genetic defect in their capacity to repair damaged DNA. HPV oncogenes cause an

  16. Enhancing Mass Lesion of the Sphenoid: Atypical Presentation of Ongoing Pneumatization

    PubMed Central

    Vallabhaneni, Deepak; Badar, Zain; Mangla, Rajiv

    2016-01-01

    Sinus pneumatization is a complex variable process that begins in early life and continues for many years. We present a case of a 6-year-old boy with progressive headaches and neurologic symptoms suggestive of intracranial pathology. The presence of enhancing tissue within the sphenoid sinus created a diagnostic dilemma which leads to a transsphenoidal biopsy. Knowledge of imaging characteristics associated with incomplete pneumatization can help differentiate it from more ominous skull base pathology and prevent unnecessary testing. We describe four-year imaging follow-up in a patient with incomplete pneumatization of the sphenoid sinus presenting as an enhancing mass lesion with subsequent follow-up imaging demonstrating gradual regression and increased aeration of the sphenoid sinus. PMID:28058123

  17. Antibody levels against alpha-galactosyl epitopes in sera of patients with squamous intraepithelial lesions and early invasive cervical carcinoma.

    PubMed

    Tremont-Lukats, I W; Avila, J L; Hernández, D; Vásquez, J; Teixeira, G M; Rojas, M

    1997-02-01

    We measured serum levels of anti-Gal(alpha 1-->3)Gal and anti-Gal(alpha 1-->2)Gal antibodies in 89 and 91 women, respectively, by using ELISA. These patients had cervical intraepithelial neoplasia (CIN) grades 1 to 3 and early invasive cervical carcinoma (ICC). Our objective was to compare anti-alpha-galactosyl antibody levels among them and with those of normal controls. High levels of anti-Gal(alpha 1-->2)Gal antibodies were detected in 22% of patients (P = 0.006). The mean level was 1.6 times greater than that of controls, without difference among subgroups. Thirty percent of patients had abnormally high anti-Gal levels (P = 0.001). Mean levels were twofold greater than the mean control value. Subsets with human papillomavirus/CIN 1 and CIN 2-3 had high immunoreactivity (P = 0.004). Both antibodies showed a significant correlation (r = 0.53, P < 0.00001). We conclude that 22 to 30% of patients with CIN 1-3 showed significantly high levels of anti-alpha-galactosyl antibodies. This seroreactivity might be related to the abnormal expression of alpha-galactosyl residues at some point of the natural history of human papillomavirus infection of the uterine cervix, suggesting an active immune response by natural antibodies against this virus. Further studies are needed to determine whether anti-alpha-galactosyl antibodies confer protection in human papillomavirus infection.

  18. Clinical performance of a resin-modified glass-ionomer and two polyacid-modified resin composites in cervical lesions restorations: 1-year follow-up.

    PubMed

    Chinelatti, M A; Ramos, R P; Chimello, D T; Palma-Dibb, R G

    2004-03-01

    The aim of this study was to assess the clinical performance of a resin-modified glass-ionomer cement (Vitremer) and two polyacid-modified resin composites (F2000 and Freedom) over 1 year. Nineteen patients with at least three cervical lesions were selected, providing an initial sample size of 87 restorations (29 per material), being 78 to non-carious and nine to carious lesions. Restorations were evaluated at baseline, 6 months and 1 year after placement, using modified US Public Health Service criteria: colour match, marginal discoloration, caries, anatomical form, marginal integrity and surface texture. At baseline, restorations were considered as acceptable for all criteria. At 1-year recall, 21 restorations per material were re-examined. Freedom was rated Bravo or Charlie for all the examined criteria and Vitremer earned an Alfa rating solely for the criterion caries. On the contrary, F2000 showed the best overall results, although presenting significant alteration in colour match. Statistical analysis of data was performed using chi-square and Mc Nemar tests. As to the evaluated periods, significant difference was observed solely between baseline and 1-year recall. Freedom and Vitremer were statistically different (P < 0.01) as to anatomical form and surface texture. For F2000, significant difference (P < 0.05) was noticed as to colour match and anatomical form. After 1-year follow-up, F2000 showed the most acceptable results as to the analysed criteria.

  19. Thirteen-year randomized controlled clinical trial of a two-step self-etch adhesive in non-carious cervical lesions.

    PubMed

    Peumans, M; De Munck, J; Van Landuyt, K; Van Meerbeek, B

    2015-03-01

    The objective of this randomized controlled clinical trial was to evaluate the 13-year clinical performance of a mild two-step self-etch adhesive in non-carious cervical lesions with and without prior selective phosphoric acid-etching of the enamel cavity margins. A total of 100 non-carious cervical lesions in 29 patients were restored with Clearfil AP-X (Kuraray Noritake). The composite restorations were bonded following two different approaches: (1) application of Clearfil SE Bond (Kuraray Noritake) following a self-etch approach (CSE-NE); (2) selective phosphoric acid-etching of enamel cavity margins before application of Clearfil SE Bond (CSE-E). The restorations were evaluated after 6 months, 1, 2, 3, 5, 8 and 13 years of clinical service regarding retention, marginal integrity and discoloration, caries occurrence, preservation of tooth vitality and post-operative sensitivity. The patient recall rate at 13 years was 62%. Six restorations, 4 of the CSE-NE group and 2 of the CSE-E group, were clinically unacceptable due to loss of retention (1 CSE-NE, 1 CSE-E), a severe marginal defect (2 CSE-NE, 1 CSE-E) and caries occurrence in combination with a severe marginal defect (1 CSE-NE) leading to a clinical success rate of 86% (CSE-NE) and 93% (CSE-E). Ageing of the restorations was characterized by a further increase in the percentage of restorations with a clinically acceptable small marginal defect (CSE-NE: 87%; CSE-E: 83%) and/or superficial marginal discoloration (CSE-NE: 53%; CSE-E: 56%). The presence of small marginal defects (CSE-NE: 86%; CSE-E: 68%) and superficial marginal discoloration (CSE-NE: 41%; CSE-E: 20%) at the incisal enamel side was more frequently noticed in the CSE-NE group than in the CSE-E group. The difference, however, was not statistically significant (McNemar, p>0.05). After 13 years, the clinical effectiveness of Clearfil SE Bond in non-carious Class-V lesions remained excellent, with selective acid-etching of the enamel cavity margins

  20. Knowledge attitudes and practices of cervical cancer screening among urban and rural Nigerian women: a call for education and mass screening.

    PubMed

    Nwankwo, K C; Aniebue, U U; Aguwa, E N; Anarado, A N; Agunwah, E

    2011-05-01

    The incidence of cervical cancer has declined in developed nations due to routine use of cervical cancer screening services. In developing nations opportunistic screening is the practice, and many women present with late-stage disease. This study was designed to ascertain the knowledge of the women in Nigeria to cervical cancer, their practice of cervical cancer screening and factors hindering the use of available screening services. A cross-sectional study was done with interviewer-administered questionnaire. Only the consenting women attending an annual Christian religious meeting in 2007 in three towns in Enugu, South Eastern Nigeria participated. Only 15.5% of the respondents were aware of availability of cervical cancer screening services. The awareness significantly varied with the level of educational attainment (P<0.0001). Only 4.2% had ever done Pap smear test and all were referred for screening. The most important factors hindering the use of available cervical cancer screening services were lack of knowledge (49.8%) and the feeling that they had no medical problems (32.0%). There is very poor knowledge and practice of cervical cancer screening among Nigerian women. Effective female education and free mass screening are necessary for any successful cervical cancer screening programme in Nigeria.

  1. [Influence of Age in the Prevalence of High-Risk Human Papiloma Virus in Women with Pre-Neoplasic Cervical Lesions in Navarra, Spain].

    PubMed

    Mercado Gutiérrez, María Rosario; Arean Cuns, Carolina; Gómez Dorronsoro, María Luisa; Paniello Alastruey, Irene; Mallor Giménez, Fermin; Lozano Escario, Maria Dolores; Santamaría Martínez, Mercedes

    2017-02-09

    Cervical carcinoma (CC) is the second cause of death among women aged 15 and 44 in Spain. CC is linked to hig-risk human papillomavirus (HR-HPV) infection and its prevalence varies according age and geographical region. The awereness of the latter is essential for public health prevention efforts. The aim was to study the age related in HR-HPV genotypes in cytologies with squamous intraepithelial lesion (SIL). From a total of 67,935 ginecologic cytologies over a four-year period, we selected cytologic specimens with SIL. We used the Cervista® test to detect HR-HPV DNA. Women were classified into two groups under 35 and over 35 years old. Proportions were estimated with confidence intervals at 95% (95% CI). HR-HPV prevalence was 59,7%; 64,6% in women under 35 years old. HR-HPV species alpha 9 type 16 (HR-HPV 16) and alpha 5 type 51 (HR-HPV 51) were the most prevalent (60,9% and 51,7%). High-grade squamous intraepithelial lesions (H-SIL) were twice as high in women under 35 years (6,5 vs. 3,7%). 88,8% of H-SIL was associated HR-HPV 16, which increases the probability of H-SIL against Low-grade squamous intraepithelial lesions (L-SIL) regardless of age. In our population HR-HPV 16 was associated to H-SIL whereas HR-HPV specie alpha 7 type 18 and HR-HPV 51 to L-SIL regardless of age. The high prevalence of HR-HPV 51 in Navrra´s population (51,7%), suggests that local vaccination programs be re-assessed.

  2. Molecular and phylogenetic analysis of the HPV 16 E4 gene in cervical lesions from women in Greece.

    PubMed

    Tsakogiannis, D; Ruether, I G A; Kyriakopoulou, Z; Pliaka, V; Skordas, V; Gartzonika, C; Levidiotou-Stefanou, S; Markoulatos, P

    2012-09-01

    The HPV16 E1(∧)E4 protein is thought to contribute to the release of newly formed viral particles from infected epithelia. In order to investigate amino acid mutations in the HPV16 E1(∧)E4 protein, the complete E4 ORF was amplified by PCR in 27 HPV16-positive cervical samples, and the amplicons were cloned. Fifteen nucleic acid variations were identified in the E4 ORF, including seven silent nucleic acid mutations. In addition, nine amino acid mutations (A7V, A7P, L16I, D45E, L59I, L59T, Q66P, S72F, H75Q) were detected in the E1(∧)E4 protein, and these were associated with the severity of cervical malignancy. A maximum-likelihood phylogenetic tree was constructed based on the E4 ORF, and nucleotide sequence analysis of the E4, E6 and E7 genes from the same samples was conducted in order to determine the phylogenetic origin of the cloned sequences from the amplified HPV16 E4. Based on the nucleotide sequence and phylogenetic analysis it was revealed that even though E4 ORF constitutes a small polymorphic portion of the viral genome (288 bp), it could provide valuable information about the origins of the HPV16 genome. In addition, molecular evolutionary analysis of the E4 coding region revealed that neutral selection is dominant in the overlapping region of the E4 and E2 ORFs.

  3. Two-year clinical performance of two one-step self-etching adhesives in the restoration of cervical lesions.

    PubMed

    Schattenberg, A; Werling, U; Willershausen, B; Ernst, C-P

    2008-09-01

    The aim of the study was to evaluate the clinical performance of two different one-step self-etching adhesives (Hybrid Bond/Sun Medical, Xeno III/Dentsply) in adhesive cervical resin composite restorations. In accordance with a split-mouth study design, 50 patients (57.3+/-13.5) received at least one pair of restorations. In each of two comparable cervical cavities, either the adhesive systems Hybrid Bond or Xeno III was used with the resin composite Filtek Supreme (3M ESPE). After 6, 12 and 24 months, the restorations were scored according to the Ryge and California Dental Association criteria. After 2 years, the resulting scores (percent) of the Ryge evaluation for the groups Hybrid Bond/ Filtek Supreme and Xeno III/ Filtek Supreme were marginal integrity, Alpha (92/78), Bravo (8/2), Charlie (0/0) and Delta (0/10); anatomic form, Alpha (92/82), Bravo (8/8) and Charlie (0/10); secondary caries, Alpha (100/100) and Bravo (0/0); marginal discoloration, Alpha (80/84), Bravo (20/12), Charlie (0/0) and not available (0/4); color match, Oscar (39/47), Alpha (51/45), Bravo (10/4), Charlie (0/0) and not available (0/4); surface, Romeo (78/69), Sierra (22/22), Tango (0/0) and Victor (0/10); tooth vitality, Alpha (98/94), Bravo (2/6); and integrity of tooth, alpha 1 (96/96) and alpha 2 (4/4). After 2 years, all Hybrid Bond restorations were retained and showed clinically acceptable results, while five Xeno III restorations were lost in part or in toto. For marginal integrity, anatomic form and surface, significant differences (p<0.05) were found but did not prove statistically significant after Bonferroni adjustment.

