Arteriovenous malformation of the vulva: a case report.

PubMed

Pereira, Nigel; Dormosh, Mayes; Mirmanesh, Michael; Guilfoil, Daniel S

2014-01-01

To report the case of a patient with a large and symptomatic vulvar lesion, necessitating surgical excision. We report the case of a 57-year-old postmenopausal woman with a 6-month history of an enlarging vulvar lesion associated with vulvar pruritus. On examination, a pedunculated 7 × 5 × 4-cm soft tissue mass attached to the left labium majus was noted. Surgical excision was performed and histopathologic evaluation revealed variably dilated, submucosal vessels with thick muscular walls and intimal thickening, but without endothelial atypia or multilayering. These findings were consistent with a final diagnosis of arteriovenous malformation of the vulva. Given the complex anatomy of the vulva, the differential diagnosis for vulvar vascular lesions can be challenging. Hence, surgical excision and histopathologic evaluation become imperative to distinguish them from other dermatologic and neoplastic conditions of the vulva.

Persistent erythematous lesion of the vulva: a diagnostic and treatment challenge.

PubMed

Lazaridou, Elizabeth; Fotiadou, Christina; Giannopoulou, Christina; Ioannides, Demetrios

2012-01-01

The painful, erythematous and eroded vulva often proves to be a diagnostic problem both clinically and histologically. Its differential diagnosis includes both non-neoplastic and neoplastic diseases like Bowen's disease and squamous cell carcinoma (SCC). We report the case of a 62-year-old woman diagnosed, after considerable delay, with Bowen's disease of the vulva that eventually progressed to invasive SCC, despite the treatment with imiquimod 5% cream. Our case indicates, on one hand, that dermoscopy could contribute to the accuracy of the pre-operative clinical diagnosis. On the other hand it confirms the fact that treatment of Bowen's disease of the vulva could be rather intriguing. Although imiquimod 5% cream is an effective, non-invasive treatment option for large lesions or poor healing sites, it should be administered with great consideration in carefully selected cases.

Papular acantholytic dyskeratosis of the vulva associated with familial Hailey-Hailey disease.

PubMed

Yu, W Y; Ng, E; Hale, C; Hu, S; Pomeranz, M K

2016-08-01

Papular acantholytic dyskeratosis (PAD) of the vulva is a rare, chronic disorder first described in 1984. It presents in young women as white to skin-coloured smooth papules over the vulva, which are persistent but asymptomatic. Histologically, there is hyperkeratosis and focal parakeratosis with acantholytic and dyskeratotic cells forming corps ronds and grains, placing PAD within Ackerman's spectrum of focal acantholytic dyskeratoses with Hailey-Hailey disease (HHD) and Darier disease. There have been 17 previous reports of PAD of the vulva, to our knowledge. Only one demonstrated a familial pattern, and none of the cases was associated with a family history of HHD. This is the first report of PAD and HHD in a single family, suggesting that PAD and HHD lie on a spectrum of disease and are genetically linked. © 2016 British Association of Dermatologists.

Clinical factors analysis of curative effect of focused ultrasound treatment for non neoplastic epithelial disorders of vulva.

PubMed

Sun, Xin; Xue, Min; Deng, Xinliang; Wan, Yajun

2010-09-01

To explore the related factors to influence the curative effect of focused ultrasound treatment for non neoplastic epithelial disorders of vulva. A total of 382 patients with non neoplastic epithelial disorders of vulva were included in this study and treated by focused ultrasound. During and after the treatment, the symptoms and physical signs of the subjects were observed, and the efficacy was evaluated. We analyzed the relation between pathologic type, age, course, area, or itch degree and curative effect. Symptoms of all patients were relieved, and appearance and color of the vulva became normal after the ultrasound treatment, with a total effective rate of 99.74%. The cure ratios of patients with different pathologic types, ages, courses, areas, and itch degrees were significantly different (χ(2)=9.58, P<0.01; χ(2)=22.385, P<0.01; χ(2)=32.260, P<0.01; χ(2)=57.99,P<0.01; χ(2)=42.13,P<0.01, respectively). Focused ultrasound treatment is safe and effective for the nonneoplastic epithelial disorders of the vulva and the efficacy is associated with the pathologic type, age, course, area, and itch degree.

Giant Vulvar Epidermoid Cyst in an Adolescent Girl

PubMed Central

Karaman, Erbil; Çim, Numan; Akdemir, Zülküf; Elçi, Erkan; Akdeniz, Hüseyin

2015-01-01

Introduction. Vulvar cyst in adolescent girls is very uncommon. Epidermoid cyst can be seen in many sites including face, trunk, and extremities but its occurrence in vulva is uncommon. This is the first case of epidermoid cyst of vulva reported in an adolescent girl. Case. A 17-year-old, adolescent girl admitted to our gynecology outpatient clinic with a complaint of painful and palpable mass in her vulva. On examination, a giant mass located in left vulva and labia majora with 11 cm in diameter was seen. The magnetic resonance imaging (MRI) showed a well-defined cystic mass without contrast enhancement. The surgery was advised to the patient and the pathologic examination of mass revealed vulvar epidermoid cyst. Discussion. Vulvar cysts generally grow slowly and the main etiologies are vulvar trauma and surgical interventions including episiotomy and female circumcision in some culture. The exact treatment is total surgical excision and pathologic examination. MRI is an important imaging modality for detection of extension to deep perineal tissue and localization of mass in vulva especially in giant ones. Conclusion. Although vulvar mass in adolescents is rare, the epidermoid cyst with benign origin should be kept in mind. PMID:25949839

Aggressive Angiomyxoma of the Vulva Mimicking Clitoromegaly in a Young Child.

PubMed

Kawamura, Masataka; Matsumoto, Fumi; Matsui, Futoshi; Yazawa, Koji; Shimada, Kenji

2017-03-01

Aggressive angiomyxoma (AAM) is a rare soft tissue tumor of mesenchymal origin that chiefly involves the vulvar and perineal region. In 90% of cases, AAM presents in women of reproductive age with a peak incidence in the fourth decade of life. To date, AAM of the vulva in young children and infancy has never been reported. We present a case of AAM of the vulva that was initially interpreted as clitoromegaly in a 3-year-old girl. Copyright © 2016 Elsevier Inc. All rights reserved.

Spindle cell sarcoma of the vulva with myofibroblastic differentiation.

PubMed

Adeleye, Amanda J; Palmeri, Nicholas; Wang, Shih-Hsiu J; Liu-Jarin, Xiaolin; Wright, Jason D

2015-04-01

Primary vulvar sarcomas are rare lesions of the lower genital tract. We report the case of a patient with a spindle cell sarcoma of the vulva. A 44-year-old woman presented with a painless vulvar mass. Vulvar biopsy demonstrated a spindle cell sarcoma with myofibroblastic differentiation. Pretreatment evaluation revealed no evidence of metastatic disease, and magnetic resonance imaging found no local masses. The patient underwent right radical vulvectomy with negative margins and tolerated the procedure well. Women undergoing gynecologic care should have routine evaluation of the vulva to detect these rare neoplasms.

Vulvar Myxoid Liposarcoma and Well Differentiated Liposarcoma With Molecular Cytogenetic Confirmation: Case Reports With Review of Malignant Lipomatous Tumors of the Vulva.

PubMed

Schoolmeester, John Kenneth; Leifer, Aaron J; Wang, Lu; Hameed, Meera R

2015-07-01

Malignant lipomatous tumors of the vulva are uncommon. We present 2 cases of liposarcoma arising in the vulva: a myxoid liposarcoma harboring DDIT3 and FUS rearrangements and a well differentiated liposarcoma/atypical lipomatous tumor harboring MDM2 amplification detected by fluorescence in situ hybridization. Both cases are the first liposarcomas of this site to be confirmed by molecular cytogenetic analysis. We also review the literature's cases of liposarcoma to further examine the clinicopathologic features of these tumors.

[Cervical adenocarcinoma with lymphatic spread presenting as carcinoma "en cuirasse"of the vulva: case report].

PubMed

Silva de Lima, Adma; Casemiro, Karla Patricia; Rovere, Rodrigo Kraft

2014-05-16

We report the case of a patient with carcinoma "en cuirasse" of the vulva. A female patient presented complaining of inguinal lymphadenopathy. Lymph node excision, immunohistochemistry analyses, and further exams showed the presence of cervical adenocarcinoma. The cancer was surgically removed and the patient was treated with radiotherapy and chemotherapy with a good initial response. Some months later she presented with intense edema of the lower limbs, hardening and thickening of the labia majora, and pelvic and genital ulceration. A cutaneous biopsy with subsequent immunohistochemical staining showed lymphatic dissemination of adenocarcinoma to the vulva. Carcinoma "en cuirasse" is a rare presentation of cutaneous metastasis in which the affected skin shows hardening and induration, acquiring a sclerodermoid appearance. This is, to the best of our knowledge, the first report in Brazil of carcinoma "en cuirasse" of the vulva associated with cervical adenocarcinoma.

Vaginal and Vulvar Cancer

MedlinePlus

... does not go away. • Changes in vulva skin color, where it is redder or whiter than normal for you. • Changes on the vulva skin, such as a rash, warts, sores, lumps or ulcers. Pay attention to your body, and know what is normal ...

An Unusual Gross Appearance of Vulval Tuberculosis Masquerading as Tumor

PubMed Central

Arakeri, Surekha U.

2014-01-01

Tuberculosis of the vulva is very rare. It is found in about 0.2% of the cases of genital tract tuberculosis. It usually presents as small shallow ulcers and multiple sinus tracts or rarely as elephantiasis of vulva. Except for very rare cases of primary tuberculosis in the vulva, it is usually associated with tuberculosis elsewhere in the body leading to secondary tuberculosis. Here, we report a case of secondary vulval tuberculosis which presented as a vulval mass in a 40-year-old female patient. The rarity of this presentation in the female genital tract is emphasized. PMID:25298898

An unusual gross appearance of vulval tuberculosis masquerading as tumor.

PubMed

Arakeri, Surekha U; Sinkar, Prachi

2014-01-01

Tuberculosis of the vulva is very rare. It is found in about 0.2% of the cases of genital tract tuberculosis. It usually presents as small shallow ulcers and multiple sinus tracts or rarely as elephantiasis of vulva. Except for very rare cases of primary tuberculosis in the vulva, it is usually associated with tuberculosis elsewhere in the body leading to secondary tuberculosis. Here, we report a case of secondary vulval tuberculosis which presented as a vulval mass in a 40-year-old female patient. The rarity of this presentation in the female genital tract is emphasized.

The Mediator Kinase Module Restrains Epidermal Growth Factor Receptor Signaling and Represses Vulval Cell Fate Specification in Caenorhabditis elegans.

PubMed

Grants, Jennifer M; Ying, Lisa T L; Yoda, Akinori; You, Charlotte C; Okano, Hideyuki; Sawa, Hitoshi; Taubert, Stefan

2016-02-01

Cell signaling pathways that control proliferation and determine cell fates are tightly regulated to prevent developmental anomalies and cancer. Transcription factors and coregulators are important effectors of signaling pathway output, as they regulate downstream gene programs. In Caenorhabditis elegans, several subunits of the Mediator transcriptional coregulator complex promote or inhibit vulva development, but pertinent mechanisms are poorly defined. Here, we show that Mediator's dissociable cyclin dependent kinase 8 (CDK8) module (CKM), consisting of cdk-8, cic-1/Cyclin C, mdt-12/dpy-22, and mdt-13/let-19, is required to inhibit ectopic vulval cell fates downstream of the epidermal growth factor receptor (EGFR)-Ras-extracellular signal-regulated kinase (ERK) pathway. cdk-8 inhibits ectopic vulva formation by acting downstream of mpk-1/ERK, cell autonomously in vulval cells, and in a kinase-dependent manner. We also provide evidence that the CKM acts as a corepressor for the Ets-family transcription factor LIN-1, as cdk-8 promotes transcriptional repression by LIN-1. In addition, we find that CKM mutation alters Mediator subunit requirements in vulva development: the mdt-23/sur-2 subunit, which is required for vulva development in wild-type worms, is dispensable for ectopic vulva formation in CKM mutants, which instead display hallmarks of unrestrained Mediator tail module activity. We propose a model whereby the CKM controls EGFR-Ras-ERK transcriptional output by corepressing LIN-1 and by fine tuning Mediator specificity, thus balancing transcriptional repression vs. activation in a critical developmental signaling pathway. Collectively, these data offer an explanation for CKM repression of EGFR signaling output and ectopic vulva formation and provide the first evidence of Mediator CKM-tail module subunit crosstalk in animals. Copyright © 2016 by the Genetics Society of America.

Intraepithelial and invasive neoplasia of the vulva in association with human papillomavirus infection.

PubMed

Planner, R S; Hobbs, J B

1988-06-01

Colposcopic examination of 335 women with cytologically detected human papillomavirus (HPV) revealed involvement of the cervix in 316 patients (94%), vagina in 276 (82%) and vulva in 148 (44%). A symptom complex of pruritus and superficial dyspareunia was found in 98 of the 148 patients with vulvar infection (66%). Histologic examination revealed HPV-associated vulvar intraepithelial neoplasia (VIN) in 11 of 148 biopsies (7.4%). Follow-up of the patients with HPV infection with or without VIN showed a spontaneous regression rate of 56% but also demonstrated progression to VIN 3 in two patients and to invasive carcinoma of the vulva in one.

Metastatic clear cell eccrine hidradenocarcinoma of the vulva: survival after primary surgical resection.

PubMed

Massad, L S; Bitterman, P; Clarke-Pearson, D L

1996-05-01

A case of clear cell eccrine hidradenocarcinoma of the vulva metastatic to regional lymph nodes with long survival after surgical resection is presented. Like the only other case reported to date, this suggests that surgical therapy alone may be adequate, even when metastasis is present.

Metastatic clear-cell hidradenocarcinoma of the vulva.

PubMed

Messing, M J; Richardson, M S; Smith, M T; King, L; Gallup, D G

1993-02-01

Clear-cell hidradenocarcinoma is a malignant tumor of sweat gland origin. It is most often found on the trunk, head, and extremities. This case report describes a rare occurrence of this tumor on the vulva of a young woman. The discovery of metastatic disease reflects the potentially aggressive nature of this tumor.

An unusual case of diffuse large B-cell lymphoma involving the vulva evaluated by 18F-FDG PET/CT.

PubMed

Treglia, Giorgio; Paone, Gaetano; Perriard, Ulrike; Ceriani, Luca; Giovanella, Luca

2014-10-01

We describe an unusual case of diffuse large B-cell lymphoma involving the vulva detected and staged by F-FDG PET/CT. An 83-year-old female patient with history of endometrial carcinoma underwent F-FDG PET/CT for follow-up. PET/CT detected an area of increased F-FDG uptake corresponding to a vulvar nodule; moderate and diffuse F-FDG uptake in the bone marrow was also evident. Based on these PET/CT findings, the patient underwent biopsy of the vulvar nodule. Histology demonstrated the presence of a diffuse large B-cell lymphoma of the vulva. Bone marrow biopsy was positive for lymphoid infiltration.

Lichenoid Dermatitis of the Vulva: Diagnosis and Differential Diagnosis for the Gynecologic Pathologist.

PubMed

Lewin, Marc R; Hick, Ryan W; Selim, Maria A

2017-09-01

Inflammatory processes affecting the vulva may present a unique challenge due to location specific changes. Different factors are behind the intricacy in the presentation of vulvar dermatoses. First, the vulva is lined by different epithelia (hair-bearing keratinized epithelium, modified mucosa, and mucosa). Furthermore, among other factors, this organ is exposed to friction, occlusion, and trauma. Lastly, as there is a tendency to look for health care advice at an advanced stage of the disease, the lesion may be modified by secondary changes due to self-treatment. This article describes the clinical presentation and pathologic features of vulvar dermatoses with a lichenoid pattern and highlights practical points for their diagnoses.

Laser therapy as the method of choice in treating young women with CIN lesions of the uterine cervix and VIN lesions of the vulva

NASA Astrophysics Data System (ADS)

Knapp, Piotr A.

1996-03-01

The aim of the studies was to attempt to investigate the results of treating young women with CIN I - III of the cervix and epithelial VIN I - III lesions of the vulva by means of the laser technique (vaporization).

Morphogenesis of the vulva and the vulval-uterine connection.

PubMed Central

Gupta, Bhagwati P; Hanna-Rose, Wendy; Sternberg, Paul W

2012-01-01

The C. elegans hermaphrodite vulva is an established model system to study mechanisms of cell fate specification and tissue morphogenesis. The adult vulva is a tubular shaped organ composed of seven concentric toroids that arise from selective fusion between differentiated vulval progeny. The dorsal end of the vulval tubule is connected to the uterus via a multinucleate syncytium utse (uterine-seam) cell. The vulval tubule and utse are formed as a result of changes in morphogenetic processes such as cell polarity, adhesion, and invagination. A number of genes controlling these processes are conserved all the way up to human and function in similar developmental contexts. This makes it possible to extend the findings to other metazoan systems. Gene expression studies in the vulval and uterine cells have revealed the presence of regulatory networks specifying distinct cell fates. Thus, these two cell types serve as a good system to understand how gene networks confer unique cell identities both experimentally and computationally. This chapter focuses on morphogenetic processes during the formation of the vulva and its connection to uterus. PMID:23208727

Primary Ewing's sarcoma of vulva: a case report and a review of the literature.

PubMed

Che, Shao-Min; Cao, Pei-Long; Chen, Hong-Wei; Liu, Zi; Meng, Du

2013-03-01

Ewing sarcomas/peripheral primitive neuroectodermal tumors (ES/pPNET) are extremely rare in the vulva. A review of the literature reveals only 14 previously reported possible cases. Here we reported a case of primary extraskeletal Ewing's sarcoma (EES) of the vulva in a 37-year-old woman. Characteristic histologic features of ES/pPNET were present in this case, including a monomorphic population of small round blue cells with cytoplasmic glycogen confirmed by periodic acid-Schiff, membrane staining with CD99 and nuclear staining with FLI-1. After surgery, the patient was found to have pulmonary metastasis and then received six cycles of polychemotherapy. She is still alive with stable disease after 1 year of follow up. Our findings underline the crucial role of immunohistochemical techniques in the differential diagnosis of small round cell tumors in these unusual locations. We also give a summary about the clinical and pathological features of the primary ES/pPNET in the vulva reported previously in the literature. © 2012 The Authors. Journal of Obstetrics and Gynaecology Research © 2012 Japan Society of Obstetrics and Gynecology.

Morphogenesis of the vulva and the vulval-uterine connection.

PubMed

Gupta, Bhagwati P; Hanna-Rose, Wendy; Sternberg, Paul W

2012-11-30

The C. elegans hermaphrodite vulva is an established model system to study mechanisms of cell fate specification and tissue morphogenesis. The adult vulva is a tubular shaped organ composed of seven concentric toroids that arise from selective fusion between differentiated vulval progeny. The dorsal end of the vulval tubule is connected to the uterus via a multinucleate syncytium utse (uterine-seam) cell. The vulval tubule and utse are formed as a result of changes in morphogenetic processes such as cell polarity, adhesion, and invagination. A number of genes controlling these processes are conserved all the way up to human and function in similar developmental contexts. This makes it possible to extend the findings to other metazoan systems. Gene expression studies in the vulval and uterine cells have revealed the presence of regulatory networks specifying distinct cell fates. Thus, these two cell types serve as a good system to understand how gene networks confer unique cell identities both experimentally and computationally. This chapter focuses on morphogenetic processes during the formation of the vulva and its connection to uterus.

Germ-line induction of the Caenorhabditis elegans vulva

PubMed Central

Thompson, Beth E.; Lamont, Liana B.; Kimble, Judith

2006-01-01

Development of the Caenorhabditis elegans vulva serves as a paradigm for intercellular signaling during animal development. In wild-type animals, the somatic gonadal anchor cell generates the LIN-3/EGF ligand to induce vulval fates in the underlying hypodermis, whereas FBF, FOG-1, and FOG-3 control germ-line development. Here we report that FBF functions redundantly with FOG-1 and FOG-3 to control vulval induction: animals lacking FBF and either FOG-1 or FOG-3 have multiple vulvae, the Muv phenotype. The fog; fbf Muv phenotype is generated by aberrant induction of vulval precursor cells (VPCs): in wild-type animals, three VPCs are induced to form a single vulva, but, in fog; fbf mutants, four or five VPCs are typically induced, resulting in ectopic vulvae. Laser ablation experiments and mosaic analyses demonstrate that the germ line is critical for the fog; fbf Muv phenotype. Consistent with that site of action, we detect FBF and FOG-1 in the germ line but not in the VPCs. The simplest interpretation is that FOG-1, FOG-3, and FBF act in the germ line to influence vulval fates. The LIN-3/EGF ligand may be the germ-line signal to the VPCs: the fog; fbf Muv phenotype depends on LIN-3 activity, and the lin-3 3′ UTR possesses an FBF binding element. Our findings reveal new insights into germ line-to-soma signals and the role of PUF proteins in animal development. PMID:16407099

Evolution of robustness in the signaling network of Pristionchus vulva development

PubMed Central

Zauner, Hans; Sommer, Ralf J.

2007-01-01

Robustness to environmental or genetic perturbation, like any other trait, is affected by evolutionary change. However, direct studies on the interplay of robustness and evolvability are limited and require experimental microevolutionary studies of developmental processes. One system in which such microevolutionary studies can be performed is vulva development in the nematode Pristionchus pacificus. Three vulval precursor cells respond to redundant cell–cell interactions, including signals from the gonad and the epidermal cell P8.p. Interestingly, P. pacificus P8.p is involved in cell fate specification of the future vulva cells by lateral inhibition but is incompetent to respond to the inductive signal from the gonad itself. These functional properties of P8.p are unknown from other nematodes, such as Caenorhabditis elegans. We began an experimental and genetic analysis of the microevolution of P8.p function. We show that vulva misspecification events differ between Pristionchus strains and species. Similarly, lateral inhibition and developmental competence of P8.p evolved within the genus Pristionchus and between natural isolates of P. pacificus. Surprisingly, in some recombinant inbred lines of two distinct P. pacificus isolates, P8.p gained competence to form vulva tissue, a trait that was never observed in P. pacificus isolates. Our results suggest differences in developmental stability between natural isolates, and we hypothesize that the remarkable evolvability of redundant cell–cell interactions allows for adaptive evolution of robustness to developmental noise. PMID:17551021

Detection and Type-Distribution of Human Papillomavirus in Vulva and Vaginal Abnormal Cytology Lesions and Cancer Tissues from Thai Women.

PubMed

Ngamkham, Jarunya; Boonmark, Krittika; Phansri, Thainsang

2016-01-01

Vulva and Vaginal cancers are rare among all gynecological cancers worldwide, including Thailand, and typically affect women in later life. Persistent high risk human papillomavirus (HR-HPV) infection is one of several important causes of cancer development. In this study, we focused on HPV investigation and specific type distribution from Thai women with abnormality lesions and cancers of the vulva and Vaginal. A total of ninety paraffin-embedded samples of vulva and Vaginal abnormalities and cancer cells with histologically confirmed were collected from Thai women, who were diagnosed in 2003-2012 at the National Cancer Institute, Thailand. HPV DNA was detected and genotyped using polymerase chain reaction and enzyme immunoassay with GP5+/ bio 6+ consensus specific primers and digoxigenin-labeled specific oligoprobes, respectively. The human β-globin gene was used as an internal control. Overall results represented that HPV frequency was 16/34 (47.1%) and 8/20 (40.0%) samples of vulva with cancer and abnormal cytology lesions, respectively, while, 3/5 (60%) and 16/33 (51.61%) samples of Vaginal cancer and abnormal cytology lesions, respectively, were HPV DNA positive. Single HPV type and multiple HPV type infection could be observed in both type of cancers and abnormal lesion samples in the different histological categorizes. HPV16 was the most frequent type in all cancers and abnormal cytology lesions, whereas HPV 18 was less frequent and could be detected as co-infection with other high risk HPV types. In addition, low risk types such as HPV 6, 11 and 70 could be detected in Vulva cancer and abnormal cytology lesion samples, whereas, all Vaginal cancer samples exhibited only high risk HPV types; HPV 16 and 31. In conclusion, from our results in this study we suggest that women with persistent high risk HPV type infection are at risk of developing vulva and Vaginal cancers and HPV 16 was observed at the highest frequent both of these, similar to the cervical cancer cases. Although the number of samples in this study was limited and might not represent the overall incidence and prevalence in Thai women, but the baseline data are of interest and suggest further study for primary cancer screening and/or developing the efficiency of prophylactic HPV vaccines in Thailand.

Nematode Tango Milonguero - the C. elegans male's search for the hermaphrodite vulva.

PubMed

Sherlekar, Amrita L; Lints, Robyn

2014-09-01

The vulva search corresponds to the first step of mating in Caenorhabditis elegans wherein the male recognizes a potential mate through contact and commences a systematic, contact-based search of her surface for the vulva. During this 'dance' the male presses his tail genitalia firmly against the hermaphrodite surface and moves backward, modulating tail posture to effect changes in search trajectory. Upon sensing the vulva, the male pauses and the insemination phase of mating begins. External tail sensilla, the rays, induce and guide the male's search by registering hermaphrodite surface cues. C. elegans male mating behavior, like many other animate interactions (such as predator-prey interactions or intrasexual aggression), is performed at close quarters and requires that participants constantly adjust their movement with respect to one another on a moment-by-moment basis. The design features of the supporting circuitry explain simultaneously the robustness, speed and acuity of the male's behavior and its male-specific nature. Processing at all levels of the circuitry appears to be distributed. Cellular components exhibit both partial redundancy (thus conferring robustness in output) and subtle functional differences (predicted to confer acuity). Surprisingly, gender-shared cell types feature prominently in the circuitry. Male-specific components form sensory pathways that render downstream gender-shared circuits responsive to mate cues, while other male cells act to augment gender-shared cell activity. Overall, the attributes of the vulva search circuitry provide insight into principles guiding the design and operation of circuits supporting dynamic social behaviors expressed by more complex and less tractable animal species. Copyright © 2014 Elsevier Ltd. All rights reserved.

Antagonism of LIN-17/Frizzled and LIN-18/Ryk in nematode vulva induction reveals evolutionary alterations in core developmental pathways.

PubMed

Wang, Xiaoyue; Sommer, Ralf J

2011-07-01

Most diversity in animals and plants results from the modification of already existing structures. Many organ systems, for example, are permanently modified during evolution to create developmental and morphological diversity, but little is known about the evolution of the underlying developmental mechanisms. The theory of developmental systems drift proposes that the development of conserved morphological structures can involve large-scale modifications in their regulatory mechanisms. We test this hypothesis by comparing vulva induction in two genetically tractable nematodes, Caenorhabditis elegans and Pristionchus pacificus. Previous work indicated that the vulva is induced by epidermal growth factor (EGF)/RAS and WNT signaling in Caenorhabditis and Pristionchus, respectively. Here, we show that the evolution of vulva induction involves major molecular alterations and that this shift of signaling pathways involves a novel wiring of WNT signaling and the acquisition of novel domains in otherwise conserved receptors in Pristionchus vulva induction. First, Ppa-LIN-17/Frizzled acts as an antagonist of WNT signaling and suppresses the ligand Ppa-EGL-20 by ligand sequestration. Second, Ppa-LIN-18/Ryk transmits WNT signaling and requires inhibitory SH3 domain binding motifs, unknown from Cel-LIN-18/Ryk. Third, Ppa-LIN-18/Ryk signaling involves Axin and β-catenin and Ppa-axl-1/Axin is epistatic to Ppa-lin-18/Ryk. These results confirm developmental system drift as an important theory for the evolution of organ systems and they highlight the significance of protein modularity in signal transduction and the dynamics of signaling networks.

Antagonism of LIN-17/Frizzled and LIN-18/Ryk in Nematode Vulva Induction Reveals Evolutionary Alterations in Core Developmental Pathways

PubMed Central

Wang, Xiaoyue; Sommer, Ralf J.

2011-01-01

Most diversity in animals and plants results from the modification of already existing structures. Many organ systems, for example, are permanently modified during evolution to create developmental and morphological diversity, but little is known about the evolution of the underlying developmental mechanisms. The theory of developmental systems drift proposes that the development of conserved morphological structures can involve large-scale modifications in their regulatory mechanisms. We test this hypothesis by comparing vulva induction in two genetically tractable nematodes, Caenorhabditis elegans and Pristionchus pacificus. Previous work indicated that the vulva is induced by epidermal growth factor (EGF)/RAS and WNT signaling in Caenorhabditis and Pristionchus, respectively. Here, we show that the evolution of vulva induction involves major molecular alterations and that this shift of signaling pathways involves a novel wiring of WNT signaling and the acquisition of novel domains in otherwise conserved receptors in Pristionchus vulva induction. First, Ppa-LIN-17/Frizzled acts as an antagonist of WNT signaling and suppresses the ligand Ppa-EGL-20 by ligand sequestration. Second, Ppa-LIN-18/Ryk transmits WNT signaling and requires inhibitory SH3 domain binding motifs, unknown from Cel-LIN-18/Ryk. Third, Ppa-LIN-18/Ryk signaling involves Axin and β-catenin and Ppa-axl-1/Axin is epistatic to Ppa-lin-18/Ryk. These results confirm developmental system drift as an important theory for the evolution of organ systems and they highlight the significance of protein modularity in signal transduction and the dynamics of signaling networks. PMID:21814488

Primary milia localized to the vulva.

PubMed

Adotama, Prince; Susa, Joseph; Glass, Donald A

2014-04-16

Multiple primary milia were found on the vulva of a 52-year-old woman who was referred to the dermatology clinic by her gynecologist. These lesions are commonly distributed on the face and rarely occur in this location without antecedent trauma. This report demonstrates the unique presentation of primary milia in the genital region and explores the diagnostic features and treatment methods of these lesions.

A multivariate analysis of clinical and morphological prognostic factors in squamous cell carcinoma of the vulva.

PubMed

Smyczek-Gargya, B; Volz, B; Geppert, M; Dietl, J

1997-01-01

Clinical and histological data of 168 patients with squamous cell carcinoma of the vulva were analyzed with respect to survival. 151 patients underwent surgery, 12 patients were treated with primary radiation and in 5 patients no treatment was performed. Follow-up lasted from at least 2 up to 22 years' posttreatment. In univariate analysis, the following factors were highly significant: presurgery lymph node status, tumor infiltration beyond the vulva, tumor grading, histological inguinal lymph node status, pre- and postsurgery tumor stage, depth of invasion and tumor diameter. In the multivariate analysis (Cox regression), the most powerful factors were shown to be histological inguinal lymph node status, tumor diameter and tumor grading. The multivariate logistic regression analysis worked out as main prognostic factors for metastases of inguinal lymph nodes: presurgery inguinal lymph node status, tumor size, depth of invasion and tumor grading. Based on these results, tumor biology seems to be the decisive factor concerning recurrence and survival. Therefore, we suggest a more conservative treatment of vulvar carcinoma. Patients with confined carcinoma to the vulva, with a tumor diameter up to 3 cm and without clinical suspected lymph nodes, should be treated by wide excision/partial vulvectomy with ipsilateral lymphadenectomy.

Treatment Outcome of Carcinoma Vulva Ten-Year Experience from a Tertiary Cancer Centre in South India.

PubMed

Jeevarajan, Sakthiushadevi; Duraipandian, Amudhan; Kottayasamy Seenivasagam, Rajkumar; Shanmugam, Subbiah; Ramamurthy, Rajaraman

2017-01-01

Carcinoma vulva is a rare disease accounting for 1.3% of all gynaecological malignancies. The present study is a 10-year retrospective review of our experience of the surgical options, morbidity, failure pattern, and survival for invasive carcinoma vulva. Retrospective analysis of case records of 39 patients who underwent surgery for invasive vulval cancer between 2004 and 2013 in the Department of Surgical Oncology at the Government Royapettah Hospital, Chennai. The median age was 55 years. Radical vulvectomy was the preferred surgery. 31 patients underwent lymphadenectomy. Seroma formation and groin skin necrosis were the most common postoperative complications. With a median follow-up of 32 months, 8 patients (20.5%) developed recurrence (systemic = 1, regional = 4, and local = 3). The estimated 5-year disease-free survival (DFS) was 65.4% and the overall survival (OS) was 85.1%. On univariate analysis, stage and lymph node involvement significantly affected OS. Nodal involvement with extracapsular spread (ECS) significantly affected both DFS and OS. The treatment of carcinoma vulva should be individualized with multidisciplinary cooperation. The paucity of data, especially from India, necessitates the need for more studies, preferably multicentric, keeping in mind the low prevalence.

Paraganglioma of the vulva: a case report and review of the literature

PubMed Central

Liu, Yong-Qiao; Yue, Jun-Qiu

2013-01-01

Paraganglioma is a neuroendocrine neoplasm, which is extremely rare in the vulva and only one case has been reported. Here we present a case of vulvar paraganglioma in a 48-year-old woman and a literature review. The patient found a lump located in the genitals below the symphysis pubis 3 months before presentation when she complained that the lump was increasing in size. A 3.2 cm x 2.3 cm x 1.5 cm nodule was excised from subcutaneous soft tissue in the vulva. Microscopy showed a diversity of cell morphologies and structures in the rich vascular network of the tumor separated the chief cells into round cell nests (Zellballen pattern). Some areas of the tumor presented epithelioid and spindle-shaped cells with increased cell density and indistinct structural characteristics. Hyaline degeneration of collagen fibers or mucoid degeneration was found in tumor interstitium. Immunohistochemical staining showed diffused expression of synaptophysin in the chief cells, focal expression of S-100 protein in the sustentacular cells and high expression of CD34 in the vascular components. Based on morphological and immunohistochemical results, a rare paraganglioma of the vulva was diagnosed. PMID:24133606

Paraganglioma of the vulva: a case report and review of the literature.

PubMed

Liu, Yong-Qiao; Yue, Jun-Qiu

2013-01-01

Paraganglioma is a neuroendocrine neoplasm, which is extremely rare in the vulva and only one case has been reported. Here we present a case of vulvar paraganglioma in a 48-year-old woman and a literature review. The patient found a lump located in the genitals below the symphysis pubis 3 months before presentation when she complained that the lump was increasing in size. A 3.2 cm x 2.3 cm x 1.5 cm nodule was excised from subcutaneous soft tissue in the vulva. Microscopy showed a diversity of cell morphologies and structures in the rich vascular network of the tumor separated the chief cells into round cell nests (Zellballen pattern). Some areas of the tumor presented epithelioid and spindle-shaped cells with increased cell density and indistinct structural characteristics. Hyaline degeneration of collagen fibers or mucoid degeneration was found in tumor interstitium. Immunohistochemical staining showed diffused expression of synaptophysin in the chief cells, focal expression of S-100 protein in the sustentacular cells and high expression of CD34 in the vascular components. Based on morphological and immunohistochemical results, a rare paraganglioma of the vulva was diagnosed.

Morphogenesis of the C. elegans vulva

PubMed Central

Schindler, Adam J

2012-01-01

Understanding how cells move, change shape, and alter cellular behaviors to form organs, a process termed morphogenesis, is one of the great challenges of developmental biology. Formation of the C. elegans vulva is a powerful, simple, and experimentally accessible model for elucidating how morphogenetic processes produce an organ. In the first step of vulval development, three epithelial precursor cells divide and differentiate to generate 22 cells of seven different vulval subtypes. The 22 vulval cells then rearrange from a linear array into a tube, with each of the seven cell types undergoing characteristic morphogenetic behaviours that construct the vulva. Vulval morphogenesis entails many of the same cellular activities that underlie organogenesis and tissue formation across species, including invagination, lumen formation, oriented cell divisions, cell-cell adhesion, cell migration, cell fusion, extracellular matrix remodelling and cell invasion. Studies of vulval development have led to pioneering discoveries in a number of these processes and are beginning to bridge the gap between the pathways that specify cells and their connections to morphogenetic behaviors. The simplicity of the vulva and the experimental tools available in C. elegans will continue to make vulval morphogenesis a powerful paradigm to further our understanding of the largely mysterious mechanisms that build tissues and organs. PMID:23418408

[Malignant vascular tumors of the vulva].

PubMed

Chokoeva, A; Tchernev, G

2015-01-01

Due to the increased vascularity as well as the unique anatomical structure, vascular lesions, which occur in the female reproductive system are common observed and diverse by their morphology. The majority of them are benign, including vascular malformations, lesions due to vascular hyperplasia, tumors with significant vascular component and others. Malignant vascular tumors are rare in the area of the vulva accounting about 1% of all vulvar lesions with vascular origin. Kaposi sarcoma, epithelioid hemangioepithelioma and epithelioid angiosarcoma have been reported with vulvar localization. With a view to their rare incidence, nonspecific clinical manifestation and aggressive behavior associated with high mortality, we present the most common malignant tumors of vascular origin arising in the vulva, as we emphasize on their epidemiology and clinical features, differential diagnosis and therapeutic algorithms for this rare type of malignancies.

Successful Treatment of Congenital Lymphangioma Circumscriptum of the Vulva with CO2 and Long-Pulsed Nd:YAG Lasers.

PubMed

Sasaki, Ryosuke; Negishi, Kei; Akita, Hirotaka; Suzuki, Kayoko; Matsunaga, Kayoko

2014-01-01

A 16-year-old girl presented with a 9-year history of vesicles on the vulva. She had initially taken a wait-and-see approach, but required treatment because of bleeding. Histological examination of a biopsied vesicle revealed dilated lymph channels in the upper dermis, suggesting lymphangioma circumscriptum (LC). The challenge for this pathology has been to find a conservative treatment with low morbidity and better results than those reported for surgical excision, which has been the mainstay of therapy. In this case, LC of the vulva was successfully treated using a 10,600-nm CO2 laser and long-pulsed Nd:YAG laser. Use of the 10,600-nm CO2 laser and long-pulsed Nd:YAG laser appeared effective for treating LC.

Short- and long-term efficacy of focused ultrasound therapy for non-neoplastic epithelial disorders of the vulva.

PubMed

Wu, C; Zou, M; Xiong, Y; Wang, L; Chen, H; Fan, Y; Li, C

2017-08-01

To investigate the short- and long-term efficacy and influential factors of focused ultrasound for the treatment of non-neoplastic epithelial disorders of the vulva (NNEDV). A retrospective observational study. A gynaecologic department in a single centre in China. Patients with NNEDV were included in this study: 85 patients were diagnosed with lichen simplex chronicus (LSC), 44 patients with vulva lichen sclerosus (VLS), and seven patients with lichen planus (LP). A total of 136 eligible patients with NNEDV were treated with focused ultrasound. After the treatment, based on changes in the degree of symptom severity and local skin signs (lesion size, skin colour and elasticity) before and after treatment, the treatment effectiveness for each patient was assessed. We further analysed the relations among pathologic type, age, course and curative rate. Statistical analysis was performed using the Chi-square (McNemar) test. Improvement in the symptoms and physical signs and the predictive factors. Symptom relief was observed in all patients. The appearance and colour of the vulva returned to normal after the ultrasound treatment. Complete remission (CR) occurred in 68 of 136 (50%) patients (41 patients with LSC and 12 patients with VLS). The response rate was 93.38% (127/136). Seven patients who had a poor response to the first session of treatment were treated again with ultrasound therapy and a good response was observed. No severe complications were observed. There was no significant difference in treatment results among the different pathological types (P > 0.05). However, the course of the disease and the age of the patients were related to the treatment results (P < 0.05). NNEDV can be treated with focused ultrasound effectively and safely. The course of the disease and the age of the patients may be predictive factors. Patients with non-neoplastic epithelial disorders of the vulva can be safely and effectively treated with focused ultrasound. No significant difference in treatment results was observed between the different types of non-neoplastic epithelial disorders of the vulva. © 2017 Royal College of Obstetricians and Gynaecologists.

The use of digital infrared thermal imaging to detect estrus in gilts.

PubMed

Sykes, D J; Couvillion, J S; Cromiak, A; Bowers, S; Schenck, E; Crenshaw, M; Ryan, P L

2012-07-01

Yorkshire/Landrace crossbred gilts (N = 32) were evaluated using digital infrared thermal imaging (DITI) to discriminate between estrus and diestrus phases of the porcine estrous cycle. Gilts (N = 32) were part of an ongoing reproductive efficiency study involving the use of raw soybean (RSB; N = 15) versus soybean meal (SBM; N = 17) as a source of dietary protein. Gilts were monitored daily for signs of estrus using a teaser boar. Thermal images of vulva surface temperatures (TEMP) were recorded at standing estrus and diestrus. Measurements for analysis included minimum (MIN), maximum (MAX), mean (AVG), and standard deviation (SD) of temperature gradients. At imaging, ambient (AMB) and rectal temperatures (RT) were recorded, and blood samples taken for serum progesterone (P(4)) concentration analysis (by RIA) to confirm stage of cycle. Mean serum progesterone values at estrus and diestrus were (mean ± SD) 1.0 ± 0.1 and 10.9 ± 0.8 ng/mL, respectively. Vulva MIN, MAX, and AVG thermal images were positively correlated with one another (P < 0.01), and were positively correlated with ambient temperature (P < 0.01). Vulva MAX and AVG thermal temperatures were greater (P < 0.05) at estrus than at diestrus (36.6 ± 0.2 °C and 33.4 ± 0.3 °C vs. 35.6 ± 0.3 °C and 31.8 ± 0.6 °C, respectively), whereas MIN and SD had no differences (P > 0.05) between stages of the cycle. No differences (P > 0.05) in RT were detected between stages and RT was not significantly correlated with vulva thermal images. Diet had no significant effect on RT or vulva temperature. Copyright © 2012. Published by Elsevier Inc.