  4. Ultrasound-guided cable-free 13-gauge vacuum-assisted biopsy of non-mass breast lesions

    PubMed Central

    Seo, Jiwoon; Jang, Mijung; Yun, Bo La; Lee, Soo Hyun; Kim, Eun-Kyu; Kang, Eunyoung; Park, So Yeon; Moon, Woo Kyung; Choi, Hye Young; Kim, Bohyoung

    2017-01-01

    Purpose To compare the outcomes of ultrasound-guided core biopsy for non-mass breast lesions by the novel 13-gauge cable-free vacuum-assisted biopsy (VAB) and by the conventional 14-gauge semi-automated core needle biopsy (CCNB). Materials and methods Our institutional review board approved this prospective study, and all patients provided written informed consent. Among 1840 ultrasound-guided percutaneous biopsies performed from August 2013 to December 2014, 145 non-mass breast lesions with suspicious microcalcifications on mammography or corresponding magnetic resonance imaging finding were subjected to 13-gauge VAB or 14-gauge CCNB. We evaluated the technical success rates, average specimen numbers, and tissue sampling time. We also compared the results of percutaneous biopsy and final surgical pathologic diagnosis to analyze the rates of diagnostic upgrade or downgrade. Results Ultrasound-guided VAB successfully targeted and sampled all lesions, whereas CCNB failed to demonstrate calcification in four (10.3%) breast lesions with microcalcification on specimen mammography. The mean sampling time were 238.6 and 170.6 seconds for VAB and CCNB, respectively. No major complications were observed with either method. Ductal carcinoma in situ (DCIS) and atypical ductal hyperplasia (ADH) lesions were more frequently upgraded after CCNB (8/23 and 3/5, respectively) than after VAB (2/26 and 0/4, respectively P = 0.028). Conclusion Non-mass breast lesions were successfully and accurately biopsied using cable-free VAB. The underestimation rate of ultrasound-detected non-mass lesion was significantly lower with VAB than with CCNB. Trial registration CRiS KCT0002267. PMID:28628656

  5. Intraventricular mass lesions at magnetic resonance imaging: iconographic essay - part 2*

    PubMed Central

    de Castro, Felipe Damásio; Reis, Fabiano; Guerra, José Guilherme Giocondo

    2014-01-01

    The present essay is illustrated with magnetic resonance images obtained at the authors' institution over the past 15 years and discusses the main imaging findings of intraventricular tumor-like lesions (colloid cyst, oligodendroglioma, astroblastoma, lipoma, cavernoma) and of inflammatory/infectious lesions (neurocysticercosis and an atypical presentation of neurohistoplasmosis). Such lesions represent a subgroup of intracranial lesions with unique characteristics and some imaging patterns that may facilitate the differential diagnosis. PMID:25741092

  6. Two-year clinical trial of a universal adhesive in total-etch and self-etch mode in non-carious cervical lesions.

    PubMed

    Lawson, Nathaniel C; Robles, Augusto; Fu, Chin-Chuan; Lin, Chee Paul; Sawlani, Kanchan; Burgess, John O

    2015-10-01

    To compare the clinical performance of Scotchbond™ Universal Adhesive used in self- and total-etch modes and two-bottle Scotchbond™ Multi-purpose Adhesive in total-etch mode for Class 5 non-carious cervical lesions (NCCLs). 37 adults were recruited with 3 or 6 NCCLs (>1.5mm deep). Teeth were isolated, and a short cervical bevel was prepared. Teeth were restored randomly with Scotchbond Universal total-etch, Scotchbond Universal self-etch or Scotchbond Multi-purpose followed with a composite resin. Restorations were evaluated at baseline, 6, 12 and 24 months for marginal adaptation, marginal discoloration, secondary caries, and sensitivity to cold using modified USPHS Criteria. Patients and evaluators were blinded. Logistic and linear regression models using a generalized estimating equation were applied to evaluate the effects of time and adhesive material on clinical assessment outcomes over the 24 month follow-up period. Kaplan-Meier method was used to compare the retention between adhesive materials. Clinical performance of all adhesive materials deteriorated over time for marginal adaptation, and discoloration (p<0.0001). Both Scotchbond Universal self-etch and Scotchbond Multi-purpose materials were more than three times as likely to contribute to less satisfying performance in marginal discoloration over time than Scotchbond Universal total-etch. The retention rates up to 24 months were 87.6%, 94.9% and 100% for Scotchbond Multi-purpose and Scotchbond Universal self-etch and total-etch, respectively. Scotchbond Universal in self- and total- etch modes performed similar to or better than Scotchbond Multipurpose, respectively. 24 month evaluation of a universal adhesive indicates acceptable clinical performance, particularly in a total-etch mode. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Usefulness of a management protocol for patients with cervical multicystic lesions: A retrospective analysis of 94 cases and the significance of GNAS mutation

    PubMed Central

    Ando, Hirofumi; Kashima, Hiroyasu; Takatsu, Akiko; Ishii, Keiko; Fujinaga, Yasunari; Shiozawa, Tanri

    2016-01-01

    Abstract Aim The proper preoperative diagnosis and management of cervical proliferative disorders presenting with multiple cysts, including minimal deviation adenocarcinoma (MDA), lobular endocervical glandular hyperplasia (LEGH), and nabothian cyst (NC), have not been fully established. We previously proposed a management protocol comprising a diagnostic approach using cytology, magnetic resonance imaging, and gastric‐type mucin and subsequent treatment. We herein evaluate the usefulness of this protocol and implications of GNAS mutations in LEGH. Methods The clinical courses of 94 patients with cervical multicystic lesions who visited our hospital between June 1995 and September 2014 were retrospectively analyzed. GNAS mutations were investigated in 10 LEGH, five LEGH with atypia, and two MDA cases. Results Of the 94 patients, the conditions of 10, 59, and 25 were clinically diagnosed as suspicious of MDA or carcinoma (S/O MDA‐Ca), suspicious of LEGH (S/O LEGH), and NC, respectively. Ten patients each with S/O MDA‐Ca and S/O LEGH underwent hysterectomy, and the correct ratio for diagnosis was 90% (18/20). Of the 42 S/O LEGH cases followed‐up for more than 12 months, three showed an increase in tumor size. After hysterectomy, two were LEGH with atypia while one was NC. The GNAS mutation was detected in two cases of LEGH with atypia, one of which showed an increase in tumor size during follow‐up. Conclusion The management protocol we propose herein will be useful. An increase in tumor size is important to detect potentially malignant LEGH. GNAS mutations may be involved in the tumorigenesis of potentially malignant LEGH. PMID:27718288

  8. High prevalence and low E6 genetic variability of human papillomavirus 58 in women with cervical cancer and precursor lesions in Southeast Mexico.

    PubMed

    Canche, Jaqueline Canul; López, Iván Rosado; Suárez, Nicolás G; Acosta, Gladis Colli; Conde-Ferráez, Laura; Cetina, Thelma Canto de; Losa, María R González

    2010-03-01

    Infection with some genotypes of human papillomavirus (HPV) is the most important risk factor associated with cervical cancer (CC). Throughout the world, HPV type 58 prevalence varies from one region to another; it is higher in women from certain countries in Asia and Latin America, such as China and Mexico. Although intratypic variants have been reported on a few occasions, our knowledge about HPV 58 genetic variation remains limited. Therefore, this work aims to (i) determine the prevalence of HPV type 58 amongst Mexican women with invasive CC or precursor lesions and (ii) identify HPV 58 sequence variants. One hundred and forty five colposcopy clinic patients were studied. Genotyping of HPV 16, 18 and 58 was determined by specific nested PCR and HPV 58 variants were detected by direct sequencing. The general prevalence of HPV was 51.7% (75/145). HPV 16 was found in 30.6% (23/75) and HPV 58 in 24% (18/75) of the patients. HPV 18 was not identified in patients with cervical intraepithelial neoplasia (CIN) grade I; it was only found in those with CIN II, with a prevalence of 6.8% (3/44). In patients with CC, the prevalence of HPV 16 and 58 was 78.9%. Regarding HPV 58 variants, 94.4% of the HPV 58 sequences were identical to the prototype strain, whereas one sample showed changes at a single nucleotide. This study demonstrates a high prevalence of HPV 58 and a low genetic variability of E6 sequences amongst Mexican colposcopy patients.

  9. CT of the normal and abnormal parametria in cervical cancer

    SciTech Connect

    Vick, C.W.; Walsh, J.W.; Wheelock, J.B.; Brewer, W.H.

    1984-09-01

    To evaluate CT criteria for differentiating a cervical cancer confined to the cervix from a lesion that invades the parametria, 16 patients with newly diagnosed, untreated cervical cancer were studied with CT. Twenty-five parameria were confined by radical hysterectomy, transvaginal parametrial fine-needle aspiration cytology, or excretory urography. In 17 tumor-positive parametria, CT findings associated with parametrial tumor invasion were: 1) irregularity or poor definition of the lateral cervical margins; 2) prominent parametrial soft-tissue strands; 3) obliteration of the periureteral fat plane; and 4) an eccentric parametrial soft-tissue mass. Irregularity of the cervical margins and prominent parametrial strands were seen most commonly with parametrial tumor invasion, but were also occasionally seen with parametrial inflammation. On the basis of the criteria developed in this report, CT may be used as an adjunct to the physical examination in differentiating stage I cervical cancer from more advanced disease in selected patients.

  10. Ectopic cervical thymus as a rare cause of pediatric neck mass: the role of ultrasound and MRI in the diagnosis. Case report.

    PubMed

    Ozel, Alper; Akdur, Pinar Ozdemır; Celebi, Irfan; Karasu, Rabia; Yilmaz, Banu; Basak, Muzaffer

    2015-06-01

    Ectopic cervical thymus (ECT) is an uncommon cause for cervical mass in the pediatric age group. Ultrasound and magnetic resonance imaging findings of the mass (located along the thymic descent pathway along the thymopharyngeal tract and has identical echostructure and signal intensities to the native thymus in the superior mediastinum) would lead to the diagnosis. The diagnosis is confirmed by fine needle aspiration biopsy or histopathology after resection. The management of ECT is a conservative follow up, except in symptomatic cases with tracheal compression and histologically confirmed neoplasia where surgery is indicated. We present the case of ECT presenting as a left upper neck mass in a 12 year old girl.

  11. Invasive Stratified Mucin-producing Carcinoma and Stratified Mucin-producing Intraepithelial Lesion (SMILE): 15 Cases Presenting a Spectrum of Cervical Neoplasia With Description of a Distinctive Variant of Invasive Adenocarcinoma.

    PubMed

    Lastra, Ricardo R; Park, Kay J; Schoolmeester, J Kenneth

    2016-02-01

    Stratified mucin-producing intraepithelial lesion (SMILE) is a cervical intraepithelial lesion, distinct from conventional squamous or glandular counterparts, believed to arise from embryonic cells at the transformation zone by transdifferentiation during high-risk HPV-associated carcinogenesis. It is characterized by stratified, immature epithelial cells displaying varying quantities of intracytoplasmic mucin throughout the majority of the lesional epithelium. We identified a distinct form of invasive cervical carcinoma with morphologic features identical to those in SMILE, which we have termed "invasive stratified mucin-producing carcinoma." Fifteen cases from 15 patients (mean 36 y; range, 22 to 64 y) were retrieved from the pathology archives of multiple institutions with a diagnosis of either SMILE or invasive cervical carcinoma with a description or comment about the invasive tumor's resemblance to SMILE. Seven cases had solely intraepithelial disease with a component of SMILE (mean 29 y; range, 22 to 40 y). The 8 other cases had invasive stratified mucin-producing carcinoma (mean 44; range, 34 to 64 y) in which SMILE was identified in 7. All cases of invasive stratified mucin-producing carcinoma demonstrated stratified, immature nuclei with intracytoplasmic mucin, which morphologically varied between cases from "mucin-rich" to "mucin-poor" in a similar manner to SMILE. All cases had mitotic figures and apoptotic debris, and an intralesional neutrophilic infiltrate was seen in the majority of cases. In cases of invasive carcinoma, the depth of invasion ranged from <1 to 19 mm. Follow-up information was available in 8 cases and ranged from 1 to 36 months (mean 11 mo). Three cases of invasive stratified mucin-producing carcinoma had biopsy or resection-proven metastatic carcinoma on follow-up. These 15 cases of cervical stratified mucin-producing lesions show a combination of intraepithelial and invasive growth patterns. Given that SMILE is well rooted as a

  12. Type-Specific HPV Prevalence in Cervical Cancer and High-Grade Lesions in Latin America and the Caribbean: Systematic Review and Meta-Analysis

    PubMed Central

    Ciapponi, Agustín; Bardach, Ariel; Glujovsky, Demián; Gibbons, Luz; Picconi, María Alejandra