Protruding vulva mutants identify novel loci and Wnt signaling factors that function during Caenorhabditis elegans vulva development.

PubMed

Eisenmann, D M; Kim, S K

2000-11-01

The Caenorhabditis elegans vulva develops from the progeny of three vulval precursor cells (VPCs) induced to divide and differentiate by a signal from the somatic gonad. Evolutionarily conserved Ras and Notch extracellular signaling pathways are known to function during this process. To identify novel loci acting in vulval development, we carried out a genetic screen for mutants having a protruding-vulva (Pvl) mutant phenotype. Here we report the initial genetic characterization of several novel loci: bar-1, pvl-4, pvl-5, and pvl-6. In addition, on the basis of their Pvl phenotypes, we show that the previously identified genes lin-26, mom-3/mig-14, egl-18, and sem-4 also function during vulval development. Our characterization indicates that (1) pvl-4 and pvl-5 are required for generation/survival of the VPCs; (2) bar-1, mom-3/mig-14, egl-18, and sem-4 play a role in VPC fate specification; (3) lin-26 is required for proper VPC fate execution; and (4) pvl-6 acts during vulval morphogenesis. In addition, two of these genes, bar-1 and mom-3/mig-14, are known to function in processes regulated by Wnt signaling, suggesting that a Wnt signaling pathway is acting during vulval development.

Treatment Outcome of Carcinoma Vulva Ten-Year Experience from a Tertiary Cancer Centre in South India

PubMed Central

Duraipandian, Amudhan; Shanmugam, Subbiah; Ramamurthy, Rajaraman

2017-01-01

Background Carcinoma vulva is a rare disease accounting for 1.3% of all gynaecological malignancies. The present study is a 10-year retrospective review of our experience of the surgical options, morbidity, failure pattern, and survival for invasive carcinoma vulva. Materials and Methods Retrospective analysis of case records of 39 patients who underwent surgery for invasive vulval cancer between 2004 and 2013 in the Department of Surgical Oncology at the Government Royapettah Hospital, Chennai. Results The median age was 55 years. Radical vulvectomy was the preferred surgery. 31 patients underwent lymphadenectomy. Seroma formation and groin skin necrosis were the most common postoperative complications. With a median follow-up of 32 months, 8 patients (20.5%) developed recurrence (systemic = 1, regional = 4, and local = 3). The estimated 5-year disease-free survival (DFS) was 65.4% and the overall survival (OS) was 85.1%. On univariate analysis, stage and lymph node involvement significantly affected OS. Nodal involvement with extracapsular spread (ECS) significantly affected both DFS and OS. Conclusion The treatment of carcinoma vulva should be individualized with multidisciplinary cooperation. The paucity of data, especially from India, necessitates the need for more studies, preferably multicentric, keeping in mind the low prevalence. PMID:29387486

Multicentric intraepithelial neoplasia involving the vulva. Clinical features and association with human papillomavirus and herpes simplex virus.

PubMed

Bornstein, J; Kaufman, R H; Adam, E; Adler-Storthz, K

1988-10-15

Sixteen of 46 patients (35%) with Grade 3 vulvar intraepithelial neoplasia (VIN 3) were found to have an additional site of lower genital tract squamous cell neoplasia, primarily in the cervix. The frequency of multicentricity decreased significantly with age. In addition, patients with multicentric disease (involving the vagina and/or cervix in addition to the vulva) had a significantly higher frequency of multifocal disease involving the vulva (involving more than one location on the vulva) and of recurrence than patients without multicentric disease. Human papillomavirus (HPV) DNA was detected by in situ hybridization in 81% of the women with multicentric squamous cell neoplasia. No significant difference was noticed between patients with multicentric and unicentric squamous cell neoplasia in the detection rate of papillomavirus antigen, HPV DNA, the various HPV types, herpes simplex virus Type 2 (HSV2)-related antigen, type-specific antibodies to HSV, and dual HPV and HSV2 infections. These findings suggest that HPV and HSV2, although strongly associated with VIN 3, do not influence the development pattern of squamous cell neoplasia, and that all patients with VIN 3, especially if they are younger than 50 years of age, should be evaluated periodically for additional centers of lower genital tract squamous cell neoplasia.

Complementary use of optical coherence tomography and 5-aminolevulinic acid induced fluorescent spectroscopy for diagnosis of neoplastic processes in cervix and vulva

NASA Astrophysics Data System (ADS)

Sapozhnikova, Veronika V.; Shakhova, Natalia M.; Kamensky, Vladislav A.; Kuranov, Roman V.; Loshenov, Victor B.; Petrova, Svetlana A.

2003-07-01

A new approach to improving the diagnostic value of optical methods is suggested, which is based on a complementary investigation of different optical parameters of biotissues. The aim of this paper is comparative study of the feasibility of two optical methods - fluorescence spectroscopy and optical coherence tomography - for visualization of borders of neoplastic processes in the uterine cervix and vulva. Fluorescence spectroscopy is based on the detection of biochemical and optical coherence tomography on backscattering properties in norm and pathological changes of tissues. By means of these optical methods changes in biochemical and morphological properties of tissues were investigated. A parallel analysis of these two optical methods and histology from the center of tumors and their optical borders was made. Thirteen female patients with neoplastic changes in uterine cervix and vulva were enrolled in this study. The borders of the tumor determined by optical methods (fluorescence spectroscopy and optical coherence tomography) are coinciding with the biopsy proved ones. In addition, OCT and fluorescence borders of tumor in the uterine cervix and vulva exceeds colposcopically detectable borders, the averaging difference 2 mm. In future optical methods would considerably enhance diagnostic accuracy of conventional methods used in oncogynecology.

An unusual case of mammary gland-like carcinoma of vulva: case report and review of literature.

PubMed

Baykal, C; Dünder, I; Turkmen, I C; Ozyar, E

2015-01-01

Accessory breast tissue is a very rare finding in the general population with an incidence of one to two percent. An even rarer occurrence is accessory mammary-like tissue which developed breast carcinoma. The authors present a case of aggressive and metastatic carcinoma of vulvar originating from mammary-like tissue. A 73-year-old Caucasian female presented with a lesion in her left vulva. The lesion was ulcerated and fragile. A dermatologist had evaluated the lesion and took a punch biopsy. Result was vulvar carcinoma. She was admitted to the gynecologic oncology clinic then after and was operated. After a radical vulvectomy and bilateral inguinal lymphadenectomy she received adjuvant radiotherapy because of lymph node metastasis. One year after the finish of radiotherapy patient was found to have lung and femur metastasis. She began to receive systemic chemotherapy for metastasis. Primary mammary-like adenocarcinoma of the vulva is exceedingly rare. There is no consensus about the diagnosis, treatment, and follow up of these patients in literature. However, given that histological data confirms these cancers are behaving like breast cancers instead of known patterns of vulva cancer, the best treatment practices for breast cancer may be applied to treat these vulvar carcinoma patients.

Morphogenesis of the caenorhabditis elegans vulva.

PubMed

Schindler, Adam J; Sherwood, David R

2013-01-01

Understanding how cells move, change shape, and alter cellular behaviors to form organs, a process termed morphogenesis, is one of the great challenges of developmental biology. Formation of the Caenorhabditis elegans vulva is a powerful, simple, and experimentally accessible model for elucidating how morphogenetic processes produce an organ. In the first step of vulval development, three epithelial precursor cells divide and differentiate to generate 22 cells of 7 different vulval subtypes. The 22 vulval cells then rearrange from a linear array into a tube, with each of the seven cell types undergoing characteristic morphogenetic behaviors that construct the vulva. Vulval morphogenesis entails many of the same cellular activities that underlie organogenesis and tissue formation across species, including invagination, lumen formation, oriented cell divisions, cell–cell adhesion, cell migration, cell fusion, extracellular matrix remodeling, and cell invasion. Studies of vulval development have led to pioneering discoveries in a number of these processes and are beginning to bridge the gap between the pathways that specify cells and their connections to morphogenetic behaviors. The simplicity of the vulva and the experimental tools available in C. elegans will continue to make vulval morphogenesis a powerful paradigm to further our understanding of the largely mysterious mechanisms that build tissues and organs. © 2012 Wiley Periodicals, Inc.

Genetic Control of Vulval Development in Caenorhabditis briggsae

PubMed Central

Sharanya, Devika; Thillainathan, Bavithra; Marri, Sujatha; Bojanala, Nagagireesh; Taylor, Jon; Flibotte, Stephane; Moerman, Donald G.; Waterston, Robert H.; Gupta, Bhagwati P.

2012-01-01

The nematode Caenorhabditis briggsae is an excellent model organism for the comparative analysis of gene function and developmental mechanisms. To study the evolutionary conservation and divergence of genetic pathways mediating vulva formation, we screened for mutations in C. briggsae that cause the egg-laying defective (Egl) phenotype. Here, we report the characterization of 13 genes, including three that are orthologs of Caenorhabditis elegans unc-84 (SUN domain), lin-39 (Dfd/Scr-related homeobox), and lin-11 (LIM homeobox). Based on the morphology and cell fate changes, the mutants were placed into four different categories. Class 1 animals have normal-looking vulva and vulva-uterine connections, indicating defects in other components of the egg-laying system. Class 2 animals frequently lack some or all of the vulval precursor cells (VPCs) due to defects in the migration of P-cell nuclei into the ventral hypodermal region. Class 3 animals show inappropriate fusion of VPCs to the hypodermal syncytium, leading to a reduced number of vulval progeny. Finally, class 4 animals exhibit abnormal vulval invagination and morphology. Interestingly, we did not find mutations that affect VPC induction and fates. Our work is the first study involving the characterization of genes in C. briggsae vulva formation, and it offers a basis for future investigations of these genes in C. elegans. PMID:23275885

Mucinous metaplasia of the vulva in a case of lichen sclerosus. A case report

PubMed Central

Rakha, E; Mayne, C; Brown, L

2005-01-01

Mucinous metaplasia of the genital area is a rare condition characterised by the emergence of mucin containing cells in stratified squamous epithelium. This report describes a unique case of benign mucinous metaplasia of the vulva associated with lichen sclerosus in a 60 year old woman. Histopathology revealed cervical type metaplasia with otherwise typical lichen sclerosus. This report discusses the pathogenesis and differential diagnosis of mucinous epithelium. PMID:16254116

Laser-induced synlabia, cryptomenorrhea, and urine retention: A case report and literature review

PubMed Central

Fadul-Elahi, Thoraya; Janjua, Nusrat Batool

2017-01-01

Cosmetic laser use has many pros and cons. The worldwide use of laser for body hair removal has led to many medical complications. Unsupervised use of the laser for hair removal in vulva may result in many problems and can merely damage the vulva, although rarely, affecting the body image. This rare and novel case report is a 21 year old virgin who presented with acute urinary retention and cryptomenorrhea due to complete synlabia secondary to unsupervised vulval laser hair removal. The urinary retention was relieved by suprapubic catheterization initially. During examination under anesthesia, the fused labia were separated by a surgical incision with drainage of hematocolpos and then, a Foley's urethral catheter was inserted. She had an uneventful recovery. We report this case to emphasize on the supervised use of laser by trained and qualified personnel for hair removal in vulva to minimize its complications. PMID:29118543

Management of radionecrosis of the vulva and distal vagina

DOE Office of Scientific and Technical Information (OSTI.GOV)

Roberts, W.S.; Hoffman, M.S.; LaPolla, J.P.

1991-05-01

Twelve patients were seen between January 1983 and June 1989 with the clinical diagnosis of radionecrosis of the vulva or distal vagina. Seven patients received radiation for vulvar cancer, three for distal vaginal cancer, and two for recurrent endometrial cancer. No patient healed spontaneously and the mean delay in surgical therapy was 8.5 months. The radionecrotic site was treated with local therapy, radical local excision (with or without colostomy), or exenteration. The operative defect was closed primarily in three patients and covered with local flaps or myocutaneous flaps in seven patients. The two patients with local care still have radionecroticmore » ulcers. One of three patients who were closed primarily continues to have an ulcer. All other patients have healed satisfactorily except one who died after two attempts to correct the problem. Radionecrosis of the vulva and distal vagina should generally be treated surgically.« less

Robustness and flexibility in nematode vulva development.

PubMed

Félix, Marie-Anne; Barkoulas, Michalis

2012-04-01

The Caenorhabditis elegans vulva has served as a paradigm for how conserved developmental pathways, such as EGF-Ras-MAPK, Notch and Wnt signaling, participate in networks driving animal organogenesis. Here, we discuss an emerging direction in the field, which places vulva research in a quantitative and microevolutionary framework. The final vulval cell fate pattern is known to be robust to change, but only recently has the variation of vulval traits been measured under stochastic, environmental or genetic variation. Whereas the resulting cell fate pattern is invariant among rhabditid nematodes, recent studies indicate that the developmental system has accumulated cryptic variation, even among wild C. elegans isolates. Quantitative differences in the signaling network have emerged through experiments and modeling as the driving force behind cryptic variation in Caenorhabditis species. On a wider evolutionary scale, the establishment of new model species has informed about the presence of qualitative variation in vulval signaling pathways. Copyright © 2012 Elsevier Ltd. All rights reserved.

Primary breast cancer of the vulva: a case report.

PubMed

Diniz da Costa, Ana Teresa Minhoto; Coelho, Ana Maria; Lourenço, Alexandre Valentim; Bernardino, Margarida; Ribeirinho, Ana Luisa; Jorge, Carlos Calhaz

2012-04-01

The occurrence of primary breast cancer of the vulva is extremely rare (24 cases described in the English-language literature). We report a case of a primary breast carcinoma of the vulva. An 82-year-old woman presented with a nodule of the left labia minor, which was excised. The histologic examination revealed the presence of adenocarcinoma of mammary origin, positive for common breast markers and for estrogen and progesterone receptors. The study for orthotopic breast carcinoma was negative, as well as the study for metastatic disease. The diagnosis of primary breast carcinoma was established. Our patient was then submitted to pelvic and inguinal radiotherapy as well as an aromatase inhibitor (letrozole), and she remained completely asymptomatic. Because of the rarity of this condition, guidelines for therapy are unavailable. The management suggested in the literature is that of primary orthotopic breast neoplasm of a similar stage.

[MALIGNANT LYMPHOMAS OF THE VULVA- DIAGNOSIS AND THERAPY].

PubMed

Chokoeva, Aa; Tchernev, G

2015-01-01

Primary malignant lymphomas affecting the female reproductive system are unusual, accounting for about 30% of all lymphomas. The majority of them are represented by non-Hodgkin lymphomas (over 90%), as their location most commonly involved the ovarian (49%), followed by the uterus (29%), fallopian tubes (11%), vagina (7%), and only in 4% of the cases, the primary lymphomas affecting the vulva. Although rare, lymphomas of the vulva are characterized by high proliferative potential, aggressive clinical course and poor prognosis and may lead to rapid vulvar and perineal destruction. Due to the rarity of their occurrence in the vulvo-vaginal area and their non-specific clinical manifestations, lymphomas with such location are often a diagnostic challenge and require a wide range of differential diagnoses. We present the epidemiological structure, the clinical and immunohistochemical markers characteristic of the most common lymphomas with vulvar localization, in order to emphasize their role in the differential diagnosis of vulvar tumor masses.

Dermatofibrosarcoma protuberans of the vulva: margins assessment and reconstructive options - a report of two cases.

PubMed

Bertolli, Eduardo; Bretchbuhl, Eduard Renè; Camarço, William Ricardo; Campagnari, Mariane; Molina, André Sapata; Baiocchi, Glauco; Macedo, Mariana Petaccia; Pinto, Clovis Antonio; Cunha, Isabela Werneck; Neto, João Pedreira

2014-12-29

Dermatofibrosarcoma Protuberans (DFSP) of the vulva is rare and oncologic surgery with free margins may lead to severe functional damage, requiring multidisciplinary approach regarding resection, margin assessment and reconstruction.Case Report: Two cases of DFSP in vulva were treated in a single institution. A 28-year-old patient with an incisional biopsy in the vulvar region revealing DFSP underwent a partial vulvectomy with clitoris preservation. Pathological studies revealed free margins and reconstructive surgery was performed. This patient is disease free in a 40 months follow up. The other, a 57-year-old patient was also referred after an incomplete resection of a DFSP in the vulvar region. A 1-cm margim resection followed by Complete Circumferential and Peripheral Deep Margin Assessment (CCPDMA) was performed. Although the upper lateral margin was positive, it was possible to perform another wide local excision with preservation of the clitoris and primary closure. DFSP of the vulva requires an accurate evaluation of margins, resections following oncological principles and reconstruction. Although being a very challenging lesion that usually implies difficult surgical management, if treated in a multidisciplinary environment, with surgical oncologists, experienced dermatopathologists and reconstructive surgeons can achieve good results. Even in difficult cases that presents with large lesions and compromising challenging areas, a complete oncologic resection can be performed minimizing functional damage for the patient.

Anatomy and Aesthetics of the Labia Minora: The Ideal Vulva?

PubMed

Clerico, C; Lari, A; Mojallal, A; Boucher, F

2017-06-01

Female genital cosmetic surgery is becoming more and more widespread both in the field of plastic and gynaecological surgery. The increased demand for vulvar surgery is spurred by the belief that the vulva is abnormal in appearance. What is normal in terms of labial anatomy? Labia minora enlargement or hypertrophy remains a clinical diagnosis which is poorly defined as it could be considered a variation of the normal anatomy. Enlarged labia minora can cause functional, aesthetic and psychosocial problems. In reality, given the wide variety of vulvar morphology among people, it is a very subjective issue to define the "normal" vulva. The spread of nudity in the general media plays a major role in creating an artificial image and standards with regard to the ideal form. Physicians should be aware that the patient's self-perception of the normal or ideal vulva is highly influenced by the arguably distorted image related to our socio-psychological environment, as presented to us by the general media and internet. As physicians, we have to educate our patients on the variation of vulvar anatomy and the potential risks of these surgeries. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Study of pruritus vulvae in geriatric age group in tertiary hospital

PubMed Central

Kaur, Jasleen; Kalsy, Jyotika

2017-01-01

Background: According to the World Health Organization criteria, geriatric population is people above 60 years of age. In this phase of life, a woman has already gone through menopause and its associated emotional, physical, and hormonal changes. These changes are due to gradual loss of estrogen that comes with menopause which results in dramatic changes in the appearance of vulva and vagina. With age, skin of vulva becomes thin, loses elasticity, and moisture so that the patient starts feeling burning and itchy sensation. The normal acidic pH changes to basic which alters the flora and makes the person prone to other bacterial infections. Apart from infections, there are many other dermatological and nondermatological causes of vulvar itching in this age group such as eczema, contact dermatitis, lichen planus (LP), lichen sclerosus atrophicans, lichen simplex chronicus (LSC), prolapse, incontinence, and carcinoma. The aim is to diagnose the causes of pruritus vulvae in the geriatric age group to decrease the misery of these patients. Methods: We selected 40 consecutive females of age group ranging from 60 to 75 years coming to skin OPD with the complaint of pruritus of vulvar region over a period of 1 year. Clinical examination, complete blood count, fasting blood sugar, wet mount, pap smear, and skin biopsy were done in every case. Results: Out of the forty patients who were included in this study, 17 (42.5%) were diagnosed as a case of LSC and 11 (27.5%) patients had atrophic vaginitis. Three (7.5%) patients presented with tinea. Three (7.5%) cases were clinically diagnosed as scabies. Another 2 (5%) cases were diagnosed as LP and Candida was seen in other 2 (5%) cases. 1 (2.5%) case was diagnosed as bacillary vaginosis and 1 (2.5%) patient was of lichen sclerosus. Conclusion: Pruritus vulvae of geriatric age group are of diverse etiology, therefore, treatment based on precise diagnosis is of prime importance. PMID:28442799

Vulvar intraepithelial neoplasia with superficially invasive carcinoma of the vulva.

PubMed

Herod, J J; Shafi, M I; Rollason, T P; Jordan, J A; Luesley, D M

1996-05-01

To investigate the long-term outcome of patients presenting with vulvar intraepithelial neoplasia (VIN) with superficially invasive carcinoma of the vulva (SICa). A retrospective study using information obtained from patient case notes. Twenty-six women found at presentation to have VIN in association with superficially invasive carcinoma were identified during a 15-year period. Pruritus vulvae was the most frequent presenting symptom in 18 patients (69%). Sixteen women (61.5%) had multiple symptoms. Features noted at vulvar examination were variable and none were pathognomonic of either VIN or of superficial invasion. All patients had VIN 3 in association with a superficially invasive carcinoma. Histological changes associated with human papillomavirus were found in 19 (73%) women. Half had a co-existent or previous abnormality of the lower genital tract. Local excision was the most frequent initial treatment (n = 9 [35%]). Mean follow up time was 65 months (range 12-174). Disease persisted after primary treatment in five women (19%). Both histological recurrence (of either VIN or SICa) or symptomatic recurrence occurred in 10 patients (38%). All patients who experienced recurrence did so within 36 months of treatment. Overall, 12 patients (46%) relapsed (histological or symptomatic recurrence); the mean time was 18 months. Fourteen patients (54%) were managed satisfactorily by their initial treatment. One patient died of recurrent cervical cancer. Three progressed to frankly invasive disease: two (aged 31 and 39 years) with carcinoma of the vulva and one aged 34 years with carcinoma of the perianal margin. All are alive and well after treatment. One patient had recurrence of superficially invasive carcinoma treated by local excision with no further problems. No episode of metastasis via lymphatic or vascular channels has been seen. Patients with superficially invasive carcinoma of the vulva may be safely treated by local excisional methods without recourse to lymphadenectomy. Relapse after primary treatment is common, and there appears to be a significant risk of progression to frankly invasive carcinoma.

Infections in Combat Casualties During Operations Iraqi and Enduring Freedom

DTIC Science & Technology

2009-04-01

bacteria other 39 112.1 Vulva/vaginal candidiasis 1 381.4 Nonsuppurative otitis media 1 451.82 Superficial phlebitis arm 2 451.83 Deep phlebitis arm 1...Coding by Pathogen Pathogen Code Code Description Number Fungus 112.1 Vulva/vaginal candidiasis 1 112.3 Candidiasis of skin/nails 1 112.5 Disseminated... candidiasis 3 112.89 Candidiasis site not available 6 112.9 Candidiasis site unspecified 13 117.3 Aspergillus 5 117.9 Mycoses 14 Gram-negative 003.8

Invasive mucinous (colloid) adenocarcinoma of ectopic breast tissue in the vulva: a case report.

PubMed

Yin, C; Chapman, J; Tawfik, O

2003-01-01

We present the first case of primary vulvar mucinous adenocarcinoma of ectopic breast origin. The patient is an 84-year-old woman with a mass on the left side of her vulva. A left partial vulvectomy with bilateral inguinal lymph node dissections revealed a mucinous adenocarcinoma that involved the dermis and subcutaneous tissue. The tumor cells were positive for estrogen receptors (ERs), progesterone receptors (PRs), and BRST-1 markers. The clinical and pathologic features, differential diagnosis, and treatment are discussed.

Lymphangiosarcoma of the edematous thigh after radiation therapy for carcinoma of the vulva

DOE Office of Scientific and Technical Information (OSTI.GOV)

Huey, G.R.; Stehman, F.B.; Roth, L.M.

1985-03-01

A 66-year-old patient was treated with external radiation therapy for an advanced carcinoma of the vulva. Seven years later, a lymphangiosarcoma developed in her edematous lower extremity. Lymphangiosarcomas have been reported to occur in postmastectomy patients; however, this is only the third case in a patient with a gynecologic primary malignancy. In anticipation of possible increased use of radiation therapy in vulvar carcinoma, gynecologists should be aware of this rare, highly aggressive neoplasm.

Extramammary Paget's disease of the vulva.

PubMed

Gavriilidis, Paschalis; Chrysanthopoulos, Konstantinos; Gerasimidou, Domniki

2013-11-21

Vulvar Paget's disease is an extremely rare neoplasm that accounts for less than 1% of the vulvar malignancies. We present a case of a 75-year-old woman, who had an eczematoid lesion involving the labia majora and minora bilaterally, with infiltration to the clitoris. Enlarged non-fixed lymph nodes were palpable in the inguinal region bilaterally. A biopsy of the vulva showed Paget's disease. She underwent radical vulvectomy with bilateral inguinal lymph node dissection. The patient remained disease free at 6-month follow-up.

Crohn's disease of the vulva.

PubMed

Barret, Maximilien; de Parades, Vincent; Battistella, Maxime; Sokol, Harry; Lemarchand, Nicolas; Marteau, Philippe

2014-07-01

Crohn's disease (CD) of the vulva is a rare, yet under recognized condition. Fistulae arising from the digestive tract account for the greater part of genital lesions in CD. However, cutaneous so-called metastatic lesions of the vulva have been reported in the literature. They are clinically challenging for gastroenterologists as well as for gynecologists, with numerous differential diagnoses, especially among venereal diseases, and require a multidisciplinary approach. The most frequently observed features of the disease are labial swelling, vulvar ulcers, and hypertrophic lesions. Biopsy samples for histological study are mandatory, in order to establish the diagnosis of vulvar CD. Treatment options include oral prolonged courses of metronidazole and systemic immunosuppressive therapy such as corticosteroids and azathioprine, with promising data published on the efficacy of infliximab. Surgery remains restricted to medical treatment failures or resection of unsightly lesions. Prospective studies or case series with long follow-up data are still missing to guide the treatment of this condition. © 2013. Published by Elsevier B.V. All rights reserved.

The under-reporting of skin disease in association with squamous cell carcinoma of the vulva.

PubMed

Zaki, I; Dalziel, K L; Solomonsz, F A; Stevens, A

1996-09-01

Histology sections from 61 cases of squamous cell carcinoma (SCC) of the vulva presenting after 1988 were reviewed for evidence of associated epithelial abnormality. Of the 50 patients with epithelium adjacent to the tumour, 24 had histological evidence of lichen sclerosus (LS), 20 of severe vulvar intraepithelial neoplasia (VIN 3), 22 of human papilloma virus (HPV) infection and three of lichen planus (LP). The clinical records and the original histology report were also subsequently reviewed and with the exception of VIN 3, these disorders were poorly reported by both clinicians and pathologists. Lichen sclerosus was diagnosed clinically in only two of the 36 hospital records available for inspection. Old terminology was used to describe some patients with epithelial disease (erythroleucoplakia in one patient with LS, leucoplakia in two patients with LS and one with LP). This study demonstrates the need to adopt standard nomenclature and increase the awareness of epithelial disease associated with SCC of the vulva among clinicians and pathologists.

Metastatic adenocarcinoma of mammary-like glands of the vulva successfully treated with surgery and hormonal therapy.

PubMed

Benito, Virginia; Arribas, Sara; Martínez, David; Medina, Norberto; Lubrano, Amina; Arencibia, Octavio

2013-01-01

Vulvar cancer is a rare malignancy; most tumors are squamous cell type while adenocarcinomas are rare. Primary adenocarcinomas of the vulva predominantly include extramammary Paget's disease and sweat gland carcinomas. Greene first described a rare form of adenocarcinoma in 1936, which was called adenocarcinoma of mammary-like glands of the vulva because of its morphologic and immunohistochemical resemblance to breast adenocarcinomas. In the management of this entity, varying combinations of surgery, radiation therapy, systemic chemotherapy and/or hormonal therapy may be used, as in patients with orthotopic breast carcinoma. However, hormonal therapy leads the way in patients with positive hormonal receptors, where other therapies cannot be used due to comorbidities or advanced age. We present the first reported case of an elderly patient with metastatic vulvar adenocarcinoma arising from mammary-like glands, successfully treated with a combination of surgery and hormonal therapy. © 2012 The Authors. Journal of Obstetrics and Gynaecology Research © 2012 Japan Society of Obstetrics and Gynecology.

Loss in 3p and 4p and gain of 3q are concomitant aberrations in squamous cell carcinoma of the vulva.

PubMed

Jee, K J; Kim, Y T; Kim, K R; Kim, H S; Yan, A; Knuutila, S

2001-05-01

Neoplasm of the vulva is a rare malignancy accounting for <5% of all female genital-tract cancer. However, in recent years the incidence of vulva intraepithelial neoplasia, known to serve as a precursor to carcinoma, has increased in young women generating considerable interest in its pathogenesis. Genetic changes at the molecular level in precursor or invasive vulvar tumors are not well investigated, and DNA copy number changes have not been reported until now. We used comparative genomic hybridization (CGH) to analyze genetic alterations in 10 primary invasive squamous cell carcinomas of the vulva. Chromosomal aberrations were identified in 8/10 cases. The most frequent chromosomal losses were 4p13-pter (five cases), 3p (four cases), and 5q (two cases), and less frequent losses were detected at 6q, 11q, and 13q (one case each). The most frequent chromosomal gains were 3q (four cases) and 8p (three cases), and less frequent gains were found in 9p, 14, 17, and 20q (one case each). The pattern of chromosomal imbalance in vulvar cancer detected by CGH was revealed to be very similar to that in cervical cancers, despite regional differences in their prevalence. These results suggest that the pathogenic pathways in vulvar and cervical carcinomas may be similar and that the genetic background may be common to these two squamous cell carcinomas.

Influence of vestibulovaginal stenosis, pelvic bladder, and recessed vulva on response to treatment for clinical signs of lower urinary tract disease in dogs: 38 cases (1990-1999).

PubMed

Crawford, Jason T; Adams, William M

2002-10-01

To determine influence of vestibulovaginal stenosis, pelvic bladder, and recessed vulva on response to treatment for clinical signs of lower urinary tract disease in dogs. Retrospective study. 38 spayed female dogs. Medical records and client follow-up were reviewed for dogs evaluated via excretory urography because of clinical signs of lower urinary tract disease. Clinical signs, results of radiography, and response to surgical or medical treatment were analyzed. Clinical signs included urinary tract infection (n = 24), urinary incontinence (20), vaginitis (11), pollakiuria or stranguria (10), and perivulvar dermatitis (4). Vaginocystourethrographic findings included vestibulovaginal stenosis (n = 28), pelvic bladder (17), and ureteritis or pyelonephritis (4). Ten dogs had a vestibulovaginal ratio of < 0.20 (severe stenosis), 9 dogs had a ratio of 0.20 to 0.25 (moderate stenosis), 9 dogs had a ratio of 0.26 to 0.35 (mild stenosis), and 10 dogs had a ratio of > 0.35 (anatomically normal). Lower urinary tract infection, incontinence, and pelvic bladder were not associated with response to treatment for recessed vulva. Vestibulovaginal stenosis with a ratio < 0.20 was significantly associated negatively with response to treatment. Dogs without severe vestibulovaginal stenosis that received vulvoplasty for a recessed vulva responded well to treatment. Vestibulovaginal stenosis is likely an important factor in dogs with vestibulovaginal ratio < 0.20. Vaginectomy or resection and anastomosis should be considered in dogs with severe vestibulovaginal stenosis and signs of lower urinary tract disease.

Unusual benign polypoid and papular neoplasms and tumor-like lesions of the vulva.

PubMed

AbdullGaffar, Badr; Keloth, Tasnim R; Raman, Lakshmiah G; Mahmood, Suaad; Almulla, Amal; AlMarzouqi, Mamoun; Al-Hasani, Salam

2014-04-01

We aimed to investigate the prevalence and spectrum of unusual benign neoplasms and tumor-like lesions presenting as vulvar polyps and papules, to study their clinical, pathologic, hormonal, and developmental features and whether they have important associations with other pathologic lesions or clinical diseases. We conducted a retrospective review study of 115 vulvar specimens over 7 years. Common lesions, for example, fibroepithelial polyps, skin tags, papillomas, abscesses, viral warts and common cysts, were excluded. We found 21 cases (18%) with uncommon benign vulvar lesions. They included 7 epithelial cysts, 3 vascular lesions, 3 glandular neoplasms, 3 endometrioses, 1 caruncle, 1 pilonidal sinus, 1 prolapsed urethra, 1 seborrheic keratosis, and 1 granular cell tumor. The age range was between 1 and 64 years with a mean age of 33 years. Most (86%) were 2.5 cm or less. Many were asymptomatic incidental pathologic findings that can be missed clinically. Nine cases have important clinical associations or coexisting incidental pathologic lesions. Some lesions demonstrated hormone receptors. Some were clinically confused with fibroepithelial polyps, abscesses, warts, melanocytic lesions, and tumors. In conclusion, although the vulva is a small compartment, its developmental and histologic complexity can result in a variety of unusual and rare benign polypoid and papular lesions, some unique to the vulva, which might present diagnostic challenges to the clinicians and pathologists. In addition, many bear controversy regarding their histogenesis and origin of development in the vulva. Copyright © 2014 Elsevier Inc. All rights reserved.

The vulva skin microclimate: influence of panty liners on temperature, humidity and pH.

PubMed

Runeman, Bo; Rybo, Göran; Larkö, Olle; Faergemann, Jan

2003-01-01

Many women use panty liners between menstrual periods. The aim of this study was to investigate whether the use of such products might influence the vulva skin. Twelve healthy women were studied on four occasions with three different product constructions and on one occasion without products. Temperature, surface wetness and surface pH were measured on vulva skin. Mean skin temperature when the women were wearing a conventional panty liner (with a non-breathable back sheet) was 35.9 degrees C, compared to 34.4 degrees C when wearing no panty liner at all (p < 0.01) and 34.5 degrees C when using a panty liner with a breathable (i.e. vapour permeable) back sheet (p < 0.01). Skin humidity was significantly higher when the conventional panty liner was used compared to no panty liner or to the breathable panty liner (both cases p < 0.01). The mean pH value at the exterior aspect of the labium majus was 5.8 with the conventional panty liner, 5.2 with no panty liner and 5.3 with the breathable panty liner (p < 0.001 and p < 0.01, respectively). The results indicate that the conventional panty liner changes the vulva skin microclimate, but that the breathable panty liner to a substantial degree keeps the microclimate at an undisturbed level. The actual effect of these differences on microbiological flora will be addressed in a subsequent study.

A persistent mass: A case of aggressive Angiomyxoma of the vulva.

PubMed

Brzezinska, B N; Clements, A E; Rath, K S; Reid, G C

2018-05-01

We present a case of aggressive angiomyxoma of the vulva. The patient presented with a persistent, enlarging vulvar mass, initially misdiagnosed as a Bartholin gland cyst. The patient underwent wide local excision, which resulted in total resection of the mass. Final pathology was consistent with aggressive angiomyxoma, a rare soft tissue tumor with a predilection for the female pelvis. Though rare, it is important to consider in the differential diagnosis of a pelvic mass, given the locally aggressive nature of this tumor and propensity for recurrence.

Anatomy of the Vulva and the Female Sexual Response.

PubMed

Yeung, Jennifer; Pauls, Rachel N

2016-03-01

The female vulva is an intricate structure comprising several components. Each structure has been described separately, but the interplay among them and physiologic significance remain controversial. The structures extend inferiorly from the pubic arch and include the mons pubis, labia majora, labia minora, vestibule, and clitoris. The clitoris is widely accepted as the most critical anatomic structure to female sexual arousal and orgasm. The female sexual response cycle is also very complex, requiring emotional and mental stimulation in addition to end organ stimulation. Copyright © 2016 Elsevier Inc. All rights reserved.

Lung Metastasis in a Case of Recurrent Poorly Differentiated Leiomyosarcoma of the Bartholin Gland: A Case Report and Review of the Literature

PubMed Central

Alfieri, Joanne

2016-01-01

Vulvar neoplasms represent four percent of all gynecological cancers. While most cases of vulvar neoplasms are benign, two percent of patients present with malignant disease. We present the case of a 37-year-old premenopausal female who presented to an outside institution with a lump in her left vulva, which had progressively enlarged to the size of an egg. A wide local excision of the left vulva was performed, and the pathology revealed a high-grade sarcoma, not otherwise specified (NOS), with negative margins. Imaging showed enlarged bilateral external iliac lymph nodes, likely metastatic. After discussion at a multidisciplinary gynecology oncology tumor board, she was treated with gemcitabine/docetaxel chemotherapy, followed by a left inguinal lymph node dissection and a left radical vulvectomy after being referred to our centre. The final pathology at that time showed a residual sarcoma of 3.5 mm in the left vulva with no lympho-vascular invasion (LVI) and negative margins, with the closest, laterally, at 2 mm. A total of three lymph nodes were negative. She received additional chemotherapy postoperatively. Approximately one year later, she returned to her gynecologist with a 1 cm mass on the left vulva. She underwent a left hemi-vulvectomy and lymph node dissection, and pathology confirmed the presence of a high-grade sarcoma with close margins. She received adjuvant radiotherapy. Three months later, she presented with persistent cough and pneumonia. Imaging revealed a 10 cm lung mass, which was believed to be metastasis from the vulva. This was confirmed with biopsy and was completely resected. Any mass in the Bartholin gland area should be investigated carefully. Poorly differentiated vulvar leiomyosarcoma in the Bartholin gland can recur locally but may also lead to distant metastasis. Despite surgical and systemic treatment, as well as adjuvant radiation, the tumor recurred. Due to the rarity of this condition, there are no clear recommendations for treatment of this disease. To our knowledge, this is the first report of vulvar leiomyosarcoma of the Bartholin gland with metastasis to the lung. PMID:27158579

Recurrent proliferating trichilemmal tumor of the vulva: a case report.

PubMed

Moraloğlu, Özlem; Güngör, Tayfun; Ozyer, Sebnem; Eryilmaz, Özlem Gün; Özdener, Tülin; Toğrul, Cihan; Bayramoğlu, Hatice

2013-01-01

Proliferating trichilemmal tumor (PTT) is a rare but morphologically distinct tumor that usually arises on the scalp of elderly women. It is composed of multiple cysts consisting of squamous epithelium with trichilemmal keratinization without granular layer interposition. Vulvar proliferating trichilemmal cyst is very rare, with, to the best of our knowledge, only 3 cases previously reported in the literature. We describe a 39-year-old woman with recurrent PTT on the left labium majus of the vulva, which had been excised from the same side 5 years before. She had a palpable nodule, approximately 2 cm in size, which was firm, mobile, and nontender; without erythema and ulceration; and covered by normal skin on the vulva. There was no inguinal lymphadenopathy. The lesion was removed by wide surgical excision; because of the tissue elasticity, primary closure was possible. The pathology result was reported as proliferating trichilemmal carcinoma with tumor-free margins. Although local recurrence after wide excision is rare, we recommend complete excision for treatment of PTT and long-term follow-up because of the possibility of recurrence.

Surgical management for squamous cell carcinoma of vulva.

PubMed

Amavi, Ayi Kossigan; Kouadio, Laurent; Adabra, Komlan; Tengue, Kodjo; Tijami, Fouad; Jalil, Abdelouahed

2016-01-01

To analyze our surgical management and the result of squamous cell carcinoma (SCC) of vulva. Retrospectively, we collected 38 cases of SCC; 17 cases of them were early SCC and 21 cases were locally advanced. The patients underwent primary surgery. The survival was estimated using Kaplan-Meier analysis and the log rank test. The mean age was 60.78 years. Total vulvectomy was performed in all patients. Superficial and deep incision of bilateral inguinal lymphadenectomy was performed by separates incisions for SCC infiltrating more than 1mm. The average tumor size was 53 mm (10 to 140mm). Morbidity was 42.1%. Lateral resection margin ≥8mm was obtained in 57.1%. Eighteen patients benefited from adjuvant radiotherapy. The follow-up median was 19.4 months (6 to 61.5 month) with 05 recurrences in 12 months. The survival using the Kaplan-Meyer analysis at 5 years, was 62.1% (71.2%N(-) vs 46.7%N(+); p = 0.13). We identified two groups for locally advanced vulva cancer. Primary surgery keeps its place. Neo adjuvant radio chemotherapy followed by surgery is the alternative treatment for locally extensive lesions.

Acute vulvar pain in a lady with post circumcision inclusion cyst of the vulva containing stones: a case report.

PubMed

Gudu, Wondimu

2014-01-06

Despite global eradication efforts, female genital cutting is still deep routed practice in some parts of Asia and East Africa. The crude and unscientific natures of the practice lead to many complications. Epidermoid inclusion cysts of the vulva are one of the late complications of female genital cutting and typically present as painless cystic swellings. But clinical presentation as 'stone' containing, hard vulvar mass is reported only once in the literature and presentation with acute vulvar pain has never been documented. A 21 yrs old, Ethiopian, unmarried, lady presented with sever acute vulvar pain, discharge, and a stony hard vulvar swelling 13 years after type-III female genital cutting (infibulation). Surgical excision of the cyst, which contained two 'stones' inside it, and defibulation were done. Histopathology confirmed calcified, keratinizing epidermoid inclusion cyst of the vulva. Clinicians, in areas where female genital cutting is prevalent, should be aware of such unusual late vulvar complication of the practice which might be misdiagnosed for other solid vulvar swellings and be familiar with the appropriate management.

Primary Langerhans Cell Histiocytosis of the Vulva: Case Report and Review of the Literature.

PubMed

Zudaire, Tamara; Guarch, Rosa; Valcayo, Ana; García, Kelly; Resano, Miguel Ángel; Requena, Diego; Rodríguez, Mercedes

2017-03-01

Langerhans cell histiocytosis (LCH) of the vulva is rare and even moreso in postmenopausal women. Twenty-six cases of primary vulvar LCH have been described in the current literature, and only 8 cases are in postmenopausal women. We report an additional case of primary vulvar LCH in a 59-yr-old woman with subsequent multiorgan involvement. In this article, we briefly describe the clinical presentation, histopathological findings, and immunohistochemistry results of vulvar LCH. We want to emphasize the importance of recognizing this entity in a woman with vulvar lesions both for the clinician and the pathologist.

Syringocysadenoma papilliferum of the vulva: a rarity in gynaecology.

PubMed

Steshenko, Oleksandr; Chandrasekaran, Nirmala; Lawton, Frank

2014-05-28

A case of syringocystadenoma papilliferum of the vulva in a 36-year-old woman is reported .The patient presented with a single cystic lesion on the left labia minora of 8 years duration with a recent increase in size and redness around the lesion. Examination revealed a polypoid cystic lesion with no regional lymphadenopathy. An excision biopsy was performed under general anaesthesia and the specimen was subjected to histological examination. Histopathology revealed closely excised syringocystadenoma papilliferum. On follow-up, the patient was asymptomatic and the wound had healed well. 2014 BMJ Publishing Group Ltd.

Detection of Human Papillomavirus Type 16 DNA and Papillomavirus Genus‐specific Antigens in Vulva and Cervix from Patients with Bowenoid Papulosis

PubMed Central

Sugase, Motoyasu; Moriyama, Shin‐ichi; Hata, Satoru; Matsukura, Toshihiko

1989-01-01

The warty disordered lesions of the vulva in three female patients were diagnosed as Bowenoid papulosis on the basis of clinical and histopathological findings. In all three vulvar lesions, human Papillomavirus type 16 (HPV 16) DNA was identified hy Southern blot hybridization and Papillomavirus genus‐specific (PGS) antigen was detected in one case immunohistochemically. Furthermore, colposcopic examination revealed the presence of abnormal uterine cervical lesions in two cases. They were found to be intraepithelial neoplasia which harbored HPV 16 DNA and were positive for PGS antigen. PMID:2540130

Sebaceous hyperplasia of the vulva: a series of cases reporting no association with the Muir-Torre syndrome.

PubMed

Roma, Andres A; Barry, Jessica; Pai, Rish K; Billings, Steven D

2014-07-01

Sebaceous gland hyperplasia is a common skin condition, very rarely reported in the female genital region. We present 13 cases from 12 patients, the first case series of sebaceous gland hyperplasia of the vulva. Differences in age at presentation and clinical presentation compared with classic sebaceous gland hyperplasia from the head and neck region were noted. Also, it was rarely included in the clinical differential diagnosis. Immunohistochemical studies to determine any possible association with the Muir-Torre syndrome were performed and mismatch repair protein loss was not identified.

Red Rashes of the Vulva.

PubMed

Morrison, Lynne H; Leclair, Catherine M

2017-09-01

Red patches and plaques of the vulva may be manifestations of neoplasms, infections, or inflammatory skin diseases. These diseases can mimic one another clinically; features that generally allow the diseases to be identified on most cutaneous surfaces can be altered in the moist, occluded vulvar environment, making clinical diagnosis difficult. A detailed history and thorough physical examination can point to the likely diagnosis, but biopsy and culture may be needed for diagnosis especially in refractory disease. It is not uncommon for several of these processes to be present concomitantly or complicating other vulvar diseases. Copyright © 2017 Elsevier Inc. All rights reserved.

Caenorhabditis elegans syndecan (SDN-1) is required for normal egg laying and associates with the nervous system and the vulva.

PubMed

Minniti, Alicia N; Labarca, Mariana; Hurtado, Claudia; Brandan, Enrique

2004-10-01

In Caenorhabditis elegans, the identification of many enzymes involved in the synthesis and modification of glycosaminoglycans (GAGs), essential components of proteoglycans, has attained special attention in recent years. Mutations in all the genes that encode for GAG biosynthetic enzymes show defects in the development of the vulva, specifically in the invagination of the vulval epithelium. Mutants for certain heparan sulfate modifying enzymes present axonal and cellular guidance defects in specific neuronal classes. Although most of the enzymes involved in the biosynthesis and modification of heparan sulfate have been characterized in C. elegans, little is known regarding the core proteins to which these GAGs covalently bind in proteoglycans. A single syndecan homologue (sdn-1) has been identified in the C. elegans genome through sequence analysis. In the present study, we show that C. elegans synthesizes sulfated proteoglycans, seen as three distinct species in western blot analysis. In the sdn-1 (ok449) deletion mutant allele we observed the lack of one species, which corresponds to a 50 kDa product after heparitinase treatment. The expression of sdn-1 mRNA and sequencing revealed that sdn-1 (ok449) deletion mutants lack two glycosylation sites. Hence, the missing protein in the western blot analysis probably corresponds to SDN-1. In addition, we show that SDN-1 localizes to the C. elegans nerve ring, nerve cords and to the vulva. SDN-1 is found specifically phosphorylated in nerve ring neurons and in the vulva, in both wild-type worms and sdn-1 (ok449) deletion mutants. These mutants show a defective egg-laying phenotype. Our results show for the first time, the identification, localization and some functional aspects of syndecan in the nematode C. elegans.

Caenorhabditis elegans histone deacetylase hda-1 is required for morphogenesis of the vulva and LIN-12/Notch-mediated specification of uterine cell fates.

PubMed

Ranawade, Ayush Vasant; Cumbo, Philip; Gupta, Bhagwati P

2013-08-07

Chromatin modification genes play crucial roles in development and disease. In Caenorhabditis elegans, the class I histone deacetylase family member hda-1, a component of the nucleosome remodeling and deacetylation complex, has been shown to control cell proliferation. We recovered hda-1 in an RNA interference screen for genes involved in the morphogenesis of the egg-laying system. We found that hda-1 mutants have abnormal vulva morphology and vulval-uterine connections (i.e., no uterine-seam cell). We characterized the vulval defects by using cell fate-specific markers and found that hda-1 is necessary for the specification of all seven vulval cell types. The analysis of the vulval-uterine connection defect revealed that hda-1 is required for the differentiation of the gonadal anchor cell (AC), which in turn induces ventral uterine granddaughters to adopt π fates, leading to the formation of the uterine-seam cell. Consistent with these results, hda-1 is expressed in the vulva and AC. A search for hda-1 target genes revealed that fos-1 (fos proto-oncogene family) acts downstream of hda-1 in vulval cells, whereas egl-43 (evi1 proto-oncogene family) and nhr-67 (tailless homolog, NHR family) mediate hda-1 function in the AC. Furthermore, we showed that AC expression of hda-1 plays a crucial role in the regulation of the lin-12/Notch ligand lag-2 to specify π cell fates. These results demonstrate the pivotal role of hda-1 in the formation of the vulva and the vulval-uterine connection. Given that hda-1 homologs are conserved across the phyla, our findings are likely to provide a better understanding of HDAC1 function in development and disease.

Caenorhabditis elegans Histone Deacetylase hda-1 Is Required for Morphogenesis of the Vulva and LIN-12/Notch-Mediated Specification of Uterine Cell Fates

PubMed Central

Ranawade, Ayush Vasant; Cumbo, Philip; Gupta, Bhagwati P.

2013-01-01

Chromatin modification genes play crucial roles in development and disease. In Caenorhabditis elegans, the class I histone deacetylase family member hda-1, a component of the nucleosome remodeling and deacetylation complex, has been shown to control cell proliferation. We recovered hda-1 in an RNA interference screen for genes involved in the morphogenesis of the egg-laying system. We found that hda-1 mutants have abnormal vulva morphology and vulval-uterine connections (i.e., no uterine-seam cell). We characterized the vulval defects by using cell fate-specific markers and found that hda-1 is necessary for the specification of all seven vulval cell types. The analysis of the vulval-uterine connection defect revealed that hda-1 is required for the differentiation of the gonadal anchor cell (AC), which in turn induces ventral uterine granddaughters to adopt π fates, leading to the formation of the uterine-seam cell. Consistent with these results, hda-1 is expressed in the vulva and AC. A search for hda-1 target genes revealed that fos-1 (fos proto-oncogene family) acts downstream of hda-1 in vulval cells, whereas egl-43 (evi1 proto-oncogene family) and nhr-67 (tailless homolog, NHR family) mediate hda-1 function in the AC. Furthermore, we showed that AC expression of hda-1 plays a crucial role in the regulation of the lin-12/Notch ligand lag-2 to specify π cell fates. These results demonstrate the pivotal role of hda-1 in the formation of the vulva and the vulval-uterine connection. Given that hda-1 homologs are conserved across the phyla, our findings are likely to provide a better understanding of HDAC1 function in development and disease. PMID:23797102

[Preinvasive lesions in gynecology -  vulva].

PubMed

Chovanec, J; Mouková, L; Feranec, R

2013-01-01

For preinvasive lesions of vulva, a common term VIN -  vulval intraepithelial neoplasia is used. VIN is a histological dia-gnosis based on abnormal squamous epithelial proliferation. There are two types of VIN apart from their association with human papillomavirus (HPV). Undifferentiated (usual) vulval intraepithelial neoplasia is commonly associated with carcinogenic genotypes of HVP, whereas differentiated vulval intraepithelial neoplasia is not associated with high-risk genotypes of HPV. The article presents an overview of VIN occurence and epidemiology, its classification system and dia-gnostics. In conclusion, VIN therapeutical possibilities are presented. It can be treated with surgical therapy (local excision, partial vulvectomy, vulvectomy, laser vaporization) or medical therapy (imiquimod).

Pseudoangiomatous stromal hyperplasia of the vulva presenting as a polypoid vulvar lesion: a lesion associated with anogenital mammary-like tissue-report of a case and review of the literature.

PubMed

Heller, Debra S; Aisner, Seena C; Fitzhugh, Valerie A; Katava, Gordana; Barrett, Theodore

2013-10-01

The study aimed to report the case of a patient with a polypoid vulvar lesion clinically thought to be an aggressive angiomyxoma. On examination, a 4.0 × 2.0 × 1.5-cm polypoid lesion was seen on the right labium majus. Histopathological findings of the excised mass were consistent with pseudoangiomatous stromal hyperplasia of the vulva Pseudoangiomatous stromal hyperplasia is a lesion of breast tissue but can occur in anogenital mammary-like glands. It must be distinguished from low-grade angiosarcoma.

Clinical features and treatment of vulvar Merkel cell carcinoma: a systematic review.

PubMed

Nguyen, Austin Huy; Tahseen, Ahmed I; Vaudreuil, Adam M; Caponetti, Gabriel C; Huerter, Christopher J

2017-01-01

Merkel cell carcinoma is a rare and aggressive neoplasm originating from mechanoreceptor Merkel cells of the stratum basale of the epidermis. Cases affecting the vulva are exceedingly rare, with the currently available literature primarily in case report form. Systematic review of the PubMed database returned 17 cases of Merkel cell carcinoma affecting the vulva. Patients presented at a mean age of 59.6 years with a firm, mobile vulvar mass. Symptoms of pain, erythema, pruritus, edema, and ulceration have been reported. Tumor histology is consistent with that of neuroendocrine tumors and typical Merkel cell carcinomas. Neuroendocrine and cytokeratin immunostains are frequently utilized in histopathological workup. Surgical management was the unanimous first-line therapy with adjuvant radiation in most cases. Recurrence occurred in 70.6% of patients at a mean follow-up of 6.3 months. Mortality was at 47.0% at a mean of 7.8 months after initial operation. Merkel cell carcinoma affecting the vulva is an extremely rare and highly aggressive neoplasm. The present review of published cases serves to comprehensively describe the clinical course and treatment approaches for vulvar Merkel cell carcinoma.

The pars intermedia: an anatomic basis for a coordinated vascular response to female genital arousal.

PubMed

Shih, Cheryl; Cold, Christopher J; Yang, Claire C

2013-06-01

The pars intermedia is an area of the vulva that has been inconsistently described in the literature. We conducted anatomic studies to better describe the tissues and vascular structures of the pars intermedia and proposed a functional rationale of the pars intermedia in the female sexual response. Nine cadaveric vulvectomy specimens were used. Each was serially sectioned and stained with hematoxylin and eosin and Masson's trichrome. Histologic ultrastructural description of the pars intermedia. The pars intermedia contains veins traveling longitudinally in the angle of the clitoris, supported by collagen-rich stromal tissues. These veins drain the different vascular compartments of the vulva, including the clitoris, the bulbs, and labia minora; also, the interconnecting veins link the different vascular compartments. The pars intermedia is not composed of erectile tissue, distinguishing it from the erectile tissues of the corpora cavernosa of the clitoris as well as the corpus spongiosum of the clitoral (vestibular) bulbs. The venous communications of the pars intermedia, linking the erectile tissues with the other vascular compartments of the vulva, appear to provide the anatomic basis for a coordinated vascular response during female sexual arousal. © 2012 International Society for Sexual Medicine.

Pagetoid spread of bladder urothelial carcinoma to the vagina and vulva.

PubMed

Lu, Bingjian; Liang, Yun

2015-01-01

To study the clinicopathologic features of a rare disease of pagetoid urothelial intraepithelial neoplasia (PUIN) in the vulva. We reviewed a case of PUIN in a Chinese woman with a long history of bladder urothelial carcinoma. The patient presented with vulvar pruritus for more than 1 month. Gynecologic examination showed a red, thickened, eczematoid lesion in the bilateral labia minora and a palpable 4-cm mass between the middle part of the vagina and the urethral meatus. Microscopically, the neoplastic cells with clear or pale eosinophilic cytoplasm were distributed throughout the squamous epithelium, with a predilection for the middle and basal portion in the vulva. Acantholysis-related papillary formation and pagetoid spread pattern to the normal squamous epithelium were also present. Invasive carcinoma was found underneath the unremarkable squamous epithelium in the vaginal biopsy. Immunohistochemistry demonstrated that these cells were negative for mucin stain, carcinoembryonic antigen, and 34βE12 and were strongly positive for cytokeratins 5/6, 7, 18, 19, and 20. This rare entity of PUIN was associated with metastatic urothelial carcinoma and should be discriminated from vulvar Paget disease and pagetoid squamous cell carcinoma in situ.

Surgical management for squamous cell carcinoma of vulva

PubMed Central

Amavi, Ayi Kossigan; Kouadio, Laurent; Adabra, Komlan; Tengue, Kodjo; Tijami, Fouad; Jalil, Abdelouahed

2016-01-01

To analyze our surgical management and the result of squamous cell carcinoma (SCC) of vulva. Retrospectively, we collected 38 cases of SCC; 17 cases of them were early SCC and 21 cases were locally advanced. The patients underwent primary surgery. The survival was estimated using Kaplan-Meier analysis and the log rank test. The mean age was 60.78 years. Total vulvectomy was performed in all patients. Superficial and deep incision of bilateral inguinal lymphadenectomy was performed by separates incisions for SCC infiltrating more than 1mm. The average tumor size was 53 mm (10 to 140mm). Morbidity was 42.1%. Lateral resection margin ≥8mm was obtained in 57.1%. Eighteen patients benefited from adjuvant radiotherapy. The follow-up median was 19.4 months (6 to 61.5 month) with 05 recurrences in 12 months. The survival using the Kaplan-Meyer analysis at 5 years, was 62.1% (71.2%N- vs 46.7%N+; p = 0.13). We identified two groups for locally advanced vulva cancer. Primary surgery keeps its place. Neo adjuvant radio chemotherapy followed by surgery is the alternative treatment for locally extensive lesions. PMID:27642483

The Caenorhabditis elegans vulva: A post-embryonic gene regulatory network controlling organogenesis

PubMed Central

Ririe, Ted O.; Fernandes, Jolene S.; Sternberg, Paul W.

2008-01-01

The Caenorhabditis elegans vulva is an elegant model for dissecting a gene regulatory network (GRN) that directs postembryonic organogenesis. The mature vulva comprises seven cell types (vulA, vulB1, vulB2, vulC, vulD, vulE, and vulF), each with its own unique pattern of spatial and temporal gene expression. The mechanisms that specify these cell types in a precise spatial pattern are not well understood. Using reverse genetic screens, we identified novel components of the vulval GRN, including nhr-113 in vulA. Several transcription factors (lin-11, lin-29, cog-1, egl-38, and nhr-67) interact with each other and act in concert to regulate target gene expression in the diverse vulval cell types. For example, egl-38 (Pax2/5/8) stabilizes the vulF fate by positively regulating vulF characteristics and by inhibiting characteristics associated with the neighboring vulE cells. nhr-67 and egl-38 regulate cog-1, helping restrict its expression to vulE. Computational approaches have been successfully used to identify functional cis-regulatory motifs in the zmp-1 (zinc metalloproteinase) promoter. These results provide an overview of the regulatory network architecture for each vulval cell type. PMID:19104047

Psoriasis superimposed on vitiligo: the tricolored vulva.

PubMed

Tin, Kyi Saw; Scurry, James; Dyall-Smith, Delwyn

2014-01-01

This study aimed to describe 2 cases of vulvar psoriasis and vitiligo resulting in a striking clinical appearance. Case 1 was of a 41-year-old woman concerned about a dark pigmentation around the introitus. Case 2 was of an 80-year-old woman with vulvar itch and red, white, and brown areas. The vulva in each case showed a tricolored appearance of well-demarcated red, white, and brown colors. Biopsies showed psoriasis superimposed on vitiligo in the red, vitiligo in the white, and normal skin in the brown areas. When psoriasis and vitiligo are colocalized, the redness of the psoriasis may mask the vitiligo resulting in a striking red, white, and brown tricolored appearance.

Expressions of miR-30c and let-7a are inversely correlated with HMGA2 expression in squamous cell carcinoma of the vulva.

PubMed

Agostini, Antonio; Brunetti, Marta; Davidson, Ben; Trope, Claes G; Heim, Sverre; Panagopoulos, Ioannis; Micci, Francesca

2016-12-20

Malignant tumors of the vulva, most of them squamous cell carcinomas, account for only 5% of cancers of the female genital tract. Though little is known about the genetic features of these tumors, the Fragile Histidine Triad (FHIT) and High Mobility Group AT-hook 2 (HMGA2) genes were found deregulated. We wanted to gain more knowledge about the expression of HMGA2-related miRNAs such as miR-30c and let-7a, and whether a correlation exists between the expression of FHIT and HMGA2, in this tumor type. An inverse correlation was found in-as-much as HMGA2 was highly expressed (mean fold change 8.8) whereas miR30c and let-7a were both downregulated (mean fold change -3.9 and -2.3, respectively). The consistent overexpression of HMGA2 found in all tumors adds to the likelihood that this gene is of importance in SCC pathogenesis. Moreover, we came to the conclusion that miRNAs may be the cause of the deregulation of HMGA2. Our results also show that SCC of the vulva presents a characteristic molecular pattern with FHIT being downregulated whereas HMGA2 is upregulated.

Recurrent vulvovaginal candidosis: focus on the vulva.

PubMed

Beikert, Florian C; Le, Minh T; Koeninger, Angela; Technau, Kristin; Clad, Andreas

2011-11-01

Recurrent vulvovaginal candidosis is a frequent disease with a serious impact on women's quality of life. Mostly, recurrences are caused by identical Candida strains suggesting C. albicans persistence in the female anogenital area. Objectives of the presented work were to identify the site of C. albicans persistence, to determine clinical symptoms and signs related to C. albicans positive vulvar cultures and to introduce a new therapeutic approach in women with RVVC. Women with an acute, culture-confirmed episode of RVVC at time of visit were included in this prospective case series. Swabs were obtained from both vagina and inter-labial sulcus. Women received a combined 20-day regimen of 100 mg oral fluconazole and ciclopiroxolamin cream topically. Follow-up visits were at 3, 6, 9 and 12 months. Of 139 women, 105 (76%) had at least one C. albicans positive culture from the external vulva. Vulvar positive cultures correlated with pruritus (OR 5.4; P < 0.001), vulvar edema (OR 3.8; P = 0.03) and fissures (OR 2.4; P = 0.03). Recurrence rates were 27%, 33% and 34% (at 6, 9, 12 months, respectively). The external vulva appears to represent a site of C. albicans persistence and source of endogenous re-infection in patients with RVVC. The combined treatment compared favorably with published fluconazole maintenance regimens. © 2011 Blackwell Verlag GmbH.

Expressions of miR-30c and let-7a are inversely correlated with HMGA2 expression in squamous cell carcinoma of the vulva

PubMed Central

Agostini, Antonio; Brunetti, Marta; Davidson, Ben; Trope, Claes G.; Heim, Sverre; Panagopoulos, Ioannis; Micci, Francesca

2016-01-01

Malignant tumors of the vulva, most of them squamous cell carcinomas, account for only 5% of cancers of the female genital tract. Though little is known about the genetic features of these tumors, the Fragile Histidine Triad (FHIT) and High Mobility Group AT-hook 2 (HMGA2) genes were found deregulated. We wanted to gain more knowledge about the expression of HMGA2-related miRNAs such as miR-30c and let-7a, and whether a correlation exists between the expression of FHIT and HMGA2, in this tumor type. An inverse correlation was found in-as-much as HMGA2 was highly expressed (mean fold change 8.8) whereas miR30c and let-7a were both downregulated (mean fold change -3.9 and -2.3, respectively). The consistent overexpression of HMGA2 found in all tumors adds to the likelihood that this gene is of importance in SCC pathogenesis. Moreover, we came to the conclusion that miRNAs may be the cause of the deregulation of HMGA2. Our results also show that SCC of the vulva presents a characteristic molecular pattern with FHIT being downregulated whereas HMGA2 is upregulated. PMID:27835588

Reconstruction of the vulva with sensate gluteal fold flaps.

PubMed

Kuokkanen, H; Mikkola, A; Nyberg, R H; Vuento, M H; Kaartinen, I; Kuoppala, T

2013-01-01

Soft-tissue reconstruction of the vulva following resection of malignancies is challenging. The function of perineal organs should be preserved and the reconstructed area should maintain an acceptable cosmetic appearance. Reconstruction with local flaps is usually sufficient in the primary phase after a radical vulvectomy. Numerous flaps have been designed for vulvar reconstruction usually based on circulation from the internal pudendal artery branches. In this paper we introduce our modification of the gluteal fold V-Y advancement flap as a primary reconstruction after a radical vulvectomy. Twenty-two patients were operated with a radical vulvectomy because of vulvar malignancies. The operation was primary in eight and secondary in 14 patients. The reconstruction of the vulva was performed in the same operation for each patient. All flaps survived completely. Wound complications were registered in three patients. Late problems with urinary stream were corrected in two patients. A local recurrence of the malignancy was observed in six patients during the follow-up period. Gluteal fold flap is easy to perform, has a low rate of complications and gives good functional results. Even a large defect can be reconstructed reliably with this method. A gluteal fold V-Y advancement flap is sensate and our modification allows the flap to be transposed with lesser dissection as presented before.

Comparative vaginal cytology of the estrous cycle of black-footed ferrets (Mustela nigripes), Siberian polecats (M. eversmanni), and domestic ferrets (M. putorius furo).

PubMed

Williams, E S; Thorne, E T; Kwiatkowski, D R; Lutz, K; Anderson, S L

1992-01-01

Vaginal cytology and vulva size were used to characterize the reproductive cycle of female black-footed ferrets (Mustela nigripes), Siberian polecats (M. eversmanni), and domestic ferrets (M. putorius furo). Emphasis was on black-footed ferrets because of the need to breed these critically endangered animals and on Siberian polecats because of the close taxonomic relationship to black-footed ferrets. Vaginal cytology of the 3 species of ferret is similar. Proestrus was characterized by an increasing percentage of superficial epithelial cells and enlargement of the vulva. During estrus, superficial cells were usually greater than or equal to 90% of epithelial cells in the vaginal lavage and after several days were fully keratinized. Neutrophils were more common during all stages of the estrous cycle in domestic ferrets than they were in the other species. Following copulation, percentage of superficial calls in the vagina declined and vulva swelling subsided. Large cells, probably of uterine symplasma origin, were observed in vaginal lavages following whelping or pseudopregnancy. Vaginal cytology is extremely useful in the reproductive management of black-footed ferrets and Siberian polecats. Knowledge of normal vaginal cytology could be applied to the diagnosis of female reproductive abnormalities in all 3 species.

Influence of menstruation on the microbiota of healthy women's labia minora as analyzed using a 16S rRNA gene-based clone library method.

PubMed

Shiraishi, Tsukasa; Fukuda, Kazumasa; Morotomi, Nobuo; Imamura, Yuri; Mishima, Junko; Imai, Shigeo; Miyazawa, Kiyoshi; Taniguchi, Hatsumi

2011-01-01

The aim of this study was to determine the influence of menstruation on the bacterial population of healthy Japanese women's vulvas, especially the labia minora. Labia minora swabs were obtained from 10 premenopausal, nonpregnant Japanese women at premenstruation and on day 2 of menstruation. Vaginal swabs were also obtained from 3 out of the 10 women. No significant difference was found in the average bacterial cell count between the menstruation and premenstruation samples. Molecular analysis using a 16S rRNA gene-based clone library method detected 22 genera from the labia minora swabs (total 20), with the genus Lactobacillus being predominant at both premenstruation and during menstruation in 7 out of the 10 women. Of the other 3 women, 2 showed various kinds of bacterial species, including oral and fecal bacteria, with Atopobium vaginae and Gardnerella vaginalis predominating in the remaining woman's vulva in both conditions. In total, 6 out of 10 cases (60%) showed significantly different microbiota of the labia minora between the two conditions. These results imply that menstruation may promote a distortion of the bacterial flora around the vulva, although it causes no significant increase of the bacterial count.

If there’s a penis, it’s most likely a man: Investigating the social construction of gender using eye tracking

PubMed Central

Briken, Peer; Dekker, Arne

2018-01-01

In their foundational work on the social construction of gender, Kessler and McKenna (1978) investigated the relationship between gender attribution and genital attribution. We used digital reproductions of the original stimuli to replicate their findings in the current social context. To further investigate the underlying decision processes we applied eye tracking. The stimuli shown varied in the composition of gender cues: from those more commonly associated with maleness to associated with femaleness. Applying the ethnomethodological approach originally used, participants were asked to decide for each stimulus whether they saw a man or a woman and to indicate subjective confidence with the decision. In line with the original results we found that the genital attribution contributed immensely to the gender attribution. Also, male gender was ascribed more often when the penis was present than was female gender when the vulva was shown. Eye tracking revealed that overall most dwell time as a proxy for important information was dedicated to the head, chest and genital areas of all the stimuli. Total dwell time depended on whether the gender attribution was made in line with the depicted genital, if the genital was a penis. Attributing female gender when a penis was present was associated with longer total dwell time, unlike attributing male gender with a vulva shown. This is indicative of higher cognitive effort and more difficulty ignoring the penis as opposed to the vulva. We interpret this finding in context of the persistent male dominance as well as to the socio-cultural understanding of the vulva as a concealed and therefore seemingly absent organ. In summary, we were able to show that the gender attribution is still closely linked to genital attribution when having a binary forced choice task and that the penis is a special cue in this attribution process. PMID:29494689

DNA hypermethylation profiles in squamous cell carcinoma of the vulva.

PubMed

Stephen, Josena K; Chen, Kang Mei; Raitanen, Misa; Grénman, Seija; Worsham, Maria J

2009-01-01

Gene silencing through promoter hypermethylation is a growing concept in the development of human cancers. In this study, we examined the contribution of aberrant methylation of promoter regions in methylation-prone tumor suppressors to the pathogenesis of vulvar cancer. Thirteen cell lines from 12 patients with squamous cell carcinoma of the vulva were evaluated for aberrant methylation status and gene copy number alterations, concomitantly, using the methylation-specific multiplex ligation-dependent probe amplification assay. Of the 22 tumor suppressor genes examined, aberrant methylation was observed for 9 genes: tumor protein p73 (TP73), fragile histidine triad (FHIT), von Hippel-Lindau (VHL), adenomatosis polyposis coli (APC), estrogen receptor 1 (ESR1), cyclin-dependent kinase inhibitor 2B (CDKN2B), death-associated protein kinase 1 (DAPK1), glutathione S-transferase pi (GSTP1), and immunoglobin superfamily, member 4 (IGSF4). The most frequently methylated genes included TP73 in 9 of 13 cell lines, and IGSF4, DAPK1, and FHIT in 3 of 13 cell lines. Methylation-specific polymerase chain reaction was performed for TP73 and FHIT to confirm aberrant methylation by methylation-specific multiplex ligation-dependent probe amplification. In the context of gene copy number and methylation status, both copies of the TP73 gene were hypermethylated. Loss or decreased mRNA expression of TP73 and IGSF4 by reverse transcription polymerase chain reaction confirmed aberrant methylation. Frequent genetic alterations of loss and gain of gene copy number included gain of GSTP1 and multiple endocrine neoplasia type 1 (MEN1), and loss of malignant fibrous histiocytoma amplified sequence 1 (MFHAS1) and IGSF4 in over 50% of the squamous cell carcinoma of the vulva cell lines. These findings underscore the contribution of both genetic and epigenetic events to the underlying pathogenesis of squamous cell carcinoma of the vulva.

Peripheral Female Genital Arousal as Assessed by Thermography Following Topical Genital Application of Alprostadil vs Placebo Arousal Gel: A Proof-of-Principle Study Without Visual Sexual Stimulation.

PubMed

Goldstein, Sue W; Gonzalez, Joshua R; Gagnon, Catherine; Goldstein, Irwin

2016-09-01

Female sexual arousal disorder is a pathophysiologic state characterized clinically by persistent or recurrent inability to attain or maintain an adequate lubrication-swelling response of sexual excitement until completion of sexual activity. Prior clinical experience with alprostadil products for men with erectile dysfunction supports its use in women with female sexual arousal disorder. To compare the effect of topical alprostadil with over-the-counter (OTC) lubricant on female genital arousal in the absence of visual sexual stimuli. Healthy premenopausal women without sexual dysfunction were recruited from the community to participate in the study. Of 17 women who consented, 10 were enrolled and completed the trial. The mean age of subjects was 32 years (range = 27-43). Study drug or placebo was applied topically to the genitals. Continuous temperature monitoring was performed. Participants completed questionnaires assessing genital sensation, effect, intensity, and duration. Change in temperature from baseline in vestibule, clitoris and vulva. In all 10 subjects, topical alprostadil induced a statistically significant increase in temperature of the vestibule, clitoris, and vulva compared with the OTC lubricant. The most rapid difference in genital temperature between placebo and alprostadil was seen on the vulva, which demonstrated a significant difference at approximately 9 minutes. There was a significant difference in temperature seen for the vestibule and clitoris at 11 and 19 minutes, respectively. Sixty percent of women reported being aware or conscious of genital sensations with topical alprostadil, but not with OTC lubricant. Discordance was noted in 30% of subjects who reported being aware or conscious of genital sensations with the two treatments and 10% who reported not being aware or conscious of genital sensations with either treatment. Topical alprostadil administered to healthy premenopausal women induced statistically significant, sustained increases in genital temperatures of the vestibule, clitoris, and vulva within 20 minutes compared with OTC lubricant. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Eccrine porocarcinoma of the vulva: a case report and review of the literature.

PubMed

Fujimine-Sato, Ayako; Toyoshima, Masafumi; Shigeta, Shogo; Toki, Asami; Kuno, Takashi; Sato, Izumi; Watanabe, Mika; Niikura, Hitoshi; Yaegashi, Nobuo

2016-11-10

Malignant tumors arising from the vulva account for only 0.6 % of all cancers in female patients. The predominant histologic type, representing about 90 % of these malignancies, is squamous cell carcinoma. Eccrine porocarcinoma is a rare malignant tumor arising from sweat glands. The incidence of eccrine porocarcinoma is estimated at 0.005-0.01 % of all cutaneous tumors. To the best of our knowledge, only seven previous cases of vulvar eccrine porocarcinoma have been reported in the English-language literature. We present the case of a patient with eccrine porocarcinoma of the vulva, and we summarize the clinical features of this disease using seven previously reported cases. A 54-year-old Japanese woman visited a local hospital complaining of fever and left vulvar pain for 2 months. An initial examination revealed a 1 × 1 cm, firm, ulcerative mass in the inner aspect of the left labium minorum. With a preoperative diagnosis of vulvar squamous cell carcinoma, we performed a radical local excision followed by bilateral inguinal lymphadenectomy. Histological examination showed eccrine porocarcinoma, stage IB (T1bN0M0). Radiation therapy with weekly cisplatin administration was then given as adjuvant therapy. One month after treatment was completed, computed tomography revealed multiple metastases in the bilateral lungs and in the sacral bone. The patient received three courses of chemotherapy (paclitaxel and carboplatin) and underwent palliative radiation therapy to the sacrum. She died of her disease 12 months after surgery. We report the case of a patient with eccrine porocarcinoma of the vulva and summarize the clinical features and the treatment options of eccrine porocarcinoma from a few retrospective case reports. Although eccrine porocarcinoma is a rare disease, clinicians and pathologists should be aware of its clinical and histological features and its biological behavior.

[Merkel cell carcinoma of the vulva - case report and the literature review].

PubMed

Jońska-Gmyrek, Joanna; Bobkiewicz, Piotr; Gmyrek, Leszek; Zółciak-Siwińska, Agnieszka; Lindner, Bogusław; Staniaszek, Jagna

2013-05-01

Merkel cell carcinoma (MCC) is a rare malignant neoplasm, mostly affecting the skin (97% of cases). It is usually found in elderly people, in the sun-exposed areas of the skin. About 50-60% of MCC cases are located on the head and the neck, less often on the extremities and the torso, and extremely rarely in the genital area. Ultraviolet radiation may be the main factor responsible for the development of the tumors but viral etiology is also debated. Due to extremely rare incidence of MCC in the area of the vulva, proper management remains a challenging task. To present a case of an aggressive MCC of the vulva and a review of the literature. A previously healthy 72-year-old patient presented at the Oncology Center of the Maria Sklodowska-Curie Institute, Warsaw, in June 2010. Four months previously the patient noticed a painless lump in the vestibular region of the vagina. She received anti-inflammatory treatment at her local gynecological clinic, with no success. In February the patient underwent removal of the vulvar tumor Histopathological examination confirmed anaplastic carcinoma. Microscopic evaluation revealed the tumor diameter to be 15mm. Surgical margins were free of neoplastic infiltration. The patient did not receive adjuvant therapy due to the results from the histopathological protocol. The disease recurred after three months. Radical vulvectomy and bilateral inguinal femoral lymphadenectomy were performed in May 2010. Histopathological examination confirmed microcellular carcinoma with no metastases to the lymph nodes and complete resection of the tumor (RO). The disease recurred in the next two months: a 50-mm tumor was found in the right inguinal lymph nodes. The decision to verify all histopathological material obtained during all procedures performed so far was made. Immunohistochemical evaluation confirmed MCC. Adjuvant radiotherapy was recommended. The area of the vulva, pelvic and inguinal lymph nodes were irradiated. One month after therapy completion the patient complained of pain in the lumbar area. An ultrasound examination of the abdomen revealed a tumor (9 cm in diameter) in the para-aortic region but it was not histopathologically verified due to extremely poor overall condition of the patient. As the condition of the woman deteriorated systematically the patient was referred to a hospice facility where she died 9 months since the primary diagnosis. MCC of the vulva is a rare neoplasm with an aggressive course. Clinical and histopathological diagnostic difficulties and consequently lack of standardized management, result in low survival rates.

Lymphoepithelioma-like carcinoma of the vulva, an underrecognized entity? Case report with a single inguinal micrometastasis detected by sentinel node technique.

PubMed

Bösmüller, Hans; Haitchi-Petnehazy, Sophie; Gruber, Christine; Roithmeier, Franz; Stummvoll, Wolfgang; Webersinke, Gerald

2011-01-10

This report describes an unusual EBV-negative lymphoepithelioma-like carcinoma of the vulva in a 73-year-old patient. The lesion was localised at the right minor labium and was resected by partial vulvectomy. A synchronous sentinel lymph node biopsy revealed a single micrometastasis in the right inguinal region, which prompted local radiotherapy. Follow-up nine months later showed only slight vulvar atrophy, without signs of local recurrence or distant metastases.Although lymphoepithelioma-like carcinomas of the skin and the female genital tract are presumed to have a better prognosis than their counterparts in the upper aerodigestive tract, possibly due to earlier detection and therapy, this case documents their potential for early metastasis.

Two new species of Rhabdias (Nematoda: Rhabditida: Rhabdiasidae) in anuran hosts from Dehradun (Uttarakhand), India.

PubMed

Rizvi, Anjum N; Bursey, Charles R; Bhutia, Pasang T

2013-04-01

Rhabdias himalayanus n. sp. from the lungs of Duttaphrynus himalayanus and Rhabdias dehradunensis n. sp. from the lungs of Nanorana minica from Dehradun, India are described and figured. Of the 3 previously described Indian species, Rhabdias himalayanus n. sp. is most similar to Rhabdias shortii in having a cylindrical corpus, inflated cuticle, and conical tail; it differs from R. shortii in having greater body measurements, longer esophagus, larger eggs, and a different pattern of cuticle inflation at the vulva and tail region. Rhabdias dehradunensis n. sp. is most similar to Rhabdias bulbicauda in that both possess a swollen posterior end; it differs from R. bulbicauda by having a subterminal anus, a prominent tail, and a postequatorial vulva.

Embryology and anatomy of the vulva: the female orgasm and women's sexual health.

PubMed

Puppo, Vincenzo

2011-01-01

Sexual health is vital to overall well-being. Orgasm is a normal psycho-physiological function of human beings and every woman has the right to feel sexual pleasure. The anatomy of the vulva and of the female erectile organs (trigger of orgasm) is described in human anatomy textbooks. Female sexual physiology was first described in Dickinson's textbook in 1949 and subsequently by Masters and Johnson in 1966. During women's sexual response, changes occur in the congestive structures that are essential to the understanding of women's sexual response and specifically of their orgasm. Female and male external genital organs arise from the same embryologic structures, i.e. phallus, urogenital folds, urogenital sinus and labioscrotal swellings. The vulva is formed by the labia majora and vestibule, with its erectile apparatus: clitoris (glans, body, crura), labia minora, vestibular bulbs and corpus spongiosum. Grafenberg, in 1950, discovered no "G-spot" and did not report an orgasm of the intraurethral glands. The hypothetical area named "G-spot" should not be defined with Grafenberg's name. The female orgasm should be a normal phase of the sexual response cycle, which is possible to achieve by all healthy women with effective sexual stimulation. Knowledge of the embryology, anatomy and physiology of the female erectile organs are important in the field of women's sexual health. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Invisibility: the lived experience of women with cancer of the vulva.

PubMed

Jefferies, Hilary; Clifford, Collette

2012-01-01

This study describes an exploration of the lived experience of 13 British women with cancer of the vulva who underwent surgical treatment. A review of the literature highlighted a paucity of knowledge as many studies were conducted during the 1980s and 1990s and investigated sexual functioning only. An interpretive phenomenological approach based on the work of Heidegger and van Manen was used to frame the study by posing the question, "What must it be like to be diagnosed with, and have surgery for a cancer of the vulva?" The women, younger than 50 years, were identified by purposive sampling and interviewed between 6 months and 5 years after surgery. The data were analyzed using framework analysis. The women's lived experience is described in its entirety by the concept of invisibility, characterized as something "no one can see," "heard of," and "talks about." The impact of this invisibility is discussed as the "invisibility of understanding" and "invisibility of support." Although many women may expect to be cured of their vulval cancer, the invisible nature of the condition and the resulting lack of understanding and support may continue for a considerable period, as every aspect of their everyday life and in their relationships may be affected. The challenge now is to raise awareness of this condition and provide greater informational and emotional support for these women.

[Paget disease of the vulva. 36 cases].