    2011-01-01

    Background Cervical cancer is a major public health problem in Latin America and the Caribbean (LA&C), showing some of the highest incidence and mortality rates worldwide. Information on HPV type distribution in high-grade cervical lesions (HSIL) and invasive cervical cancer (ICC) is crucial to predict the future impact of HPV16/18 vaccines and screening programmes, and to establish an appropriate post-vaccinal virologic surveillance. The aim was to assess the prevalence of HPV types in HSIL and ICC in studies in LA&C. Methods and Findings We performed a systematic review, following the MOOSE guidelines for systematic reviews of observational studies, and the PRISMA statement for reporting systematic reviews and meta-analyses. Inclusion criteria were at least ten cases of HSIL/ICC, and HPV-type elicitation. The search, without language restrictions, was performed in MEDLINE, Cochrane Library, EMBASE, LILACS from inception date to December 2009, proceedings, reference lists and consulting experts. A meta-analysis was performed using arc-sine transformations to stabilize the variance of simple proportions. Seventy-nine studies from 18 countries were identified, including 2446 cases of HSIL and 5540 of ICC. Overall, 46.5% of HSIL cases harbored HPV 16 and 8.9% HPV18; in ICC, 53.2% of cases harbored HPV 16 and13.2% HPV 18. The next five most common types, in decreasing frequency, were HPV 31, 58, 33, 45, and 52. Study's limitations comprise the cross-sectional design of most included studies and their inherent risk of bias, the lack of representativeness, and variations in the HPV type-specific sensitivity of different PCR protocols. Conclusions This study is the broadest summary of HPV type distribution in HSIL and ICC in LA&C to date. These data are essential for local decision makers regarding HPV screening and vaccination policies. Continued HPV surveillance would be useful, to assess the potential for changing type-specific HPV prevalence in the post

  13. Assessment of the frequency of genetic alterations (LOH/MSI) in patients with intraepithelial cervical lesions with HPV infection: a pilot study.

    PubMed

    Migdalska-Sęk, Monika; Karowicz-Bilińska, Agata; Pastuszak-Lewandoska, Dorota; Czarnecka, Karolina H; Nawrot, Ewa; Domańska-Senderowska, Daria; Kiszałkiewicz, Justyna; Brzeziańska-Lasota, Ewa

    2016-05-01

    In the present study, we analyzed (1) the type of HPV infection and (2) the frequency of loss of heterozygosity and microsatellite imbalance (LOH/MSI) in normal cytology and cervical intraepithelial neoplasia (CIN1-3). The cytological material included: low-grade squamous intraepithelial lesions (CIN1, n = 11), high-grade lesions (CIN2 and CIN3, n = 13), and cytologically normal cells from non-neoplastic cervical samples (n = 8). HPV genotyping was done using RealLine HPV 16/18 kit. We used 20 microsatellite markers from: 1p31.2, 3p14.3, 3p21.3, 3p22.2, 3p24.2, 3p25.3, 7q32.2, 9p21.3, 11p15.5, 12q23.2, and 16q22.1. LOH/MSI was correlated with clinicopathological parameters. The presence of HPV DNA was revealed in 78.13 % samples, including normal cytology. LOH/MSI was the most frequent for: 3p25.3 (39 %), 3p22.2 (20.83 %), 3p24.2 (20 %), and 3p14.3 (16.67 %). It was demonstrated that D3S1234 (FHIT; 3p14.3), D3S1611 (MLH1; 3p22.2), D3S1583 (RARB; 3p24.2), D3S1317 and D3S3611 (VHL; 3p25.3) could differentiate patients with CIN2/CIN3 versus CIN1, showing significantly higher frequency in CIN2/CIN3. LOH/MSI frequency for other than 3p markers was lower, 10-22.2 %. The simultaneous occurrence of LOH/MSI for several markers (OFAL) was higher in CIN2/CIN3. Significant differences in OFAL were found between samples with versus without HPV infection. In HPV-positive patients, significant differences in OFAL were found between normal cytology, CIN1 and CIN2/CIN3. HPV infection influences the increase in LOH/MSI frequency, especially in tumor suppressor gene loci. Several studied microsatellite markers seem to be useful for CIN grading. Hopefully, the obtained results, if confirmed on larger patient cohort, would allow creating a panel of markers supporting clinical diagnosis in patients with HPV infection.

  14. Association Study between Cervical Lesions and Single or Multiple Vaccine-Target and Non-Vaccine Target Human Papillomavirus (HPV) Types in Women from Northeastern Brazil.

    PubMed

    Chagas, Bárbara Simas; Comar, Manola; Gurgel, Ana Pavla Almeida Diniz; Paiva, Sérgio; Seraceni, Silva; de Freitas, Antonio Carlos; Crovella, Sergio

    2015-01-01

    We performed an association between high-grade squamous intraepithelial lesions (HSIL), low-grade squamous intraepithelial lesions (LSIL) and single or multiple vaccine-target as well as non-vaccine target Human papillomavirus (HPV) types. Using bead-based HPV genotyping, 594 gynecological samples were genotyped. An association between squamous intraepithelial lesion (SIL) and presence of HPV16, 18, 31, 58 and 56 types were calculated. The risk was estimated by using odds ratio (OR) and 95% of confidence intervals (CI). A total of 370 (62.3%) women were HPV positive. Among these, 157 (42.7%) presented a single HPV infection, and 212 (57.3%) were infected by more than one HPV type. HPV31 was the most prevalent genotype, regardless single and multiple HPV infections. Single infection with HPV31 was associated with LSIL (OR=2.32; 95%CI: 1.01 to 5.32; p=0.04); HPV31 was also associated with LSIL (OR=3.28; 95%CI: 1.74 to 6.19; p= 0.0002) and HSIL (OR=3.82; 95%CI: 2.10 to 6.97; p<0.001) in multiple HPV infections. Risk to harbor cervical lesions was observed in multiple HPV infections with regard to the HPV56 (OR=5.39; 95%CI: 2.44 to 11.90; p<0.001for LSIL; OR=5.37; 95%CI: 2.71 to 10.69; p<0.001) and HPV58 (OR=3.29; 95%CI: 1.34 to 8.09; p=0.0091 for LSIL; OR=3.55; 95%CI: 1.56 to 8.11; p=0.0026) genotypes. In addition, women coinfected with HPV16/31/56 types had 6 and 5-fold increased risk of HSIL (OR=6.46; 95%CI: 1.89 to 22.09; p=0.002) and LSIL (OR=5.22; 95%CI: 1.10 to 24.70; p=0.03), respectively. Multiple HPV infections without HPV16/18 has 2-fold increased risk of HSIL (OR=2.57; 95%CI: 1.41 to 4.70; p=0.002) and LSIL OR=2.03; 95%CI: 1.08 to 3.79; p=0.02). The results of this study suggest that single and multiple vaccine target as well as non-vaccine target HPV types are associated with LSIL and HSIL. These finding should be taken into consideration in the design of HPV vaccination strategies.

  15. Association Study between Cervical Lesions and Single or Multiple Vaccine-Target and Non-Vaccine Target Human Papillomavirus (HPV) Types in Women from Northeastern Brazil

    PubMed Central

    Chagas, Bárbara Simas; Comar, Manola; Gurgel, Ana Pavla Almeida Diniz; Paiva, Sérgio; Seraceni, Silva; de Freitas, Antonio Carlos; Crovella, Sergio

    2015-01-01

    We performed an association between high-grade squamous intraepithelial lesions (HSIL), low-grade squamous intraepithelial lesions (LSIL) and single or multiple vaccine-target as well as non-vaccine target Human papillomavirus (HPV) types. Using bead-based HPV genotyping, 594 gynecological samples were genotyped. An association between squamous intraepithelial lesion (SIL) and presence of HPV16, 18, 31, 58 and 56 types were calculated. The risk was estimated by using odds ratio (OR) and 95% of confidence intervals (CI). A total of 370 (62.3%) women were HPV positive. Among these, 157 (42.7%) presented a single HPV infection, and 212 (57.3%) were infected by more than one HPV type. HPV31 was the most prevalent genotype, regardless single and multiple HPV infections. Single infection with HPV31 was associated with LSIL (OR=2.32; 95%CI: 1.01 to 5.32; p=0.04); HPV31 was also associated with LSIL (OR=3.28; 95%CI: 1.74 to 6.19; p= 0.0002) and HSIL (OR=3.82; 95%CI: 2.10 to 6.97; p<0.001) in multiple HPV infections. Risk to harbor cervical lesions was observed in multiple HPV infections with regard to the HPV56 (OR=5.39; 95%CI: 2.44 to 11.90; p<0.001for LSIL; OR=5.37; 95%CI: 2.71 to 10.69; p<0.001) and HPV58 (OR=3.29; 95%CI: 1.34 to 8.09; p=0.0091 for LSIL; OR=3.55; 95%CI: 1.56 to 8.11; p=0.0026) genotypes. In addition, women coinfected with HPV16/31/56 types had 6 and 5-fold increased risk of HSIL (OR=6.46; 95%CI: 1.89 to 22.09; p=0.002) and LSIL (OR=5.22; 95%CI: 1.10 to 24.70; p=0.03), respectively. Multiple HPV infections without HPV16/18 has 2-fold increased risk of HSIL (OR=2.57; 95%CI: 1.41 to 4.70; p=0.002) and LSIL OR=2.03; 95%CI: 1.08 to 3.79; p=0.02). The results of this study suggest that single and multiple vaccine target as well as non-vaccine target HPV types are associated with LSIL and HSIL. These finding should be taken into consideration in the design of HPV vaccination strategies. PMID:26176537

  16. Composite resin restorations of non-carious cervical lesions in patients with diabetes mellitus and periodontal disease: pilot study.

    PubMed

    Nassar, Carlos A; Nassar, Patrícia O; Secundes, Mayron B; Busato, Priscilla do Monte Ribeiro; Camilotti, Veridiana

    2012-01-01

    Diabetes mellitus is a set of metabolic diseases characterized by hyperglycemia resulting from absolute or relative deficiency in insulin secretion by the pancreas and/or impaired insulin action in target tissues. Oral health maintenance through health care, as well as metabolic control are important measures for the overall health of diabetic patients. The objective of this study was to determine the relationship between biocompatibility of composite resin restorations with different nanoparticles, polishing in abfraction lesions in anterior and posterior teeth with periodontal tissues in patients with diabetes mellitus. We selected 20 patients--10 patients with diabetes mellitus and 10 patients without diabetes mellitus-, but with a total of 30 restorations in each group receiving composite resin restorations, who were evaluated for periodontal purposes: Plaque Index, Gingival Index; Probing Depth, Clinical Attachment Level and Bleeding on Probing. In addition, the restorations will receive assessments according to criteria for Marginal Adaptation, Anatomical Shape, Marginal Discoloration, ormation of caries, Post-operative Sensitivity and Retention. The total period was 90 days. The results showed a significant improvement in periodontal parameters assessed (p < 0.05) in both groups. With regard to assessments of the restorations, it was observed that there was no statistically significant difference (p > 0.05) among all criteria evaluated within the 90-day period. Thus, we conclude that in a short period (90 days) there is clinical biocompatibility of composite resin with nanoparticles restorations in abfraction lesions and periodontal tissues of patients with diabetes mellitus, regardless the type of polish these restorations receive.

  17. Stress-strain Analysis of Premolars With Non-carious Cervical Lesions: Influence of Restorative Material, Loading Direction and Mechanical Fatigue.

    PubMed

    Machado, A C; Soares, C J; Reis, B R; Bicalho, A A; Raposo, Lha; Soares, P V

    Noncarious cervical lesions (NCCLs) are characterized by a loss of dental structure at the cementoenamel junction (CEJ) caused by stress, biocorrosion, and attrition. Variations in occlusal loading can promote different stress and strain patterns on the CEJ. Restoration of NCCLs is part of lesion management; however, there is still no conclusive restorative protocol for NCCLs. This study aimed to evaluate the stress and strain distribution of maxillary premolars with NCCLs according to three factors: 1) restorative technique; 2) direction of occlusal loading; and 3) mechanical fatigue. Three-dimensional (3D) finite element analysis (FEA) and strain gauge testing were used to assess stress and strain, respectively. 3D-FEA orthotropic, linear, and elastic models were generated: sound tooth (SO); unrestored NCCL; or NCCL restored with glass ionomer; flowable composite resin; nanofilled composite resin (CR); lithium disilicate ceramic; and nanofilled composite resin core associated with a lithium disilicate laminate (CL). A 150-N compressive static load was applied in two conditions: axially in both cusps (Al); and at a 45° angle to the long axis of the tooth applied to the palatine cusp (Ol). For the experimental tests, specimens were treated as described previously, and one strain gauge was attached to the buccal surface of each tooth to record tooth strains before and after cyclic loading (200,000 cycles, 50 N). FEA showed that the association of NCCL and Ol resulted in higher stress values. CR and CL restorations showed the closest biomechanical behavior to SO for both loading types. Loaded Al or Ol specimens showed higher strain values after mechanical fatigue. Lower stress and strain were observed with Al when compared with Ol. The restoration of NCCLs with composite resin only or associated with ceramic laminates seems to be the best approach because the results for those groups were similar in biomechanical behaviors to sound teeth.