PubMed

Molinie, V; Paniel, B J; Lessana-Leibowitch, M; Moyal-Barracco, M; Pelisse, M; Escande, J P

1993-01-01

Thirty six patients with Paget's disease of the vulva were reviewed. The median age of the patients at diagnosis was 67 years (range: 45-91 years). One patient had a history of previous mammary adenocarcinoma. Screening for malignancy revealed two colonic tumours. Two patients with negative screening at presentation developed, 12 and 18 months respectively after vulvectomy, an ovarian carcinoma stage IIc and a cervical and urethral adenocarcinoma. All patients were treated by surgery based on extent of the disease. The operations performed included total vulvectomy (n = 11), partial vulvectomy (n = 14) and wide local excision (n = 4). Out of the 36 patients, 29 were available to follow-up. The median follow-up period was 74 months (range 2-204 months). Three patients died of metastatic disease due to vulval adenocarcinoma and breast carcinoma, or of liver metastases from an unknown adenocarcinoma. Eighteen of the 29 patients followed up remained free of disease. Five out of the 16 patients with positive margins recurred, as did 5 out of 9 patients with negative margins. Treatment of Paget's disease of the vulva is surgical. In order to prevent recurrence, some authors have proposed surgical excision extending beyond the visible clinical lesions with intraoperative frozen sections. The data we recorded show that free margins do not seem to correlate with recurrence, so that large excision beyond the clinical lesion is not useful.

Melanoma of the vulva and vagina: principles of staging and their relevance to management based on a clinicopathologic analysis of 85 cases.

PubMed

Seifried, Susan; Haydu, Lauren E; Quinn, Michael J; Scolyer, Richard A; Stretch, Jonathan R; Thompson, John F

2015-01-01

Primary melanomas of the vulva and vagina are rare. As a result, it has been difficult to develop evidence-based guidelines for their management. By analyzing a large series of patients with vulval and vaginal melanomas, this study sought to document the most common presenting features, identify clinical and pathologic predictors of outcome, and provide management guidelines. A clinicopathologic analysis of 85 patients with primary melanomas of the vulva or vagina diagnosed and treated at Melanoma Institute Australia and associated units in Sydney, Australia, between 1960 and 2011 was performed. Predictors of disease-free and melanoma-specific survival (MSS) were determined. Patients with American Joint Committee on Cancer (AJCC) stage 0-II had a significantly better MSS (5Y MSS = 63.6 %, n = 59) compared with those with stage III disease (5Y MSS = 0 %, n = 12, p < 0.001). Tumor thickness, ulceration status, and pathologic clearance margin were significant predictors of MSS. Disease-free survival was predicted by these factors and additionally by tumor mitotic rate. The results of this study provide evidence to support the appropriateness of utilizing the AJCC (7th edition) cutaneous melanoma staging system for vulval and vaginal melanomas. Detection and removal of these melanomas at an early stage with pathologically confirmed clear margins confers the best chance of cure.

Lymphatic Mapping and Sentinel Lymph Node Biopsy in Women With Squamous Cell Carcinoma of the Vulva: A Gynecologic Oncology Group Study

PubMed Central

Levenback, Charles F.; Ali, Shamshad; Coleman, Robert L.; Gold, Michael A.; Fowler, Jeffrey M.; Judson, Patricia L.; Bell, Maria C.; De Geest, Koen; Spirtos, Nick M.; Potkul, Ronald K.; Leitao, Mario M.; Bakkum-Gamez, Jamie N.; Rossi, Emma C.; Lentz, Samuel S.; Burke, James J.; Van Le, Linda; Trimble, Cornelia L.

2012-01-01

Purpose To determine the safety of sentinel lymph node biopsy as a replacement for inguinal femoral lymphadenectomy in selected women with vulvar cancer. Patients and Methods Eligible women had squamous cell carcinoma, at least 1-mm invasion, and tumor size ≥ 2 cm and ≤ 6 cm. The primary tumor was limited to the vulva, and there were no groin lymph nodes that were clinically suggestive of cancer. All women underwent intraoperative lymphatic mapping, sentinel lymph node biopsy, and inguinal femoral lymphadenectomy. Histologic ultra staging of the sentinel lymph node was prescribed. Results In all, 452 women underwent the planned procedures, and 418 had at least one sentinel lymph node identified. There were 132 node-positive women, including 11 (8.3%) with false-negative nodes. Twenty-three percent of the true-positive patients were detected by immunohistochemical analysis of the sentinel lymph node. The sensitivity was 91.7% (90% lower confidence bound, 86.7%) and the false-negative predictive value (1-negative predictive value) was 3.7% (90% upper confidence bound, 6.1%). In women with tumor less than 4 cm, the false-negative predictive value was 2.0% (90% upper confidence bound, 4.5%). Conclusion Sentinel lymph node biopsy is a reasonable alternative to inguinal femoral lymphadenectomy in selected women with squamous cell carcinoma of the vulva. PMID:22753905

Vulvar apocrine adenocarcinoma: a case with nodal metastasis and intranodal mucinous differentiation.

PubMed

Alsaad, Khaled O; Obaidat, Nidal; Dube, Valerie; Chapman, William; Ghazarian, Danny

2009-01-01

Primary vulvar adenocarcinomas are rare tumors, and their histogenesis is not fully understood. They are classified into extramammary Paget's disease, sweat gland carcinomas, and "breast-like" adenocarcinomas of the vulva. The latter resemble adenocarcinomas arising in the breast morphologically and immunophenotypically. Rare cases of adenocarcinoma with apocrine features have been reported, and whether these neoplasms originate from the "native apocrine" sweat glands or from "anogenital mammary-like" glands are still debatable. The presence of normal mammary-like glands in the vicinity of the tumor, the transitional malignant morphological features from normal mammary-like glands and the tumor, the breast-like histological features of the tumor, and the expression of estrogen and progesterone receptors generally suggest an origin from anogenital mammary-like glands. Absence of these features points toward native apocrine sweat glands as the source of these neoplasms. In this report, we present a patient who was initially diagnosed with Paget's disease of the right vulva, which was treated by hemi-vulvectomy, and who later presented with primary vulvar apocrine adenocarcinoma with metastasis to the inguinal lymph nodes and intranodal mucinous/colloidal differentiation: a feature, to the best of our knowledge, not reported before. We also reviewed the histogenesis of the vulvar adenocarcinomas, with emphasis on the morphological features that separate the tumors arising from the anogenital mammary-like glands in the vulva from those arising from the native vulvar sweat glands.

Vulva Anatomy

MedlinePlus

... exact term or phrase, no variations. Use multiple keywords separated by spaces (e.g. kidney renal ) for ... higher those with all or most of the keywords. Plurals and other variations are automatically included. To ...

Lymphoepithelioma-like carcinoma of the vulva, an underrecognized entity? Case report with a single inguinal micrometastasis detected by sentinel node technique

PubMed Central

2011-01-01

This report describes an unusual EBV-negative lymphoepithelioma-like carcinoma of the vulva in a 73-year-old patient. The lesion was localised at the right minor labium and was resected by partial vulvectomy. A synchronous sentinel lymph node biopsy revealed a single micrometastasis in the right inguinal region, which prompted local radiotherapy. Follow-up nine months later showed only slight vulvar atrophy, without signs of local recurrence or distant metastases. Although lymphoepithelioma-like carcinomas of the skin and the female genital tract are presumed to have a better prognosis than their counterparts in the upper aerodigestive tract, possibly due to earlier detection and therapy, this case documents their potential for early metastasis. PMID:21219641

Vulva reconstruction after pelvic exenteration, using a unique combination of two flaps

PubMed Central

van Bommel, Annelotte C M; Schreuder, Henk W R; Schellekens, Pascal P A

2011-01-01

A 64-year-old woman with recurrence of carcinoma of the vulva in an irradiated area received an en-bloc total pelvic exenteration. Reconstruction of the pelvic defect was performed with an anterolateral thigh (ALT) flap and a rectus abdominis muscle (RAM) flap (PM/RAM). This combination of flaps is unique, with excellent results. In a large defect, often irradiated in advance, well-vascularised tissue should be placed. Multiple flaps can be used to reconstruct these large pelvic defects, each with their own advantages and disadvantages. The combination of flaps used in this case uses the good properties of both flaps: the reliable and well-vascularised PM/RAM in combination with the ALT flap to provide much bulk in extreme large defects. PMID:22692483

Tantalum-182 Therapy of Vulva Carcinomas. Physical Data, Dosimetry Applications and Techniques, and Results (in German)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jakob, A.

1963-04-01

Experiences with Ta-182 therapy of vulva carcinoma are described. A description is given of the spectrum, the half-value-layer of Ta 182 in water and lead, the dose distribution in tissue, dosimetry, technique of application, and protection of the attending personnel. The results are discussed which were obtained so far on 31 patients since 1955. Radio-tantalum is particularly indicated on old patients or those with heart and circulation troubles, on whom an operation cannot be risked. The strain on the patient is small; the operation is quick, simple and without danger; rest in bed is not always required; no mutilation occurs;more » the costs are low; and the radiation burden for therapist and nursing personnel is small.« less

DOP-2 D2-Like Receptor Regulates UNC-7 Innexins to Attenuate Recurrent Sensory Motor Neurons during C. elegans Copulation

PubMed Central

Correa, Paola A.; Gruninger, Todd

2015-01-01

Neuromodulation of self-amplifying circuits directs context-dependent behavioral executions. Although recurrent networks are found throughout the Caenorhabditis elegans connectome, few reports describe the mechanisms that regulate reciprocal neural activity during complex behavior. We used C. elegans male copulation to dissect how a goal-oriented motor behavior is regulated by recurrently wired sensory-motor neurons. As the male tail presses against the hermaphrodite's vulva, cholinergic and glutamatergic reciprocal innervations of post cloaca sensilla (PCS) neurons (PCA, PCB, and PCC), hook neurons (HOA, HOB), and their postsynaptic sex muscles execute rhythmic copulatory spicule thrusts. These repetitive spicule movements continue until the male shifts off the vulva or genital penetration is accomplished. However, the signaling mechanism that temporally and spatially restricts repetitive intromission attempts to vulva cues was unclear. Here, we report that confinement of spicule insertion attempts to the vulva is facilitated by D2-like receptor modulation of gap-junctions between PCB and the hook sensillum. We isolated a missense mutation in the UNC-7(L) gap-junction isoform, which perturbs DOP-2 signaling in the PCB neuron and its electrical partner, HOA. The glutamate-gated chloride channel AVR-14 is expressed in HOA. Our analysis of the unc-7 mutant allele indicates that when DOP-2 promotes UNC-7 electrical communication, AVR-14-mediated inhibitory signals pass from HOA to PCB. As a consequence, PCB is less receptive to be stimulated by its recurrent synaptic partner, PCA. Behavioral observations suggest that dopamine neuromodulation of UNC-7 ensures attenuation of recursive intromission attempts when the male disengages or is dislodged from the hermaphrodite genitalia. SIGNIFICANCE STATEMENT Using C. elegans male copulation as a model, we found that the neurotransmitter dopamine stimulates D2-like receptors in two sensory circuits to terminate futile behavioral loops. The D2-like receptors promote inhibitory electrical junction activity between a chemosensory and a mechanosensory circuit. Therefore, both systems are attenuated and the animal ceases the recursive behavior. PMID:26156999

Vulvodynia FAQ

MedlinePlus

... may be taken. Your gynecologist may use a cotton swab to touch areas of the vulva. The ... helpful in relieving or reducing symptoms: • Wear 100% cotton underwear. • Do not wear underwear while sleeping. • Avoid ...

Disorders of the Vulva

MedlinePlus

... You may need additional treatment. What is contact dermatitis? Contact dermatitis is caused by irritation of the skin by ... Lichen simplex chronicus may be a result of contact dermatitis or other skin disorder that has been present ...

How Do Health Care Providers Diagnose Vaginitis?

MedlinePlus

... Share Facebook Twitter Pinterest Email Print How do health care providers diagnose vaginitis? To find out the cause of a woman's symptoms, her health care provider will Examine the vagina, the vulva, and ...

Angiosarcoma of the Vulva: A Case Report.

PubMed

Sheinis, Michal; Cesari, Matthew; Selk, Amanda

2016-01-01

This case illustrates that a very benign looking lesion can be an aggressive cancer. Vulvar lesions need a biopsy to rule out malignancy if they are painful, progressing in size, or changing in appearance.

Paget's disease of the vulva--a review of our experience.

PubMed

Petković, S; Jeremić, K; Vidakovic, S; Jeremić, J; Lazović, G

2006-01-01

The aim of our study was to review our experience with Paget's disease of the vulvar relative to initial examination, treatment and oncological outcome. Ten women with extramammary Paget's diseases of the vulva were treated during the 10-year period. The charts of these patients were reviewed and data were collected regarding patient demographics, symptoms, previous Paget's disease, surgical treatments and time to recurrence. Eight women (80%) were treated with wide local excision or partial vulvectomy, and two patients (20%) required radical resection for invasive adenocarcinoma. The group of women who had invasive diseases also underwent inquinofemoral lymphadenectomy and no lymphatic metastases were noted. Three women (30%) experienced recurrence. The mean time to relapse was 30 months (range 3-88 months). Recurrence is very common and long-term monitoring is recommended with careful examination of any abnormal vulvar lesion.

Successfully treated case of epithelioid sarcoma of the vulva.

PubMed

Chiyoda, Tatsuyuki; Ishikawa, Mitsuya; Nakamura, Masaru; Ogawa, Mariko; Takamatsu, Kiyoshi

2011-12-01

Epithelioid sarcoma of the vulva is an extremely rare and aggressive tumor. This tumor most commonly occurs on the labia majora in women of reproductive age. The molecular pathogenesis remains largely unknown. Only 20 cases of vulvar epithelioid sarcoma have been reported to date and more than half have had poor outcomes. We report a successfully treated case of vulvar epithelioid sarcoma in a 33-year-old woman. We performed a radical vulvectomy with flap reconstruction. Three years after surgery, the patient remains well, showing no evidence of recurrence. Early tissue diagnosis of vulvar epithelioid sarcoma is essential because this tumor can be clinically misdiagnosed as a benign lesion. Gynecologists should be aware of this rare tumor variant and carefully plan the treatment. © 2011 The Authors. Journal of Obstetrics and Gynaecology Research © 2011 Japan Society of Obstetrics and Gynecology.

Verrucous carcinoma of the vulva: diagnosis and treatment.

PubMed

Campaner, Adriana Bittencourt; Cardoso, Fernanda de Araujo; Fernandes, Gustavo Leme; Veasey, John Verrinder

2017-01-01

Vulvar cancer accounts for less than 1% of malignancies in women. Verrucous carcinoma of the vulva is a rare histological variation, comprising less than 1% of vulvar cancer cases. Although it is characterized as being locally invasive, the condition is not associated with metastatic spreading. Lesions present in the form of a verrucous, ulcerated, and bleeding tumor that can reach large dimensions. This type of tumor can be mistaken for condylomata, both macroscopically and microscopically. We report the case of an 81-year-old patient with a large vulvar tumor presented for eight years, initially considered as a Buschke-Löwenstein tumor. The patient underwent radical vulvectomy with a V-Y advancement flap technique. This type of tumor should be considered by clinicians dealing with condylomatous ulcerative lesions that do not respond to the usual treatment.

Vaginal itching and discharge - child

MedlinePlus

... vulvae; Itching - vaginal area; Vulvar itching; Yeast infection - child ... To prevent and treat vaginal irritation, your child should: Avoid colored or perfumed toilet tissue and bubble bath. Use plain, unscented soap. Limit bath time to 15 minutes or less. Ask ...

Urogenital tumors

DOE Office of Scientific and Technical Information (OSTI.GOV)

Weller, R.E.

An overview is provided for veterinary care of urogenital tumors in companion animals, especially the dog. Neoplasms discussed include tumors of the kidney, urinary bladder, prostate, testis, ovary, vagina, vulva and the canine transmissible venereal tumor. Topics addressed include description, diagnosis and treatment.

The normal vulva in medical textbooks.

PubMed

Andrikopoulou, M; Michala, L; Creighton, S M; Liao, L-M

2013-10-01

When a healthy woman expresses concerns about her vulva, the doctor's response should be informed by clinical knowledge. For many doctors, accumulation of such knowledge would have begun with undergraduate teaching and medical textbooks. The aim of this study is to examine the information on female genital morphology in medical textbooks. A total of 59 gynaecology and anatomy textbooks were searched for information on the dimensions of vulval constitutent parts. No textbook gave measurements for all vulval structures. Vaginal length was reported in 21/59 textbooks, clitoral size in 15/59 and labia minora in 1/59. Where measurements appear, they suggest narrower ranges than recent reports. Information of vulval morphology is scanty and inaccurate in medical textbooks. The general lack of professional resources means that doctors may consciously or non-consciously rely upon personal experiences and popular culture to form their opinions, as do their patients.

Unique Case of Imperforate Hymen.

PubMed

Coppola, Lynn

2016-02-01

Imperforate hymen typically presents in adolescence with pain, hematocolpometra and primary amenorrhea. This case documents a previously unreported etiology for an atypical presentation with a history of recent menstruation. A female adolescent presented with symptoms of urinary retention and leg pain. She reported a history of irregular, painful menses. Clinical examination revealed a pelvic mass and imperforate hymen. Sonography was consistent with hematocolpometra. Before a planned hymenectomy, the patient began to pass dark blood through a fistulous opening in her vulva. Hymenectomy resulted in complete resolution of the pain and hematocolpometra. Identification of the fistulous tract explained the patient's history of menstrual bleeding despite an imperforate hymen. Spontaneous rupture of hematocolpometra through a fistulous tract to the vulva is a previously unreported atypical presentation of imperforate hymen in a "menstruating" adolescent with pain and a pelvic mass. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Cloacogenic Adenocarcinoma of the Vulva: A Case Report and Review of the Literature.

PubMed

Tepeoğlu, Merih; Üner, Halit; Haberal, A Nihan; Özen, Özlem; Kuşçu, Esra

2017-02-04

Primary adenocarcinoma of the vulva, unrelated to the native glands of perineum is an extremely rare neoplasm. Despite awareness of this lesion for over 40 years, the origin is not beyond speculation. The most reasonable hypothesis is based on the remnants of cloacal differentiation during early days of life. Here we report the case of a 60-year-old patient with a vulvar mass, who underwent partial vulvectomy and bilateral regional lymph node dissection. The tumor was composed of papillary and complex glandular structures and exhibited diffuse positivity for cytokeratin 20 and polyclonal CEA, CDX2, and focal positivity with cytokeratin 7. Unlike the indolent behavior of this malignant neoplasm according to the literature, we found two metastatic inguinal lymph nodes. She did not receive adjuvant therapy and is still alive, free of disease 38 months after surgery. We present different aspects of vulvar adenocarcinomas with a case report.

Lymphovenous Anastomosis and Secondary Resection for Noonan Syndrome with Vulvar Lymphangiectasia

PubMed Central

Tielemans, Hanneke J.P.; Ulrich, Dietmar J.O.

2016-01-01

Summary: In this case report we describe the use of a 2-stage approach to treat severe recurrent vulvar lymphangiectasia in a patient with Noonan syndrome. First, 3 functional lymphatic vessels were identified and anastomosed to venules in an end-to-end fashion. Then, in a second surgical procedure, the vulvar lesions were resected as much as possible and the vulva was reconstructed. By the 12-month follow-up the patient had recovered well. Although there were still some small vesicles on the left labia there was no more ooze, itch, and pain. Lymphatic mapping using indocyanine green showed improvement of the edema of her vulva region and patent LVA. In addition to the demonstration of this 2-stage approach, this case report also demonstrates the benefits of preemptive LVA before performing surgery that may be at high risk for postoperative lymph edema. PMID:27622088

Fibroma of the vulva: a case report.

PubMed

Berlin, Melvin; Berlin, Scott

2007-06-01

It is rare to see large vulvar growths that are not trauma related in young women. The largest vulvar mass recorded dates back to 1851. Fibroma of the vulva is not common but, if not seen early and removed, can be emotionally draining for the patient. A large vulvar mass was found in an 18-year-old woman and was expeditiously excised. The patient was emotionally withdrawn and would not participate in any school or social activities. She would carry moist paper towels with her to prevent maceration of the lower abdomen and lesion wall. An extraordinary physical finding can embarrass and alter a patient's demeanor and should be addressed without delay. The emotional condition of our patient prior to surgery consisted of depression and emotional stress due to the large vulvar mass. Following surgery the patient was comfortable, and her demeanor is now excellent.

[Fungal diseases of vulva and vagina caused by Candida species].

PubMed

Stock, Ingo

2010-09-01

Fungal diseases of vulva and vagina attributed to Candida species (vulvovaginal candidosis) are the most frequent mycoses of women. They show acute or chronic courses and different disease patterns which can strongly affect the quality of life of the women who are concerned. In general, the most common cause of acute vulvovaginal candidosis is Candida albicans, followed by C. glabrata. In chronic recurrent vulvovaginal candidosis, C. albicans and C. glabrata are often equally distributed. In several cases, treatment requires an antimycotic therapy which refers to the severity and main form of disease as well as to the aetiological agent. Most vulvovaginal candidoses are accessible to the treatment with local and systemic antimycotic agents. Generally, in Germany azoles such as clotrimazole, fluconazole and itraconazole, the polyens nystatin and Amphotericin B and the hydroxypyridone derivative ciclopirox are available for antimycotic therapy of vulvovaginal candidoses. Significance of non-conventional and adjuvant therapeutic approaches is considered to be generally low.

Invasive Paget Disease of the Vulva.

PubMed

Borghi, Chiara; Bogani, Giorgio; Ditto, Antonino; Martinelli, Fabio; Signorelli, Mauro; Chiappa, Valentina; Scaffa, Cono; Perotto, Stefania; Leone Roberti Maggiore, Umberto; Recalcati, Dario; Lorusso, Domenica; Raspagliesi, Francesco

2018-01-01

Extramammary Paget disease of the vulva (EPDV) is a rare occurrence with an indolent and relapsing course. Progression to invasion occurs in 4% to 19% of cases. The aim of this study is to report clinical-pathological features and outcomes of patients treated for invasive EPDV. Data of consecutive patients treated between 2000 and 2017 for invasive EPDV were reviewed. Among 79 patients with EPDV, 10 (12.7%) presented a microinvasive or invasive form at first diagnosis or during follow-up. All of them underwent upfront radical surgery; 7 (70%) received subsequent radiotherapy, chemotherapy, or both. The mortality rate was 40%. The recurrence rate after treatment for invasive forms was 60%, with a mean time to first recurrence of 20 (range, 5-36) months. Our study confirms that invasive EPDV remains a rare gynecological neoplasm with a poor prognosis. Multicentre trials or well-organized prospective data collection could improve the knowledge about the management of invasive EPDV.

Clinico-pathological and biological prognostic variables in squamous cell carcinoma of the vulva.

PubMed

Gadducci, Angiolo; Tana, Roberta; Barsotti, Cecilia; Guerrieri, Maria Elena; Genazzani, Andrea Riccardo

2012-07-01

Several clinical-pathological parameters have been related to survival of patients with invasive squamous cell carcinoma of the vulva, whereas few studies have investigated the ability of biological variables to predict the clinical outcome of these patients. The present paper reviews the literature data on the prognostic relevance of lymph node-related parameters, primary tumor-related parameters, FIGO stage, blood variables, and tissue biological variables. Regarding these latter, the paper takes into account the analysis of DNA content, cell cycle-regulatory proteins, apoptosis-related proteins, epidermal growth factor receptor [EGFR], and proteins that are involved in tumor invasiveness, metastasis and angiogenesis. At present, the lymph node status and FIGO stage according to the new 2009 classification system are the main predictors for vulvar squamous cell carcinoma, whereas biological variables do not have yet a clinical relevance and their role is still investigational. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

RAB-7 Antagonizes LET-23 EGFR Signaling during Vulva Development in Caenorhabditis elegans

PubMed Central

Skorobogata, Olga; Rocheleau, Christian E.

2012-01-01

The Rab7 GTPase regulates late endosome trafficking of the Epidermal Growth Factor Receptor (EGFR) to the lysosome for degradation. However, less is known about how Rab7 activity, functioning late in the endocytic pathway, affects EGFR signaling. Here we used Caenorhabditis elegans vulva cell fate induction, a paradigm for genetic analysis of EGFR/Receptor Tyrosine Kinase (RTK) signaling, to assess the genetic requirements for rab-7. Using a rab-7 deletion mutant, we demonstrate that rab-7 antagonizes LET-23 EGFR signaling to a similar extent, but in a distinct manner, as previously described negative regulators such as sli-1 c-Cbl. Epistasis analysis places rab-7 upstream of or in parallel to lin-3 EGF and let-23 EGFR. However, expression of gfp::rab-7 in the Vulva Presursor Cells (VPCs) is sufficient to rescue the rab-7(−) VPC induction phenotypes indicating that RAB-7 functions in the signal receiving cell. We show that components of the Endosomal Sorting Complex Required for Transport (ESCRT)-0, and -I, complexes, hgrs-1 Hrs, and vps-28, also antagonize signaling, suggesting that LET-23 EGFR likely transits through Multivesicular Bodies (MVBs) en route to the lysosome. Consistent with RAB-7 regulating LET-23 EGFR trafficking, rab-7 mutants have increased number of LET-23::GFP-positive endosomes. Our data imply that Rab7, by mediating EGFR trafficking and degradation, plays an important role in downregulation of EGFR signaling. Failure to downregulate EGFR signaling contributes to oncogenesis, and thus Rab7 could possess tumor suppressor activity in humans. PMID:22558469

Frequent NFIB-associated Gene Rearrangement in Adenoid Cystic Carcinoma of the Vulva.

PubMed

Xing, Deyin; Bakhsh, Salwa; Melnyk, Nataliya; Isacson, Christina; Ho, Julie; Huntsman, David G; Gilks, C Blake; Ronnett, Brigitte M; Horlings, Hugo M

2017-05-01

Adenoid cystic carcinoma is a rare malignant tumor that usually arises in the major and minor salivary glands and other locations containing secretory glands, including the lower female genital tract. Lower female genital tract carcinomas with adenoid cystic differentiation can be subclassified into 2 distinct groups based on the presence or absence of high-risk HPV. Cervical mixed carcinomas with some adenoid cystic differentiation are high-risk HPV-related but pure adenoid cystic carcinomas of vulvar and cervical origin appear to be unrelated to high-risk HPV. Mechanisms by which normal cells give rise to an HPV-unrelated adenoid cystic carcinoma remain largely unknown. Studies demonstrate that chromosomal translocation involving the genes encoding the transcription factors MYB and NFIB functions as a driving force of adenoid cystic carcinomas development regardless of anatomic site. The current study used fluorescence in situ hybridization with 3 different probes including MYB break-apart probe, NFIB break-apart probe, and MYB-NFIB fusion probe to assess for the presence of gene rearrangements in adenoid cystic carcinomas of the vulva. Six (66.7%) of 9 vulvar adenoid cystic carcinomas demonstrated NFIB rearrangement. Of these 6 cases with a disturbed NFIB, only 2 cases (33.3%) were positive for a MYB rearrangement that was also confirmed by a positive MYB-NFIB fusion pattern. NFIB-associated gene rearrangement is a frequent genetic event in vulvar adenoid cystic carcinomas. Chromosome translocations involving NFIB but with an intact MYB indicate the presence of novel oncogenic mechanisms for the development of adenoid cystic carcinomas of the vulva.

Angiomyofibroblastoma of the vulva: a case report of a pedunculated variant and review of the literature.

PubMed

Sims, Shireen Madani; Stinson, Kathryn; McLean, Frederick W; Davis, John D; Wilkinson, Edward J

2012-04-01

Angiomyofibroblastoma (AMF) is a benign mesenchymal tumor usually found in the vulva. We reviewed 70 cases of vulvar AMF that have been reported in the English-language literature and report 1 case of a pedunculated variant. Our case brings the total reported to 71 and is only the fourth pedunculated variant reported. This 50-year-old woman presented to our gynecology clinic with a 1-year history of a left labial mass. It began as pea-sized, and rapidly grew to 12 cm in diameter. Physical examination demonstrated a 12-cm pedunculated soft mass arising from the left labia majora. The clinical diagnosis was aggressive angiomyxoma, and a simple excision was performed. The final pathology demonstrated AMF. The patient remains free from tumor at 4 years of follow-up. Seventy-one cases were summarized. The mean age at presentation was 45 years. The lesions were equally distributed between the left (52%) and right (48%). The most common clinical diagnosis was a Bartholin gland cyst (46%) or lipoma (15%). The mean duration of the lesion before seeking treatment was 29 months, and the mean diameter at presentation was 5.9 cm. All of the patients were treated with simple excision. The mean duration of follow-up was 37 months. There was 1 report of sarcomatous transformation 2 years after initial treatment. Angiomyofibroblastoma is a rare benign tumor that most often occurs in the vulva. Differential diagnosis may include aggressive angiomyxoma, Bartholin cyst, or lipoma. The treatment of choice is simple total excision, which is usually curative.

RAB-7 antagonizes LET-23 EGFR signaling during vulva development in Caenorhabditis elegans.

PubMed

Skorobogata, Olga; Rocheleau, Christian E

2012-01-01

The Rab7 GTPase regulates late endosome trafficking of the Epidermal Growth Factor Receptor (EGFR) to the lysosome for degradation. However, less is known about how Rab7 activity, functioning late in the endocytic pathway, affects EGFR signaling. Here we used Caenorhabditis elegans vulva cell fate induction, a paradigm for genetic analysis of EGFR/Receptor Tyrosine Kinase (RTK) signaling, to assess the genetic requirements for rab-7. Using a rab-7 deletion mutant, we demonstrate that rab-7 antagonizes LET-23 EGFR signaling to a similar extent, but in a distinct manner, as previously described negative regulators such as sli-1 c-Cbl. Epistasis analysis places rab-7 upstream of or in parallel to lin-3 EGF and let-23 EGFR. However, expression of gfp::rab-7 in the Vulva Presursor Cells (VPCs) is sufficient to rescue the rab-7(-) VPC induction phenotypes indicating that RAB-7 functions in the signal receiving cell. We show that components of the Endosomal Sorting Complex Required for Transport (ESCRT)-0, and -I, complexes, hgrs-1 Hrs, and vps-28, also antagonize signaling, suggesting that LET-23 EGFR likely transits through Multivesicular Bodies (MVBs) en route to the lysosome. Consistent with RAB-7 regulating LET-23 EGFR trafficking, rab-7 mutants have increased number of LET-23::GFP-positive endosomes. Our data imply that Rab7, by mediating EGFR trafficking and degradation, plays an important role in downregulation of EGFR signaling. Failure to downregulate EGFR signaling contributes to oncogenesis, and thus Rab7 could possess tumor suppressor activity in humans.

Cervical Cancer

MedlinePlus

... knowledge” about their bodies and health. What is cervical cancer? Cancer is a disease in which cells in the body grow out of control. Cancer ... for HPV— the virus that can cause precancerous cell changes and cervical cancer. Fallopian Tube Ovary Uterus Cervix Vagina Vulva www. ...

Cancer Treatment for Women: Possible Sexual Side Effects

MedlinePlus

... the clitoris. These play a major part in sexual arousal in women. Removing the vulva and the clitoris ... www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/fertility-and-sexual-side-effects/sexuality-for-women-with-cancer.html. ...

Sex pheromone in the dog.

PubMed

Goodwin, M; Gooding, K M; Regnier, F

1979-02-09

Methyl p-hydroxybenzoate has been identified in the vaginal secretions of female dogs in estrus. When small amounts of this compound were applied to the vulvas of anestrous or spayed females, males placed with these females became sexually aroused and attempted to mount them.

Primary Localization and Tumor Thickness as Prognostic Factors of Survival in Patients with Mucosal Melanoma

PubMed Central

Mehra, Tarun; Grözinger, Gerd; Mann, Steven; Guenova, Emmanuella; Moos, Rudolf; Röcken, Martin; Claussen, Claus Detlef; Dummer, Reinhard; Clasen, Stephan

2014-01-01

Background Data on survival with mucosal melanoma and on prognostic factors of are scarce. It is still unclear if the disease course allows for mucosal melanoma to be treated as primary cutaneous melanoma or if differences in overall survival patterns require adapted therapeutic approaches. Furthermore, this investigation is the first to present 10-year survival rates for mucosal melanomas of different anatomical localizations. Methodology 116 cases from Sep 10 1984 until Feb 15 2011 retrieved from the Comprehensive Cancer Center and of the Central Register of the German Dermatologic Society databases in Tübingen were included in our analysis. We recorded anatomical location and tumor thickness, and estimated overall survival at 2, 5 and 10 years and the mean overall survival time. Survival times were analyzed with the Kaplan-Meier method. The log-rank test was used to compare survival times by localizations and by T-stages. Principal Findings We found a median overall survival time of 80.9 months, with an overall 2-year survival of 71.7%, 5-year survival of 55.8% and 10-year survival of 38.3%. The 10-year survival rates for patients with T1, T2, T3 or T4 stage tumors were 100.0%, 77.9%, 66.3% and 10.6% respectively. 10-year survival of patients with melanomas of the vulva was 64.5% in comparison to 22.3% of patients with non-vulva mucosal melanomas. Conclusion Survival times differed significantly between patients with melanomas of the vulva compared to the rest (p = 0.0006). It also depends on T-stage at the time of diagnosis (p<0.0001). PMID:25383553

Primary localization and tumor thickness as prognostic factors of survival in patients with mucosal melanoma.

PubMed

Mehra, Tarun; Grözinger, Gerd; Mann, Steven; Guenova, Emmanuella; Moos, Rudolf; Röcken, Martin; Claussen, Claus Detlef; Dummer, Reinhard; Clasen, Stephan; Naumann, Aline; Garbe, Claus

2014-01-01

Data on survival with mucosal melanoma and on prognostic factors of are scarce. It is still unclear if the disease course allows for mucosal melanoma to be treated as primary cutaneous melanoma or if differences in overall survival patterns require adapted therapeutic approaches. Furthermore, this investigation is the first to present 10-year survival rates for mucosal melanomas of different anatomical localizations. 116 cases from Sep 10 1984 until Feb 15 2011 retrieved from the Comprehensive Cancer Center and of the Central Register of the German Dermatologic Society databases in Tübingen were included in our analysis. We recorded anatomical location and tumor thickness, and estimated overall survival at 2, 5 and 10 years and the mean overall survival time. Survival times were analyzed with the Kaplan-Meier method. The log-rank test was used to compare survival times by localizations and by T-stages. We found a median overall survival time of 80.9 months, with an overall 2-year survival of 71.7%, 5-year survival of 55.8% and 10-year survival of 38.3%. The 10-year survival rates for patients with T1, T2, T3 or T4 stage tumors were 100.0%, 77.9%, 66.3% and 10.6% respectively. 10-year survival of patients with melanomas of the vulva was 64.5% in comparison to 22.3% of patients with non-vulva mucosal melanomas. Survival times differed significantly between patients with melanomas of the vulva compared to the rest (p = 0.0006). It also depends on T-stage at the time of diagnosis (p < 0.0001).

[Use of the CO2 laser in the treatment of pathologic changes in the vulva, vagina and uterine cervix].

PubMed

Stanimirović, B; Zivanović, Z; Popović-Lazić, J

1990-01-01

In the period from April 1987 to April 1990, 230 patients with pathological changes of the vulva, vagina and cervix uteri were treated with the CO2-laser. The diagnosis and pretreatment stages of the diseases were confirmed by the cytodiagnostic, colposcopic and histopathological results of the biophysics. In most cases, DNA-hybridization of human papilloma viruses confirmed their virus etiology. Twenty patients had peak condyloma of the vulva and vagina, 34 had benign cervical diseases, 65 were at the premalignant and 111 in the first stages of malignant cervical disease. Vaporizations, conical or cylindrical excisions were performed depending on the nature of disease and its localisation. The average age of operated patients was 30.6 years and the average parity 0.69. Operations were performed using analgesia and in rare cases total anesthesia. After the excision treatment, the tissue was checked histo-pathologically according to the principle of series. The complications were very rare. After operation, postoperative control was performed after 3.9 and 15 months, and later once a year. The results have shown that one treatment was sufficient in 80% of patients for curing vulvar and vaginal disease and 20% patients needed repeat because of the condyloma that relapsed. After the first treatment, benign and premalignant cervical diseases were cured in 100% of cases. In 95.4% operated patients at the first stages of cervical malignant diseases, the excisional treatment was final and in 4.6% needed an additional radical therapy because of a higher stage of lesion found by the conular histo-pathological analysis. There were no relapses relating to the cervix.

Reactive fibroblastic and myofibroblastic proliferation of the vulva (Cyclist's Nodule): A hitherto poorly described vulval lesion occurring in cyclists.

PubMed

McCluggage, W Glenn; Smith, John H F

2011-01-01

Perineal nodules occurring in male cyclists are reported in the literature, although the histologic features are not extensively documented. There has been little description of similar lesions in the female population. We describe 4 cases in which a vulval nodule or swelling developed in competitive female cyclists aged 15 to 45 years. The lesions were unilateral and occurred on the right or left labium majus (2 cases each). The histologic features were similar in all cases and consisted of a haphazard admixture of adipose tissue, variably cellular hyalinized tissue containing bland spindle-shaped fibroblasts, blood vessels, and nerve fibers. In some areas, thick cords of fibrous tissue imparted a keloid-like appearance. Other histologic features included plump mesenchymal cells with round or ovoid nuclei and abundant eosinophilic cytoplasm resulting in an epithelioid, plasmacytoid, or ganglion-like appearance (2 cases), a lymphocytic infiltrate around blood vessels (3 cases), foci of fat necrosis (1 case), and collections of elastic fibers (2 cases). One case recurred, the histologic features of the recurrent lesion being identical to the original. The overall morphologic appearances, especially in the cases with plump mesenchymal cells, bore some resemblance to proliferative fasciitis. Immunohistochemically, the cells were estrogen receptor positive and the plump mesenchymal cells were smooth muscle actin positive, in keeping with myofibroblasts. Desmin, S100, CD34, and HMGA2 were negative. Pathologists should be aware of this pseudoneoplastic lesion occurring on the vulva, which arises in a specific clinical setting and has the potential to be misdiagnosed as a variety of other mesenchymal lesions. We term this lesion as reactive fibroblastic and myofibroblastic proliferation of the vulva or "cyclist's nodule."

Surgical Treatment of Paget Disease of the Vulva: Prognostic Significance of Stromal Invasion and Surgical Margin Status.

PubMed

Sopracordevole, Francesco; Di Giuseppe, Jacopo; De Piero, Giovanni; Canzonieri, Vincenzo; Buttignol, Monica; Giorda, Giorgio; Ciavattini, Andrea

2016-04-01

The aim of the study was to evaluate the risk of recurrence according to the surgical margin status and the presence of invasion or of superficially invasive carcinoma in patients with extramammary Paget disease (EMPD) of the vulva, who underwent elective surgical treatment. We performed a retrospective analysis of 27 patients with first diagnosis of extramammary Paget disease of the vulva, who underwent primary and elective surgical treatment from January 1989 to December 2014. A p value of less than .05 was considered statistically significant. Multivariable logistic regression was performed to adjust for confounding factors. We observed invasive disease in 11 cases, with microinvasion in 8 of them. A positive surgical margin was found in 10 patients. During a median follow-up period of 79.5 months, 8 patients (29.6%) showed a first recurrence after a median (range) time of 4.9 (2.3-7.1) years. No significant differences were observed between patients with recurrence and patients without recurrence with respect to age, number of vulvar sectors involved, bilaterality and multifocality, presence of invasion or microinvasion, and surgical margin status. However, during the follow-up period, the presence of invasion was higher (67% vs 41%) in patients with recurrence compared with patients without recurrence. The rate of recurrence of the disease after therapy is high. Patients should be subjected to a close and long-term follow-up to identify those who must undergo further treatment, especially if they presented with an invasive or even microinvasive disease. A free margin of no greater than 1 to 2 cm might be the most appropriate surgical choice.

Investigation of the sensitivity of a cross-polarized light visualization system to detect subclinical erythema and dryness in women with vulvovaginitis.

PubMed

Farage, Miranda A; Singh, Mukul; Ledger, William J

2009-07-01

An enhanced visualization technique using polarized light (Syris v600 enhanced visualization system; Syris Scientific LLC, Gray, ME) detects surface and subsurface ( approximately 1 mm depth) inflammation. We sought to compare the Syris v600 system with unaided visual inspection and colposcopy of the female genitalia. Erythema and dryness of the vulva, introitus, vagina, and cervix were visualized and scored by each method in patients with and without vulvitis. Subsurface visualization was more sensitive in detecting genital erythema and dryness at all sites whether or not symptoms were present. Subsurface inflammation of the introitus, vagina, and cervix only was detected uniquely in women with vulvar vestibulitis syndrome (VVS). A subset of women presenting with VVS exhibited subclinical inflammation of the vulva vestibule and vagina (designated VVS/lichen sclerosus subgroup). Enhanced visualization of the genital epithelial subsurface with cross-polarized light may assist in diagnosing subclinical inflammation in vulvar conditions heretofore characterized as sensory syndromes.

Multiple granular cell tumors with metachronous occurrence in tongue and vulva. Clinicopathological and immunohistochemical study

PubMed Central

Vera-Sirera, Beatriz; Zabala, Pablo; Aviño-Mira, Carlos; Vera-Sempere, Francisco J.

2014-01-01

Granular cell tumor (GCT) usually occurs as a single tumor, although sometimes multiple lesions can occur. In present report we analyze the clinicopathological and immunohistochemical features of a multiple GCT involving the tongue of a 14-year-old girl, with no other abnormalities, with a metachronous occurrence of a second GCT in vulva, after a period of 10 years. Both tumors revealed S-100, vimentin and CD57 positivity. In addition, over expression of calretinin was observed in tumor cells located in the vicinity of pseudoepitheliomatous hyperplasia (PEH) of the tongue. Tumor vasculature situated close to the PEH showed marked CD105 reactivity, data not described so far, suggesting an interaction between PEH cells and underlying stroma, since GCT completely lacks CD105 vessels. Our study emphasizes that patients with GCT, especially young patients, should be followed long-term, looking for multiple tumors or other abnormalities suggestive of a systemic syndrome, given the associations described in multiple GCT. PMID:25949003

Vulvar mucinous adenocarcinoma with neuroendocrine differentiation: A case report and review of the literature.

PubMed

van Rosmalen, M H J; Reijnen, C; Boll, D; Pijnenborg, J M A; van der Wurff, A A M; Piek, J M J

2016-03-01

There are limited cases in literature of patients with mucinous adenocarcinoma of the vulva with neuroendocrine differentiation have. With this new case, we aim to provide an overview of the existing literature and present a tool with relevant markers for the pathologist in the differential diagnosis. A 92-year-old multiparous, Caucasian woman presented with a 8 cm spherical tumor of the left major labium. Since the initial punch biopsy was not conclusive, a local resection was performed. Histopathological examination showed mucus production, large pools of mucin with trabeculae and cribriform glandular structures with strongly atypical columnar epithelium. Additional immunohistochemical analysis demonstrated expression of: CEA, CK7, EMA, and the neuroendocrine markers synaptophysin and chromogranin supporting the diagnosis. In this report, we present a new case of a mucinous adenocarcinoma of the vulva with neuroendocrine differentiation based immunohistochemical analysis. Due to the indolent tumor behavior, partial vulvectomy is the therapy of choice. Copyright © 2016 Elsevier GmbH. All rights reserved.

Polarization dependant in vivo second harmonic generation imaging of Caenorhabditis elegans vulval, pharynx, and body wall muscles

NASA Astrophysics Data System (ADS)

Psilodimitrakopoulos, Sotiris; Santos, Susana; Amat-Roldan, Ivan; Mathew, Manoj; Thayil K. N., Anisha; Artigas, David; Loza-Alvarez, Pablo

2008-02-01

Second harmonic generation (SHG) imaging has emerged in recent years as an important laboratory imaging technique since it can provide unique structural information with submicron resolution. It enjoys the benefits of non-invasive interaction establishing this imaging modality as ideal for in vivo investigation of tissue architectures. In this study we present, polarization dependant high resolution SHG images of Caenorhabditis elegans muscles in vivo. We imaged a variety of muscular structures such as body walls, pharynx and vulva. By fitting the experimental data into a cylindrical symmetry spatial model we mapped the corresponding signal distribution of the χ (2) tensor and identified its main axis orientation for different sarcomeres of the earth worm. The cylindrical symmetry was considered to arise from the thick filaments architecture of the inside active volume. Moreover, our theoretical analysis allowed calculating the mean orientation of harmonophores (myosin helical pitch). Ultimately, we recorded and analysed vulvae muscle dynamics, where SHG signal decreased during in vivo contraction.

Role of female intimate hygiene in vulvovaginal health: Global hygiene practices and product usage.

PubMed

Chen, Ying; Bruning, Elizabeth; Rubino, Joseph; Eder, Scott E

2017-12-01

Women use various feminine hygiene products, often as part of their daily cleansing routine; however, there is a paucity of published medical literature related to the external vulva and how personal hygiene practices can affect it. This review article provides background information on the physiological changes that occur during women's lives and reviews the relevance of transient and resident microbiota as they relate to common vaginal and vulvar disorders. It also discusses the need for female intimate hygiene, common practices of feminine hygiene from a global perspective, and the potential benefits of using suitable external, topical feminine vulvar washes to minimize the risk of vulvovaginal disorders and to improve overall intimate health in women around the world. Supported by international guidelines, daily gentle cleansing of the vulva is an important aspect of feminine hygiene and overall intimate health. Women should be encouraged to choose a carefully formulated and clinically tested external wash that provides targeted antimicrobial and other health benefits without negatively impacting on the natural vulvovaginal microbiota.

Collision of Ductal Carcinoma In Situ of Anogenital Mammary-like Glands and Vulvar Sarcomatoid Squamous Cell Carcinoma.

PubMed

Tran, Tien A N; Deavers, Michael T; Carlson, J Andrew; Malpica, Anais

2015-09-01

A spectrum of invasive adenocarcinomas presumably arising from the anogenital mammary-like glands of the vulva has been reported. Even rarer are the cases of pure ductal carcinoma in situ that originated from these unique glandular structures. Herein, we report an 81-yr-old woman presented with an invasive well-differentiated squamous cell carcinoma of the vulva. Unexpectedly, the underlying dermis demonstrated a cystically dilated structure that displayed a layer of malignant squamous cells in the periphery, and a second centrally located population of neoplastic cells exhibiting glandular differentiation. In addition, a spindle and pleomorphic malignant cell population consistent with a sarcomatoid carcinoma was identified around the cystic structure. Scattered benign anogenital mammary-like glands were present in the adjacent dermis. The histologic and immunohistochemical findings were consistent with those of vulvar squamous cell carcinoma that has undergone sarcomatoid transformation after spreading in a pagetoid fashion into an underlying focus of ductal carcinoma in situ of anogenital mammary-like gland origin.

Evaluation of the Role of Vibrational Spectroscopy in the Assessment of Vulval Disease

ClinicalTrials.gov

2017-08-03

Normal Vulval Skin; Lichen Sclerosus; High Grade Dysplasia - Usual Type ('VIN 2-3'); High Grade Dysplasia - Differentiated Type ('VIN 2-3'); Squamous Cell Carcinoma; Epithelial Hyperplasia Without Atypia; Atypia Not Otherwise Specified/ Low Grade Dysplasia ('VIN 1'); Pagets Disease of the Vulva

Syndrome in question.

PubMed

Wu, Yinhua; Qiao, Jianjun; Fang, Hong

2014-01-01

Vulvovaginal-gingival syndrome is characterized by erosions and desquamation of the vulva, vagina, and gingiva. We reported a case of a 32-year-old woman presenting with an 8-year history of damage to the vulval and perianal anatomy and limitation of mouth opening. The patient's symptoms were relieved after treatment with topical tacrolimus cream.

Morphological and molecular characterization of Pratylenchus lentis n. sp. (Nematoda: Pratylenchidae) from Sicily

USDA-ARS?s Scientific Manuscript database

Pratylenchus lentis n. sp. parasitizing roots of lentil in Sicily, Italy, is described and illustrated. The new species is characterized by a high lip region with three annuli, stylet mean length of 16 micrometers with anteriorly flattened knobs, cylindrical body with a relatively anterior vulva, l...

Assessment of the female patient with urinary incontinence.

PubMed

Bates, Frankie

2002-10-01

Understanding the pelvic floor anatomy and all of its components is crucial when performing pelvic floor examination and assessing patients suffering from urinary incontinence. It is important for urology nurses to understand the pelvic floor, including the muscle, nerve, and fascia involved; external and internal examination of the vulva; and global assessment of the patient.

Syndrome in question*

PubMed Central

Wu, Yinhua; Qiao, Jianjun; Fang, Hong

2014-01-01

Vulvovaginal-gingival syndrome is characterized by erosions and desquamation of the vulva, vagina, and gingiva. We reported a case of a 32-year-old woman presenting with an 8-year history of damage to the vulval and perianal anatomy and limitation of mouth opening. The patient's symptoms were relieved after treatment with topical tacrolimus cream. PMID:25184936

ON THE SO-CALLED LATE OR THERAPEUTICAL RADIONECROSIS (in Italian)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Piemonte, M.

1960-01-01

Anatomical and clinical characteristics of the alteration known as late or therapeutical necrosis are reviewed and the most characteristical aspects of this alteration in various anatomical sites are discussed. Radionecroses of the tongue, of the palate, of the skin, of the uterus cervix, of the vulva, and of the penis are illustrated. (auth)

Angiofibroma of the vulva.

PubMed

Ahmadnia, Hassan; Kamalati, Ali; Dolati, Mahmood; Akhavan Rezayat, Alireza; Katebi, Mehrdad

2014-01-01

Cellular angiofibroma is a benign and rare tumor. It usually arises in middle-aged women and involves the vulva. Complete local excision of the tumor is the best cure, and, usually, there is no recurrence after surgery. We describe a 20-year-old woman with a painless, growing vulvar mass who presented about 3 years ago. Her past medical history was negative for oral contraceptives, tobacco, and alcohol, and there were no similar lesions in her family history. A physical examination revealed two masses on the right and the left labia majora and similar lesions on the left axilla and both breasts. An uncomplicated simple resection of the vulvar masses was done in the operating room. There was no evidence of recurrence 12 months after surgery. Histopathologic examination revealed that the findings were consistent with the diagnosis of the cellular angiofibroma. Based on our knowledge, this patient is the youngest case of vulvar angiofibroma. The lesions were large and symmetrical (on both labia majora), although they differed in size. Extravulvar (breast and axilla) lesions were also noteworthy in this patient.

Peripheral primitive neuroectodermal tumor of the vulva: report of a case with imprint cytology.

PubMed

Takeshima, N; Tabata, T; Nishida, H; Furuta, N; Tsuzuku, M; Hirai, Y; Hasumi, K

2001-01-01

Peripheral primitive neuroectodermal tumor (PNET) of the vulva is an extremely rare disease, and, to our knowledge, only two cases have been previously reported. A 45-year-old woman presented with a mass in the right labium major. Three years after removal of the tumor, she noticed a new lesion in the same place and underwent a partial vulvectomy. The imprint cytology of the recurrent tumor showed a monomorphic appearance, composed of small round cells with scant cytoplasm against a hemorrhagic background. These tumor cells were loosely connective, but rosettelike structures were observed focally. On pathologic examination, the neoplasm was composed of small round tumor cells showing sinusoidal, diffuse or micropapillary growth. Immunohistochemically, the neoplastic cells stained positively for neuron-specific enolase, vimentin and HBA 71 and negatively for cytokeratin, HBA 45 and muscle-specific actin. The morphologic characteristics of the disease were well expressed in the imprint cytology, and this influenced the selection of immunohistochemical studies. Cytologic examination for vulvar tumors, even imprint cytology, can be a useful tool in obtaining an accurate pathologic diagnosis of a rare disease, such as peripheral PNET.

Vulvar Pyogenic Granuloma in a Postmenopausal Woman: Case Report and Review of the Literature

PubMed Central

Arikan, Deniz Cemgil; Kiran, Gurkan; Sayar, Hamide; Kostu, Bulent; Coskun, Ayhan; Kiran, Hakan

2011-01-01

Introduction. Although pyogenic granulomas (PG) are common and benign vascular proliferations of the skin and mucous membranes, they are relatively rare on the vulva. Case Presentation. A 57-year-old G7P7 postmenopausal woman presented with a 3-year history of a foul smell and bleeding lesions in the genital region. A gynecologic examination revealed multiple large papillomatous, pedunculated, and lobulated lesions that were cherry-red and infective in appearance. There was a 2-cm lesion at the upper intersection of the labia majora, a 2-cm lesion on the right labium majus, and a 4-cm lesion on the clitoris. The patient complained of itching, and the lesions were asymptomatic, except for occasional bleeding. All lesions were excised and sent for histopathological examination, which revealed an ulcerated polypoidal structure with extensive proliferation of vascular channels lined by a single layer of endothelium. The histopathological features were consistent with PG. Conclusion. The present case is the first case of multiple pyogenic granulomas on the vulva in a postmenopausal woman. PMID:21912553

Primary Ewing sarcoma of vulva, confirmed with molecular cytogenetic analysis: A rare case report with diagnostic and treatment implications.

PubMed

Rekhi, Bharat; Chinnaswamy, Girish; Vora, Tushar; Shah, Sneha; Rangarajan, Venkatesh

2015-01-01

Primary vulvar Ewing sarcoma (ES)/PNET is an uncommonly documented tumor, especially with molecular results. A 10-year-old girl presented with left vulvar swelling, a year ago. Her abdominopelvic ultrasound revealed a 12 cm × 8 cm sized, mixed echogenic blood-filled lesion in the left vulva; radiologically considered as a hematoma. Vulvectomy revealed a multinodular grey-brown tumor, microscopically comprising malignant round cells. Immunohistochemically, tumor cells diffusely expressed MIC2/CD99 and Fli1 and subsequently displayed EWSR1 rearrangement, confirming diagnosis of ES/PNET. Subsequently, PET-CT scan revealed residual local lesion with lung metastases. The patient was induced on EFT 2001 chemotherapy protocol. Three months after chemotherapy completion, there was no metabolically active disease on PET scan. Four months later, MRI disclosed recurrent primary and metastatic pulmonary lesions. She was planned for scar excision and adjuvant radiotherapy, but unfortunately defaulted further treatment. This forms the eighth case of primary vulvar ES/PNET confirmed with molecular cytogenetic result, underscoring therapeutic value of objective diagnosis in such cases.

Receptivity of female Neohelice granulata (Brachyura, Varunidae): different strategies to maximize their reproductive success in contrasting habitats

NASA Astrophysics Data System (ADS)

Sal Moyano, María Paz; Luppi, Tomás; Gavio, María Andrea; Vallina, Micaela; McLay, Colin

2012-12-01

The extent of the receptive period may determine the mating strategies employed by female crabs to obtain mates. Here, we studied the receptivity of female Neohelice granulata (Dana, 1851) in the laboratory, including the form of the vulvae and the anatomy of the seminal receptacle (SR). We examined the factors that influence the duration of receptivity by comparing two populations inhabiting contrasting habitats: Mar Chiquita Coastal lagoon (MCL), which is an oligo-polyhaline estuary, and San Antonio Oeste (SAO), which is an eu-hyperhaline marine bay. Non-receptive females have immobile vulva opercula, while receptive females have mobile opercula. Histological sections of the SR showed that the degree of epithelium secretions was associated with the receptive stage of females, and they may be involved in the maintenance of viable sperm and in the dehiscence of spermatophores. The existence of a special tissue at the junction of the oviduct and the SR was described and proposed as an internal mechanism influencing the timing of ovulation. The duration of receptivity was dependent on the SR load and the capacity to lay eggs. Thus, females with empty SR exhibited longer receptivity and did not lay eggs, while those with full SR exhibited shorter receptivity and always laid eggs. Interpopulation differences showed that females from SAO had shorter receptivity and heavier SR and laid eggs more frequently than females from MCL. Based on our results, we suggest that N. granulata females can adjust the duration of their receptivity and control the moment of fertilization according to different internal mechanisms related to the morphology of the vulvae, the fullness of the SR and anatomical attributes of the SR. An important consequence of this control is greater sperm competition. The extent of the receptive period and the number of times that a female could become receptive in a single reproductive season may also depend on the habitat characteristics.

Vulvar epithelioid hemangiosarcoma with solar elastosis in a mare.

PubMed

Gumber, Sanjeev; Baia, Petrisor; Wakamatsu, Nobuko

2011-09-01

A 15-year-old female gray Appaloosa horse was presented with history of a mass over the right dorsal commissure of vulva for the past 7 months. Based on histopathological examination, and positive staining with factor VIII-related antigen, vimentin, and Verhoeff-van Gieson stain, the vulvar mass was diagnosed as hemangiosarcoma with marked solar elastosis.

Fox–Fordyce disease of the vulva

PubMed Central

Gurusamy, Lakshmipriya; Jegadeesan, Muhilan; Jayakumar, Salai

2016-01-01

Fox–Fordyce disease is a rare, chronic skin disorder which affects the apocrine areas. This disease is due to the obstruction of the apocrine sweat duct. Extragenital regions are commonly affected than the genital region. We, herein, report a case of Fox–Fordyce in a female, with onset in the fifth decade and involving only the genital region. PMID:27190415

The medical care of the neovagina of transgender women: a review.

PubMed

Cornelisse, Vincent J; Jones, Rosemary A; Fairley, Christopher K; Grover, Sonia R

2017-10-01

For transgender women, genital adjustment surgery involves removal of the natal reproductive organs and creation of a neovagina, vulva and clitoris. We conducted a review of the medical literature in order to summarise the issues that can affect the health of the neovagina in the long term, and to make recommendations on how to manage these issues.

Avelumab With Valproic Acid in Virus-associated Cancer

ClinicalTrials.gov

2018-06-11

Cancer That is Associated With a Chronic Viral Infection; p16 Positive SCCHN; Squamous Cell Carcinoma of the Cervix; p16 Positive Squamous Cell Carcinoma of the Vagina or Vulva; p16 Positive Squamous Cell Carcinoma of the Penis; p16 Positive Squamous Cell Carcinoma of the Anus or Anal Canal; EBER Positive NPC; EBER Positive Hodgkins and Non-hodgkins Lymphona

Velvet Vulvas at School: The Catalyzing Power of the Arts in Education

ERIC Educational Resources Information Center

Quinn, Therese

2008-01-01

As a teacher of art teachers, this author values and promotes an education through the arts that loves freedom, an education through art connected to powerful social ideas and movements, connected to social justice. This is not a kind of education common today in public schools, but it has a rich lineage. Drawing inspiration from Maxine Greene,…

On the description of two new species of Paurodontella (Nematoda: Paurodontinae) with a key and diagnostic compendium to the species of the genus

USDA-ARS?s Scientific Manuscript database

Two new species of Paurodontella collected around the roots of wheat (Triticum aestivum L.) are described and illustrated. One new species is characterized by having a short cylindrical, robust body markedly tapering at both ends with an anteriorly located vulva, short post-uterine sac, lateral fiel...

Vaginal rupture and evisceration in a dog.

PubMed

Prassinos, Nikitas N; Adamama-Moraitou, Katerina K; Ververidis, Haralabos N; Anagnostou, Tilemachos L; Kladakis, Stefanos E

2010-09-01

A 1.5-year-old German Shepherd mixed breed dog was admitted with mild haemorrhage from the vulva and a perineal mass of 24-hour duration, which had been first observed immediately after parturition. Parturition had occurred at low ambient temperature, and only one puppy survived out of the seven oversized fetuses. The dog was in poor body condition, dehydrated, hypothermic, depressed, non-ambulatory and in a state of shock. Intestinal loops, the urinary bladder and the uterine horns and body were protruding from the vulva. A true vaginal prolapse was also observed. The abdominal viscera were flushed with warm sterile saline solution, protected and maintained wet. The laboratory findings included moderate anaemia, leukocytosis, hypoalbuminaemia, azotaemia and elevated liver enzyme activities. Stabilisation of the dog's general condition was attempted before surgery. Antimicrobial and analgesic drugs were also administered. After exploratory laparotomy the protruding organs, which were in good condition, were reduced. A recent rupture in the vaginal wall, approximately 6 cm long, was observed. Ovariohysterectomy and partial vaginectomy were performed. The preoperative course of therapy was continued, but the bitch died 12 hours later. The probable cause of vaginal rupture and evisceration in this bitch was tenesmus and/or trauma due to the oversized fetuses.

[Initial surgical management of squamous carcinoma of the vulva].

PubMed

Salazar-Báez, Israel; Salazar-Campos, Jessica E; López-Arias, Alhely; Villavicencio-Valencia, Verónica; Coronel-Martínez, Jaime; Candelaria-Hernández, Myrna; Pérez-Montiel, Delia; Pérez-Plasencia, Carlos; Rojas-García, Aurora Elizabeth; Cantú de León, David

2016-01-01

Vulvar cancer accounts for approximately 4% of gynecological malignancies. At the Instituto Nacional de Cancerologia in Mexico it occupies the fourth place. The purpose of this study is to assess the management of squamous carcinoma of the vulva with initial surgical treatment. It is a descriptive retrospective, observational study, from January 1, 2002 to December 31, 2012. Twenty-seven patients, clinical stages I, II, or III, initial surgical management, with at least one year of follow-up were included. In 51.85% a partial vulvectomy was performed and in 40.74% a wide excision; 66.66% underwent inguinofemoral dissection. Recurrence occurred in 25.91% of cases and the overall survival at 10 years was 63%. It is concluded that with invasion of up to 1 mm of lymph node, affection is 0%; with invasion of 1 mm and up to 5 mm this increases to 25%; an invasion of more than 5 mm implies up to 45%. Recurrence in our study was primarily distant, necessitating long-term monitoring with emphasis on symptoms to request imaging studies when suspected. Adjuvant therapy should be offered to patients with positive nodes, close or positive margins, and tumors larger than 4 cm.

The nT1 translocation separates vulval regulatory elements from the egl-18 and elt-6 GATA factor genes.

PubMed

Koh, Kyunghee; Bernstein, Yelena; Sundaram, Meera V

2004-03-01

egl-18 and elt-6 are partially redundant, adjacent genes encoding GATA factors essential for viability, seam cell development, and vulval development in Caenorhabditis elegans. The nT1 reciprocal translocation causes a strong Vulvaless phenotype, and an nT1 breakpoint was previously mapped to the left arm of LGIV, where egl-18/elt-6 are located. Here we present evidence that the nT1 vulval phenotype is due to a disruption of egl-18/elt-6 function specifically in the vulva. egl-18 mutations do not complement nT1 for vulval defects, and the nT1 breakpoint on LGIV is located within approximately 800 bp upstream of a potential transcriptional start site of egl-18. In addition, we have identified a approximately 350-bp cis-regulatory region sufficient for vulval expression just upstream of the nT1 breakpoint. By examining the fusion state and division patterns of the cells in the developing vulva of nT1 mutants, we demonstrate that egl-18/elt-6 prevent fusion and promote cell proliferation at multiple steps of vulval development.

[Vaginismus and our experience in treating this sexual problem].

PubMed

Sirakov, M

2013-01-01

According to various statistics from 4.2 to 42% of women in reproductive age, complained of a mild or severe problems in sexual function. The study presents own data on treatment of vaginismus in 14 girls and young women aged 16 to 36 years who have turned from 2007 to 2012 to the Cabinet Children and adolescent gynaecology at the University Hospital "Maychin dom". A primary examination established a high and tenacious hymen in 7 (50%) patients. The patients demonstrated fear, but still allowed careful examination. At 3 girls (21.43%) a combined cause of complaints was found. They demonstrated fear of pain during coitus and reported bad memory of the first sexual attempts; they had high and tenacious hymen and were able to tolerate touching the vulva after much persusions. In 3 (21.43%) patients consequences of puritan education were registered. They did not allowed to touch the vulva despite the declaration that would allow such. In one patients (7.14%) a unstretchable vagina was found. She demonstrated dyspareunia (avoiding intercourse and having one failed marriage) but she tolerated penetration of her vagina of one phalanx. In all cases of vaginismus we performed educational lectures and artefitial defloration.

Paget's disease of the vulva: a clinicopathologic institutional review.

PubMed

Mendivil, Alberto A; Abaid, Lisa; Epstein, Howard D; Rettenmaier, Mark A; Brown, John V; Micha, John P; Wabe, Marie A; Goldstein, Bram H

2012-12-01

The aim of this study was to assess the clinicopathologic characteristics of patients with Paget's disease of the vulva who were treated by our gynecologic oncology service between 1985 and 2010. Vulvar Paget's disease patient demographics, pathologic diagnosis, treatment and follow-up data were reviewed over a 25-year period. The vulvar Paget's disease patients were primarily (62.5%) treated with a partial simple vulvectomy. Three patients had a history of malignancy, although none of them was intercurrent. Eleven patients had microscopically positive margins, 5 of whom developed progressive disease. Conversely, 5 patients had negative margins, of whom 4 had recurrent disease. There was a significant relationship between the presence of invasive disease and patient progression-free interval (PFI) (p = 0.007), but margin status and lesion size did not correlate with PFI (p > 0.05). Median patient PFI and follow-up was 30 and 53 months, respectively. We found a significant relationship between the presence of invasive disease and patient PFI in vulvar Paget's disease although the presence of microscopic positive margins and lesion size were not prognostic indicators. In patients with high risk factors, prolonged surveillance should be considered an essential component of optimal patient management.

C. elegans Vulva Induction: An In Vivo Model to Study Epidermal Growth Factor Receptor Signaling and Trafficking.

PubMed

Gauthier, Kimberley; Rocheleau, Christian E

2017-01-01

Epidermal growth factor receptor (EGFR)-mediated activation of the canonical Ras/MAPK signaling cascade is responsible for cell proliferation and cell growth. This signaling pathway is frequently overactivated in epithelial cancers; therefore, studying regulation of this pathway is crucial not only for our fundamental understanding of cell biology but also for our ability to treat EGFR-related disease. Genetic model organisms such as Caenorhabditis elegans, a hermaphroditic nematode, played a vital role in identifying components of the EGFR/Ras/MAPK pathway and delineating their order of function, and continues to play a role in identifying novel regulators of the pathway. Polarized activation of LET-23, the C. elegans homolog of EGFR, is responsible for induction of the vulval cell fate; perturbations in this signaling pathway produce either a vulvaless or multivulva phenotype. The translucent cuticle of the nematode facilitates in vivo visualization of the receptor, revealing that localization of LET-23 EGFR is tightly regulated and linked to its function. In this chapter, we review the methods used to harness vulva development as a tool for studying EGFR signaling and trafficking in C. elegans.

Augmented Central Pain Processing in Vulvodynia

PubMed Central

Hampson, Johnson P.; Reed, Barbara D.; Clauw, Daniel J.; Bhavsar, Rupal; Gracely, Richard H.; Haefner, Hope K.; Harris, Richard E.

2013-01-01

Vulvodynia (VVD) is a chronic pain disorder, wherein women display sensitivity to evoked stimuli at the vulva and/or spontaneous vulvar pain. Our previous work suggests generalized hyperalgesia in this population, however little is known about central neurobiological factors that may influence pain in VVD. Here we investigated local (vulvar) and remote (thumb) pressure evoked pain processing in 24 VVD patients compared to 13 age-matched, pain-free healthy controls (HC). As a positive control we also examined thumb pressure pain in 24 fibromyalgia (FM) patients. The VVD and FM patients displayed overlapping insular brain activations that were greater than HC, in response to thumb stimulation (P<0.005 corrected). Compared to HC, VVD participants displayed greater levels of activation during thumb stimulation within the insula, dorsal mid-cingulate, posterior cingulate and thalamus (P<0.005 corrected). Significant differences between VVD subgroups (primary versus secondary and provoked versus unprovoked) were seen within the posterior cingulate with thumb stimulation, and within the precuneus region with vulvar stimulation (provoked versus unprovoked only). The augmented brain activation in VVD patients in response to a stimulus remote from the vulva suggests central neural pathology in this disorder. Moreover, differing central activity between VVD subgroups suggests heterogeneous pathologies within this diagnosis. PMID:23578957

[Morphologic manifestations of human papillomavirus infection in the vulvar and anogenital region].

PubMed

Hadzić, B; Djurdjević, S; Hadzić, M; Jerant-Patić, V

1998-01-01

Human papillomavirus (HPV) infection of the female genital tract is a sexually transmissible disease most frequently manifested by warts on the vulva, anogenital region, vagina and cervix. Precancerous lesions of vulvar intraepithelial neoplasia (VIN) as well as the development of invasive malignant neoplasms are also related to the infections caused by some HPV types. Infections with HPV-6 and HPV-11, the disease is often polycentric, sometimes reaching gigantic dimensions, elicit venereal warts. Amongst several histological criteria for diagnosing this change, the most typical is koilocytosis, with perinuclear halo formation with a thick cytoplasmic border. Precancerous changes of the vulva and anogenital region are displastic changes of the squamous epithelium, characterized by high mitotic activity, disturbance of nucleocytoplasmic relationship and lack of differentiation in the upper epithelial layers. The changes in the epithelium divided into thirds starting from basal membrane is the main criterion in estimating the degree of dysplasia, marked by VIN 1, VIN 2 and VIN 3. According to the nuclear and cytoplasmic characteristics. VINs are subclassified into three types: basaloid, verrucous (condylomatous) and well differentiated. Basaloid and verrucous (condylomatous) VIN types are morphological markers of HPV infection. The squamous cell carcinoma of the vulva and anogenital region is a morphologically heteregenous neoplasm with particular histological entities connected with HPV infection. Four cases of patients with changes in the anogenital region in the form of small to gigantic polypoid formations were reported. The histological features corresponded to vulvar intraepithelial neoplasms (VIN lesions), as well as to neoplastic changes characteristic of HPV infection. The evolution of the changes from typical condylomas through VIN lesions to infiltrative neoplasms, taking place over the years, was also verified. Some histologically typical epithelial changes in the scope of VIN, as well as some histological types of malignant neoplasms, are associated with HPV-16 and HPV-18, and with HPV-31 to a smaller extent. The oncogenic potential of these viruses is established by in vitro cultures, but also by their finding in 50-90% of genital neoplasia in different series analyzed. The oncogenic potential of the virus depends on numerous heteregenous and complex factors denoted as risk factors. A typical, morphologically well-differentiated change is condyloma acuminatum, with the finding of acanthosis, hyperkeratosis, parakeratosis, dyskeratosis, and koilocytosis, which is always an accompanying morphological quality in these changes. In precancerous lesions and infiltrative neoplasms, koilocytosis is not a necessary finding. The HPV infection of the vulva and anogenital region is reflected in a spectrum of histological changes. Condylomatous verrucous lesions, smaller papular or plaque-like changes with VIN histological features, as well as infiltrative malignant neoplasia with certain histological properties, could be induced by different HPV types. In the absence of data of in situ hybridization and immuno-electron microscopy as the reliable evidence of the presence of a certain HPV genotype, histological changes mostly characteristic of HPV infection could serve as an indirect pathway.

Testicular feminization in the Finnish racoon dog (Nyctereutes procyonoides).

PubMed

Smith, A; Nes, N; Berg, K A; Valtonen, M; Mäkinen, A; Lukola, A

1983-12-01

The clinical features of testicular feminization in the racoon dog (Nyctereutes procyonoides) are reported. The condition is characterized by a normal male karyotype, but a mixed phenotype consisting of vulva, enlarged clitoris and scrotal testes. Partial spermatogenesis with a relative arrest at the first meiotic division was observed. The likely underlying genetic defect and mode of inheritance are discussed, together with implications for breeding programmes.

Development of a Diagnosis Related Management System for the Department of OBGYN at Winn Army Community Hospital, Fort Stewart, Georgia

DTIC Science & Technology

1990-05-01

69 z 359 Uterine procedure for non-malig age ា m 360 Vagina , cervix and vulva procedures M 361 Laparoscopy and incisional tubal inter 362 Endoscopic...based retrospective z clinical data. Medical Care, 9, (11),1071-1082. K z Bradford, C.K. (1986). Methodology, myths , and maths of m• • X DRG’s. Virgo

Sexual Activity, Psychosexual Distress, and Fear of Progression in Women With Human Papillomavirus-Related Premalignant Genital Lesions.

PubMed

Nagele, Eva; Reich, Olaf; Greimel, Elfriede; Dorfer, Martha; Haas, Josef; Trutnovsky, Gerda

2016-02-01

Genital human papillomavirus (HPV) infections are very common in women 18 to 30 years old and substantially affect women's sexual health. To examine sexual activity, psychosexual distress, and fear of progression in women diagnosed with HPV-related precancerous genital lesions. In this observational study, women diagnosed with premalignant lesions of the cervix, vagina, or vulva were recruited from a university hospital-based colposcopy clinic. Quantitative data from three validated patient-administered questionnaires (Sexual Activity Questionnaire, German version of the Cervical Dysplasia Distress Questionnaire, and Fear of Progression Questionnaire) were compared within the study population, according to the location of the genital lesion, and with relevant reference populations. Qualitative data from two written open-ended questions about women's thoughts regarding diagnosis and information were analyzed. Two-hundred nine women completed the questionnaires. Seventy-eight percent of women (n = 162) were referred for evaluation of suspect lesions of the cervix, 8% (n = 17) of the vagina, and 14% (n = 30) of the vulva. There were no significant differences in questionnaire results among the three patient groups, except for sexual consequences (Cervical Dysplasia Distress Questionnaire) and recent sexual activity (Sexual Activity Questionnaire). Women with vulvar lesions were most likely to worry about sexual consequences (ie, being unable to have children, being sexually less attractive, or infecting a sexual partner; P = .04). The Sexual Activity Questionnaire subscales sexual pleasure (P = .15) and sexual habits (P = 1.00) were similar to those in a healthy control population, whereas sexual discomfort (P = .51) was comparable to that in a reference population of women who survived cervical cancer. The subscale partner-specific concerns (Fear of Progression Questionnaire) was similar to that in a reference population of patients with cancer (P = .28). HPV-related precancerous genital lesions, especially of the vulva, are likely to cause concerns about sexual health. Effective information and communication are important to lessen negative sexual consequences and anxiety. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

The caenorhabditis elegans CDT-2 ubiquitin ligase is required for attenuation of EGFR signalling in vulva precursor cells

PubMed Central

2010-01-01

Background Attenuation of the EGFR (Epidermal Growth Factor Receptor) signalling cascade is crucial to control cell fate during development. A candidate-based RNAi approach in C. elegans identified CDT-2 as an attenuator of LET-23 (EGFR) signalling. Human CDT2 is a component of the conserved CDT2/CUL4/DDB1 ubiquitin ligase complex that plays a critical role in DNA replication and G2/M checkpoint. Within this complex, CDT2 is responsible for substrate recognition. This ubiquitin ligase complex has been shown in various organisms, including C. elegans, to target the replication-licensing factor CDT1, and the CDK inhibitor p21. However, no previous link to EGFR signalling has been identified. Results We have characterised CDT-2's role during vulva development and found that it is a novel attenuator of LET-23 signalling. CDT-2 acts redundantly with negative modulators of LET-23 signalling and CDT-2 or CUL-4 downregulation causes persistent expression of the egl-17::cfp transgene, a marker of LET-23 signalling during vulva development. In addition, we show that CDT-2 physically interacts with SEM-5 (GRB2), a known negative modulator of LET-23 signalling that directly binds LET-23, and provide genetic evidence consistent with CDT-2 functioning at or downstream of LET-23. Interestingly, both SEM-5 and CDT-2 were identified independently in a screen for genes involved in receptor-mediated endocytosis in oocytes, suggesting that attenuation of LET-23 by CDT-2 might be through regulation of endocytosis. Conclusions In this study, we have shown that CDT-2 and CUL-4, members of the CUL-4/DDB-1/CDT-2 E3 ubiquitin ligase complex attenuate LET-23 signalling in vulval precursor cells. In future, it will be interesting to investigate the potential link to endocytosis and to determine whether other signalling pathways dependent on endocytosis, e.g. LIN-12 (Notch) could be regulated by this ubiquitin ligase complex. This work has uncovered a novel function for the CUL-4/DDB-1/CDT-2 E3 ligase that may be relevant for its mammalian oncogenic activity. PMID:20977703

Three new and a known species of the genus Proleptonchus Lordello, 1955 (Nematoda: Leptonchidae) with a diagnostic compendium of the genus.

PubMed

Ahad, Sumaya; Ahmad, Wasim

2016-11-09

This paper deals with the description of three new and one known species of the genus Proleptonchus Lordello, 1955. Proleptonchus kazirangus n. sp. from Kaziranga National Park, India is characterized by having 1.08-1.45 mm long body; cap-like, offset, lip region; 7-8 µm long odontostyle and 10-12 µm long odontophore; short, pear-shaped pharyngeal bulb offset by a constriction, occupying about 18-21% of total neck length; female genital system mono-prodelphic; pars dilatata uteri with distinctly sclerotized central lumen containing refringent apophyses; posterior uterine sac 78-112 µm long, with sac-like structure representing a rudimentary oviduct; transverse vulva, short, rounded-conoid tail and males with 31-33 µm long spicules, lateral guiding pieces and seven, regularly spaced ventromedian supplements. P. prerectus n. sp. from Japan is characterized by having 1.18-1.43 mm long body; lip region cap-like, offset by a slight constriction; odontostyle 8 µm, odontophore 9-10 µm; short cylindroid basal bulb offset by a constriction, occupying about 16-20% of total neck length; female genital system mono-prodelphic; pars dilatata uteri with sclerotized refringent apophyses; posterior uterine sac small, 27-36 µm; transverse vulva; a prerectal chamber and short, rounded-hemispheroid tail. P. japonicus n. sp. also from Japan is characterized by having 0.91-1.04 mm long body; lip region cap-like, set off by a slight constriction; odontostyle 5 µm and odontophore 10-11 µm long; pharynx consists of a very slender, non-muscular anterior part, separated from pyriform basal bulb by a constriction, with thickened lumen in posterior region, occupying about 18-20% of total neck length; female genital system mono-prodelphic; posterior uterine sac small, 20-24 µm long; transverse vulva and short, rounded-conoid tail. P. shamimi Bajaj & Bhatti, 1980 is redescribed and its relationship with closely related species is discussed. A diagnostic compendium of all the valid species of Proleptonchus is also provided.

True vaginal prolapse in a bitch.

PubMed

Alan, M; Cetin, Y; Sendag, S; Eski, F

2007-08-01

Frequently, vaginal fold prolapse is the protrusion of edematous vaginal tissue into and through the opening of the vulva occurring during proestrus and estrus stages of the sexual cycle. True vaginal prolapse may occur near parturition, as the concentration of serum progesterone declines and the concentration of serum oestrogen increases. In the bitch, this type of true vaginal prolapse is a very rare condition. This short communication describes a 5-year-old female, cross-breed dog in moderate condition, weighing 33 kg, with distocia and true vaginal prolapse. Abdominal palpation and transabdominal ultrasonography revealed live and dead foetuses in the uterine horns. One dead and four live fetuses were removed from uterus by cesarean section. The ovariohysterectomy was performed after repositioning the vaginal wall with a combination of traction from within the abdomen and external manipulation through the vulva. Re-occurrence of a vaginal prolapse was not observed and the bitch recovered completely after the surgical therapy. Compared to other vaginal disorders, vaginal prolapse is an uncommon condition in the bitch. In the present case, extreme tenesmus arising from distocia may have predisposed to the vaginal prolapse. The cause of dystocia was probably the disposition of the first foetus. We concluded that the vaginal prolapse was the result of dystocia in the present case.

All change: the lived experience of younger women with cancer of the vulva.

PubMed

Jefferies, Hilary; Clifford, Collette

2012-08-01

To generate an understanding of the women's own perspectives of their care and address a gap in knowledge in relation to the broader impact of vulval cancer. Few people go though life without experiencing events that can change their perspective on how they see themselves, their role in society and their relationship with those around them. People are multi-dimensional, so a person with has a physical illness is also affected psychologically and sociologically. Qualitative. Based on the work of Heidegger and van Manen, an interpretative phenomenological research study was undertaken to explore the experiences of thirteen women under 50 years of age with vulval cancer living in the UK. Data were analysed using framework analysis and showed that a diagnosis of cancer of the vulva and the subsequent treatment has an effect on physical, psychological and sexual functioning. The concept of 'All Change' expressed the sentiment that following the diagnosis and surgery, everything has changed; life is not the same as it was before diagnosis. This included both physical and psychological changes and impacts on perceptions of body image. The challenge is to raise awareness of vulval cancer among health care professions and society in general and determine the most effective interventions in facilitating pre and post operative support for these women. © 2012 Blackwell Publishing Ltd.

Dynein-mediated trafficking negatively regulates LET-23 EGFR signaling

PubMed Central

Skorobogata, Olga; Meng, Jassy; Gauthier, Kimberley; Rocheleau, Christian E.

2016-01-01

Epidermal growth factor receptor (EGFR) signaling is essential for animal development, and increased signaling underlies many human cancers. Identifying the genes and cellular processes that regulate EGFR signaling in vivo will help to elucidate how this pathway can become inappropriately activated. Caenorhabditis elegans vulva development provides an in vivo model to genetically dissect EGFR signaling. Here we identified a mutation in dhc-1, the heavy chain of the cytoplasmic dynein minus end–directed microtubule motor, in a genetic screen for regulators of EGFR signaling. Despite the many cellular functions of dynein, DHC-1 is a strong negative regulator of EGFR signaling during vulva induction. DHC-1 is required in the signal-receiving cell and genetically functions upstream or in parallel to LET-23 EGFR. LET-23 EGFR accumulates in cytoplasmic foci in dhc-1 mutants, consistent with mammalian cell studies in which dynein is shown to regulate late endosome trafficking of EGFR with the Rab7 GTPase. However, we found different distributions of LET-23 EGFR foci in rab-7 versus dhc-1 mutants, suggesting that dynein functions at an earlier step of LET-23 EGFR trafficking to the lysosome than RAB-7. Our results demonstrate an in vivo role for dynein in limiting LET-23 EGFR signaling via endosomal trafficking. PMID:27654944

New species of Spauligodon Skrjabin, Schikhobalova & Lagodovskaja, 1960 and Thubunea Seurat, 1914 (Nematoda) from the gastro-intestinal tract of lizards in Iran.