  18. Development of anti-E6 pegylated lipoplexes for mucosal application in the context of cervical preneoplastic lesions.

    PubMed

    Lechanteur, Anna; Furst, Tania; Evrard, Brigitte; Delvenne, Philippe; Hubert, Pascale; Piel, Géraldine

    2015-04-10

    Cervical cancer induced by human papillomavirus (HPV) is the fourth highest mortality causing cancer in women despite the use of prophylactic vaccines. E6 targeting represents an attractive strategy to treat this cancer. Indeed, oncoprotein E6 is produced by keratinocytes infected by HPV and is partially responsible for carcinogenesis. E6 interferes with the apoptosis process in stressed cells by degradation of p53 tumor suppressor gene. Our strategy consists in using E6 siRNA complexed with pegylated lipoplexes. The addition of hydrophilic polymer around the nanoparticles is crucial to use them by vaginal application on account of cervicovaginal mucus. Physicochemical characteristics were evaluated and in vitro assays were performed to evaluate transfection potential, E6 mRNA extinction and p53 re-expression. Cationic liposomes DOTAP/Cholesterol/DOPE 1/0.75/0.5 (N/P 2.5) with or without 50% DSPE-PEG2000 and associated with siE6 have demonstrated good physicochemical characteristics in terms of complexation, size, surface charge and stability. Both lipoplexes have been tested on CaSki cell line (HPV 16+) with 50 nM and 100 nM of siE6. Lipoplexes formulations induce 30-40% of E6 mRNA extinction and induce the re-expression of p53. In conclusion, pegylated anti-E6 lipoplexes have demonstrated their efficiency to cross the cellular membrane and to release siRNA into the cytoplasm confirmed by final p53 protein production. Copyright © 2015 Elsevier B.V. All rights reserved.

  19. Clinical evaluation of resin-modified glass-ionomer restorative cements in cervical 'abrasion' lesions: one-year results.

    PubMed

    Maneenut, C; Tyas, M J

    1995-10-01

    Sixty non-undercut Class V "abrasion" lesions in 13 patients were restored with light-cured Type IIa glass-ionomer cements in accordance with the manufacturer's instructions, 20 each with Fuji II LC, Photac-Fil, and Vitremer. Patients were recalled for examination and photographs 1 week, 6 months, and 1 year posttreatment. Color, marginal discoloration, and retention of the restorations were assessed at each recall period. At 1 year, no loss of restorations was found. Analysis revealed statistically significant darkening in color of the Vitremer restorations, no significant change in color of the Fuji II LC and Photac-Fil restorations, and statistically significant but clinically negligible development of marginal discoloration of all materials.

  20. High-risk human papillomavirus DNA test: could it be useful in low-grade cervical lesion triage? Five-year follow-up.

    PubMed

    Saccardi, Carlo; Gizzo, Salvatore; Noventa, Marco; Anis, Omar; Di Gangi, Stefania; Patrelli, Tito Silvio; D'Antona, Donato; Nardelli, Giovanni Battista

    2014-02-01

    We conducted a retrospective, observational study in order to evaluate the role of high-risk human papillomavirus (hrHPV)-DNA test in patients with first diagnosis of low-grade squamous intraepithelial lesions (L-SILs).Patients were divided into group A, annual Papanicolaou test and hrHPV-DNA tests (167 patients) and group B, immediate colposcopy, followed by annual papanicolaou test and hrHPV-DNA tests (164 patients). We assessed sensitivity, specificity, negative predictive value (NPV), positive predictive value, positive-negative likelihood ratio of hrHPV-DNA test, and 5-year relative risk of cervical intraepithelial neoplasia grade 2 in hrHPV-DNA+. Colposcopy is still considered the best choice for women with L-SIL and hrHPV-DNA+ test. High sensitivity and NPV of hrHPV-DNA test permit to use it in the follow-up of L-SIL with a HPV-negative status, without necessity of referring to colposcopy.

  1. One year comparative clinical evaluation of EQUIA with resin-modified glass ionomer and a nanohybrid composite in noncarious cervical lesions

    PubMed Central

    Vaid, Deepa Sunil; Shah, Nimisha Chinmay; Bilgi, Priyanka Shripad

    2015-01-01

    Aims: Comparative evaluation of EQUIA with a resin-modified glass ionomer cement (RMGIC; GC Gold Label glass ionomer light cured universal restorative cement) and a nanohybrid composite (Tetric N-Ceram) in noncarious cervical lesions (NCCLs). Background: To establish the most suitable material for the restoration of NCCLs. Settings and Design: In vivo study. Materials and Methods: Eighty-seven NCCLs were randomly restored with EQUIA, a RMGIC, and a nanohybrid composite. Clinical evaluation of the restorations was done following the Unites States Public Health criteria by a single-blinded investigator. Data were formulated, and statistical analysis was done by Chi-square test. Statistical Analysis Used: Chi-square test. Results: No significant difference was found between EQUIA, RMGIC, and nanohybrid composite at 1-month, at 6 months, and at 1-year (P > 0.05). Conclusions: EQUIA, resin-modified glass ionomer, and nanohybrid composite performed equally at 1-month, 6 months, and 1-year follow-up periods. PMID:26752837

  2. Eighteen-month randomized clinical trial on the performance of two etch-and-rinse adhesives in non-carious cervical lesions.

    PubMed

    da Costa, Thays Regina Ferreira; Ferri, Letícia Dias; Loguercio, Alessandro Dourado; Reis, Alessandra

    2014-12-01

    An 18-month randomized, controlled prospective study evaluated, in an intra-individual comparison, the clinical performance of two-step etch-and-rinse adhesives in non-carious cervical lesions (NCCL). 35 subjects, with at least two similar sized NCCL participated in this study. After sample size calculation, 70 restorations were placed, according to one of the following groups: Adper Single Bond 2 (SB) and Ambar (AM). The restorations were placed incrementally using a resin composite (Opallis). The restorations were evaluated at baseline and after 6 and 18 months according to the FDI criteria. The differences in the ratings of the two materials after 6 and 18 months were tested with Fisher's exact test (α = 0.05), and the performance of the each material at baseline and after 6 and 18 months was evaluated by Wilcoxon test (α = 0.05). All subjects attended the 18-month recall. No significant differences were observed between the materials for any criteria evaluated. Only four restorations (two from each material) were lost after 18 months. Thus, the retention rates of both materials at 18 months were 94.2% (95% CI 81-98%). Nine restorations (four Ambar and five Adper Single Bond 2) showed marginal discoloration which was solved with a polishing procedure. Both adhesive systems showed acceptable clinical retention rates after 18 months.

  3. Age and HPV type as risk factors for HPV persistence after loop excision in patients with high grade cervical lesions: an observational study.

    PubMed

    Pirtea, Laurențiu; Grigoraş, Dorin; Matusz, Petru; Pirtea, Marilena; Moleriu, Lavinia; Tudor, Anca; Ilina, Răzvan; Secoşan, Cristina; Horhat, Florin; Mazilu, Octavian

    2016-10-06

    Persistent infections with high risk human papillomaviruses (HR-HPV) cause virtually all cervical cancers. An observational study was conducted aiming to estimate the rate of HPV infection persistence after LEEP in patients with high grade squamous intraepithelial lesions (HSIL). Moreover, the study investigated if persistence is age related. For this reason a total of 110 patients were included between January 2010 and June 2015. At 6 months after LEEP the overall HPV infection persistence rate was 40.9 %, at 12 months 20 % and at 18 months 11.8 %. Type 16 showed the highest persistence rate: 27.3 % at 6 months, 12.7 % at 12 months and 10 % at 18 months after LEEP. The persistence for HPV type 16 at 6 months after LEEP was significantly higher in the group > =36.5 years old compared to the persistence rate in the group <36.5 years old (p = 0.0027, RR = 2.75, 95 %ϵ(1.34; 5.64)) (see Table 3). LEEP does not completely eradicate HPV infection. HPV persistence rate after LEEP is higher in infections with type 16 and in women older than 36.5 years.

  4. Determination of similarity measures for pairs of mass lesions on mammograms by use of BI-RADS lesion descriptors and image features.

    PubMed

    Muramatsu, Chisako; Li, Qiang; Schmidt, Robert A; Shiraishi, Junji; Doi, Kunio

    2009-04-01

    To determine similarity measures for selection of pathology-known similar images that would be useful for radiologists as a reference guide in the diagnosis of new breast lesions on mammograms. The images were obtained from the Digital Database for Screening Mammography developed by the University of South Florida. For determination and evaluation of similarity measures, the "gold standard" of similarities for 300 pairs of masses was determined by 10 breast radiologists. For determining similarity measures that would agree with radiologists' similarity determination, an artificial neural network (ANN) was trained with the radiologists' subjective similarity ratings and the image features. The image features were determined subjectively using the Breast Imaging Reporting and Data System (BI-RADS) lesion descriptors and objectively by computerized image analysis. The similarity measures determined by the ANN were compared to the gold standard and evaluated in terms of the correlation coefficient. The similarity measures determined using the BI-RADS descriptors only were not as useful as those determined by use of the image features only. When the BI-RADS margin ratings were combined with the image features, the correlation coefficient between the subjective ratings and the objective measures improved slightly (r = 0.76) compared to those based on the image features alone (r = 0.74). The inclusion of the BI-RADS margin descriptors may be useful for determination of similarity measures, especially when it is difficult to obtain the manual outlines of the masses and if the BI-RADS descriptors were provided consistently by radiologists.

  5. Extremes in body mass index affect overall survival in women with cervical cancer.

    PubMed

    Clark, Leslie H; Jackson, Amanda L; Soo, Adrianne E; Orrey, Danielle C; Gehrig, Paola A; Kim, Kenneth H

    2016-06-01

    To examine the effect of BMI on pathologic findings, cancer recurrence and survival in cervical cancer patients. A retrospective cohort study of cervical cancer patients treated from July 2000 to March 2013 was performed. BMI was calculated, and patients were classified by BMI. The primary outcome was overall survival (OS). Secondary outcomes included stage, histopathology, disease-specific survival (DSS) and recurrence free survival (RFS). Kaplan-Meier survival curves were generated and compared using Cox proportional hazard ratios. Of 632 eligible patients, 24 (4%) were underweight, 191 (30%) were normal weight, 417 (66%) were overweight/obese. There was no difference in age (p=0.91), stage at presentation (p=0.91), grade (p=0.46), or histology (p=0.76) between weight categories. There were fewer White patients in the underweight (54%) and overweight/obese (58%) groups compared to the normal weight (71%) group (p=0.04). After controlling for prognostic factors, underweight and overweight/obese patients had worse median RFS than normal weight patients (7.6 v 25.0months, p=0.01 and 20.3 v 25.0months, p=0.03). Underweight patients also had worse OS (10.4 v 28.4months, p=0.031) and DSS (13.8 v 28.4months, p=0.04) compared to normal weight patients. Overweight/obese patients had worse OS than normal weight patients (22.2 v 28.4months, p=0.03) and a trend toward worse DSS (21.9 v 28.4months, p=0.09). Both extremes of weight (underweight and overweight/obesity) were associated with worse survival in patients with cervical cancer. Optimizing weight in cervical cancer patients may improve outcomes in these patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Evaluation of the cone biopsy excisor compared with the large loop for electrosurgical excision of cervical lesions.

    PubMed

    Fischer; Alexandarian; Gagliardi; Oglesby; Scribner; Asuncion; Mesologitis

    1998-07-01

    Excisor cases vs 10 of 77 (13%) LEEP cases submitted one specimen to pathology, P <.001 based on a chi(2) test. Mean number of specimens submitted to pathology per case in the Cone Biopsy Excisor group was 1.1 +/- 0.5 vs 2.2 +/- 0.8 in the LEEP group, P <.001 based on a t test. Margins were unable to be interpreted because of thermal damage in 2 of 78 (3%) in the Cone Biopsy Excisor group vs 14 of 77 (18%) in the LEEP group, P <.003 based on a chi(2) test.Conclusion: The Cone Biopsy Excisor provided a cervical specimen that had less fragmentation and less thermal damage with margins that were less likely to be indeterminate than those obtained with the large loop electrosurgical procedure.

  7. Intra-articular soft-tissue masses of the ankle. Meniscoid lesions and transarticular fibrous bands.

    PubMed

    Stienstra, J J

    1994-07-01

    Meniscoid lesions and fibrous bands are unique lesions, most likely of differing origin. Although they are similar in clinical presentation, their appearance at arthroscopy is clearly different. The meniscoid lesion is attached only at its origin at the inferolateral gutter on the anterior talofibular ligament. Fibrous bands are attached at two ends and may be found anywhere in the joint but are most common extending dramatically over the anterior joint line. Unexpected encountering of a fibrous band should alert the surgeon to carefully inspect the joint for other associated (occult) pathology. Because of the frequent association of bands with antecedent fracture, the observation of this lesion should lead the clinician to consider antecedent intra-articular fracture (transchondral fracture, malleolar fracture, and tibial pilon fracture) as a likely co-pathology. Careful examination of the ankle and review of the radiographs and other available images may be helpful in assessing the joint for these injuries when fibrous bands are encountered. The association of meniscoid lesion with prior soft tissue injury (sprain) is also important to understanding this lesion. Excision of both these abnormal lesions in concert with repair of coexistent pathology is associated with improvement of symptoms. Finally, both fibrous bands and meniscoid lesions are associated with symptoms that warrant closer inspection and observation. Whether the operative intervention is open or closed, the reader can benefit from the information presented.

  8. Clinical effectiveness of a one-step self-etch adhesive in non-carious cervical lesions at 2 years.

    PubMed

    Ermis, R Banu; Van Landuyt, Kirsten L; Cardoso, Marcio Vivan; De Munck, Jan; Van Meerbeek, Bart; Peumans, Marleen

    2012-06-01

    A 2-year randomized, controlled prospective study evaluated the clinical effectiveness of a one-step self-etch adhesive and a "gold-standard" three-step etch-and-rinse adhesive in non-carious Class-V lesions. The null hypothesis tested was that the one-step self-etch adhesive does perform clinically equally well as the three-step etch-and-rinse adhesive. A total of 161 lesions in 26 patients were restored with Clearfil AP-X (Kuraray). The restorations were bonded either with the "all-in-one" adhesive Clearfil S3 Bond (Kuraray) or with the three-step etch-and-rinse adhesive Optibond FL (Kerr). The restorations were evaluated at baseline and after 6 months, 1 and 2 years, regarding their retention, marginal adapation, marginal discoloration, caries occurrence, preservation of tooth vitality and post-operative sensivity. Retention loss, severe marginal defects and/or discoloration that needed intervention (repair or replacement) and the occurrence of caries were considered as clinical failures. The recall rate at 2 years was 93.8%. Only one Clearfil S3 Bond restoration was lost at the 2-year recall. All other restorations were clinically acceptable. The number of restorations with defect-free margins decreased severely during the 2-year study period (to 6.7% and 25.3% for Clearfil S3 Bond and Optibond FL, respectively). The Clearfil S3 Bond restorations presented significantly more small marginal defects at the enamel side than the Optibond FL restorations (Clearfil S3 Bond: 93.3%; Optibond FL: 73.3%; p = 0.000). Superficial marginal discoloration increased in both groups (to 53.3% and 36% for Clearfil S3 Bond and Optibond FL, respectively) and was also more pronounced in the Clearfil S3 Bond group (p = 0.007). After 2 years, the simplified one-step self-etch adhesive Clearfil S3 Bond and the three-step etch-and-rinse adhesive Optibond FL were clinically equally successful, even though both adhesives were characterized by progressive degradation in marginal

  9. Impact of biliary stents on EUS-guided FNA of pancreatic mass lesions.

    PubMed

    Ranney, Nathaniel; Phadnis, Milind; Trevino, Jessica; Ramesh, Jayapal; Wilcox, C Mel; Varadarajulu, Shyam

    2012-07-01

    Few studies have evaluated the impact of biliary stents on EUS-guided FNA. To compare diagnostic yield of EUS-FNA in patients with or without biliary stents. Retrospective study. Tertiary referral center. Patients with obstructive jaundice secondary to solid pancreatic mass lesions who underwent EUS-FNA over 5 years. The primary objective was to compare the diagnostic accuracy of EUS-FNA in patients with or without biliary stents and between patients with plastic stents or self-expandable metal stents (SEMSs). Secondary objectives were to assess the technical difficulty of EUS-FNA by comparing the number of passes required to establish diagnosis and to identify predictors of a false-negative diagnosis. Of 214 patients who underwent EUS-FNA, 150 (70%) had biliary stents and 64 (30%) had no stents in place. Of 150 patients with biliary stents, 105 (70%) were plastic and 45 (30%) were SEMSs. At EUS-FNA, the diagnosis was pancreatic cancer in 155 (72%), chronic pancreatitis in 17 (8%), other cancer in 31 (14%), and indeterminate in 11 (5%). There was no difference in rates of diagnostic accuracy between patients with or without stents (93.7% vs 95.3%; P = .73) and between plastic or SEMSs (95.2% vs 95.5%, P = .99), respectively. Median number of passes to diagnosis was not significantly different between patients with or without stents (2 [interquartile ratio range (IQR) = 1-3] vs 2 [IQR = 1-4]; P = .066) and between plastic or SEMS (2.5 [IQR = 1-4] vs 2 [IQR = 1-4], P = .69), respectively. On univariate analysis, EUS-FNA results were false-negative in patients with large pancreatic masses (>3 cm vs <3 cm, 9.35% vs 0.93%, P = .005) that required more FNA passes (<2 vs >2 passes, 0% vs 11.8%, P < .0001). Retrospective study. The presence or absence of a biliary stent, whether plastic or metal, does not have an impact on the diagnostic yield or technical difficulty of EUS-FNA. Copyright © 2012 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All

  10. Impact of biliary stents on EUS-guided FNA of pancreatic mass lesions

    PubMed Central

    Ranney, Nathaniel; Phadnis, Milind; Trevino, Jessica; Ramesh, Jayapal; Wilcox, C. Mel; Varadarajulu, Shyam

    2014-01-01

    Background Few studies have evaluated the impact of biliary stents on EUS-guided FNA. Aim To compare diagnostic yield of EUS-FNA in patients with or without biliary stents. Design Retrospective study. Setting Tertiary referral center. Patients Patients with obstructive jaundice secondary to solid pancreatic mass lesions who underwent EUS-FNA over 5 years. Main Outcome Measures The primary objective was to compare the diagnostic accuracy of EUS-FNA in patients with or without biliary stents and between patients with plastic stents or self-expandable metal stents (SEMSs). Secondary objectives were to assess the technical difficulty of EUS-FNA by comparing the number of passes required to establish diagnosis and to identify predictors of a false-negative diagnosis. Results Of 214 patients who underwent EUS-FNA, 150 (70%) had biliary stents and 64 (30%) had no stents in place. Of 150 patients with biliary stents, 105 (70%) were plastic and 45 (30%) were SEMSs. At EUS-FNA, the diagnosis was pancreatic cancer in 155 (72%), chronic pancreatitis in 17 (8%), other cancer in 31 (14%), and indeterminate in 11 (5%). There was no difference in rates of diagnostic accuracy between patients with or without stents (93.7% vs 95.3%; P = .73) and between plastic or SEMSs (95.2% vs 95.5%, P = .99), respectively. Median number of passes to diagnosis was not significantly different between patients with or without stents (2 [interquartile ratio range (IQR) = 1–3] vs 2 [IQR = 1–4]; P = .066) and between plastic or SEMS (2.5 [IQR = 1–4] vs 2 [IQR = 1–4], P = .69), respectively. On univariate analysis, EUS-FNA results were false-negative in patients with large pancreatic masses (>3 cm vs <3 cm, 9.35% vs 0.93%, P = .005) that required more FNA passes (<2 vs >2 passes, 0% vs 11.8%, P < .0001). Limitations Retrospective study. Conclusions The presence or absence of a biliary stent, whether plastic or metal, does not have an impact on the diagnostic yield or technical difficulty of EUS

  11. The Effects of Body Mass Index on Complications and Survival Outcomes in Patients with Cervical Carcinoma Undergoing Curative Chemoradiation Therapy

    PubMed Central

    Kizer, Nora T.; Thaker, Premal H.; Gao, Feng; Zighelboim, Israel; Powell, Matthew A.; Rader, Janet S.; Mutch, David G.; Grigsby, Perry W.

    2014-01-01

    Background The effect of body mass index (BMI) on treatment outcomes for patients with locally advanced cervical carcinoma undergoing definitive chemoradiation is unclear. Methods This study cohort included all cervical carcinoma patients (n = 404) with stage IB1 and positive lymph nodes or stage ≥ IB2 treated at our facility from January 1998 to January 2008. Mean follow-up time was 47.2 months. BMI was calculated using the National Institute of Health online calculator. BMI categories were created according to the World Health Organization classification system. Primary outcomes were overall survival, disease free survival, and complication rate. Univariate and multivariate analyses were performed. Kaplan-Meier survival curves were generated and compared using Cox proportional hazard models. Results On multivariate analysis, when compared to normal weight subjects (18.5-24.9 kg/m2), a BMI < 18.5 kg/m2 was associated with decreased overall survival (HR 2.37, 95% CI 1.28 - 4.38, p<0.01). The 5-year overall survivals were 33%, 60%, and 68% for a BMI < 18.5 kg/m2, BMI 18.5-24.9 kg/m2, and a BMI > 24.9 kg/m2 respectively. A BMI < 18.5 kg/m2 was associated with increased risk for grade 3 or 4 complications when compared to patients with a BMI > 24.9 kg/m2 (radiation enteritis: 16.7% vs. 13.6 % p= 0.03, fistula: 11.1% vs. 8.8% p= 0.05, bowel obstruction 33.3% vs. 4.4% p< 0.001, lymphedema: 5.6% vs. 1.2% p=0.02). Conclusions Underweight patients (BMI < 18.5 kg/m2) with locally advanced cervical cancer have diminished overall survival and more complications than normal weight and obese patients. PMID:20945318

  12. Treatment of multilevel cervical spondylotic myeloradiculopathy with posterior decompression and fusion with lateral mass plate fixation and local bone graft.

    PubMed

    Huang, Russel C; Girardi, Federico P; Poynton, Ashley R; Cammisa Jr, Frank P

    2003-04-01

    This is a retrospective review of 32 patients with multilevel cervical myelopathy treated by laminectomy and lateral mass plate fusion. The prognosis of surgically treated myelopathy is evaluated as well as prognostic factors for recovery of myelopathy. Diagnoses included cervical spondylosis or ossification of the posterior longitudinal ligament. Final follow-up was at 15.2 months (mean) postoperatively. Myelopathy was graded preoperatively and postoperatively by the system of Nurick. All patients had preoperative radiographs and magnetic resonance imaging (MRI). The presence of abnormal T2-weighted MRI signal (myelomalacia) was noted. Postoperative studies included flexion-extension radiographs to assess fusion and MRI to evaluate decompression of neural elements and resolution of myelomalacia. Severity of preoperative Nurick myelopathy, presence of myelomalacia, and age were evaluated as potential prognostic indicators for surgically treated myelopathy. Mean Nurick score improved from 2.6 (range 1-4) to 1.8 (range 0-3) postoperatively (p < 0.0001). Twenty-two patients (71%) had improvement in Nurick grade of at least one point, and nine showed no improvement. No patients had deterioration of Nurick grade. Preoperative myelomalacia was noted in 15 (47%) patients, and all 15 had residual myelomalacia postoperatively. Severe myelopathy, age, and myelomalacia had no prognostic value for improvement of myelopathy. Complications included pseudarthrosis (3%), wound infection (9%), and transient C5 palsy (6%). This study demonstrates excellent outcomes from laminectomy and fusion in multilevel cervical myelopathy. A high rate of improvement of myelopathy was observed, neurologic deterioration did not occur, and complication rates were low. Severe myelopathy and myelomalacia on preoperative MRI had no prognostic value.

  13. Osteochondromas of the cervical spine in atypical location.

    PubMed

    Schomacher, M; Suess, O; Kombos, T

    2009-06-01

    In the current article we review the available English literature by pubmed search engine on the topic of osteochondromas and their location in the cervical spine. The focus is to investigate the location of the lesions in cervical spine and to analyze clinical presentations and symptoms of patients, the aetiology and histopathology examination of the masses. In addition we report a rare illustrative case of a 62 year-old man with an osteochondroma of the cervical spine. The mass developed at a very slow rate for many years and produced no clinical symptoms. The location of the extradural mass in the right atlanto-axial joint of C1 and C2 is extremely rare and was not been reported so far. After preoperative CT- and MRI-imaging the entire mass could be removed.

  14. Serial type-specific human papillomavirus (HPV) load measurement allows differentiation between regressing cervical lesions and serial virion productive transient infections.