PubMed

Pazoki, Samaneh; Rahimian, Hassan

2014-11-01

As part of a faunistic study on helminth parasites of Iranian lizards collected from localities in the north of Isfahan province in Iran, two new nematode species belonging to two different families, Pharyngodonidae Travassos, 1919 and Physalopteroidae Railliet, 1893, were found and are, hereby, described. Spauligodon persiensis n. sp. from the large intestine of Cyrtopodion scabrum Heyden is characterised by its imperceptible lateral alae, lack of spicule, different shape of the genital curtain, position of last pair of papillae, aspinose tail in males, position of the vulva and excretory pore, and a tail filament with six to nine spines in females. Thubunea mobedii n. sp. from the stomach of Laudakia nupta nupta (De Filipi) differs from the other species in the genus by possessing a vulva at level of the posterior portion of the oesophageal-intestinal junction in females, lacking spicules, and having a different number of papillae in males. The present paper provides the results of detailed morphological examination of the two new nematode species, using both light and scanning electron microscopy. Taxonomically important characteristics for the members of the two nematode genera, Spauligodon Skrjabin, Schikhobalova & Lagodovskaja, 1960 and Thubunea Seurat, 1914, are also reviewed.

Basal cell carcinoma of the vulva: a case series.

PubMed

Mulvany, Nicholas J; Rayoo, Mukta; Allen, David G

2012-10-01

To review the diagnostic features and characteristics of an uncommon tumour, basal cell carcinoma (BCC) of the vulva. The clinical and pathological details of six vulvar BCCs were reviewed. Four of the BCCs arose in isolation, one was combined with vulvar Paget's disease and another was intimately associated with a poorly differentiated squamous cell carcinoma. The average age of the six patients was 76 years (75 years for 'isolated' BCC; 78 years for BCC 'mixed' with other lesions). The duration of symptoms averaged 13 months in 'isolated' BCC but 24 months in 'mixed' BCC. Vulvar pruritus was the most common presenting complaint in the four cases of 'isolated' BCC. The initial biopsies included shave (× 2) or punch biopsies (× 4). Definitive surgery included excisional biopsy (× 2) or a wide local excision (× 3). In the five assessable tumours, the maximum tumour diameter averaged 19.8 mm (range 11-36 mm). In the sixth patient the BCC was contiguous with a 70 mm, unresectable, poorly differentiated squamous cell carcinoma which was treated by radiotherapy alone. : Although the histological diagnosis of vulvar BCC was straightforward in some of our cases, others presented difficulties due to non-representative initial biopsies, insufficient clinical information or contiguity with lesions of greater clinical significance such as Paget's disease or squamous cell carcinoma.

Electrosurgical operation of vulvar carcinoma with postoperative irradiation of inguinal lymph nodes

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kucera, H.; Weghaupt, K.

1988-02-01

The results of treatment in the department of 607 patients with invasive squamous cell carcinoma of the vulva between 1952 and 1980 is described and analyzed. The absolute 5-year cure rate in these patients was 60.3%. Particular attention was given to lymph node status (TNM system) in the analysis of the last 141 patients treated. The absolute 5-year survival rate was 67% for the N0-N1 patients and 43% for the N2-N3 patients. Patients were treated uniformly by means of electrosurgical operation and postactinic irradiation of the inguinal lymph nodes. Operative lymphadenectomy was performed only in 5% of cases when themore » diameter of inguinal lymph nodes was greater than 2 cm. This simple surgical technique, in combination with irradiation of inguinal lymph nodes, gives excellent results and avoids the complications associated with inguinofemoral lymphadenectomy. Owing to its combination of electrosurgical operation of the vulva and irradiation of the inguinal regions as a standard procedure, the treatment involves extremely low strain on the patient and is almost free of complications. This seems to be particularly important as the results of our treatment are not less satisfactory than those of more aggressive procedures.« less

Swedish Plectida (Nematoda). Part 9. The genus Leptolaimoides Vitiello, 1971.

PubMed

Holovachov, Oleksandr

2015-05-01

Three known and two new species of Leptolaimoides are described from bottom sediments collected in Skagerrak off the west coast of Sweden. The following known species are redescribed: Leptolaimoides haploopis Jensen, 1978, L. tubulosus Vitiello, 1971 and L. hexatubulosus Hoang Lai-Phu et al., 2009. Leptolaimoides filicaudatus sp. n. is characterised by the 431-543 µm long body; cephalic sensilla papilliform; amphid 23-26 µm long, located 9-10 µm from anterior end; first body pore located 35-37 µm from anterior end; lateral field simple along most of body, areolated on tail, arising 36-40 µm from anterior end; female without supplements, vagina without pars refringens, vulva midventral; male without tubular and without alveolar supplements; spicules arcuate and 16 µm long. Leptolaimoides leptomicron sp. n. is characterised by the 776-847 µm long body; cephalic sensilla papilliform; amphid 15-17 µm long, located 9-13 µm from anterior end; first body pore located 40-46 µm from anterior end; lateral field areolated, arising 26-28 µm from anterior end; female without supplements, vagina without pars refringens, vulva midventral; male with three tubular and without alveolar supplements, spicules arcuate and 28-29 µm long. The diagnosis of the genus Leptolaimoides is emended and a tabular compendium and dichotomous identification key to species of the genus Leptolaimoides are provided.

Aggressive angiomyxoma of the vulva: case report.

PubMed

Ribeiro, José Carlos Castelo Branco; Vieira, Sabas Carlos; Silva, Benedito Borges da; Santos, Lina Gomes dos; Costa, Pedro Vítor Lopes; Fonsêca, Lia Andréa Costa da

2015-01-01

Female patient, 42-years-old, complaining of difficulty in urinating and swelling in the vulvar area for one year. Her gynecological examination showed extensive injury in the vulvar region and the biopsy done was inconclusive. The removal of the lesion was conducted. After the procedure, the patient remains free of recurrence for 15 months. This case highlights the need to consider angiomyxoma in the differential diagnosis for tumors of unknown cause in the vulvar region.

Perineal template techniques for interstitial implantation of gynecological cancers using the Paris system of dosimetry

DOE Office of Scientific and Technical Information (OSTI.GOV)

Leung, S.

1990-09-01

Since 1984, perineal template/needle techniques for interstitial implantation of gynecologic cancer-cervix, vagina, vulva-have been developed at the Peter MacCallum Cancer Institute. The Paris System of dosimetry has been used resulting in greater dose homogeneity, fewer needles and radioactive sources and considerable simplification and ease of implantation compared with comparable techniques developed in the United States. Principles and techniques of implantation are described in detail.

H3K9me2/3 Binding of the MBT Domain Protein LIN-61 Is Essential for Caenorhabditis elegans Vulva Development

PubMed Central

Koester-Eiserfunke, Nora; Fischle, Wolfgang

2011-01-01

MBT domain proteins are involved in developmental processes and tumorigenesis. In vitro binding and mutagenesis studies have shown that individual MBT domains within clustered MBT repeat regions bind mono- and dimethylated histone lysine residues with little to no sequence specificity but discriminate against the tri- and unmethylated states. However, the exact function of promiscuous histone methyl-lysine binding in the biology of MBT domain proteins has not been elucidated. Here, we show that the Caenorhabditis elegans four MBT domain protein LIN-61, in contrast to other MBT repeat factors, specifically interacts with histone H3 when methylated on lysine 9, displaying a strong preference for di- and trimethylated states (H3K9me2/3). Although the fourth MBT repeat is implicated in this interaction, H3K9me2/3 binding minimally requires MBT repeats two to four. Further, mutagenesis of residues conserved with other methyl-lysine binding MBT regions in the fourth MBT repeat does not abolish interaction, implicating a distinct binding mode. In vivo, H3K9me2/3 interaction of LIN-61 is required for C. elegans vulva development within the synMuvB pathway. Mutant LIN-61 proteins deficient in H3K9me2/3 binding fail to rescue lin-61 synMuvB function. Also, previously identified point mutant synMuvB alleles are deficient in H3K9me2/3 interaction although these target residues that are outside of the fourth MBT repeat. Interestingly, lin-61 genetically interacts with two other synMuvB genes, hpl-2, an HP1 homologous H3K9me2/3 binding factor, and met-2, a SETDB1 homologous H3K9 methyl transferase (H3K9MT), in determining C. elegans vulva development and fertility. Besides identifying the first sequence specific and di-/trimethylation binding MBT domain protein, our studies imply complex multi-domain regulation of ligand interaction of MBT domains. Our results also introduce a mechanistic link between LIN-61 function and biology, and they establish interplay of the H3K9me2/3 binding proteins, LIN-61 and HPL-2, as well as the H3K9MT MET-2 in distinct developmental pathways. PMID:21437264

Basaloid and warty carcinomas of the vulva. Distinctive types of squamous cell carcinoma frequently associated with human papillomaviruses.

PubMed

Kurman, R J; Toki, T; Schiffman, M H

1993-02-01

In a previous study, we described an elevated prevalence of human papillomavirus (HPV) in two specific types of squamous cell carcinoma of the vulva designated basaloid carcinoma (BC) and warty carcinoma (WC) compared with the conventional type of keratinizing squamous cell carcinoma (KSC). To determine whether there were other differences in their clinical presentation or behavior, we examined 100 cases of squamous cell carcinoma of the vulva classified as BC (28 cases), WC (seven cases), and KSC (65 cases). We included only cases in which tissue adjacent to the tumor was present so that the presence of intraepithelial lesions (squamous hyperplasia, lichen sclerosus, and vulvar intraepithelial neoplasia [VIN]) could be correlated with the different types of invasive carcinomas. Microscopically, BC was characterized by a relatively uniform population of small, ovoid cells with a high nuclear-cytoplasmic ratio resembling VIN 3. Although WC was similar to typical squamous cell carcinoma, it contained many squamous cells that displayed marked nuclear pleomorphism, enlargement, atypia, and multinucleation in conjunction with cytoplasmic cavitation resembling koilocytotic atypia in intraepithelial lesions. The majority of the women with BC and WC were less than 60 years of age, and the proportion of black women was higher as compared with the women with KSC, the majority of whom were white and over 65 years of age. On crude comparison, women with BC appeared to have a survival advantage compared with women with KSC; however, through multivariate modelling, when all possible confounding variables were taken into account, there was little residual impression of a survival advantage of women with BC compared with those having KSC. Substantial differences were found among the three types of carcinoma with regard to the prevalence of adjacent intraepithelial lesions. Squamous hyperplasia was found adjacent to KSC in 54 (83%) of the 65 cases, whereas 27 (77%) of 35 cases of BC and WC had adjacent basaloid or warty VIN. These findings suggest that VIN is a precursor of BC and WC. In view of the high frequency of HPV-DNA detected in VIN and in BC and WC, the findings support the view that HPV has a role in the development of these tumors. In addition, a difference was found in the distribution of associated cervical and vaginal tumors with the three types of vulvar carcinomas.(ABSTRACT TRUNCATED AT 400 WORDS)

Medical Surveillance Monthly Report (MSMR). Volume 10, Number 2, April 2004

DTIC Science & Technology

2004-04-01

2,944 13.1 Noninflammatory disorders of cervix 21,651 14.2 Cancer of female breast 2,914 12.9 Inflammatory disease of cervix, vagina and vulva 19,624...malignant neoplasms 4,225 (82) 1,159 (91) 1,631 (40) Oral conditions Dental caries 1,259 (106) 985 (95) 23 (112) Periodontal disease 881 (109) 755 (99...respiratory disease surveillance, US Army..............................................33 Update: Pre- and post-deployment health assessments, US Armed Forces

[Saforelle - a new approach to treat vaginitis].

PubMed

Karamisheva, V; Nachev, A

2015-01-01

Infections of the vulva and vagina are one of the most common gynecological diseases. They can be determined by a variety of physical, chemical and biological factors. The main risk factors contributing to vaginitis are aerobic and anaerobic bacterias, fungal and viral infections, and irritants. Subjective complaints are pruritus, vulvar and/or perivulvar erytema and different in volume and characterization discharge. Excepting etiological treatment in most cases it is necessary to use additional agents, for example Saforelle.

Vulvar lymphangioma circumscriptum: a rare complication of therapy for squamous cell carcinoma of the cervix

DOE Office of Scientific and Technical Information (OSTI.GOV)

LaPolla, J.; Foucar, E.; Leshin, B.

1985-11-01

The clinical and pathological features of a case of multifocal lymphangioma circumscriptum of the vulva are reported in a patient with chronic lymphedema of a lower extremity. Ten years previously the patient had been treated for squamous cell carcinoma of the cervix. Although lymphangioma circumscriptum is an extremely rare complication of altered lymphatic drainage, the presence of multiple noninflammatory vesicular appearing lesions in this setting should suggest the correct diagnosis.

Aggressive angiomyxoma of the vulva: case report

PubMed Central

Ribeiro, José Carlos Castelo Branco; Vieira, Sabas Carlos; da Silva, Benedito Borges; dos Santos, Lina Gomes; Costa, Pedro Vítor Lopes; da Fonsêca, Lia Andréa Costa

2015-01-01

Female patient, 42-years-old, complaining of difficulty in urinating and swelling in the vulvar area for one year. Her gynecological examination showed extensive injury in the vulvar region and the biopsy done was inconclusive. The removal of the lesion was conducted. After the procedure, the patient remains free of recurrence for 15 months. This case highlights the need to consider angiomyxoma in the differential diagnosis for tumors of unknown cause in the vulvar region. PMID:26061077

Definitive radiotherapy for locally advanced squamous cell carcinoma of the vulva and technical issues: a case report

NASA Astrophysics Data System (ADS)

Kumar, Gokula; Norhafizah, I.; Shazril, I.; Nursyatina, AR; Aziz, MZ Abdul; Zin, Hafiz M.; Zakir, MK; Norjayadi; Norliza, AS; Ismail, A.; Khairun, N.

2017-05-01

This case report describes a complex radical 3D-Conformal Radiotherapy treatment planning, dosimetric issues and outcome of definitive treatment of un-resectable carcinoma of the vulvar in a 42-year old lady. The patient presented with large fungating mass of the vulva which was biopsy confirmed as Keratinizing Squamous Cell Carcinoma. Further staging investigation revealed locally advanced disease (T4), with bilateral inguinal lymph nodes involvement. There is no systemic metastasis or intra-pelvic nodes. The patient was seen by Gynae-Oncology team and the disease was deemed un-resectable without significant morbidity. She was treated to a total dose of 64.8Gy in 36 fractions over 7 weeks with concurrent weekly Cisplatinum in 2 phases. 3D-Conformal radiotherapy technique using the modified segmental boost technique (MSBT, large PA and small AP photon fields with inguinal electron matching) was used. TLD chips were used for in-vivo dose verification in phase 1 and 2 of the treatment. At completion of planned radiotherapy, patient had a complete clinical response, grade 2-3 skin toxicity, grade 2 rectal toxicity, and grade 2 dysuria Vulval Squamous Cell Carcinomas are very radiosensitive tumours and the skills of the treating Radiation Oncologist, Dosimetrists, Physicist, Radiation Therapist and also nurses is of foremost importance is ensuring good clinical outcomes.

Aloneness: the lived experience of women with cancer of the vulva.

PubMed

Jefferies, H; Clifford, C

2011-11-01

Cancer of the vulva is a rare condition that has been subject to limited research with a paucity of studies into the impact of this disease. Although the physical effects may readily be described, little is known about the psychological, emotional and social impact of this condition. To increase insights, a qualitative research study was undertaken to explore the experiences of women with vulval cancer living in the UK. An interpretive phenomenological approach based on the work of Heidegger and Van Manen was used to frame the study in which 13 women under 50 years of age were interviewed between 6 months and 5 years after their surgery. Data were analysed using framework analysis described by Ritchie and Spencer. This article describes the concept of aloneness which emerged from the data. This includes consideration of the women's sense of isolation due to the geographical distance between the woman's home and the hospital, and a sense of separation as they described their loss of sexual function and ability to enjoy the sexual relationship they had previously, following the onset of their symptoms of vulval cancer and subsequent treatment. The women's sense of aloneness was also manifest in their perception that there was a lack of knowledge and understanding about this condition both in their social world and the healthcare system in which they received treatment. © 2011 Blackwell Publishing Ltd.

Topical Benzocaine and Methemoglobinemia.

PubMed

Hieger, Michelle A; Afeld, Jamiee L; Cumpston, Kirk L; Wills, Brandon K

Methemoglobinemia can cause life-threatening hypoxia associated with cyanosis and dyspnea not responsive to oxygen. We present a case of recurrent methemoglobinemia because of occult use of topical benzocaine to the vulva. A 47-year-old female with medical history of vulvar cancer and HIV undergoing chemoradiation was sent by the oncology clinic to the emergency department for worsening dyspnea, fatigue, hypoxia to 78% on room air, and gradual onset of cyanosis over the past week. A methemoglobin (MetHb) level was 49%. She received methylene blue, and repeat MetHb levels initially decreased but later increased to 56% despite continued treatment. Additional interviews with the patient revealed she was applying vagicaine (20% benzocaine), an over the counter preparation to the vulvar area for analgesia, and she continued application while hospitalized. She received a total of 6 mg/kg methylene blue and underwent vaginal lavage with 60 mL of sterile saline and cleansed with soapy water. Cyanosis, hypoxia, and dyspnea resolved, and the MetHb level decreased to 5.4% on the day of discharge. Benzocaine is a frequent cause of iatrogenic methemoglobinemia. In this case, additional medication inquiries were helpful in making the diagnosis. Many patients do not consider over-the-counter medications to be potentially harmful. Methemoglobinemia from occult topical benzocaine administration to the vulva is an uncommon exposure route. Occult medication use can be a source of methemoglobinemia.

[Treatment of cancer of the vulva].

PubMed

Body, G; Lansac, J

1983-01-01

The authors suggest a therapeutic scheme for carcinomata (intra-epithelial, micro-invasive and invasive) of the vulva after reviewing the literature and in the light of their own experience. It seems to them that treatment of these cancers can be carried out in the following way: Intra-epithelial cancers: partial vulvectomy for localised lesions or when treatment should be as conservative as possible. Total vulvectomy, or better still, superficial vulvectomy in other cases. Micro-invasive carcinomata: where the invasion is less than 2 mm: only total vulvectomy. Where the invasion is more than 2 mm: total vulvectomy with bilateral superficial lymphadenectomy. This is carried out as a complete lymphadenectomy when the lymph glands are found to be affected in the operating theatre. Invasive carcinomata: we exclude metastatic cancers where the local treatment is only carried out to give some palliation to the patient and sometimes can be combined with chemotherapy when that is possible. Patients that are operable: total vulvectomy with of course bilateral lymphadenectomy. This can be extended to iliac chains when Cloquet's gland is invaded. Radiotherapy after operation is to be discussed seeing that there are important sequelae from this. Lymph gland involvement can be unilateral in cases of N- stage I unilateral patients. Pelvic exenteration is only to be considered for young women who are in good general health and who have no pelvic metastases.

Polarized hyperspectral imaging system for in vivo detection of vulvar lichen sclerosis

NASA Astrophysics Data System (ADS)

Qu, Yingjie; Ren, Wenqi; Liu, Songde; Liu, Peng; Xie, Lan; Zhang, Xiaoyuan; Zhang, Shiwu; Chang, Shufang; Xu, Ronald

2016-03-01

Vulvar lichen sclerosis (VLS) is a chronic, inflammatory and mucocutaneous disease of extragenital skin, which often goes undetected for years. The underlying causes are associated with the decrease of VEGF that reduces the blood oxygenation of vulva and the structural changes in the collagen fibrils, which can lead to scarring of the affected area. However, few methods are available for quantitative detection of VLS. Clinician's examinations are subjective and may lead to misdiagnosis. Spectroscopy is a potentially effective method for noninvasive detection of VLS. In this paper, we developed a polarized, hyperspectral imaging system for quantitative assessment. The system utilized a hyperspectral camera to collect the reflectance images of the entire vulva under Xenon lamp illumination with and without a polarizer in front of the fiber. One image (Ipar) acquired with the AOTF parallel to the polarization of illumination and the other image (Iper) acquired with the AOTF perpendicular to the illumination. This paper compares polarized images of VLS in a pilot clinical study. The collected reflectance data under Xenon lamp illumination without a polarizer are calibrated and the hyperspectral signals are extracted. An IRB approved clinical trial was carried out to evaluate the clinical utility for VLS detection. Our pilot study has demonstrated the technical potential of using this polarized hyperspectral imaging system for in vivo detection of vulvar lichen sclerosis.

Early invasive vulvar squamous cell carcinoma arising in a woman with vulvar pemphigus vulgaris and systemic lupus erythematosus.

PubMed

Bifulco, Giuseppe; Mandato, Vincenzo D; Piccoli, Roberto; Giampaolino, Pierluigi; Mignogna, Chiara; Mignogna, Michele D; Costagliola, Luigi; Nappi, Carmine

2010-06-23

Pemphigus vulgaris (PV) is an autoimmune blistering disease of the skin and mucous membranes. Genital involvement occurs when most other common sites are concurrently affected or are in remission. Systemic lupus erythematosus (SLE) is an autoimmune disease that may affect many parts of the body and the skin with occasional bullous lesions. Pemphigus vulgaris and SLE may be associated, albeit rarely. Here, we report the first case of a woman affected with SLE presenting with early invasive squamous cell carcinoma (SCC) arising from Pemphigus Vulgaris of the vulva. A 27-year-old Caucasian woman was admitted to our Gynaecology Unit for bleeding vegetant lesions of the vulva. Her history was characterized by systemic lupus erythematosus and PV. Biopsy showed concomitant PV and vulvar intraepithelial neoplasia (VIN) grade 3. One month later a new biopsy revealed progression from VIN 3 to early SCC. Despite chemotherapy, no remission of disease was observed. She died six months after diagnosis Our case underlines PV as another chronic inflammatory disease of the lower genital tract predisposing to VIN-SCC. It suggests the need for careful follow-up of patients with chronic inflammatory disease, especially when concomitant autoimmune disorders are present. Moreover, a biopsy should be always performed if there are PV lesions because of the possibility of neoplastic disease.

Early invasive vulvar squamous cell carcinoma arising in a woman with vulvar pemphigus vulgaris and systemic lupus erythematosus

PubMed Central

2010-01-01

Background Pemphigus vulgaris (PV) is an autoimmune blistering disease of the skin and mucous membranes. Genital involvement occurs when most other common sites are concurrently affected or are in remission. Systemic lupus erythematosus (SLE) is an autoimmune disease that may affect many parts of the body and the skin with occasional bullous lesions. Pemphigus vulgaris and SLE may be associated, albeit rarely. Here, we report the first case of a woman affected with SLE presenting with early invasive squamous cell carcinoma (SCC) arising from Pemphigus Vulgaris of the vulva. Case presentation A 27-year-old Caucasian woman was admitted to our Gynaecology Unit for bleeding vegetant lesions of the vulva. Her history was characterized by systemic lupus erythematosus and PV. Biopsy showed concomitant PV and vulvar intraepithelial neoplasia (VIN) grade 3. One month later a new biopsy revealed progression from VIN 3 to early SCC. Despite chemotherapy, no remission of disease was observed. She died six months after diagnosis Conclusion Our case underlines PV as another chronic inflammatory disease of the lower genital tract predisposing to VIN-SCC. It suggests the need for careful follow-up of patients with chronic inflammatory disease, especially when concomitant autoimmune disorders are present. Moreover, a biopsy should be always performed if there are PV lesions because of the possibility of neoplastic disease. PMID:20573220

Changes in Men's Salivary Testosterone and Cortisol Levels, and in Sexual Desire after Smelling Female Axillary and Vulvar Scents.

PubMed

Cerda-Molina, Ana Lilia; Hernández-López, Leonor; de la O, Claudio E; Chavira-Ramírez, Roberto; Mondragón-Ceballos, Ricardo

2013-01-01

Several studies have shown that a woman's vaginal or axillary odors convey information on her attractivity. Yet, whether such scents induce psychoneuroendocrinological changes in perceivers is still controversial. We studied if smelling axillary and vulvar odors collected in the periovulatory and late luteal phases of young women modify salivary testosterone and cortisol levels, as well as sexual desire in men. Forty-five women and 115 men, all of them college students and unacquainted with each other, participated in the study. Female odors were collected on pads affixed to the axilla and on panty protectors both worn the entire night before experiments. Men provided five saliva samples, a basal one before the smelling procedure, and four more 15, 30, 60, and 75 min after exposure to odors. Immediately after smelling the odor source, men answered a questionnaire rating hedonic qualities of scents, and after providing the last saliva sample they answered questionnaire on sexual desire. We found that periovulatory axillary and vulvar odors increased testosterone and cortisol levels, with vulvar scents producing a more prolonged effect. Luteal axilla odors decreased testosterone and cortisol levels, while luteal vulva odors increased cortisol. Periovulatory axilla and vulva scents accounted for a general increase of interest in sex. These odors were also rated as more pleasant and familiar, while luteal vulvar odors were perceived as intense and unpleasant.

Changes in Men’s Salivary Testosterone and Cortisol Levels, and in Sexual Desire after Smelling Female Axillary and Vulvar Scents

PubMed Central

Cerda-Molina, Ana Lilia; Hernández-López, Leonor; de la O, Claudio E.; Chavira-Ramírez, Roberto; Mondragón-Ceballos, Ricardo

2013-01-01

Several studies have shown that a woman’s vaginal or axillary odors convey information on her attractivity. Yet, whether such scents induce psychoneuroendocrinological changes in perceivers is still controversial. We studied if smelling axillary and vulvar odors collected in the periovulatory and late luteal phases of young women modify salivary testosterone and cortisol levels, as well as sexual desire in men. Forty-five women and 115 men, all of them college students and unacquainted with each other, participated in the study. Female odors were collected on pads affixed to the axilla and on panty protectors both worn the entire night before experiments. Men provided five saliva samples, a basal one before the smelling procedure, and four more 15, 30, 60, and 75 min after exposure to odors. Immediately after smelling the odor source, men answered a questionnaire rating hedonic qualities of scents, and after providing the last saliva sample they answered questionnaire on sexual desire. We found that periovulatory axillary and vulvar odors increased testosterone and cortisol levels, with vulvar scents producing a more prolonged effect. Luteal axilla odors decreased testosterone and cortisol levels, while luteal vulva odors increased cortisol. Periovulatory axilla and vulva scents accounted for a general increase of interest in sex. These odors were also rated as more pleasant and familiar, while luteal vulvar odors were perceived as intense and unpleasant. PMID:24194730

Malignant granular cell tumors: the role of electron microscopy in the definitive diagnosis of an extremely aggressive soft tissue neoplasm.

PubMed

Knowles, Kurt J; Al-Delfi, Firas; Abdulsattar, Jehan; Lacour, Robin; Black, Destin; Chaudhery, Shabnum; Turbat-Herrera, Elba A

2018-01-01

Granular cell tumors (GCTs) are rare soft tissue neoplasms which may be multicentric. The vast majority are benign, however approximately 100 malignant GCTs have been reported, with only 8 originating in the vulva. Malignant GCTs are very aggressive with very poor survival rates. As the diagnosis of malignant GCT carries an extremely poor prognosis, the utilization of EM ensures that the most accurate diagnosis possible can be rendered.

Isolation of a Breast Cancer Tumor Suppressor Gene from Chromosome 3p

DTIC Science & Technology

1997-10-01

and persistence of HPV infection and p53 mutation in cancer of the cervix uteri and the vulva. Int. J. Cancer . 63, 639-645. 17 Nancarrow, J.K., Holman...heterozygosity on the short arm of chromosome 3 in carcinoma of the uterine cervix . Cancer Res. 49, 3598-3601. 9. APPENDIX. Figure Legends: Figure 2. Map...uterine cervix . Cancer Asmssimilarities by 1Res., 49, 3598-3601.Assembled sequences were analyzed for database14. Cohen, A.J., Li, F.P., Berg, S

Update on current care guideline: Cytological changes in the cervix, vagina and vulva.

PubMed

Annually approximately 160 new cervical cancers are diagnosed in Finland. Screening has decreased both incidence and mortality by 80%. Both primary HPV-testing and Pap smear can be used in screening. In the future HPV vaccination will decrease the number of cervical cancers. Abnormal findings in Pap smears indicate management. LSIL lesions are followed up especially among young women and HSIL lesions treated. Follow-up after treatment should be reliably arranged, because increased risk of cancer remains ever after treatment.

A PILOT STUDY OF TOPICAL IMIQUIMOD THERAPY FOR THE TREATMENT OF RECURRENT EXTRAMAMMARY PAGET'S DISEASE

PubMed Central

Cowan, Renee A.; Black, Destin R.; Hoang, Lien N.; Park, Kay J.; Soslow, Robert A.; Backes, Floor J.; Gardner, Ginger J.; Abu-Rustum, Nadeen R.; Leitao, Mario M.; Eisenhauer, Eric L.; Chi, Dennis S.

2016-01-01

Objective The objective of this prospective pilot study was to assess the clinical and histologic effects of topical imiquimod therapy on recurrent extramammary Paget's disease of the vulva. Methods Patients with biopsy-proven recurrent extramammary Paget's disease presenting to the gynecology outpatient services at two participating institutions were recruited for conservative treatment with 5% imiquimod cream from 2007 to 2011. The topical cream was to be applied 3 times per week for 12 weeks. Punch biopsy and photography were performed at baseline and at the 12-week time point. Results Eight patients from two institutions were enrolled. Complete clinical and histologic response was achieved in 6 (75%) patients by the 12-week follow-up appointment. Of the two remaining patients, one had a complete clinical response but no significant histologic response; the other patient was removed from the study protocol secondary to intolerable local irritation. Two patients continue to have no evidence of disease after a median follow-up of 35 months. Five are alive with disease. No patients progressed to invasive cancer while receiving therapy. Conclusion Topical 5% imiquimod cream is a safe and feasible option for women suffering from recurrent extramammary Paget's disease of the vulva, and should be considered as a viable alternative to surgical management. Given the rare nature of this disease, additional multi-institutional prospective studies should be conducted to explore the efficacy of this treatment regime. PMID:27112632

Further Studies on Soil Nematode Fauna in North Western Iran with the Description of One New Species.

PubMed

Pedram, Majid; Pourjam, Ebrahim; Atighi, Mohammad Reza; Panahandeh, Yousef

2015-06-01

Heterodorus youbertghostai n. sp. is described and illustrated based on morphological, morphometric, and molecular data. The new species was found in two geographically distant points in northwestern Iran and is characterized by having angular lip region, separated from the rest body by a constriction, body length of 1,432.5 to 1,751.3 µm, odontostyle length of 24 to 28 µm, rod-like odontophore, 37.0 to 42.5 µm long, lacking flanges at base, double guiding ring at 14 to 16 µm distance from anterior end, pharyngeal bulb comprising 40% to 48% of pharynx, intestine usually containing green material, female reproductive system amphidelphic with less divided short uterus, specific structure of pars distalis vaginae, bluntly conical tail, dorsally convex and ventrally flat, with rounded tip and saccate bodies in ventral side. The new species comes more close to H. conicaudatus and H. irregularis by its morphology and morphometric characters. Compared to former, it has remarkable difference in vulva position and tail characters, and compared to the latter, it could be separated by shorter body, posteriorly located vulva, wider lip region, and longer tail. In phylogenetic analyses using partial sequences of 28S rDNA D2-D3, the new species formed a fully supported clade with several isolates of H. brevidentatus, prevalent in Iran. The other nordiid taxon, Enchodorus dolichurus, already reported from Iran, was also sequenced for the same genomic region and included in phylogenetic analyses.

Rhabdomyosarcoma of the lower female genital tract: an analysis of 144 cases.

PubMed

Nasioudis, Dimitrios; Alevizakos, Michail; Chapman-Davis, Eloise; Witkin, Steven S; Holcomb, Kevin

2017-08-01

The aim of the present study was to elucidate the clinico-pathological characteristics of female patients with lower genital tract rhabdomyosarcoma (RMS) stratified by age group and investigate their prognosis, using a multi-institutional database. The National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database was accessed (1973-2013) and a cohort of females diagnosed with RMS of the lower genital tract (vulva, vagina, cervix) was drawn. Five-year overall survival (OS) rate was estimated following generation of Kaplan-Meier curves and compared with the log-rank test. A total of 144 eligible cases were identified; 51.4 and 48.6% originated from the vagina/vulva and the cervix, respectively. Median patient age was 16 years and distant metastases were rare (ten cases). The majority of tumors were of embryonal histology (75.7%). Non-embryonal RMS was more prevalent in the older patient groups. Tumors originating from the cervix were more common among adolescents and premenopausal women. Rate of LN involvement was 52.9 and 20% for vulvovaginal and cervical tumors (p = 0.02). Five-year OS rate was 68.4%; factors associated with better OS were younger age, absence of distant metastasis, embryonal histology, negative LNs, and performance of surgery. For prepubertal girls and adolescents, radical surgery did not confer a survival benefit compared to local tumor excision. RMS of the lower genital tract primarily affects prepubertal girls and adolescents, who have excellent survival rates; however, outcomes for adults remain poor.

CO2 laser ablation of external genital lesions with a SwiftLase flashscanner: treatment of extramammary Paget's disease of the vulva, penile condylomata, and other lesions

NASA Astrophysics Data System (ADS)

Sacknoff, Eric J.; Schweitzer, Jay; Slatkine, Michael; Mead, Douglass S.

1995-05-01

The ability to vaporize extremely thin layers of epithelial tissue without any char and with minimal thermal necrosis is extremely advantageous in the treatment of superficial lesions of the external genitalia. We present a novel CO2 laser `SwiftLase' flashscan technology capable of providing char free ablation of 3 mm diameter lesions with only 150 micron residual thermal necrosis depth at power level as low as 10 watts. These power levels are achievable with a small transportable CO2 laser. The SwiftLaser is a miniature opto- mechanical scanner which homogeneously covers a 3 mm diameter surface with a 0.1 mm spot size focused beam within 0.1 seconds. The instantaneous beam's dwelling time is 1 millisecond. The instantaneous power density level at the focal point is higher than the threshold for char free ablation, thus providing a large char free ablation crater. Since depth of each ablated layer is 0.1 mm, the depth of treatment can be precisely controlled. The SwiftLaser technology has extensively and successfully been used in the last two years for the treatment of HPV in female lower tracts (Vulvectomy). The same technique may be performed with extramammary Paget's disease of the vulva, penile condylomata, and other epithelial disorders of the external genitalia without damage to surrounding healthy tissue. Technique and clinical results will be discussed.

Reproductive functional anatomy and oestrous cycle pattern of the female brush-tailed porcupine (Atherurus africanus, Gray 1842) from Gabon.

PubMed

Mayor, P; López-Béjar, M; Jori, F; Fenech, M; López-Gatius, F

2003-07-15

In the present study, we examined certain features of the functional anatomy of the female genital tract of the wild brush-tailed porcupine (Atherurus africanus) to obtain data on the reproductive biology of this African forest rodent. Two consecutive experiments were performed. The aim of the first was to establish macroscopic and microscopic features of the genital organs, and to explore correlations between predominant ovarian structures and vaginal contents in 20 wild, mature females. In the second experiment, we inspected the external genitalia and vaginal smears of a further 10 females in captivity on a daily basis for 90 days. The uterus of the brush-tailed porcupine is bicornuate and composed of two separated uterine horns, a uterine body and cervix. The genital tract does not present a vaginal vestibule. Thus, there is no portion common to genital and urinary tracts. Females in the follicular phase of the oestrous cycle showed increased cornification of the vaginal epithelium and a high density of eosinophilic cells in vaginal smears. The vulva and vaginal opening were open, reddish and tumefacted. In luteal phase or in pregnancy, epithelial cornification and eosinophilic features were notably reduced and the vagina presented a pale, non-tumefacted vulva and a vaginal closure membrane. Females in captivity showed spontaneous cycles, a polyoestrous reproduction pattern and, based on features of the external genitalia and vaginal smears, their oestrous cycle length was 27.1+/-6.4 days (n=12).

A Cholinergic-Regulated Circuit Coordinates the Maintenance and Bi-Stable States of a Sensory-Motor Behavior during Caenorhabditis elegans Male Copulation

PubMed Central

Liu, Yishi; LeBeouf, Brigitte; Guo, Xiaoyan; Correa, Paola A.; Gualberto, Daisy G.; Lints, Robyn; Garcia, L. Rene

2011-01-01

Penetration of a male copulatory organ into a suitable mate is a conserved and necessary behavioral step for most terrestrial matings; however, the detailed molecular and cellular mechanisms for this distinct social interaction have not been elucidated in any animal. During mating, the Caenorhabditis elegans male cloaca is maintained over the hermaphrodite's vulva as he attempts to insert his copulatory spicules. Rhythmic spicule thrusts cease when insertion is sensed. Circuit components consisting of sensory/motor neurons and sex muscles for these steps have been previously identified, but it was unclear how their outputs are integrated to generate a coordinated behavior pattern. Here, we show that cholinergic signaling between the cloacal sensory/motor neurons and the posterior sex muscles sustains genital contact between the sexes. Simultaneously, via gap junctions, signaling from these muscles is transmitted to the spicule muscles, thus coupling repeated spicule thrusts with vulval contact. To transit from rhythmic to sustained muscle contraction during penetration, the SPC sensory-motor neurons integrate the signal of spicule's position in the vulva with inputs from the hook and cloacal sensilla. The UNC-103 K+ channel maintains a high excitability threshold in the circuit, so that sustained spicule muscle contraction is not stimulated by fewer inputs. We demonstrate that coordination of sensory inputs and motor outputs used to initiate, maintain, self-monitor, and complete an innate behavior is accomplished via the coupling of a few circuit components. PMID:21423722

Observations on a cucullanid nematode of marine fishes from Taiwan Strait, Dichelyne (Cucullanellus) jialaris n. sp.

PubMed

Luo, Damin; Guo, Shulin; Fang, Wenzhen; Huang, Heqin

2004-06-01

During a helminthological examination of marine fishes from south of the Minnan-Taiwan Bank Fishing Ground, Taiwan Strait, Fujian, China, a new cucullanid nematode, Dichelyne (Cucullanellus) jialaris n. sp., was removed from the intestine of the red seabream, Pagrus major (Temminck & Schlegel, 1834). The new species differs from its congeners mainly in the following characters: body size medium but with relative long spicules of 1.01 mm (0.97-1.06) in length or 20.0% (18.21-21.8%) of the body length; proximal end of spicules somewhat expanded and distal end rounded; gubernaculum I-shaped, slightly narrow in the middle part, both ends rounded; both anterior and posterior cloaca lips round or oval, prominent and unequal in size. The anterior cloaca lip is at least 2 times larger than the posterior one. There is a conspicuous papilliform structure within the central of anterior and posterior cloacal lip. Vulva of female is not prominent, slightly postequatorial; distance from vulva to anterior end of body is 4.3 (3.0-5.5) mm or 58.0% (54.0-62.0%) of the body length. Considering the result of comparing the structure of so-called unpaired median papilla with the 10 pairs of caudal petiolated papillae in the body of the same individual. the papilliform structures are just a backstop for the cloacal lips, this new species represents the first record of a nematode of the Dichelyne, subgenus Cucullanellus in marine fishes of China Sea.

Sebaceous carcinoma of the vulva: critical approach to grading and review of the literature.

PubMed

Pusiol, T; Morichetti, D; Zorzi, M G

2011-06-01

Sebaceous glands are abundant on the vulva, but vulvar sebaceous carcinoma (SC) is an uncommon neoplasm. We report a case of SC of the vulva in a 51 year-old woman. The patient presented a 6-month history of an asymptomatic 2.5 x 1.5 cm exophytic tumour localized on the left labium majora. Tumorectomy was performed. Histologically, the lesion had an irregular lobular growth pattern composed of lobules or sheets of malignant cells separated by fibrovascular stroma. There was a mixture of sebaceous-type differentiation, small ducts and areas showing basaloid or squamous features. Centrally-located tumour cells showed moderate EMA immunoreactivity, especially enhancing cytoplasmic "bubbliness". Tumour cells were immunoreactive for CAM 5.2. The immunoreactivity for intranuclear p53 staining was > 10%. Southern blot hybridization and PCR studies did not detect HPV DNA. Hemivulvectomy was performed. After 18 months of follow-up, the patient has no evidence of recurrence, metastases or other malignant tumours. The grading of cutaneous SC proposed by Rutten et al. (World Health Organization Classification of Skin Tumours) and Patterson & Wick (Nonmelanocytic Tumours of the Skin. Armed Forces Institute of Pathology) is based on patterns of tumour growth rather than cytological features. Such grading of skin SC, including vulvar SC, should not be used since its prognostic value has not been sufficiently documented. As the number of reported vulvar SCs is very limited, their natural history is unknown and the optimal treatment has not been established. The follow-up of 7 reported cases supports the general opinion that the tumour may be aggressive. SC groin node metastases carry a devastating prognosis, and unrecognized disease in the inguinofemoral lymph nodes is nearly always fatal. The use of sentinel lymph nodes (SLN) has evolved as an effective surgical technique for identifying early subclinical regional nodal involvement for many solid tumours throughout the body for staging disease; this is because extra-ocular SCs cause widespread metastatic disease. In our opinion, SLN should be used in conjunction with wide local excision of the primary tumour to investigate regional subclinical metastases. In the presence of a positive sentinel node, early lymphadenectomy with or without radiotherapy could be used to reduce tumour-related morbidity and mortality. The histopathologic differential diagnosis of SC is wide-ranging, including virtually all other malignant clear cell tumours of the skin. The proliferative pattern, immunostaining and cytologic features permit exclusion of neoplasms that mimic SC, but a diagnosis of SC should be rendered only if the overall attributes of the lesion are appropriate for such a interpretation.