    PubMed

    Depuydt, Christophe E; Jonckheere, Jef; Berth, Mario; Salembier, Geert M; Vereecken, Annie J; Bogers, Johannes J

    2015-08-01

    Persistent high-risk human papillomavirus (HPV) infection is strongly associated with the development of high-grade cervical intraepithelial neoplasia (CIN) or cancer. Not all persistent infections lead to cancer. Viral load measured at a single time-point is a poor predictor of the natural history of HPV infections. However the profile of viral load evolution over time could distinguish nonprogressive from progressive (carcinogenic) infections. A retrospective natural history study was set up using a Belgian laboratory database including more than 800,000 liquid cytology specimens. All samples were submitted to qPCR identifying E6/E7 genes of 18 HPV types. Viral load changes over time were assessed by the linear regression slope. Database search identified 261 untreated women with persistent type-specific HPV DNA detected (270 infections) in at least three of the last smears for a average period of 3.2 years. Using the coefficient of determination (R²) infections could be subdivided in a latency group (n = 143; R² < 0.85) and a regressing group (n = 127; R² ≥ 0.85). In (≥ 3) serial viral load measurements, serial transient infections with latency is characterized by a nonlinear limited difference in decrease or increase of type-specific viral load (R² < 0.85 and slopes between 2 measurements 0.0010 and -0.0010 HPV copies/cell per day) over a longer period of time (1553 days), whereas regression of a clonal cell population is characterized by a linear (R² ≥ 0.85) decrease (-0.0033 HPV copies/cell per day) over a shorter period of time (708 days; P < 0.001). Using serial HPV type-specific viral load measurements we could for the first time identify regressing CIN2 and CIN3 lesions. Evolution of the viral load is an objective measurable indicator of the natural history of HPV infections and could be used for future triage in HPV-based cervical screening programs.

  15. A large cross-sectional survey investigating the knowledge of cervical cancer risk aetiology and the predictors of the adherence to cervical cancer screening related to mass media campaign.

    PubMed

    De Vito, Corrado; Angeloni, Claudio; De Feo, Emma; Marzuillo, Carolina; Lattanzi, Amedeo; Ricciardi, Walter; Villari, Paolo; Boccia, Stefania

    2014-01-01

    The aims of this study were to compare the characteristics of women who got a Pap-test during the mass media campaign, carried out in an Italian region by broadcasts advertising, and two years later and to identify the determinants of knowledge of cervical cancer etiology and of the adherence to the mass media campaign. A cross-sectional survey was carried out through a self-administered questionnaire. A total of 8570 randomly selected women were surveyed, 823 of these had a Pap-test during the mass media campaign period and 7747 two years later. Higher educational level, being not married, and living in urban areas were the main independent characteristics associated with a higher level of knowledge of cervical cancer etiology, although a previous treatment following a Pap smear abnormality was the strongest predictor (OR=2.88; 95% CI: 2.43-3.41). During the campaign period women had the Pap-test more frequently as a consequence of the mass media campaign (OR=8.28; 95% CI; 5.51-12.45). Mass media campaign is a useful tool to foster cervical screening compliance; however, its short-term effect suggests repeating it regularly.

  16. Improving the Accuracy of Computer-aided Diagnosis for Breast MR Imaging by Differentiating between Mass and Nonmass Lesions.

    PubMed

    Gallego-Ortiz, Cristina; Martel, Anne L

    2016-03-01

    To determine suitable features and optimal classifier design for a computer-aided diagnosis (CAD) system to differentiate among mass and nonmass enhancements during dynamic contrast material-enhanced magnetic resonance (MR) imaging of the breast. Two hundred eighty histologically proved mass lesions and 129 histologically proved nonmass lesions from MR imaging studies were retrospectively collected. The institutional research ethics board approved this study and waived informed consent. Breast Imaging Reporting and Data System classification of mass and nonmass enhancement was obtained from radiologic reports. Image data from dynamic contrast-enhanced MR imaging were extracted and analyzed by using feature selection techniques and binary, multiclass, and cascade classifiers. Performance was assessed by measuring the area under the receiver operating characteristics curve (AUC), sensitivity, and specificity. Bootstrap cross validation was used to predict the best classifier for the classification task of mass and nonmass benign and malignant breast lesions. A total of 176 features were extracted. Feature relevance ranking indicated unequal importance of kinetic, texture, and morphologic features for mass and nonmass lesions. The best classifier performance was a two-stage cascade classifier (mass vs nonmass followed by malignant vs benign classification) (AUC, 0.91; 95% confidence interval (CI): 0.88, 0.94) compared with one-shot classifier (ie, all benign vs malignant classification) (AUC, 0.89; 95% CI: 0.85, 0.92). The AUC was 2% higher for cascade (median percent difference obtained by using paired bootstrapped samples) and was significant (P = .0027). Our proposed two-stage cascade classifier decreases the overall misclassification rate by 12%, with 72 of 409 missed diagnoses with cascade versus 82 of 409 missed diagnoses with one-shot classifier. Separately optimizing feature selection and training classifiers for mass and nonmass lesions improves the accuracy

  17. Four lateral mass screw fixation techniques in lower cervical spine following laminectomy: a finite element analysis study of stress distribution.

    PubMed

    Song, Mingzhi; Zhang, Zhen; Lu, Ming; Zong, Junwei; Dong, Chao; Ma, Kai; Wang, Shouyu

    2014-08-09

    Lateral mass screw fixation (LSF) techniques have been widely used for reconstructing and stabilizing the cervical spine; however, complications may result depending on the choice of surgeon. There are only a few reports related to LSF applications, even though fracture fixation has become a severe complication. This study establishes the three-dimensional finite element model of the lower cervical spine, and compares the stress distribution of the four LSF techniques (Magerl, Roy-Camille, Anderson, and An), following laminectomy -- to explore the risks of rupture after fixation. CT scans were performed on a healthy adult female volunteer, and Digital imaging and communication in medicine (Dicom) data was obtained. Mimics 10.01, Geomagic Studio 12.0, Solidworks 2012, HyperMesh 10.1 and Abaqus 6.12 software programs were used to establish the intact model of the lower cervical spines (C3-C7), a postoperative model after laminectomy, and a reconstructive model after applying the LSF techniques. A compressive preload of 74 N combined with a pure moment of 1.8 Nm was applied to the intact and reconstructive model, simulating normal flexion, extension, lateral bending, and axial rotation. The stress distribution of the four LSF techniques was compared by analyzing the maximum von Mises stress. The three-dimensional finite element model of the intact C3-C7 vertebrae was successfully established. This model consists of 503,911 elements and 93,390 nodes. During flexion, extension, lateral bending, and axial rotation modes, the intact model's angular intersegmental range of motion was in good agreement with the results reported from the literature. The postoperative model after the three-segment laminectomy and the reconstructive model after applying the four LSF techniques were established based on the validated intact model. The stress distribution for the Magerl and Roy-Camille groups were more dispersive, and the maximum von Mises stress levels were lower than the other

  18. Four lateral mass screw fixation techniques in lower cervical spine following laminectomy: a finite element analysis study of stress distribution

    PubMed Central

    2014-01-01

    Background Lateral mass screw fixation (LSF) techniques have been widely used for reconstructing and stabilizing the cervical spine; however, complications may result depending on the choice of surgeon. There are only a few reports related to LSF applications, even though fracture fixation has become a severe complication. This study establishes the three-dimensional finite element model of the lower cervical spine, and compares the stress distribution of the four LSF techniques (Magerl, Roy-Camille, Anderson, and An), following laminectomy -- to explore the risks of rupture after fixation. Method CT scans were performed on a healthy adult female volunteer, and Digital imaging and communication in medicine (Dicom) data was obtained. Mimics 10.01, Geomagic Studio 12.0, Solidworks 2012, HyperMesh 10.1 and Abaqus 6.12 software programs were used to establish the intact model of the lower cervical spines (C3-C7), a postoperative model after laminectomy, and a reconstructive model after applying the LSF techniques. A compressive preload of 74 N combined with a pure moment of 1.8 Nm was applied to the intact and reconstructive model, simulating normal flexion, extension, lateral bending, and axial rotation. The stress distribution of the four LSF techniques was compared by analyzing the maximum von Mises stress. Result The three-dimensional finite element model of the intact C3-C7 vertebrae was successfully established. This model consists of 503,911 elements and 93,390 nodes. During flexion, extension, lateral bending, and axial rotation modes, the intact model’s angular intersegmental range of motion was in good agreement with the results reported from the literature. The postoperative model after the three-segment laminectomy and the reconstructive model after applying the four LSF techniques were established based on the validated intact model. The stress distribution for the Magerl and Roy-Camille groups were more dispersive, and the maximum von Mises stress

  19. Use of volumetric features for temporal comparison of mass lesions in full field digital mammograms

    SciTech Connect

    Bozek, Jelena Grgic, Mislav; Kallenberg, Michiel; Karssemeijer, Nico

    2014-02-15

    Purpose: Temporal comparison of lesions might improve classification between benign and malignant lesions in full-field digital mammograms (FFDM). The authors compare the use of volumetric features for lesion classification, which are computed from dense tissue thickness maps, to the use of mammographic lesion area. Use of dense tissue thickness maps for lesion characterization is advantageous, since it results in lesion features that are invariant to acquisition parameters. Methods: The dataset used in the analysis consisted of 60 temporal mammogram pairs comprising 120 mediolateral oblique or craniocaudal views with a total of 65 lesions, of which 41 were benign and 24 malignant. The authors analyzed the performance of four volumetric features, area, and four other commonly used features obtained from temporal mammogram pairs, current mammograms, and prior mammograms. The authors evaluated the individual performance of all features and of different feature sets. The authors used linear discriminant analysis with leave-one-out cross validation to classify different feature sets. Results: Volumetric features from temporal mammogram pairs achieved the best individual performance, as measured by the area under the receiver operating characteristic curve (A{sub z} value). Volume change (A{sub z} = 0.88) achieved higher A{sub z} value than projected lesion area change (A{sub z} = 0.78) in the temporal comparison of lesions. Best performance was achieved with a set that consisted of a set of features extracted from the current exam combined with four volumetric features representing changes with respect to the prior mammogram (A{sub z} = 0.90). This was significantly better (p = 0.005) than the performance obtained using features from the current exam only (A{sub z} = 0.77). Conclusions: Volumetric features from temporal mammogram pairs combined with features from the single exam significantly improve discrimination of benign and malignant lesions in FFDM mammograms

  20. Unusual presentation of neurobrucellosis: a solitary intracranial mass lesion mimicking a cerebral tumor : a case of encephalitis caused by Brucella melitensis.

    PubMed

    Erdem, Mehtap; Namiduru, Mustafa; Karaoglan, Ilkay; Kecik, Vuslat Bosnak; Aydin, Abdullah; Tanriverdi, Mustafa

    2012-10-01

    Among the diverse presentations of neurobrucellosis, solitary intracranial mass lesions are extremely rare. To the best of our knowledge, we describe here the second case of neurobrucellosis mimicking a cerebral tumor caused by Brucella melitensis. The mass lesion was clinically and radiologically indistinguishable from a brain tumor. The diagnosis was established by isolating Brucella melitensis in a blood culture and a positive Wright's agglutination test on the cerebrospinal fluid at 1:320 titers. Paraffin sections of the cerebral mass showed nongranulomatous encephalitis. We suggest that patients with an isolated intraparenchymal mass lesion with nongranulomatous encephalitis should also be studied for brucellosis in endemic areas.

  1. HPV mRNA Is More Specific than HPV DNA in Triage of Women with Minor Cervical Lesions

    PubMed Central

    Sørbye, Sveinung Wergeland; Fismen, Silje; Gutteberg, Tore Jarl; Mortensen, Elin Synnøve; Skjeldestad, Finn Egil

    2014-01-01

    Background In Norway, repeat cytology and HPV testing comprise delayed triage of women with minor cytological lesions. The objective of this study was to evaluate HPV DNA and HPV mRNA testing in triage of women with an ASC-US/LSIL diagnosis. Materials and Methods We used repeat cytology, HPV DNA testing (Cobas 4800) and HPV mRNA testing (PreTect HPV-Proofer) to follow up 311 women aged 25–69 years with ASC-US/LSIL index cytology. Results Of 311 women scheduled for secondary screening, 30 women (9.6%) had ASC-H/HSIL cytology at triage and 281 women (90.4%) had ASC-US/LSIL or normal cytology. The HPV DNA test was positive in 92 (32.7%) of 281 instances, and 37 (13.2%) were mRNA positive. Of the 132 women with repeated ASC-US/LSIL, we received biopsies from 97.0% (65/67) of the DNA-positive and 92.9% (26/28) of the mRNA-positive cases. The positive predictive values for CIN2+ were 21.5% (14/65) for DNA positive and 34.6% (9/26) for mRNA positive (ns). The odds ratio for being referred to colposcopy in DNA-positive cases were 2.8 times (95% CI: 1.8–4.6) higher that of mRNA-positive cases. Compared to the mRNA test, the DNA test detected four more cases of CIN2 and one case of CIN3. Conclusions The higher positivity rate of the DNA test in triage leads to higher referral rate for colposcopy and biopsy, and subsequent additional follow-up of negative biopsies. By following mRNA-negative women who had ASC-US/LSIL at triage with cytology, the additional cases of CIN2+ gained in DNA screening can be discovered. Our study indicates that in triage of repeated ASC-US/LSIL, HPV mRNA testing is more specific and is more relevant in clinical use than an HPV DNA test. PMID:25405981

  2. Acoustic streaming cannot discriminate reliably between endometriomas and other types of adnexal lesion: a multicenter study of 633 adnexal masses.

    PubMed

    Van Holsbeke, C; Zhang, Jingh; Van Belle, V; Paladini, D; Guerriero, S; Czekierdowski, A; Muggah, H; Ombelet, W; Jurkovic, D; Testa, A C; Valentin, L; Van Huffel, S; Bourne, T; Timmerman, D

    2010-03-01

    To determine the ability of acoustic streaming to discriminate between endometriomas and other adnexal masses. We used data from 1938 patients with an adnexal mass included in Phase 2 of the International Ovarian Tumor Analysis (IOTA) study. All patients had been examined by transvaginal gray-scale and Doppler ultrasound following a standardized research protocol. Assessment of acoustic streaming was voluntary and was carried out only in lesions containing echogenic cyst fluid. Acoustic streaming was defined as movement of particles inside the cyst fluid during gray-scale and/or color Doppler examination provided that the probe had been held still for two seconds to ensure that the movement of the particles was not caused by movement of the probe or the patient. Only centers where acoustic streaming had been evaluated in > 90% of cases were included. Sensitivity, specificity, positive and negative likelihood ratios (LR+, LR-), and positive and negative predictive values (PPV and NPV) of acoustic streaming with regard to endometrioma were calculated. 460 (24%) masses were excluded because they were examined in centers where masses with echogenic cyst fluid had been evaluated for the presence of acoustic streaming. Acoustic streaming was evaluated in 633 of 646 lesions containing echogenic cyst fluid. It was present in 19 (9%) of 209 endometriomas and in 55 (13%) of 424 other lesions. This corresponds to a sensitivity of absent acoustic streaming with regard to endometrioma of 91% (190/209), a specificity of 13% (55/424), LR+ of 1.04, LR- of 0.69, PPV of 34% (190/559) and NPV of 74% (55/74). Acoustic streaming cannot discriminate reliably between endometriomas and other adnexal lesions, and the presence of acoustic streaming does not exclude an endometrioma. Copyright (c) 2009 ISUOG. Published by John Wiley & Sons, Ltd.

  3. Clinical long-term retention of etch-and-rinse and self-etch adhesive systems in non-carious cervical lesions. A 13 years evaluation.

    PubMed

    van Dijken, Jan W V; Sunnegårdh-Grönberg, Karin; Lindberg, A

    2007-09-01

    The aim of this study was to evaluate the clinical long-term retention to dentin of seven adhesive systems. A total of 337 Class V restorations of three three-step etch-and-rinse, one two-step etch-and-rinse and three self-etch adhesive systems were placed in non-carious cervical lesions without intentional enamel involvement. The restorations were evaluated at baseline and then every 6 months during a 13 years follow-up. Dentin bonding efficiency was determined by the percentage of lost restorations. During the 13 years, 275 restorations could be evaluated. The cumulative loss rate at 13 years was 60.3%, with significant different failures rates for the different systems varying between 26.3 and 94.7%. Three materials fulfilled the ADA 18 months full acceptance criteria. Three systems showed already at 18 months or earlier catastrophical debonding rates. The annual failure rates for the three-step etch-and-rinse systems were: Allbond 2 4.1%, Clearfil LB 2.0% and Denthesive 7.3%. For the two-step etch-and-rinse Gluma 2000 6.5%, and for the self-etch systems ART 3.2%, Denthesive 2 5.7% and PUB 3 4.5% A continuous degradation of the resin-dentin bond was observed for all bonding systems during the follow-up expressed by the increasing loss rates. A wide variation of dentin bonding effectiveness was seen between the systems independent to adhesion strategy.

  4. Effect of dentin roughness on the adhesive performance in non-carious cervical lesions: a double-blind randomized clinical trial.

    PubMed

    Loguercio, Alessandro D; Luque-Martinez, Issis Virginia; Fuentes, S; Reis, Alessandra; Muñoz, Miguel Angel

    2017-09-26

    This double-blind randomized clinical trial evaluates the influence of dentin roughening (RO) on the clinical behavior of a new universal multi-mode adhesive (Tetric N-Bond Universal; Ivoclar-Vivadent) applied as self-etch and as etch-and-rinse in non-carious cervical lesions (NCCLs). A total of 192 restorations were randomly placed in 48 patients according to the following groups: ER - Etch-and-rinse (no preparation); SE - self-etch (no preparation); ER+RO and; SE+RO. The resin composite Empress Direct (Ivoclar-Vivadent) was placed incrementally. The restorations were evaluated after one week (baseline), 6 and 18 months, using the FDI and USPHS criteria. Statistical analyses were performed using appropriate tests (α=0.05). Fifteen restorations were lost at 18 months (3 for SE, 2 for ER, 5 for SE+RO and 5 for ER+RO) (p >0.05 between groups). Post-operative sensitivity wasn't observed in any of the recall periods. Eighty-four restorations were considered to have minor discrepancies in marginal adaptation at the 18-month recall using the FDI criteria (24 for SE, 18 for ER, 22 for SE+RO and 20 for ER+RO; p >0.05 between groups). Nineteen restorations were considered to have minor discrepancies in marginal discoloration at the 18-month recall (10 for SE, 03 for ER, 05 for SE+RO and 01 for ER+RO; p >0.05 between groups). The dentin roughening before application of Tetric N-Bond Universal as self-etch and etch-and-rinse didn't affect the clinical behavior of composite restorations placed in NCCLs. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Potential impact of a nonavalent HPV vaccine on HPV related low-and high-grade cervical intraepithelial lesions: A referral hospital-based study in Sicily.

    PubMed

    Capra, Giuseppina; Giovannelli, Lucia; Matranga, Domenica; Bellavia, Carmelina; Guarneri, Maria Francesca; Fasciana, Teresa; Scaduto, Giovanna; Firenze, Alberto; Vassiliadis, Alessandra; Perino, Antonio

    2017-08-03

    While bivalent and quadrivalent HPV vaccines have been used for about 10 years, a nonavalent vaccine against HPV types 6/11/16/18/31/33/45/52 and 58 has been recently approved by FDA and EMA and is now commercially available. The objective of our study was to evaluate the potential impact of the nonavalent vaccine on HPV infection and related low- and high-grade squamous intraepithelial lesions (LSIL, HSIL), compared to the impact of the quadrivalent vaccine, in a female population living in Sicily (Italy). Low estimates of HPV vaccine impact were calculated as prevalence of HPV 6/11/16/18/31/33/45/52 and 58 genotypes, alone or in association, but excluding presence of other HPV types; high estimates were calculated as prevalence of HPV 6/11/16/18/31/33/45/52 and 58 genotypes alone or in association, in the presence of other HPV types. The nonavalent HPV vaccine showed increased impact, compared to the quadrivalent vaccine. Estimates of potential impact varied from 30.9% (low estimate) to 53.3% (high estimate) for LSIL, and from 56.9% to 81,0% for HSIL. The proportion of additional cases potentially prevented by the nonavalent vaccine was 14.4%-23.8% for LSIL, and 19.0%-32.8% for HSIL. The benefit of the nonavalent vaccine compared to the quadrivalent vaccine was more than 80% for both low and high impact estimates for LSIL and more than 50% for both low and high impact estimates for HSIL. The present study confirms that the switch from a first generation HPV vaccines to a nonavalent vaccine would increase the prevention of cervical HSIL in up to 90% of cases.

  6. Intramedullary Lesion Length on Postoperative Magnetic Resonance Imaging is a Strong Predictor of ASIA Impairment Scale Grade Conversion Following Decompressive Surgery in Cervical Spinal Cord Injury.

    PubMed

    Aarabi, Bizhan; Sansur, Charles A; Ibrahimi, David M; Simard, J Marc; Hersh, David S; Le, Elizabeth; Diaz, Cara; Massetti, Jennifer; Akhtar-Danesh, Noori

    2017-04-01

    Evidence indicates that, over time, patients with spinal cord injury (SCI) improve neurologically in various degrees. We sought to further investigate indicators of grade conversion in cervical SCI. To detect predictors of ASIA impairment scale (AIS) grade conversion in SCI following surgical decompression. In a retrospective study, demographics, clinical, imaging, and surgical data from 100 consecutive patients were assessed for predictors of AIS grade conversion. American Spinal Injury Association motor score was 17.1. AIS grade was A in 52%, B in 29%, and C in 19% of patients. Surgical decompression took place on an average of 17.6 h following trauma (≤12 h in 51 and >12 h in 49). Complete decompression was verified by magnetic resonance imaging (MRI) in 73 patients. Intramedullary lesion length (IMLL) on postoperative MRI measured 72.8 mm, and hemorrhage at the injury epicenter was noted in 71 patients. Grade conversion took place in 26.9% of AIS grade A patients, 65.5% of AIS grade B, and 78.9% of AIS grade C. AIS grade conversion had statistical relationship with injury severity score, admission AIS grade, extent of decompression, presence of intramedullary hemorrhage, American Spinal Injury Association motor score, and IMLL. A stepwise multiple logistic regression analysis indicated IMLL was the sole and strongest indicator of AIS grade conversion (odds ratio 0.950, 95% CI 0.931-0.969). For 1- and 10-mm increases in IMLL, the model indicates 4% and 40% decreases, respectively, in the odds of AIS grade conversion. Compared with other surrogates, IMLL remained as the only predictor of AIS grade conversion.

  7. Detection of human papillomavirus 16 and 18 DNA in epithelial lesions of the lower genital tract by in situ hybridization and polymerase chain reaction: cervical scrapes are not substitutes for biopsies.

    PubMed Central

    Margall, N; Matias-Guiu, X; Chillon, M; Coll, P; Alejo, M; Nunes, V; Quilez, M; Rabella, N; Prats, G; Prat, J

    1993-01-01

    Human papillomavirus (HPV) types 16 and 18 in 66 women with histologically documented lesions of the genital tract and 64 control cohorts were investigated. The efficacies of in situ hybridization and polymerase chain reaction (PCR) in detecting HPV 16 and 18 DNA were analyzed. In order to assess the usefulness of replacing biopsies with cervical scrapes, the two samples were compared by PCR. The prevalence rates of HPV infection by PCR were 59.1 and 10.9% in patients and controls, respectively. PCR was three times more sensitive than in situ hybridization (52.6 versus 17.8%). However, the need to improve PCR sensitivity by subsequent dot blot hybridization reduced one of the main advantages of PCR, i.e., expeditious diagnosis. Cervical scrapes were less sensitive than biopsies (13.6 versus 53%), although with four (6.1%) patients with intraepithelial neoplasias, HPV DNA was identified only by means of cervical scraping. We conclude that obtaining biopsy specimens and cervical scraping are complementary sampling procedures. Images PMID:8385153

  8. A scalp lesion over an extracerebral mass: a sign of a radiation-induced meningioma.

    PubMed

    García Santos, J M; Climent, V

    1992-01-01

    Radiation-induced meningiomas have a characteristic biological behaviour, so that their recognition is important as regards follow-up. We stress the importance of a scalp lesion over the meningioma on magnetic resonance imaging as a sign of previous radiotherapy.

  9. Freiburg neuropathology case conference: a midline mass lesion in an infant.

    PubMed

    Taschner, C A; Staszewski, O; van Velthoven, V; Müller, M; Kontny, U; Hader, C; Prinz, M

    2011-06-01

    This article presents the case of a 10-month-old baby girl with an atypical teratoid/rhabdoid tumor. The differential diagnosis relied on the findings from magnetic resonance with T1 and T2-weighted imaging as well as histological and immunohistochemical methods. The characteristics of the possible candidate lesions considered for the differential diagnosis are described.

  10. Body mass index, Bishop score, and sonographic measurement of the cervical length as predictors of successful labor induction in twin gestations.