Estimation of the overall burden of cancers, precancerous lesions, and genital warts attributable to 9-valent HPV vaccine types in women and men in Europe.

PubMed

Hartwig, Susanne; St Guily, Jean Lacau; Dominiak-Felden, Géraldine; Alemany, Laia; de Sanjosé, Silvia

2017-01-01

In addition to cervical cancer, human papillomavirus (HPV) is responsible for a significant proportion of cancers and precancerous lesions of the vulva, vagina, anus, penis, head and neck, as well as genital warts. We estimated the annual number of new cases of these diseases attributable to 9-valent HPV vaccine types in women and men in Europe. The annual number of new cancers of the cervix, vulva, vagina, anus, penis, and selected head and neck sites in the population of the European Medicines Agency territory was estimated based on age-specific incidence rates extracted from Cancer Incidence in 5 Continents, Volume X and Eurostat population data for 2015. The annual number of new cancers attributable to 9-valent HPV vaccine types was estimated by applying the HPV attributable fraction from reference publications based on a large European multicenter study. For non-cervical cancers, HPV attributable fractions were based on oncogenically-active HPV infections only (i.e., detection of HPV DNA and either mRNA and/or p16 positivity). For precancerous lesions of the cervix, vulva, vagina, and anus, and for genital warts, previously published estimations were updated for the 2015 population. The annual number of new cancers attributable to 9-valent HPV vaccine types was estimated at 47,992 (95% bound: 39,785-58,511). Cervical cancer showed the highest burden (31,130 cases), followed by head and neck cancer (6,786 cases), anal cancer (6,137 cases), vulvar cancer (1,466 cases), vaginal cancer (1,360 cases), and penile cancer (1,113 cases). About 81% were estimated to occur in women and 19% in men. The annual number of new precancerous lesions (CIN2+, VIN2/3, VaIN2/3, and AIN2/3) and genital warts attributable to 9-valent HPV vaccine types was estimated at 232,103 to 442,347 and 680,344 to 844,391, respectively. The burden of cancers associated with 9-valent HPV vaccine types in Europe is substantial in both sexes. Head and neck cancers constitute a heavy burden, particularly in men. Overall, about 90% of HPV-related cancers, 80% of precancerous lesions, and 90% of genital warts are expected to be attributable to 9-valent HPV vaccine types each year, demonstrating the important preventive potential of the 9-valent HPV vaccine in Europe.

Reliability of the U.S. Army Ambulatory Care Data Base (ACDB) Study: Methodology and Clinical Findings

DTIC Science & Technology

1989-02-01

medical record as Flu Symptoms and Inflammation of Mucous Membrane of the Nose. In such cases, the Principal Investigator, in consultation with staff...Nonavailability could have been caused by a patient’s clinical appointment or relocation, personal retention of records, selection of the record for a quality...8217, TENITtlS 233𔃻 CIS VULVA 6141 H1IONIC SAIPINGITIS/OOPHORITIS 2 i-.- 1 Nip"- HYEI;AVI, k 213 SYPILIS 𔃻 4CONSYLOMAIA 6201 CORPiiS LUTEUM CYST ,*N2’. f

[Fibroadenoma in an accessory breast. A case of polythelia and fibroadenoma in the left breast region and a perivulvar accessory breast].

PubMed

Degrell, I

1979-08-02

The case of a 32-year-old female patient with multiple malformations (hare-lip, polythelia, fibroadenoma in an accessory mammary gland) and independent of these, another fibroadenoma in the breast is reported. The fibroadenoma developing in the accessory breast around the vulva, diagnosed by means of aspiration biopsy cytology, should be payed special attention. This case also confirms the applicability in preoperative diagnostics of aspiration biopsy cytology, a method which has proved to be effective for years.

Reduction of uterine prolapse in a sow by laparotomy.

PubMed

Raleigh, P J

1977-01-29

In the past, total uterine prolapse in the sow has been regarded as a grave condition because manipulative reposition through the vulva and vagina is extremely difficult, if not impossible, and amputation is merely a salvage procedure with a mortality rate approaching 100 percent. Laparotomy as a means of facilitating reduction of the prolapse in the sow appears to have been overlooked although it is a standard procedure in dogs and cats. This report describes a case of uterine prolapse in a sow successfully treated by laparotomy.

Hystrignathus dearmasi sp. n. (Oxyurida, Hystrignathidae), first record of a nematode parasitizing a Panamanian Passalidae (Insecta, Coleoptera)

PubMed Central

Morffe, Jans; García, Nayla

2010-01-01

Abstract Hystrignathus dearmasi sp. n. (Oxyurida: Hystrignathidae) is described from an unidentified passalid beetle (Coleoptera: Passalidae) from Panama. It resembles Hystrignathus cobbi Travassos & Kloss, 1957 from Brazil, by having a similar form of the cephalic end, extension of cervical spines and absence of lateral alae. It differs from the latter species by having the body shorter, the oesophagus and tail comparatively larger, the vulva situated more posterior and the eggs ridged. This species constitutes the first record of a nematode parasitizing a Panamanian passalid. PMID:21594186

Radiation-induced lichen sclerosus of the vulva : First report in the medical literature.

PubMed

Edwards, Lisa R; Privette, Emily D; Patterson, James W; Tchernev, Georgi; Chokoeva, Anastasiya Atanasova; Wollina, Uwe; Lotti, Torello; Wilson, Barbara B

2017-03-01

A 67-year-old woman presented with a firm plaque in the perineal region, 16 months after diagnosis of a high-grade basaloid squamous cell carcinoma of the vagina and treatment by external beam radiation therapy and vaginal cuff brachytherapy. The differential diagnosis included radiation-induced morphea, radiation dermatitis, or, possibly, radiation-induced lichen sclerosus. Biopsy findings, including special staining, confirmed the diagnosis of radiation-induced lichen sclerosus. To our knowledge, this is the first report of radiation-induced lichen sclerosus of the vulvar region.

Primary vulvar neoplasia: a review of in situ and invasive carcinoma, 1935-1972.

PubMed

Japaze, H; Garcia-Bunuel, R; Woodruff, J D

1977-04-01

This survey reports the past 38 years of experience with 192 cases of carcinoma of the vulva seen and treated at the Johns Hopkins Hospital. The review stresses the increased incidence of in situ neoplasia and the importance of individualization of therapy. Also the changing concepts in terminology (eg, the leukoplakic vulvitis of the past is the dystrophy of the present) suggest that the precursory alterations of previous discussions must be reviewed in the light of such an altered nomenclature. Features of epidemiologic and histologic importance are discussed.

A case of reccuring giant condyloma of vulva in infant without sexual abuse successfully treated with electrocoagulation in Benin

PubMed Central

Akpadjan, Fabrice; Adégbidi, Hugues; Attinsounon, Cossi Angelo; Koudoukpo, Christiane; Dégboé, Bérénice; Agbessi, Nadège; Atadokpèdé, Félix

2017-01-01

We report here a case of giant vulval condyloma in a two-year-old infant infected by her “baby sitter” without sexual abuse. Treated by surgical excision coupled with electrocoagulation, it was noted a rapid recurrence two weeks after treatment requiring a second electrocoagulation session. More than a year later, no lesion was noted, thus demonstrating therapeutic success. The unavailability of imiquimod in our context requires a systematic use of invasive treatment regardless of the age of the patient. PMID:28904687

A case of reccuring giant condyloma of vulva in infant without sexual abuse successfully treated with electrocoagulation in Benin.

PubMed

Akpadjan, Fabrice; Adégbidi, Hugues; Attinsounon, Cossi Angelo; Koudoukpo, Christiane; Dégboé, Bérénice; Agbessi, Nadège; Atadokpèdé, Félix

2017-01-01

We report here a case of giant vulval condyloma in a two-year-old infant infected by her "baby sitter" without sexual abuse. Treated by surgical excision coupled with electrocoagulation, it was noted a rapid recurrence two weeks after treatment requiring a second electrocoagulation session. More than a year later, no lesion was noted, thus demonstrating therapeutic success. The unavailability of imiquimod in our context requires a systematic use of invasive treatment regardless of the age of the patient.

Monitoring the body temperature of cows and calves using video recordings from an infrared thermography camera.

PubMed

Hoffmann, Gundula; Schmidt, Mariana; Ammon, Christian; Rose-Meierhöfer, Sandra; Burfeind, Onno; Heuwieser, Wolfgang; Berg, Werner

2013-06-01

The aim of this study was to assess the variability of temperatures measured by a video-based infrared camera (IRC) in comparison to rectal and vaginal temperatures. The body surface temperatures of cows and calves were measured contactless at different body regions using videos from the IRC. Altogether, 22 cows and 9 calves were examined. The differences of the measured IRC temperatures among the body regions, i.e. eye (mean: 37.0 °C), back of the ear (35.6 °C), shoulder (34.9 °C) and vulva (37.2 °C), were significant (P < 0.01), except between eye and vulva (P = 0.99). The quartile ranges of the measured IRC temperatures at the 4 above mentioned regions were between 1.2 and 1.8 K. Of the investigated body regions the eye and the back of the ear proved to be suitable as practical regions for temperature monitoring. The temperatures of these 2 regions could be gained by the use of the maximum temperatures of the head and body area. Therefore, only the maximum temperatures of both areas were used for further analysis. The data analysis showed an increase for the maximum temperature measured by IRC at head and body area with an increase of rectal temperature in cows and calves. The use of infrared thermography videos has the advantage to analyze more than 1 picture per animal in a short period of time, and shows potential as a monitoring system for body temperatures in cattle.

Cryphodera sinensis n. sp. (Nematoda: Heteroderidae), a non-cyst-forming parasitic nematode from the root of ramie Boehmeria nivea in China.

PubMed

Zhuo, K; Wang, H H; Ye, W; Peng, D L; Liao, J L

2014-12-01

Cryphodera sinensis n. sp. is described from ramie (Boehmeria nivea) based on the morphology and molecular analyses of rRNA small subunit (SSU), D2D3 expansion domains of large subunit (LSU D2D3) and internal transcribed spacer (ITS). This new species is characterized by oval females with a distinct subcrystalline layer and pronounced and protruding vulval lip, distinctly concave vulva-anus profile and a vulva-anus distance of 29.5-35.8 μm. Males possess two annuli in the lip region, a stylet 27-32.5 μm in length with round knobs sloping slightly posteriorly, lateral fields with three lines, spicules 20-28 μm long and the presence of a short cloacal tube. Second-stage juveniles possess three lip annuli, a stylet 28-31 μm in length with well-developed knobs projected anteriorly and three lines along the lateral field. The pointed tail, 52-65 μm long, possesses a mucro-like tip and a hyaline region, 24.5-35 μm long. Large phasmids with a lens-like structure are located 2-6 annuli posterior to the anus. Phylogenetic analysis shows that the species has unique SSU, LSU D2D3 and ITS rRNA sequences. Phylogenetic relationships of the three rDNA sequences of C. sinensis n. sp. and other cystoid/cyst nematodes are analysed together with a comparison of other species within the genus Cryphodera.

Occurrence of Leishmania infantum and associated histological alterations in the genital tract and mammary glands of naturally infected dogs.

PubMed

Boechat, Viviane Cardoso; Mendes Junior, Artur Augusto Velho; Madeira, Maria de Fátima; Ferreira, Luiz Claudio; Figueiredo, Fabiano Borges; Rodrigues, Francisco das Chagas de Carvalho; Oliveira, Valéria da Costa; de Oliveira, Raquel de Vasconcellos Carvalhaes; Menezes, Rodrigo Caldas

2016-06-01

The objectives of this study were to evaluate the occurrence of Leishmania infantum in the male and female genital tract and female mammary glands of dogs and the parasite burden and to identify histological alterations associated with this protozoan. Twenty male and 20 female Leishmania-seropositive dogs with isolation of L. infantum were examined. Tissue samples of the prepuce, glans, epididymis, testes, prostate, vulva, vagina, uterus, uterine tubes, and mammary glands were analyzed by immunohistochemistry and histopathology. For parasitological culture and in situ hybridization, samples were collected from the testis, epididymis, and uterus. Additionally, seminal fluid was aspirated from the epididymis for parasitological culture. In the genital tract, 34 (85 %) dogs, including 18 males and 16 females, were positive for Leishmania. Of these, 27 (79 %) animals were symptomatic. Leishmania was detected in the mammary glands of 13 (65 %) females. L. infantum was isolated for the first time from the seminal fluid and uterus of naturally infected dogs. The parasite burden and intensity of the inflammatory reaction were greater in the prepuce and glans of males and in the vulva and mammary glands of females. In addition to inflammation, testicular degeneration, atrophy, absence of spermatogenesis, and necrosis were observed. Detection of amastigote forms in the mammary gland lumen indicates possible elimination of this parasite in milk. The frequent parasitism observed in the genital tract of infected males and females and the viability of L. infantum in seminal fluid and uterus suggest the possibility of bidirectional venereal and vertical transmission.

High-risk human papillomavirus infection of the genital tract of women with a previous history or current high-grade vulvar intraepithelial neoplasia.

PubMed

Goffin, Frederic; Mayrand, Marie-Hélène; Gauthier, Philippe; Alobaid, A; Lussier, Christian; Provencher, Diane; Drouin, Pierre; Franco, Eduardo L; Coutlée, François

2006-06-01

Human papillomavirus (HPV) infection is associated with high-grade vulvar intraepithelial neoplasia (VIN-3). The prevalence of anogenital HPV infection in women with previously treated VIN-3 has not been documented yet. This cross-sectional study compared high-risk HPV DNA detection rates in women with past (n = 30) and current (n = 22) VIN-3 to those without current or past VIN (n = 86). HPV DNA was detected in vulvar and cervical samples with Hybrid Capture 2 (HC-2). Smoking was associated in multivariate analysis with current VIN-3 (odds ratio (OR) 8.3, 95% confidence interval (CI) 2.0-8.2) and any VIN-3 history (OR 6.5, 95% CI 2.5-16.5). High-risk HPV DNA was found on the vulva of 64%, 33%, and 20% of women with current VIN-3, past VIN-3, and without previous or current VIN, respectively. After controlling for age and smoking, high-risk HPV vulvar infection was associated with cervical high-risk HPV infection (OR 8.6, 95% CI 2.8-26.5; P = 0.001). After controlling for age, HPV infection was more often multifocal in women with current VIN-3 compared to women with previous but no current VIN-3 lesion (OR 17.6, 95% CI 1.4-227.2). Multifocal vulvar HPV infection was detected in women with previous or active VIN-3. Longitudinal studies are required to determine if the multifocality of HPV infection on the vulva could explain the high recurrence rate of VIN-3.

Laminin-5 gamma 2 chain as an invasivity marker for uni- and multifocal lesions in the lower anogenital tract.

PubMed

Nordström, Britta; Einhorn, N; Silfverswärd, C; Sjövall, K; Tryggvason, K; Auer, G

2002-01-01

During recent decades it has become apparent that there are two types of vulvar disease: the classic type found in elderly women with unicentric and unifocal lesions, and the type found in younger women, in which precancerous and invasive changes develop in the anogenital lower tract in a multicentric and multifocal fashion, often over a long period of observation. The laminin-5 gamma 2 chain is an extracellular protein that is a component of the basement membrane. Recently its expression has been recognized as a marker in cervical cancer that permits identification of invasive capacity. The aim of our study was to determine if laminin-5 gamma 2 chain antibody can act as a sensitivity marker of invasive capacity in precancerous and invasive carcinoma in women with uni- and multifocal changes in the anogenital tract. The result showed that all patients in the older group of women with invasive carcinoma of the vulva had moderate to high positive expression of the laminin-5 gamma 2 chain. In the group of younger patients with multifocal precancerous changes observed over long periods, most of the patients with vulva intraepithelial neoplasia (VIN) 3 showed laminin-5 gamma 2 chain positivity already in the precancerous changes, and all of them developed invasivity during the period of observation. Normal epithelium without atypia was mostly negative or of low immunoreactivity of laminin-5. In conclusion, positive laminin-5 gamma 2 chain expression seems to indicate the invasiveness potential of precancerous lesions and is also expressed in all investigated invasive carcinomas of the anogenital tract.

Human papillomavirus is associated with the frequent detection of warty and basaloid high-grade neoplasia of the vulva and cervical neoplasia among immunocompromised women.

PubMed

Petry, K U; Köchel, H; Bode, U; Schedel, I; Niesert, S; Glaubitz, M; Maschek, H; Kühnle, H

1996-01-01

A total of 158 women who either HIV-infected or under iatrogenic immunosuppression were examined regularly during a 4-year period to evaluate if certain vulvar neoplasms and cervical neoplasia have similar associated risk factors. Patients with CIN were matched prospectively with immunocompetent controls with CIN. Forty-eight cervical lesions were detected among patients, including 2 invasive carcinoma and 15 CIN-3 lesions, compared to 11 vulvar lesions, including 2 invasive carcinoma and 7 VIN-3 lesions. Women who have more than five life-time partners were more likely to have HPV-DNA positive cervical swabs and vulvar scrapes as well as cervical and/or vulvar neoplasia. Compared to 2.7% of controls 15.2% of patients with CIN had coexisting high-grade lesions of the vulva. With 1 exception all patients with vulvar neoplasia either suffered from symptomatic immunodeficiency or received immunosuppressive drugs for more than 10 years. Except for 1 VIN-3 lesions, all vulvar neoplasms were associated with HPV-DNA types 16, 31, and/or 33. Six of nine patients as well as the 2 controls with coexisting vulvar and cervical neoplasia had the same HPV-type associated with both lesions. All vulvar lesions were classified as either "warty" or "basaloid". In conclusion cervical and bowenoid/basaloid vulvar neoplasia seem to have a similar HPV-related genesis. Malfunction of the cellular immune response appears to be a cofactor in the genesis of HPV-associated neoplasia at both sites.

Final results of a phase 2 study using continuous 5% Imiquimod cream application in the primary treatment of high-grade vulva intraepithelial neoplasia.

PubMed

Le, Tien; Menard, Chantal; Hicks-Boucher, Wendy; Hopkins, Laura; Weberpals, Johanne; Fung-Kee-Fung, Michael

2007-09-01

To investigate the activity of 5% Imiquimod cream in the primary treatment of vulva intraepithelial neoplasia (VIN) grade 2/3. Patients with histologically confirmed VIN 2/3 were recruited from regional colposcopy units. A Simon two-stage phase 2 study design was used. Imiquimod cream was applied over the abnormal VIN areas by the patients, using an escalating dose regimen for a total treatment duration of 16 weeks. Colposcopy assessments were performed every 2 weeks to evaluate for response. A historical cohort of VIN 2/3 patients treated with primary surgical ablation was used to compare recurrence patterns. Thirty-nine patients enrolled in the study. Six patients dropped out due to side effects and non-compliance with study protocol. Thirty-six patients (92%) had VIN 3. Therapy was well tolerated with the most common observed side effects being only minor skin irritation at the application site. Histologic complete response was observed in 21 patients with partial response in another nine patients. The overall response rate was 77% using intention to treat principle. No VIN progression or cancer was diagnosed. At a median follow-up of 16 months in the whole study cohort, eight recurrences (20.5%) were observed. In comparison, the recurrence rate for primary surgically treated patients was 53.5% (p=0.013). Imiquimod cream was well tolerated and resulted in the regression in a majority of high-grade VIN lesions. The recurrence rate appeared to be comparable to primary surgical ablation.

Over-the-counter treatments and perineal hygiene in postmenopausal women.

PubMed

Erekson, Elisabeth A; Martin, Deanna K; Brousseau, E Christine; Yip, Sallis O; Fried, Terri R

2014-03-01

The objective of this descriptive study was to quantify the personal hygiene habits/practices of, as well as the over-the-counter (OTC) products used by, postmenopausal women. Specifically, we were interested in any product that would contact the vulva or vagina. We performed a cross-sectional study of postmenopausal women seeking routine gynecologic care. We developed a questionnaire on their personal hygiene habits/practices and the OTC products that they use that would contact the vulva or vagina. We recruited postmenopausal women seeking gynecologic care from two separate gynecology practices. Descriptive statistics were performed as appropriate to characterize the frequency of reported treatments and practices. The questionnaire on OTC treatments and perineal hygiene was completed by 114 postmenopausal women. Fifty-eight women (50.9%) reported using at least one OTC vulvovaginal treatment in the last 3 months, including barrier treatments, topical anesthetics, powders, and antifungals. Women often used more than one OTC product. Thirty-seven women (32.5%) reported the use of two or more OTC products. Powders were used by 34 women (29.8%). Talcum powder was the most commonly used powder (26 of 34; 76.5%). Nine postmenopausal women (7.9%) reported douching in the last 3 months. We found that more than half of postmenopausal women seeking gynecologic care have used an OTC product for vulvovaginal symptoms in the last 3 months and that one third of women use two or more products. Because the use of OTC products is very common, our study highlights the need for a detailed history inquiry about OTC product use and perineal hygiene practices.

Bilateral accessory breast tissue of the vulva: a case report introducing a novel labiaplasty technique.

PubMed

Wagner, I Janelle; Damitz, Lynn A; Carey, Erin; Zolnoun, Denniz

2013-05-01

We present the case of a 23-year-old female with bilateral ectopic breast tissue of the vulva, the repair of which necessitated a novel labiaplasty technique. Labiaplasty is becoming an increasingly frequent cosmetic procedure, and the popularity of brief didactic labiaplasty courses has risen in response to consumer demand. There is a paucity of detailed anatomic description of female sensory innervation patterns to the clitoris and surrounding structures. This places patients at risk for denervation of clitoral structures during labiaplasty procedures. Our novel technique proposes a method of individualized patient neurosensory mapping preoperatively, which allows for surgical planning to avoid injury to the sensory branches of the dorsal clitoral nerve. A 23-year-old female presented with bilateral vulvar masses that involved the clitoral complex, which had first become apparent during the second trimester of pregnancy, and failed to resolve in the postpartum period. We describe the preoperative planning and intraoperative approach and dissection to labiaplasty in this patient, which was complex given the size of the masses, and specifically designed to avoid injury to sensory branches of the dorsal clitoral nerve. As labiaplasty becomes more common, it is important to approach labiaplasty patients with a detailed understanding of the sensory innervation of the clitoris and surrounding structures, to avoid nerve injury and resultant sexual dysfunction. Traditional labiaplasty approaches may violate the sensory innervation patterns of the clitoral region, thus causing a sensory loss that affects patient sexual function. Our novel approach to preoperative clitoral nerve sensory mapping provides an alternative method of labiaplasty that may avoid denervation injury.

Haemangiosarcoma in the uterine remnant of a spayed female dog.

PubMed

Wenzlow, N; Tivers, M S; Selmic, L E; Scurrell, E J; Baines, S J; Smith, K C

2009-09-01

A 11-year-old, female, spayed greyhound was presented with a haemorrhagic discharge from the vulva. Clinical examination, vaginoscopy and a computed tomography scan showed an irregular egg-sized mass in the region of the cervix and uterine stump. An endoscopic grab biopsy (incisional) suggested a malignant mesenchymal tumour. Following this, surgical excision of the cranial vagina, cervix and the uterine remnant was performed. The final diagnosis of haemangiosarcoma was based on histological examination of the larger excisional biopsy specimen and was confirmed by positive immunolabelling of the neoplastic endothelial cells for the von Willebrand factor.

Atopic and Contact Dermatitis of the Vulva.

PubMed

Pichardo-Geisinger, Rita

2017-09-01

Pruritus, or itch, is a common vulvar complaint that is often treated empirically as a yeast infection; however, yeast infections are just one of the many conditions that can cause vulvar itch. Ignoring other conditions can prolong pruritus unnecessarily. Atopic dermatitis, irritant contact dermatitis, and allergic contact dermatitis are extremely common noninfectious causes of vulvar itch that are often underdiagnosed by nondermatologists. Identifying these conditions and treating them appropriately can significantly improve a patient's quality of life and appropriately decrease health care expenditures by preventing unnecessary additional referrals or follow-up visits and decreasing pharmaceutical costs. Copyright © 2017 Elsevier Inc. All rights reserved.

Reconstruction of Peripelvic Oncologic Defects.

PubMed

Weichman, Katie E; Matros, Evan; Disa, Joseph J

2017-10-01

After studying this article, the participant should be able to: 1. Understand the anatomy of the peripelvic area. 2. Understand the advantages and disadvantages of performing peripelvic reconstruction in patients undergoing oncologic resection. 3. Select the appropriate local, pedicled, or free-flap reconstruction based on the location of the defect and donor-site characteristics. Peripelvic reconstruction most commonly occurs in the setting of oncologic ablative surgery. The peripelvic area contains several distinct reconstructive regions, including vagina, vulva, penis, and scrotum. Each area provides unique reconstructive considerations. In addition, prior or future radiation therapy or chemotherapy along with cancer cachexia can increase the complexity of reconstruction.

Erosive Lichen Planus.

PubMed

Mauskar, Melissa

2017-09-01

Lichen planus is an inflammatory mucocutaneous condition with a myriad of clinical manifestations. There are 3 forms of lichen planus that effect the vulva: papulosquamous, hypertrophic, and erosive. Erosive lichen planus can progress to vulvar scaring, vaginal stenosis, and squamous cell carcinoma; these long-term sequelae cause sexual distress, depression, and decreased quality of life for patients. Diagnosis is often delayed because of patient embarrassment or clinician misdiagnosis. Early recognition and treatment is essential to decreasing the morbidity of this condition. Multimodal treatment, along with a multidisciplinary approach, will improve outcomes and further clinical advances in studying this condition. Copyright © 2017 Elsevier Inc. All rights reserved.

Response of the genital tract to gonadotropin stimulation of the afollicular (x-irradiated) ovary in the beagle

DOE Office of Scientific and Technical Information (OSTI.GOV)

Andersen, A.C.; Momeni, M.H.; Stebbins, E.

1975-06-01

The morphologic response of the genital system in 16 beagles with afollicular (x-irradiated) ovaries has been examined following follicle and luteinizing hormone treatment. The dogs received a single brief exposure of 5 R daily or 10 R on alternate days from birth to 60 days of age (total 300 R). When the dogs were 7 months or older, the hormone treatment caused enlargement of the afollicular ovary and specific changes resembling proestrus in the oviduct and uterus; the vagina and vulva did not respond to the treatment. (auth)

Chylous ascites: a sequel of pelvic radiation therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sipes, S.L.; Newton, M.; Lurain, J.R.

1985-12-01

Chylous ascites is an unusual condition with many causes. Two cases are presented in which it appeared to be related to whole pelvis irradiation in one patient for carcinoma of the vagina and in another for carcinoma of the vulva. The diagnosis is made by paracentesis and analysis of the fluid. The underlying disease usually requires identification by exploratory laparotomy. Although a malignant process is the most common cause, the only findings in the authors' cases were widespread radiation changes in the intestine. After diagnosis treatment by low-fat diet with medium-chain triglyceride supplements resulted in disappearance of chylous ascites.

Role of paclitaxel and cisplatin as the neoadjuvant treatment for locally advanced squamous cell carcinoma of the vulva.

PubMed

Raspagliesi, Francesco; Zanaboni, Flavia; Martinelli, Fabio; Scasso, Santiago; Laufer, Joel; Ditto, Antonino

2014-01-01

The therapeutic outcomes of patients with advanced vulvar cancer are poor. Multi-modality treatments including concurrent chemoradiation or different regimens of neoadjuvant chemotherapy (NACT), and surgery have been explored to reduce the extent of surgery and morbidity. The present single-institution trial aimed to evaluate the efficacy and toxicity of paclitaxel and cisplatin in locally advanced vulvar cancer. From 2002 to 2009, 10 patients with stage III-IV locally advanced squamous cell carcinoma of the vulva were prospectively treated with 3 courses of paclitaxel-ifosfamide-cisplatin or paclitaxel-cisplatin. Nine of them subsequently underwent radical local excision or radical partial vulvectomy and bilateral inguino-femoral lymphadenectomy. The clinical response rate of all enrolled patients was 80%, whereas the pathological responses included 1 case with complete remission, 2 with persistent carcinoma in situ, and 6 invasive cancer cases with tumor shrinkage of more than 50%. Four patients had positive nodes. Forty percent of patients experienced grade 3-4 bone marrow toxicity, which was successfully managed with granulocyte-colony stimulating factor, even in cases of elderly patients. Median progression-free survival after surgery was 14 months (range, 5 to 44 months). Six of the 7 recurrent cases were local, and 3 of them were treated with salvage surgery while the other 3 received radiation with or without chemotherapy. After a median follow-up period of 40 months (range, 5 to 112 months), 55.5% of patients remained alive with no evidence of disease, including 2 long-term survivors after recurrence at 5 and 9 years. Based on the high response rate and manageable toxicity, NACT with paclitaxel and cisplatin with or without ifosfamide followed by surgery could be considered as a therapeutic option for locally advanced vulvar cancer.

Role of paclitaxel and cisplatin as the neoadjuvant treatment for locally advanced squamous cell carcinoma of the vulva

PubMed Central

Zanaboni, Flavia; Martinelli, Fabio; Scasso, Santiago; Laufer, Joel; Ditto, Antonino

2014-01-01

Objective The therapeutic outcomes of patients with advanced vulvar cancer are poor. Multi-modality treatments including concurrent chemoradiation or different regimens of neoadjuvant chemotherapy (NACT), and surgery have been explored to reduce the extent of surgery and morbidity. The present single-institution trial aimed to evaluate the efficacy and toxicity of paclitaxel and cisplatin in locally advanced vulvar cancer. Methods From 2002 to 2009, 10 patients with stage III-IV locally advanced squamous cell carcinoma of the vulva were prospectively treated with 3 courses of paclitaxel-ifosfamide-cisplatin or paclitaxel-cisplatin. Nine of them subsequently underwent radical local excision or radical partial vulvectomy and bilateral inguino-femoral lymphadenectomy. Results The clinical response rate of all enrolled patients was 80%, whereas the pathological responses included 1 case with complete remission, 2 with persistent carcinoma in situ, and 6 invasive cancer cases with tumor shrinkage of more than 50%. Four patients had positive nodes. Forty percent of patients experienced grade 3-4 bone marrow toxicity, which was successfully managed with granulocyte-colony stimulating factor, even in cases of elderly patients. Median progression-free survival after surgery was 14 months (range, 5 to 44 months). Six of the 7 recurrent cases were local, and 3 of them were treated with salvage surgery while the other 3 received radiation with or without chemotherapy. After a median follow-up period of 40 months (range, 5 to 112 months), 55.5% of patients remained alive with no evidence of disease, including 2 long-term survivors after recurrence at 5 and 9 years. Conclusion Based on the high response rate and manageable toxicity, NACT with paclitaxel and cisplatin with or without ifosfamide followed by surgery could be considered as a therapeutic option for locally advanced vulvar cancer. PMID:24459577

Disease progression and recurrence in women treated for vulvovaginal intraepithelial neoplasia

PubMed Central

Baumann, Marc; Mueller, Michael; Fink, Daniel; Heinzl, Siegfried; Imesch, Patrick; Dedes, Konstantin

2013-01-01

Objective The malignant potential of intraepithelial neoplasia of the vulva and vagina after treatment is not well defined. Our objective was to examine risk factors for recurrence and invasive disease. Methods Four hundred sixty-four women with biopsy proven high-grade intraepithelial neoplasia of the vulva and vagina were identified in the electronic databases of four colposcopy clinics. Inclusion criteria were a follow-up of more than one year, no history of invasive cancer and no invasive cancer within the first year after initial treatment. We investigated the potential factors associated with recurrence and progression using a logistic regression analysis to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results Of the 411 eligible patients, 123 patients (29.9%) recurred later than one year after initial treatment and 24 patients (5.8%) progressed to invasive disease. According to multivariate analyses, the risk factors associated with recurrence were multifocality (OR, 3.33; 95% CI, 2.02 to 5.51), immunosuppression (OR, 2.51; 95% CI, 1.09 to 5.81), excision as initial treatment (vs. laser evaporation; OR, 1.79; 95% CI, 1.11 to 2.91) and smoking (OR, 1.61; 95% CI, 1.02 to 2.55). Risk factors for progression to invasive disease were immunosuppression (OR, 4.00; 95% CI, 1.30 to 12.25), multifocality (OR, 3.05; 95% CI, 1.25 to 7.43) and smoking (OR, 2.97; 95% CI, 1.16 to 7.60), but not treatment modality. Conclusion Laser evaporation combined with extensive biopsy is at least as efficacious as initial treatment of intraepithelial neoplasia with excision. Smoking is a risk factor for both recurrence and progression to invasive disease. Hence, smoking cessation should be advised and maintaining a long follow-up period due to late relapses is necessary. PMID:23875073

The influence of antibiotic treatment of bitches in oestrus on their attractiveness to males during mating.

PubMed

Dziecioł, M; Nizański, W; Stańczyk, E; Kozdrowski, R; Najder-Kozdrowska, L; Twardoń, J

2013-01-01

The aim of this study was to evaluate the influence of the antibiotic treatment, including the mode of drugs administration, on bitches' attractiveness to the stud dogs during mating. Moreover, we tried to estimate the possibility of aversive effect of the drug vehicle on the male behavior. In experiment I, four bitches in oestrus without antibiotic treatment (group A), four bitches treated with intravaginal antibiotic (group B) and four bitches treated with intramuscular antibiotic (group C) were presented to four stud dogs. In experiment II, bitches in oestrus (n = 5) were presented to the males (n = 2) before and after the application to the females' vulva the antibiotic carrier--Miglyol 840 (Sasol, Germany). In both experiments the presence of the typical sexual behavior of the males (sniffing, licking the vulva and anal region, mating attempts) was evaluated. In experiment III the reaction of the males to the samples containing oestrual discharge from the bitches untreated and treated with antibiotics was evaluated. In the last part of study the aversion reaction to the samples containing antibiotic and the antibiotic carrier was evaluated. The results of experiments showed that females treated with the antibiotics were less attractive to males than untreated females, regardless of the method of administration. We did not observe adverse effect of the antibiotic carrier but samples from the bitches treated with antibiotics were significantly less attractive to the males. We concluded that the reason for reduced attractiveness of the bitches in oestrus after antibiotic treatment was the changes in semiochemical signal emitted by treated females as a consequence of elimination of the vaginal bacterial flora, which seems to be involved in creation of the typical, recognizable by the stud dogs, oestrual signal but also by the possible covering effect of used drugs.

Female genital schistosomiasis due to Schistosoma haematobium. Clinical and parasitological findings in women in rural Malawi.

PubMed

Kjetland, E F; Poggensee, G; Helling-Giese, G; Richter, J; Sjaastad, A; Chitsulo, L; Kumwenda, N; Gundersen, S G; Krantz, I; Feldmeier, H

1996-12-30

A total of 51 women with urinary schistosomiasis haematobium were examined in order to identify diagnostic indicators for female genital schistosomiasis (FGS). Patients were selected at random from the outpatient department of the Mangochi District Hospital, Malawi. The medical histories were recorded according to a pre-designed questionnaire and the women were subjected to a thorough gynaecological examination including colposcopy and photographic documentation of lesions. Microscopy of genital biopsies revealed that 33 of the 51 women had S. haematobium ova in cervix, vagina and/or vulva in addition to the presence of ova in urine. The most sensitive diagnostic procedure was beside microscopic examination of a wet cervix biopsy crushed between two glass slides, which revealed 25 of the 33 genital infections. There was a significant correlation between the size of genital lesions and the number of ova counted per mm2 of crushed tissue. Women with FGS had significantly more tumours in the vulva than women with schistosomiasis limited to the urinary tract. Most of the observed genital pathology could easily be identified by the naked eye, but colposcopic examination yielded valuable additional information like the demonstration of neovascularisation around cervical sandy patches. Few of the symptoms previously regarded as indicators for FGS could be linked to the presence of schistosome ova in genital tissue. Husbands of infertile women with FGS had children with other women significantly more often than husbands of women who only had urinary schistosomiasis. This, together with the finding that the majority of the divorced women had FGS, indicates that the manifestation of this disease may have implications for the marital and sexual life of the affected women.

[CONDYDAV: A multicentre observational study of patients presenting external genital warts in France].

PubMed

Chanal, J; Fouéré, S; Yassir-Oria, F; Spenatto, N; Bouscarat, F; Picot, E; Martinet, P; Vernay-Vaisse, C; Pelletier, F; Courtieu, C; Baclet, V; Bernier, C; Aymar-Moulene, D; Dupuis-Fourdan, F; Passeron, A; Bara-Passot, C; Pinault, A-L; Misery, L; Janier, M; Dupin, N

2016-11-01

Since 2007 in France, human papilloma virus (HPV) vaccination has been licensed for use as a vaccine against HPV 6, 11, 16 and 18. The impact on the epidemiology of external genital warts (EGWs) in a large population remains unclear. To determine epidemiologic and clinical features of patients presenting EGWs in France in the era of HPV vaccination. In this prospective, observational study, we analyzed clinical features and treatments between January 1st, 2012 and March 31, 2012 for patients consulting for EGWs at 15 STI clinics throughout France. A total of 372 men and 111 women were included; mean age 31.2 years. The women were younger than the men (31.7 and 28.9 years respectively P<0.05). Among the patients, 416 (85.7%) were heterosexual, 13 bisexual and 54 (11.2%) homosexual, including one female. Males reported more sexual partners in the last 12 months (more than 3 partners in 32.6% versus 11.9%, P<0.01). Among the men, 230 had involvement of the penis alone and 46 had involvement of the anus alone. Seventy-six patients had EGWs of the anus, and of these 26 were MSM. In females, 76 had an infection of the vulva alone and 22 co-infection of the vulva and anus. MSM and females were at higher risk than heterosexual males for anal involvement (P<0.0001 and P=0.004, respectively). Three women had been vaccinated: two with Gardasil ® and one with Cervarix ® . Cryotherapy was the preferred treatment. With the advent of HPV vaccination, a global strategy for the prevention and treatment of EGW should be implemented. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Assessment of clinical application of pulse oximetry probes in llamas and alpacas.

PubMed

Grubb, Tamara L; Anderson, David E

2017-08-01

The placement and accuracy of pulse oximeter probes can vary markedly among species. For our study, we aimed to assess the accuracy of pulse oximetry and to determine the most clinically useful sites for probe placement in llamas and alpacas. The objectives included an analysis of pulse oximetry probes for accurate assessment of llamas and alpacas and to determine the best placement of the probes to achieve accurate readings. For study 1, saturation of haemoglobin with oxygen was measured in 184 arterial blood gas samples (SaO 2 ) using a co-oximeter and compared to saturation of haemoglobin with oxygen simultaneously measured using a pulse oximeter (S p O 2 ). The bias and precision for the SpO 2 -S a O 2 difference was calculated and plotted on a Bland-Altman plot. For study 2, S p O 2 data was collected 624 times from a variety of sites [tongue (T), nasal septum (NS), lip (L), vulva (V), prepuce (P), ear (E), and scrotum (S)] and recorded based upon a percentage of successful readings. Results for study 1 revealed that S p O 2 was consistently 0 to -6% points different than S a O 2 . The bias and precision of the S p O 2 -S a O 2 difference was -2.6 ± 1.7%. Results for study 2 uncovered that 540 recordings were successful readings and were obtained from the tongue and nasal septum with 97% accuracy, the lip 80%, vulva 62%, prepuce 59%, ear and scrotum < 50%. We concluded that pulse oximetry probes provide reliable estimates of arterial haemoglobin oxygen saturation in llamas and alpacas and is most accurately read when placed on the nasal septum or tongue.

THE EFFECT OF RADIATION ON HEREDITY

DOE Office of Scientific and Technical Information (OSTI.GOV)

Katsumi, T.