    PubMed

    Park, Kyo-Hoon; Hong, Joon-Seok; Kang, Woong-Sun; Shin, Dong-Myung; Kim, Shi-Nae

    2009-01-01

    To evaluate the predictive value of body mass index (BMI), Bishop score, and sonographic measurement of cervical length for predicting successful labor induction (defined as an ability to achieve the active phase of labor corresponding to a cervical dilatation of > or =4 cm within 12 h of initiating oxytocin) in near-term twin gestations. This prospective, observational study enrolled 72 consecutive women with twin gestations at >36.0 weeks' gestation who were scheduled for induction of labor. Transvaginal ultrasound for measurement of the cervical length was performed and the Bishop score was determined by digital examination. The BMI was calculated based on the weight and height at the time of induction. Labor induction was successful in 63% (45/72) of women. The mean BMI was significantly lower in women who had successfully induced labor, but no significant differences existed with respect to the mean cervical length, median Bishop score, proportion of parous and nulliparous women, and the mean total birth weight of the twin pairs between the two patient groups. Multiple logistic regression demonstrated that only BMI provided a significant contribution in predicting successful labor induction. BMI independently predicted the success of labor induction in twin gestations but the sonographic measurement of the cervical length and Bishop score had poor predictive values for successful induction.

  11. Long-term outcomes and prognostic analysis of modified open-door laminoplasty with lateral mass screw fusion in treatment of cervical spondylotic myelopathy

    PubMed Central

    Su, Nan; Fei, Qi; Wang, Bingqiang; Li, Dong; Li, Jinjun; Meng, Hai; Yang, Yong; Guo, Ai

    2016-01-01

    Objectives The purpose of the present study was to explore and analyze the long-term outcomes and factors that affect the prognosis of expansive open-door laminoplasty with lateral mass screw fusion in treatment of cervical spondylotic myelopathy (CSM). Methods We retrospectively reviewed 49 patients with multilevel CSM who had undergone expansive open-door laminoplasty with lateral mass screws fixation and fusion in our hospital between February 2008 and February 2012. The average follow-up period was 4.6 years. The clinical data of patients, including age, sex, operation records, pre- and postoperation Japanese Orthopedic Association (JOA) scores, cervical spine canal stenosis, and cervical curvature, were collected. Increased signal intensity (ISI) on T2-weighted magnetic resonance imaging and ossification of the posterior longitudinal ligament were also observed. Paired t-test was used to analyze the treatment effectiveness and recovery of neuronal function. The prognostic factors were analyzed with multivariable linear regression model. Results Forty-nine patients with CSM with a mean age of 59.44 years were enrolled in this study. The average of preoperative JOA score was 9.14±2.25, and postoperative JOA score was 15.31±1.73. There was significant difference between the pre- and postoperative JOA scores. The clinical improvement rate was 80.27%. On follow-up, five patients had complaints of neck and shoulder pain, but no evidence of C5 nerve palsy was found. Developmental cervical spine canal stenosis was present in all patients before surgery. Before surgery, ISI was observed in eight patients, while ossification of the posterior longitudinal ligament was found in 12 patients. The average of preoperative cervical curvature was 21.27°±8.37° and postoperative cervical curvature was 20.09°±1.29°, and there was no significant difference between the pre- and postoperative cervical curvatures. Multivariable linear regression analysis results showed that

  12. Effect of slice thickness on detectability in breast CT using a prewhitened matched filter and simulated mass lesions

    PubMed Central

    Packard, Nathan J.; Abbey, Craig K.; Yang, Kai; Boone, John M.

    2012-01-01

    Purpose: Dedicated breast CT (bCT) is an emerging technology with the potential to improve the detection of breast cancer in screening and diagnostic capacities. Typically, the 3D volume reconstructed from the scanner is displayed as sectional images. The purpose of this study was to evaluate the effect of section thickness on the detectability of simulated masses using a prewhitened matched filter (PWMF) as a model observer. Methods: A breast CT scanner has been designed and fabricated in the authors’ laboratory with more than 200 women imaged in IRB-approved phase I and phase II trials to date. Of these, 151 bilateral data sets were selected on the basis of low artifact content, sufficient breast coverage, and excluding cases with breast implants. BIRADS breast density ratings were available for 144 of these patients. Spherical mass lesions of diameter 1, 2, 3, 5, 11, and 15 mm were mathematically generated and embedded at random locations within the parenchymal region of each bCT volume. Microcalcifications were not simulated in this study. For each viewing plane (sagittal, axial, and coronal) and section thickness (ranging from 0.3 to 44 mm), section images of the breast parenchyma containing the lesion were generated from the reconstructed bCT data sets by averaging voxels over the length of the section. Using signal known exactly (SKE) model observer methodology, receiver operating characteristic (ROC) curve analysis was performed on each generated projected image using a PWMF based model observer. ROC curves were generated for each breast data set, and the area under the ROC curve (AUC) was evaluated as well as the sensitivity at 95% specificity. Results: For all lesion sizes, performance rises modestly to a peak before falling off substantially as section thickness increases over the range of the study. We find that the optimal section thickness tracks the size of the lesion to be detected linearly with a small positive offset and slopes ranging from 0

  13. Association between human papillomavirus (HPV) 16, HPV18, and other HR-HPV viral load and the histological classification of cervical lesions: Results from a large-scale cross-sectional study.

    PubMed

    Wu, Zeni; Qin, Yu; Yu, Lulu; Lin, Chunqing; Wang, Hong; Cui, Jianfeng; Liu, Bin; Liao, Yiqun; Warren, De'Andre; Zhang, Xun; Chen, Wen

    2017-03-01

    The relationship between HPV viral load and histological grades in the development of cervical cancer is in argument. It is helpful to better understand the association by quantitatively detecting viral load of HPV16, 18, and a pool of 12 other high-risk HPV type (OT) independently on the samples of precancer and cancer. A cross-sectional study was performed in five medical centers of China. Histological diagnosis made by local pathologists was adjudicated via a pathology expert panel. A fully automated real-time PCR test was used for the measurement of HPV16, 18, OT, and human β-globin gene. A total of 2,513 women [1,341 normal, 209 low grade intraepithelial lesion (LSIL), 392 high grade intraepithelial lesion (HSIL), 520 squamous cell carcinoma (SCC), and 51 adenocarcinoma (ADC)] were included. There is a linear increase in the total 14 HPV viral load with histological grade from normal to SCC. This trend was not observed in HPV18 infection but HPV16. The viral load for OT was low in normal, peaked in LSIL and HSIL, and declined in SCC and ADC. In the co-infection of HPV16 and HPV18, HPV16 viral load was significantly higher than HPV18 in LSIL and HSIL. In co-infection of HPV16 and OT, higher HPV16 viral load was also seen in SCC and ADC. Viral load of HPV16 increases with cervical lesion grade and is predominant in cervical cancer. HPV18 viral load is low in precancer, but going up in cancer. OT viral load shows inverse trend of HPV18. J. Med. Virol. 89:535-541, 2017. © 2016 Wiley Periodicals, Inc.

  14. Automated analysis of non-mass-enhancing lesions in breast MRI based on morphological, kinetic, and spatio-temporal moments and joint segmentation-motion compensation technique

    NASA Astrophysics Data System (ADS)

    Hoffmann, Sebastian; Shutler, Jamie D.; Lobbes, Marc; Burgeth, Bernhard; Meyer-Bäse, Anke

    2013-12-01

    Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) represents an established method for the detection and diagnosis of breast lesions. While mass-like enhancing lesions can be easily categorized according to the Breast Imaging Reporting and Data System (BI-RADS) MRI lexicon, a majority of diagnostically challenging lesions, the so called non-mass-like enhancing lesions, remain both qualitatively as well as quantitatively difficult to analyze. Thus, the evaluation of kinetic and/or morphological characteristics of non-masses represents a challenging task for an automated analysis and is of crucial importance for advancing current computer-aided diagnosis (CAD) systems. Compared to the well-characterized mass-enhancing lesions, non-masses have no well-defined and blurred tumor borders and a kinetic behavior that is not easily generalizable and thus discriminative for malignant and benign non-masses. To overcome these difficulties and pave the way for novel CAD systems for non-masses, we will evaluate several kinetic and morphological descriptors separately and a novel technique, the Zernike velocity moments, to capture the joint spatio-temporal behavior of these lesions, and additionally consider the impact of non-rigid motion compensation on a correct diagnosis.

  15. Commercial flight and patients with intracranial mass lesions: a caveat. Report of two cases.

    PubMed

    Zrinzo, Ludvic U; Crocker, Matthew; Zrinzo, Laurence V; Thomas, David G T; Watkins, Laurence

    2006-10-01

    The authors report two cases of neurological deterioration following long commercial flights. Both individuals harbored intracranial space-occupying lesions. The authors assert that preexisting reduced intracranial compliance diminishes an individual's reserve to accommodate the physiological changes resulting from a commercial flight. Airline passengers are exposed to a mild degree of hypercapnia as well as conditions that simulate those of high-altitude ascents. High-altitude cerebral edema following an ascent to great heights is one facet of acute mountain sickness and can be life threatening in conditions similar to those present on commercial flights. Comparable reports documenting neurological deterioration at high altitudes in patients with coexisting space-occupying lesions were also reviewed.

  16. Analysis of 3D Subharmonic Ultrasound Signals from Patients with Known Breast Masses for Lesion Differentiation

    DTIC Science & Technology

    2014-12-01

    ductal carcinomas (23/35) made up the majority of the malignant cases, while fibroadenoma (30/99) was the most prevalent classification of the benign...heterogeneity plot of a benign case (a fibroadenoma ) across the peripheral and central sections. The presence of vascularity in the central sections is...heterogeneity plots of (a) benign ( fibroadenoma ) and (b) malignant (invasive ductal carcinoma) across the peripheral and central sections of the lesion

  17. Prevalence and concordance of high-risk papillomavirus infection in male sexual partners of women diagnosed with high grade cervical lesions.

    PubMed

    López Diez, Elena; Pérez, Sonia; Iñarrea, Amparo; de la Orden, Angel; Castro, Máximo; Almuster, Sheila; Tortolero, Leonardo; Rodríguez, Moises; Montero, Ruben; Ojea, Antonio

    2017-05-01

    Little is known about the characteristics of high-risk papillomavirus (HR-HPV) infection in men. The aims of this cross-sectional study were: (a) to investigate HR-HPV prevalence and genotype distribution in men, sexual partners of women presenting with high-grade cervical intraepithelial neoplasia (HG-CIN), according to epidemiological characteristics, and (b) to assess type-specific concordance between partners. A total of 125 men were recruited within the first 6 months after HG-CIN diagnosis of their partner. Samples from the coronal sulcus, glans penis shaft, and scrotum were tested with linear array HPV genotyping assay (Roche Diagnostics, Mannheim, Germany). Type-specific concordance within 120 couples was studied. Epidemiological factors were evaluated by multivariate logistic regression analysis. SPSS 19 (IBM, Chicago, USA). The prevalence of HR-HPV infection in males was 50.4% (63/125). HPV16/53/52/51/66/31 were the most frequent genotypes (24/10.4/9.6/8.8/8/7.2%, respectively). Current smoking was associated with an increased risk for HR-HPV infection in men (38.2% (21/55) vs 60% (42/70), OR 2.4, p=0.025). Among 60 infected couples, 62% shared at least one genotype: 41.7% couples were concordantly HPV16 positive and 18.3% were HPV16 negative (kappa value: 0.21). The proportion of women with the same genotype as their male partner was higher than the proportion of men sharing the same genotype as their female partner: 58.7% (37/63) vs 30.8% (37/120), p<0.0001. Sexual partners of women with HG-CIN are a significant reservoir and vector of HPV infection, a fact that could contribute to making viral clearance more difficult to achieve in their partners after treatment of their HG-CIN lesions. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  18. Augmented serum level of major histocompatibility complex class I-related chain A (MICA) protein and reduced NKG2D expression on NK and T cells in patients with cervical cancer and precursor lesions.

    PubMed

    Arreygue-Garcia, Naela A; Daneri-Navarro, Adrian; del Toro-Arreola, Alicia; Cid-Arregui, Angel; Gonzalez-Ramella, Oscar; Jave-Suarez, Luis F; Aguilar-Lemarroy, Adriana; Troyo-Sanroman, Rogelio; Bravo-Cuellar, Alejandro; Delgado-Rizo, Vidal; Garcia-Iglesias, Trinidad; Hernandez-Flores, Georgina; Del Toro-Arreola, Susana

    2008-01-21

    Cervical cancer is the second most common cancer in women worldwide. NK and cytotoxic T cells play an important role in the elimination of virus-infected and tumor cells through NKG2D activating receptors, which can promote the lysis of target cells by binding to the major histocompatibility complex class I-related chain A (MICA) proteins. Increased serum levels of MICA have been found in patients with epithelial tumors. The aim of this study was to compare the levels of s