1963-07-01

A review of radiation genetics is presented. (BBB)<>18:017509Changes in plasma aldolase activity in 11 cases of cancer of the uterus (10 cervical and one endometrial adenocarcinoma) and one case of epithelioma of the vulva were studied before, during, and after radiotherapy. Only in two cases was aldolase activity higher than normal. After radium therapy these values increased in 10 cases, with a maximum increase of 4 U/ ml from a normal level of 4 to 8 U/ml. In four cases the increase was 3 to 4 U/ ml; in six, 0.2 to 1.5 U/ml; in two, there was a decreasemore » of 0.8 and 1 U/ml. The third determination, made a week after the end of therapy, indicated a drop in activity of plasma except in two cases. In five determinations made one month after therapy, a further decrease was noted, except in the one case of epithelioma of the vulva irradiated with a smaller total dose. The average control value of 17% for the increase in aldolase activity found here is less than that found in other studies of malignant tumors, and much less than that found in other diseases. There appears to be a relation between enzymatic activity and tissue necrosis, but equation of this increase and necrosis is oversimplified because of the many exceptions. The gradual elimination of the enzyme by natural routes of excretion and the possibility of an antienzyme, which can block aldolase and thus decrease its activity value below normal, deserve exploration. It is suggested that the value of study of plasma aldolase activity lies not in its diagnostic but in its prognostic significance. (BBB)« less

Associations between HLA-A\\B\\DRB1 polymorphisms and risks of vulvar lichen sclerosus or squamous cell hyperplasia of the vulva.

PubMed

Liu, G L; Cao, F L; Zhao, M Y; Shi, J; Liu, S H

2015-12-07

In this study, we aimed to explore the associations between HLA-A\\B\\DRB1 polymorphisms and the risks of vulvar lichen sclerosus (VLS) or squamous cell hyperplasia of the vulva (SCHV) in Han Chinese women. We enrolled 76 Han Chinese women with VLS (Group A), 74 with SCHV (Group B), and 66 healthy women (control group) in this study. Polymerase chain reaction amplification with sequence specific primers (PCR-SSP) was used to determine HLA-A\\B\\DRB1 polymorphisms. Compared with the control group, HLA-A*11, -B*15, and -DRB1*12 were present at a higher frequency in groups A and B, while HLA-B*13 was present at a higher frequency in group A. Fewer women in group A carried HLA-A*31, -DRB1*01, and -DRB1*03 genotypes and fewer women in group B carried HLA-B*40 and -DRB1*03 genotypes. Significant differences were found between group B and the control group for HLA-A*11, -B*15, -B*40, and -DRB1*03, and between group A and the control group for HLA-B*15 and -DRB1*12. The HLA-A*11, HLA-B*13, HLA-B*15, and HLA-DRB1*12 genotypes were associated with a higher risk of VLS, while the HLA-A*31, HLA-DRB1*01, and HLA-DRB1*03 genotypes were associated with a lower risk of VLS. In addition, carrying HLA-A*11, HLA-B*15, HLA-B*35, and HLA-DRB1*12 genotypes, and carrying HLA-B*40 and HLA-DRB1*03 genotypes were found to be risk or protective factors for SCHV, respectively.

Different DNA damage and cell cycle checkpoint control in low- and high-risk human papillomavirus infections of the vulva.

PubMed

Santegoets, Lindy A M; van Baars, Romy; Terlou, Annelinde; Heijmans-Antonissen, Claudia; Swagemakers, Sigrid M A; van der Spek, Peter J; Ewing, Patricia C; van Beurden, Marc; van der Meijden, Willem I; Helmerhorst, Theo J M; Blok, Leen J

2012-06-15

Human papillomavirus (HPV) infections may result in benign hyperplasia, caused by low-risk HPV types, or (pre)malignant lesions caused by high-risk HPV types. The molecular basis of this difference in malignant potential is not completely understood. Here, we performed gene profiling of different HPV infected vulvar tissues (condylomata acuminata (n = 5), usual type vulvar intraepithelial neoplasia (uVIN) (n = 9)) and control samples (n = 14) using Affymetrix Human U133A plus 2 GeneChips. Data were analyzed using OmniViz®, Partek® and Ingenuity® Software. Results were validated by real-time RT-PCR and immunostaining. Although similarities were observed between gene expression profiles of low- and high-risk HPV infected tissues (e.g., absence of estrogen receptor in condylomata and uVIN), high-risk HPV infected tissues showed more proliferation and displayed more DNA damage than tissues infected with low-risk HPV. These observations were confirmed by differential regulation of cell cycle checkpoints and by increased expression of DNA damage-biomarkers p53 and γH2AX. Furthermore, FANCA, FANCD2, BRCA1 and RAD51, key players in the DNA damage response, were significantly upregulated (p < 0.05). In addition, we compared our results with publicly available gene expression profiles of various other HPV-induced cancers (vulva, cervix and head-and-neck). This showed p16(INK4a) was the most significant marker to detect a high-risk HPV infection, but no other markers could be found. In conclusion, this study provides insight into the molecular basis of low- and high-risk HPV infections and indicates two main pathways (cell cycle and DNA damage response) that are much stronger affected by high-risk HPV as compared to low-risk HPV. Copyright © 2011 UICC.

A model of the regulatory network involved in the control of the cell cycle and cell differentiation in the Caenorhabditis elegans vulva.

PubMed

Weinstein, Nathan; Ortiz-Gutiérrez, Elizabeth; Muñoz, Stalin; Rosenblueth, David A; Álvarez-Buylla, Elena R; Mendoza, Luis

2015-03-13

There are recent experimental reports on the cross-regulation between molecules involved in the control of the cell cycle and the differentiation of the vulval precursor cells (VPCs) of Caenorhabditis elegans. Such discoveries provide novel clues on how the molecular mechanisms involved in the cell cycle and cell differentiation processes are coordinated during vulval development. Dynamic computational models are helpful to understand the integrated regulatory mechanisms affecting these cellular processes. Here we propose a simplified model of the regulatory network that includes sufficient molecules involved in the control of both the cell cycle and cell differentiation in the C. elegans vulva to recover their dynamic behavior. We first infer both the topology and the update rules of the cell cycle module from an expected time series. Next, we use a symbolic algorithmic approach to find which interactions must be included in the regulatory network. Finally, we use a continuous-time version of the update rules for the cell cycle module to validate the cyclic behavior of the network, as well as to rule out the presence of potential artifacts due to the synchronous updating of the discrete model. We analyze the dynamical behavior of the model for the wild type and several mutants, finding that most of the results are consistent with published experimental results. Our model shows that the regulation of Notch signaling by the cell cycle preserves the potential of the VPCs and the three vulval fates to differentiate and de-differentiate, allowing them to remain completely responsive to the concentration of LIN-3 and lateral signal in the extracellular microenvironment.

MIB-1 Is Required for Spermatogenesis and Facilitates LIN-12 and GLP-1 Activity in Caenorhabditis elegans.

PubMed

Ratliff, Miriam; Hill-Harfe, Katherine L; Gleason, Elizabeth J; Ling, Huiping; Kroft, Tim L; L'Hernault, Steven W

2018-05-01

Covalent attachment of ubiquitin to substrate proteins changes their function or marks them for proteolysis, and the specificity of ubiquitin attachment is mediated by the numerous E3 ligases encoded by animals. Mind Bomb is an essential E3 ligase during Notch pathway signaling in insects and vertebrates. While Caenorhabditis elegans encodes a Mind Bomb homolog ( mib-1 ), it has never been recovered in the extensive Notch suppressor/enhancer screens that have identified numerous pathway components. Here, we show that C. elegans mib-1 null mutants have a spermatogenesis-defective phenotype that results in a heterogeneous mixture of arrested spermatocytes, defective spermatids, and motility-impaired spermatozoa. mib-1 mutants also have chromosome segregation defects during meiosis, molecular null mutants are intrinsically temperature-sensitive, and many mib-1 spermatids contain large amounts of tubulin. These phenotypic features are similar to the endogenous RNA intereference (RNAi) mutants, but mib-1 mutants do not affect RNAi. MIB-1 protein is expressed throughout the germ line with peak expression in spermatocytes followed by segregation into the residual body during spermatid formation. C. elegans mib-1 expression, while upregulated during spermatogenesis, also occurs somatically, including in vulva precursor cells. Here, we show that mib-1 mutants suppress both lin-12 and glp-1 ( C. elegans Notch) gain-of-function mutants, restoring anchor cell formation and a functional vulva to the former and partly restoring oocyte production to the latter. However, suppressed hermaphrodites are only observed when grown at 25°, and they are self-sterile. This probably explains why mib-1 was not previously recovered as a Notch pathway component in suppressor/enhancer selection experiments. Copyright © 2018 by the Genetics Society of America.

Cellular Angiofibroma of Oral Mucosa: Report of Two Cases

PubMed Central

2009-01-01

Cellular angiofibroma is a benign vascular neoplasm that typically arises in the vulva, perineal, and paratesticular region. Microscopically the lesions exhibit multiple small, non-dilated capillary channels, many of which contain erythrocytes. The endothelial lining cells are prominent, with monomorphic oval nuclei. Interposed among the vessels are both delicate and mature collagen fibers with fibroblastic hypercellularity that is variable in older lesions where sclerosis is prominent. The lesions usually do not recur following simple excision. Recent evidence indicates that cellular angiofibromas may be cytogenetically related to spindle cell lipoma. This represents the first reported instances of cellular angiofibroma in the oral cavity. PMID:19644547

Rhizonema sequoiae n.gen. n.sp. from Coast Redwood Sequoia sempervirens (D.Don) Endl.

PubMed Central

Del Prado Vera, I. Cid; Lownsbery, B. F.; Maggenti, A. R.

1983-01-01

Rhizonema sequoiae n.gen, u. sp. is described from the roots of Coast Redwood, Sequoia sempervirens (D. Don) Endl., growing near Lake Lagunitas, Marin County, California. Rhizonema females are annulated over their entire bodies, are wholly embedded in host tissue, and secrete an abundant amount of gel material. Mature females do not form a cyst. The vulva is located on a large posterior terminal cone, and the anus is on the dorsal vulval lip. Esophageal glands of the second-stage larvae fill more than half of the body cavity. Tails of the vermiform males are blunt, and a cloacal tubus is present. PMID:19295834

Methyl - aminolevulinic acid photodynamic therapy and topical tretinoin in a patient with vulvar extramammary Paget's disease.

PubMed

Magnano, Michela; Loi, Camilla; Bardazzi, Federico; Burtica, Elena Cleopatra; Patrizi, Annalisa

2013-01-01

Extramammary Paget's disease is a rare neoplasm of apocrine gland-bearing areas of the skin. The most common site of presentation is the vulva. Surgery is the most frequently reported therapy so far; however, it is invasive and it is complicated by a high rate of recurrence. For this reason, several less-invasive treatments have been recently proposed, including photodynamic therapy. We describe in this article the case of an 84-year-old patient with a noninvasive vulvar extramammary Paget's disease successfully treated with methyl-aminolevulinic acid photodynamic therapy associated with topical tretinoin. © 2013 Wiley Periodicals, Inc.

Use of the rhomboid flap after partial vulvectomy.

PubMed

Barnhill, D R; Hoskins, W J; Metz, P

1983-10-01

Primary closure of vulvar excisions is usually satisfactory in the anterior vulva, where the skin is mobile. In the posterior and posterolateral areas, however, closure often must be accomplished under tension with resulting wound breakdown and scar formation that can be disfiguring and cause dyspareunia. The rhomboid skin flap was described as early as 1946. Initially described for closure of facial defects, the technique has found application in the closure of a variety of traumatic and surgical defects. The authors present eight patients who underwent closure of vulvar defects using single or multiple rhomboid flaps. The applicability of the procedure to vulvar surgery is discussed and the technique is described.

Squamous cell carcinoma arising in Hailey-Hailey disease of the vulva.

PubMed

Cockayne, S E; Rassl, D M; Thomas, S E

2000-03-01

A 61-year-old woman, who was known to have Hailey-Hailey disease, presented with increasing vulval soreness. Biopsy showed vulval intraepithelial neoplasia (VIN) 3 and subsequent histology from a vulvectomy specimen showed extensive VIN with early invasive squamous cell carcinoma. This may be another example of chronic inflammation of the vulval area leading to the development of squamous cell carcinoma. However, in this case, chronic human papillomavirus may also have played a part, leading to VIN and reactivation of the Hailey-Hailey disease. We can find no previous reports of squamous cell carcinoma developing in the setting of Hailey-Hailey disease.

Lactational ectopic breast tissue of the vulva: case report and brief historical review.

PubMed

Pieh-Holder, Kelly L

2013-04-01

Ectopic breast tissue is defined as glands of breast tissue located outside of the normal anatomic breasts. Historically, ectopic breast tissue has been thought to arise from a remnant of the embryonic mammary ridge along the "milk line" or the midaxillary line from the axilla to the groin, including the vulvar region. Extramammary tissue displays the same pathologic and physiologic changes as normal breast tissue and is often discovered in multiparous women as the result of swelling from lactational activity. We present a case report of a gravid patient with lactating vulvar mass and a brief historical perspective of vulvar ectopic breast tissue.

Whole pelvis megavoltage irradiation with single doses of 1000 rad to palliate advanced gynecologic cancers. [Incidence and severity of acute complications

DOE Office of Scientific and Technical Information (OSTI.GOV)

Boulware, R.J.; Caderao, J.B.; Delclos, L.

1979-03-01

This study reviews the experiences at M.D. Anderson Hospital of treating advanced gynecologic malignacies for palliation with single doses of 1000 rad per fraction. When feasible, this treatment was repeated twice (for a total of 3 treatments between intervals of 3 to 4 weeks. The patients who received 3 treatments had the best palliation; 2 treatments were more effective than 1. The palliative response was good in cervix, vagina, and vulva, poor in endometrial and ovarian carcinoma. The follow-up was short in some cases, but the acute complications appear minimal.

Challenging Ulcerative Vulvar Conditions: Hidradenitis Suppurativa, Crohn Disease, and Aphthous Ulcers.

PubMed

Stewart, Kristen M A

2017-09-01

This article discusses the clinical evaluation and approach to patients with 3 complex ulcerative vulvar conditions: hidradenitis suppurativa, metastatic Crohn disease of the vulva, and aphthous ulcers. These conditions are particularly challenging to medical providers because, although each is known to present with nonspecific examination findings that vary in morphology, the predominance of the diagnosis is based on clinical examination and exclusion of a wide variety of other conditions. Care of patients with these conditions is further complicated by the lack of therapeutic data and the significant impact these conditions have on quality of life. Copyright © 2017 Elsevier Inc. All rights reserved.

Anovulvar cleft and vaginal prolapse-hyperplasia in a bitch.

PubMed

Mostachio, G Q; Vicente, W R R; Cardilli, D J; Pires, E A; Toniollo, G H

2007-12-01

This report presents the case of a nine-month-old bitch with incomplete occlusion of the skin and mucosa between the anus and dorsal commissure of the vulva. This anomaly, known as anovulvar cleft, was associated with a vaginal prolapse-hyperplasia. Anovulvar cleft is a rare condition in bitches and is caused by incomplete closure of the dorsal urogenital folds. Anovulvar cleft can lead to clitoritis, abrasion, dryness and devitalisation of the smooth exposed mucosa. Surgery can correct the condition. In the present study, surgical resection of the hyperplasic vaginal tissue associated with perineoplasty using an inverted V-shaped incision showed excellent results. An ovariohysterectomy was also performed to prevent recurrence of the vaginal prolapse-hyperplasia.

Factor analysis and cluster analysis research on the relationship between the trace elements of flowers of Gentianaceae plants and the traditional Chinese medicine efficacy from Qinghai-Tibet Plateau

NASA Astrophysics Data System (ADS)

Zhou, Libing

2017-06-01

Flowers of Gentianaceae plants have historically been used in treating gastritis, dysuria, pruritus vulvae and detoxification. Gentianaceae plants have medicinal applications to treat a wide range of diseases such as rheumatic arthritis, pneumonia along with cough, chronic gastritis, et al Therefore, the research on the relationship between human health and trace elements of flowers of Gentianaceae plants is of great significance. These studies provide the scientific base and theoretical foundation for the future large-scale rational relation development of Gentianaceae plants resources as well as the relationship between the race elements of them and traditional Chinese medicine efficacy.

Sodium Tetradecyl Sulphate Direct Intralesional Sclerotherapy of Venous Malformations of the Vulva and Vagina: Report of Five Cases

DOE Office of Scientific and Technical Information (OSTI.GOV)

Krokidis, Miltiadis, E-mail: mkrokidis@hotmail.com; Venetucci, Pietro; Hatzidakis, Adam

2011-02-15

We report five cases of female patients affected by symptomatic focal external genital venous malformations treated with percutaneous direct intralesional injection of sodium tetradecyl sulphate (STS). All patients were referred because of discomfort and pain when sexual intercourse was attempted. Direct sclerotherapy with 3% STS was performed on a day-hospital basis with the patient under local anesthesia. Complete resolution of the symptoms was achieved in all cases. No major adverse effects were reported. Direct intralesional sclerotherapy with STS may be considered a safe and effective method for the treatment of female external genital malformation without the necessity of general anesthesiamore » for pain control.« less

A new species of Spauligodon (Nematoda; Oxyuroidea; Pharyngodonidae) and other Nematodes in Cyrtodactylus epiroticus (Squamata; Gekkonidae) from Papua New Guinea.

PubMed

Bursey, Charles R; Goldberg, Stephen R; Kraus, Fred

2017-12-20

Spauligodon papuensis sp. nov. from the large intestines of Cyrtodactylus epiroticus (Gekkonidae) from Papua New Guinea is described and illustrated. Spauligodon papuensis sp. nov. represents the 54th species assigned to the genus and the second species from the Oceanic Region. The new species is separated from congeners by the unique combination of aspinose filamentous tail and no spicule in the male; and spinose filamentous tail, fusiform, flanged eggs, and postbulbar vulva in the female. Four additional species of nematodes were also found in C. epiroticus: mature specimens of Cosmocerca zugi, Falcaustra papuensis, Physalopteroides milnensis and larvae of Abbreviata sp.

Urine cup for collection of urine from cows.

PubMed

Fellner, V; Weiss, M F; Belo, A T; Belyea, R L; Martz, F A; Orma, A H

1988-08-01

A urine cup for continuous and complete collection of urine from cows was constructed from Plastisol, cotton webb strapping, Velcro Brand touch fasteners [corrected], snap-fasteners, denim patches, weather stripping, and vacuum hose. The urine cup was made from Plastisol using a heated lead mold. It was large enough to enclose a 9 cm x 6 cm area around the vulva of a cow and was attached by strapping and Velcro Brand touch fasteners [corrected] to patches glued to the rump. Urine cups were used repeatedly and provided for long-term collection of urine from cows, eliminating the need for indwelling catheters. Applications include long-term nutrient balance, radioisotope, and metabolism studies.

Further description of Cruzia tentaculata (Rudolphi, 1819) Travassos, 1917 (Nematoda: Cruzidae) by light and scanning electron microscopy.

PubMed

Adnet, F A O; Anjos, D H S; Menezes-Oliveira, A; Lanfredi, R M

2009-04-01

Species of Cruzia are parasites of the large intestine of marsupials, reptiles, amphibians, and mammalians. Cruzia tentaculata specimens were collected from the large intestine of Didelphis marsupialis (Mammalia: Didelphidae) from Colombia (new geographical record) and from Brazil and analyzed by light and scanning electron microscopy. The morphology of males and females by light microscopy corroborated most of the previous description and the ultrastructure by scanning electron microscopy evidence: the topography of the cuticle, deirids, amphids, phasmids in both sexes, a pair of papillae near the vulva opening, and the number and location of male caudal papillae, adding new features for species identification only observed by this technique.

[Burning Vulva: Significance of Surgery in Inflammatory and Precancerous Vulvar Pathologies].

PubMed

Ghisu, Gian-Piero; Fink, Daniel

2015-06-17

Vuval pathologies manifested by allodynia and burning sensations can be due to infection, inflammatory dermatoses or other causes. Infective as well as certain inflammatory diseases, e.g. drug eruptions, allergic eczemas, irritative dermatitis/vulvitis, Behcet's Syndrome and pemphigus/pemphigoid usually respond well to conservative treatment. The category of inflammatory diseases also contains pathologies that in certain circumstances do require a surgical intervention, e.g. Lichen ruber planus/Lichen sclerosus, Condyloma, scars, premalignant lesions (VIN, genital M. Paget) and cancer. Vulodynia also can cause some stinging to the vulvar skin. The surgical aspects relating to the treatment of the benign and premalignant pathologies indicated above are mentioned in this mini-review.

Childhood asymmetric labium majus enlargement: mimicking a neoplasm.

PubMed

Vargas, Sara O; Kozakewich, Harry P W; Boyd, Theonia K; Ecklund, Kirsten; Fishman, Steven J; Laufer, Marc R; Perez-Atayde, Antonio R

2005-08-01

We report a distinctive lesion of the labium majus resected in 14 girls from 3.9 to 13.2 years of age. All presented with enlargement of 1 or occasionally both labia majora. Radiographic imaging and surgical exploration showed expansion of the labium majus without definable borders. Grossly, specimens consisted of fibro-fatty tissue from 2 to 8 cm in greatest dimension. Microscopic examination revealed the usual constituents of vulvar soft tissue, with expansion of the fibrous component. Sparsely to moderately cellular interconnected bands encircled lobules of fat, blood vessels, and nerves. The bands consisted of plump and occasionally stellate or round fibroblasts immersed in an abundant pale myxoid matrix containing thin collagen fibers. These fibrous bands merged with thinner denser fibrous septa simlar to those seen in the vulva from age-matched controls. Elastic stains showed variably abundant thin parallel elastic fibers. Fibroblasts were immunohistochemically positive for estrogen and progesterone receptors. Electron microscopy showed fibroblasts with dilated rough endoplasmic reticulum cisternae and prominent nuclear fibrous laminae; extracellular matrix contained precollagen, collagen, elastic fibers, and numerous proteoglycan granules. Cytogenetic analysis of 3 lesions revealed a normal karyotype. Recurrence was observed in 7 (50%) patients, and regression was observed in 1 whose recurrence was not reexcised. Over an 11-year period at Children's Hospital (Boston, MA), these lesions represented 22% of all pediatric vulvar soft tissue masses and 3% of all vulvar lesions biopsied. We conclude that "childhood asymmetric labium majus enlargement" is a distinctive clinicopathologic entity of pre- and early puberty. Recognition of this fairly common lesion is important, since it may clinically, radiographically, and histologically mimic an infiltrative neoplasm. Its occurrence at an age roughly coincident with the time of breast budding, capacity for spontaneous regression, histologic architecture and composition of elements native to the vulva, expression of hormone receptors, and normal karyotype suggest that it is an asymmetric physiologic enlargement in response to hormonal surges of pre- and early puberty.

Searching beyond the usual papillomavirus suspects in squamous carcinomas of the vulva, penis and head and neck.

PubMed

Félez-Sánchez, Marta; Vergara, Marleny; de Sanjosé, Silvia; Castellsagué, Xavier; Alemany, Laia; Bravo, Ignacio G

2016-11-01

Human Papillomaviruses (HPVs) are involved in the etiology of anogenital and head and neck cancers. The HPV DNA prevalence greatly differs by anatomical site. Indeed, the high rates of viral DNA prevalence in anal and cervical carcinomas contrast with the lower fraction of cancer cases attributable to HPVs in other anatomical sites, chiefly the vulva, the penis and head and neck. Here we analyzed 2635 Formalin Fixed Paraffin Embedded surgical samples that had previously tested negative for the presence of HPVs DNA using the SPF10/DEIA procedure, in order to identify the presence of other PVs not explicitly targeted by standard molecular epidemiologic approaches. All samples were reanalyzed using five broad-PV PCR primer sets (CP1/2, FAP6064/FAP64, SKF/SKR, MY9/MY11, MFI/MFII) targeting the main PV main clades. In head and neck carcinoma samples (n=1141), we recovered DNA from two BetaHPVs, namely HPV20 and HPV21, and from three cutaneous AlphaPVs, namely HPV2, HPV57 and HPV61. In vulvar squamous cell carcinoma samples (n=902), we found one of the samples containing DNA of one cutaneous HPV, namely HPV2, and 29 samples contained DNA from essentially mucosal HPVs. In penile squamous cell carcinoma samples (n=592), we retrieved the DNA of HPV16 in 16 samples. Our results show first that the SPF10/DEIA is very sensitive, as we recovered only 2.1% (55/2635) false negative results; second, that although the DNA of cutaneous HPVs can be detected in cancer samples, their relative contribution remains anyway minor (0.23%; 6/2635) and may be neglected for screening and vaccination purposes; and third, their contribution to malignancy is not necessarily warranted and needs to be elucidated. Copyright © 2016 Elsevier B.V. All rights reserved.

Vaginal disorders.

PubMed

Soderberg, S F

1986-05-01

Chronic vaginitis is the most common vaginal disorder. Dogs with vaginitis show no signs of systemic illness but often lick at the vulva and have purulent or hemorrhagic vaginal discharges. Vaginitis is most commonly secondary to a noninfectious inciting factor such as congenital vaginal anomalies, clitoral hypertrophy, foreign bodies, trauma to the vaginal mucosa, or vaginal tumors. Inspection of the caudal vagina and vestibule both visually and digitally will often reveal the source of vaginal irritation. Vaginal cytology is used to establish the stage of the estrous cycle as well as distinguish uterine from vaginal sources of discharge. Vaginal cultures are used to establish the predominant offending organism associated with vaginal discharges and may be used as a guide for selection of a therapeutic agent. Vaginitis is best managed by removing the inciting cause and treating the area locally with antiseptic douches. Congenital malformations at the vestibulovaginal or vestibulovulvar junction may prevent normal intromission. Affected bitches may be reluctant to breed naturally because of pain. Such defects are detected best by digital examination. Congenital vaginal defects may be corrected by digital or surgical means. Prolapse of tissue through the lips of the vulva may be caused by clitoral hypertrophy, vaginal hyperplasia, or vaginal tumors. Enlargement of clitoral tissue is the result of endogenous or exogenous sources of androgens. Treatment of this condition includes removal of the androgen source and/or surgical removal of clitoral tissue. Vaginal hyperplasia is detected during proestrus or estrus of young bitches. Hyperplastic tissue will regress during diestrus. Tissue that is excessively traumatized and/or prolapse of the entire vaginal circumference may be removed surgically. Ovariohysterectomy may be used to prevent recurrence. Vaginal tumors are detected most often in older intact bitches. Such tumors are generally of smooth muscle or fibrous tissue origin and benign. Surgical excision of the tumor combined with ovariohysterectomy is usually curative.

The C. elegans male exercises directional control during mating through cholinergic regulation of sex-shared command interneurons.

PubMed

Sherlekar, Amrita L; Janssen, Abbey; Siehr, Meagan S; Koo, Pamela K; Caflisch, Laura; Boggess, May; Lints, Robyn

2013-01-01

Mating behaviors in simple invertebrate model organisms represent tractable paradigms for understanding the neural bases of sex-specific behaviors, decision-making and sensorimotor integration. However, there are few examples where such neural circuits have been defined at high resolution or interrogated. Here we exploit the simplicity of the nematode Caenorhabditis elegans to define the neural circuits underlying the male's decision to initiate mating in response to contact with a mate. Mate contact is sensed by male-specific sensilla of the tail, the rays, which subsequently induce and guide a contact-based search of the hermaphrodite's surface for the vulva (the vulva search). Atypically, search locomotion has a backward directional bias so its implementation requires overcoming an intrinsic bias for forward movement, set by activity of the sex-shared locomotory system. Using optogenetics, cell-specific ablation- and mutant behavioral analyses, we show that the male makes this shift by manipulating the activity of command cells within this sex-shared locomotory system. The rays control the command interneurons through the male-specific, decision-making interneuron PVY and its auxiliary cell PVX. Unlike many sex-shared pathways, PVY/PVX regulate the command cells via cholinergic, rather than glutamatergic transmission, a feature that likely contributes to response specificity and coordinates directional movement with other cholinergic-dependent motor behaviors of the mating sequence. PVY/PVX preferentially activate the backward, and not forward, command cells because of a bias in synaptic inputs and the distribution of key cholinergic receptors (encoded by the genes acr-18, acr-16 and unc-29) in favor of the backward command cells. Our interrogation of male neural circuits reveals that a sex-specific response to the opposite sex is conferred by a male-specific pathway that renders subordinate, sex-shared motor programs responsive to mate cues. Circuit modifications of these types may make prominent contributions to natural variations in behavior that ultimately bring about speciation.

The C. elegans Male Exercises Directional Control during Mating through Cholinergic Regulation of Sex-Shared Command Interneurons

PubMed Central

Sherlekar, Amrita L.; Janssen, Abbey; Siehr, Meagan S.; Koo, Pamela K.; Caflisch, Laura; Boggess, May; Lints, Robyn

2013-01-01

Background Mating behaviors in simple invertebrate model organisms represent tractable paradigms for understanding the neural bases of sex-specific behaviors, decision-making and sensorimotor integration. However, there are few examples where such neural circuits have been defined at high resolution or interrogated. Methodology/Principal Findings Here we exploit the simplicity of the nematode Caenorhabditis elegans to define the neural circuits underlying the male’s decision to initiate mating in response to contact with a mate. Mate contact is sensed by male-specific sensilla of the tail, the rays, which subsequently induce and guide a contact-based search of the hermaphrodite’s surface for the vulva (the vulva search). Atypically, search locomotion has a backward directional bias so its implementation requires overcoming an intrinsic bias for forward movement, set by activity of the sex-shared locomotory system. Using optogenetics, cell-specific ablation- and mutant behavioral analyses, we show that the male makes this shift by manipulating the activity of command cells within this sex-shared locomotory system. The rays control the command interneurons through the male-specific, decision-making interneuron PVY and its auxiliary cell PVX. Unlike many sex-shared pathways, PVY/PVX regulate the command cells via cholinergic, rather than glutamatergic transmission, a feature that likely contributes to response specificity and coordinates directional movement with other cholinergic-dependent motor behaviors of the mating sequence. PVY/PVX preferentially activate the backward, and not forward, command cells because of a bias in synaptic inputs and the distribution of key cholinergic receptors (encoded by the genes acr-18, acr-16 and unc-29) in favor of the backward command cells. Conclusion/Significance Our interrogation of male neural circuits reveals that a sex-specific response to the opposite sex is conferred by a male-specific pathway that renders subordinate, sex-shared motor programs responsive to mate cues. Circuit modifications of these types may make prominent contributions to natural variations in behavior that ultimately bring about speciation. PMID:23577128

Urogenital Applications of Probiotic Bacteria

NASA Astrophysics Data System (ADS)

Reid, Gregor

The urogenital tract extends from the perineal skin close to the anus, to the vulva, vagina, cervix, uterus, urethra, bladder and kidneys. The uterus, bladder and kidneys are regarded as being sterile, although it will not be surprising if molecular techniques discover that this is not necessarily the case. The importance of the urogenital tract in the health of women cannot be understated. Given its proximity to potential pathogens emerging from the rectum, exposure to sexually transmitted organisms, hormonal fluctuations that affect cells, use of tampons, contraceptives and douches, and the birthing process, it is remarkable that this area is not constantly infected. Nevertheless, it has been estimated that almost every female will have a vaginal or bladder infection at some point in her life.

'Vulval oedema': a conundrum!

PubMed

Afshan, Nida; Gokhale, Leena

2015-11-04

Massive oedema of the vulva appears to be a sequel of an underlying systemic disease in pregnant women. Isolated vulval oedema in pregnancy is rare. Vulval oedema has been treated, depending on pathophysiology, with steroids, furosemide, albumin and continuous epidural analgaesia. We present a case of vulval oedema, where the oedema was confined to the labia minora in a healthy young pregnant woman. The patient was in pain and extreme discomfort due to the labial swelling, and caesarean section was being considered for delivery as the massive oedema would obstruct the birth canal. The swelling, however, resolved successfully by simple drainage. In the literature, there have been cases delivered by caesarean section as vulval swelling was causing an obstruction. 2015 BMJ Publishing Group Ltd.

An Analysis of Vulvar Necrotizing Fasciitis in the Unique and Ethnically Diverse Hawaiian Population

PubMed Central

Busse, Raydeen

2010-01-01

Vulvar necrotizing fasciitis is a surgical emergency with a high rate of morbidity and mortality. Our case series adds seven patients to the literature and presents the first group that is predominantly of Pacific-Islander origin. This study not only confirms traditional risk factors such as diabetes mellitus, obesity and hypertension but investigates ethnicity and socioeconomic status as risk factors. Also presented is a case of recurrent necrotizing fasciitis initially involving the vulva, then the back. In any patient for which there is suspicion of vulvar necrotizing fasciitis, surgical diagnosis remains the gold standard and facilitates rapid debridement of all necrotic tissues. Aggressive surgical debridement with broad spectrum antibiotic coverage is required to minimize mortality. PMID:20222491

Sclerotherapy with bleomycin for recurrent massive inguinal lymphoceles following partial vulvectomy and bilateral lymphadenectomy-Case report and literature review.

PubMed

Elsandabesee, D; Sharma, B; Preston, J; Ostrowski, J; Nieto, J

2004-02-01

Formation of lymphoceles following radical vulvectomy presents a formidable problem that is associated with high degree of morbidity. A variety of approaches have been described in the literature to treat this condition. An 82-year-old woman developed massive inguinal lymphoceles following partial vulvectomy and inguinal lymphadenectomy for cancer vulva. The lymphoceles involved wide surface areas extending to both flanks, and accumulation of lymph was very rapid at a rate of 1 l daily. The condition failed to respond to continuous drainage and compression for 6 weeks, but responded quickly to sclerotherapy using bleomycin without any significant side effects. Intracavitary bleomycin could be used safely and effectively in huge rapidly accumulating lymphoceles.

Lesions and Neoplasms of the Penis: A Review.

PubMed

Heller, Debra S

2016-01-01

In addition to practitioners who care for male patients, with the increased use of high-resolution anoscopy, practitioners who care for women are seeing more men in their practices as well. Some diseases affecting the penis can impact on their sexual partners. Many of the lesions and neoplasms of the penis occur on the vulva as well. In addition, there are common and rare lesions unique to the penis. A review of the scope of penile lesions and neoplasms that may present in a primary care setting is presented to assist in developing a differential diagnosis if such a patient is encountered, as well as for practitioners who care for their sexual partners. A familiarity will assist with recognition, as well as when consultation is needed.

Hysteroscopy and episiotomy in a rescued, cold-stressed Florida manatee (Trichechus manatus latirostris) for diagnosis and treatment of a retained fetal skeleton.

PubMed

Hall, Natalie H; Walsh, Mike; DeLuca, Catherine; Bukoski, Alex

2012-09-01

A rescued female manatee was observed expelling a fetal bone from the vulva. The manatee was anesthetized and diagnosed with uterine retention of a fetal skeleton by ultrasound and hysteroscopy. Episiotomy was performed to gain manual access to the vagina and uterus for removal of the skeleton. Second intention healing of the episiotomy site produced excellent results. Rescued female manatees should receive a thorough reproductive tract evaluation since presence of retained fetal tissues might not be evident in blood or hormone analyses. Retention of a whole or partial dead fetus can be life-threatening to manatees, and retained tissues should be removed as early as possible.

Depth and Patterns of Adnexal Involvement in Primary Extramammary (Anogenital) Paget Disease: A Study of 178 Lesions From 146 Patients.

PubMed

Konstantinova, Anastasia M; Shelekhova, Ksenya V; Stewart, Colin J; Spagnolo, Dominic V; Kutzner, Heinz; Kacerovska, Denisa; Plaza, Jose A; Suster, Saul; Bouda, Jiri; Pavlovsky, Michal; Kyrpychova, Liubov; Michal, Michal; Guenova, Emmanuella; Kazakov, Dmitry V

2016-11-01

Extramammary Paget disease (EMPD) is a rare neoplasm usually presenting in the anogenital area, most commonly in the vulva. Adnexal involvement in primary EMPD is a very common feature and serves as a pathway for carcinoma to spread into deeper tissue. The depth of carcinomatous spread along the appendages and the patterns of adnexal involvement were studied in 178 lesions from 146 patients with primary EMPD. Hair follicles and eccrine ducts were the adnexa most commonly affected by carcinoma cells. The maximal depth of involvement was 3.6 mm in this series. When planning topical therapy or developing novel local treatment modalities for EMPD, this potential for significant deep spread along adnexa should be taken into account.

Effective multimodality treatment for advanced epidermoid carcinoma of the female genital tract

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kalra, J.; Cortes, E.; Chen, S.

1985-07-01

Fifteen patients with advanced or recurrent squamous-cell carcinoma of the cervix, vulva, vagina, and urethra were treated with simultaneous combination chemotherapy (5-fluorouracil infusion and mitomycin C) and radiotherapy (3,000 rad for a period of three weeks). Three to four weeks after completion of radiotherapy, 13 of 15 patients achieved partial or complete tumor shrinkage. Nine of 15 patients are alive, eight of whom (at a median follow-up time of 24 months) have no evidence of disease. The longest survival time was 45 + months. There was minimal toxicity associated with this therapy. The results of this pilot study suggest thatmore » the simultaneous administration of radiation and chemotherapy is an effective method of treatment of advanced female genital tract carcinoma.« less

Long-term incidence trends of HPV-related cancers, and cases preventable by HPV vaccination: a registry-based study in Norway

PubMed Central

Campbell, Suzanne; Nygård, Mari

2018-01-01

Objectives Examine long-term incidence trends of human papillomavirus (HPV)-related cancer in Norway, and estimate the number of cancer cases preventable by vaccines against HPV 16/18 or HPV 16/18/31/33/45/52/58. Design Observational registry-based study. We extracted incident cases of HPV-related cancer during 1953–2015 from the Cancer Registry of Norway. Tumour HPV prevalence estimates from large international meta-analyses or from Norway were used to estimate the protective potential of HPV vaccines. Participants and setting The Norwegian population. Primary outcome measures Incidence trend analyses during 1953–2015 for squamous cell carcinoma (SCC) of the cervix, vulva, vagina, oropharynx, anus and penis, and adenocarcinoma of the cervix. Additionally, the number of cancer cases preventable by HPV vaccination. Results Among women, incidences of SCC of the anus, oropharynx, vulva and cervical adenocarcinoma increased, while vaginal SCC showed no trend. For these cancers combined, the average annual percentage change (AAPC) during 1953–2015 was 1.2 (95% CI 0.7 to 1.6). The incidence of cervical SCC generally decreased during 1976–2004 and remained stable thereafter. Among men, incidences of SCC of the anus, oropharynx and penis increased. The AAPC during 1953–2015 combined for all male HPV-related cancer was 1.9 (95% CI 1.3 to 2.5). A vaccine against HPV 16/18 might yearly prevent 402 (95% CI 382 to 420) cancers. A vaccine against HPV 16/18/31/33/45/52/58 might yearly prevent 478 (95% CI 464 to 490) cancers, of which 206 (95% CI 202 to 209) occur in non-cervical organs, and 113 (95% CI 110 to 115) occur among men. Conclusions The incidences of HPV-related cancers that are not effectively prevented by screening have generally increased during 1953–2015. HPV vaccination can prevent a substantial number of cancers in Norway, in cervical and non-cervical organs, among women and men. PMID:29476028

An AGEF-1/Arf GTPase/AP-1 Ensemble Antagonizes LET-23 EGFR Basolateral Localization and Signaling during C. elegans Vulva Induction

PubMed Central

Skorobogata, Olga; Escobar-Restrepo, Juan M.; Rocheleau, Christian E.

2014-01-01

LET-23 Epidermal Growth Factor Receptor (EGFR) signaling specifies the vulval cell fates during C. elegans larval development. LET-23 EGFR localization on the basolateral membrane of the vulval precursor cells (VPCs) is required to engage the LIN-3 EGF-like inductive signal. The LIN-2 Cask/LIN-7 Veli/LIN-10 Mint (LIN-2/7/10) complex binds LET-23 EGFR, is required for its basolateral membrane localization, and therefore, vulva induction. Besides the LIN-2/7/10 complex, the trafficking pathways that regulate LET-23 EGFR localization have not been defined. Here we identify vh4, a hypomorphic allele of agef-1, as a strong suppressor of the lin-2 mutant Vulvaless (Vul) phenotype. AGEF-1 is homologous to the mammalian BIG1 and BIG2 Arf GTPase guanine nucleotide exchange factors (GEFs), which regulate secretory traffic between the Trans-Golgi network, endosomes and the plasma membrane via activation of Arf GTPases and recruitment of the AP-1 clathrin adaptor complex. Consistent with a role in trafficking we show that AGEF-1 is required for protein secretion and that AGEF-1 and the AP-1 complex regulate endosome size in coelomocytes. The AP-1 complex has previously been implicated in negative regulation of LET-23 EGFR, however the mechanism was not known. Our genetic data indicate that AGEF-1 is a strong negative regulator of LET-23 EGFR signaling that functions in the VPCs at the level of the receptor. In line with AGEF-1 being an Arf GEF, we identify the ARF-1.2 and ARF-3 GTPases as also negatively regulating signaling. We find that the agef-1(vh4) mutation results in increased LET-23 EGFR on the basolateral membrane in both wild-type and lin-2 mutant animals. Furthermore, unc-101(RNAi), a component of the AP-1 complex, increased LET-23 EGFR on the basolateral membrane in lin-2 and agef-1(vh4); lin-2 mutant animals. Thus, an AGEF-1/Arf GTPase/AP-1 ensemble functions opposite the LIN-2/7/10 complex to antagonize LET-23 EGFR basolateral membrane localization and signaling. PMID:25329472

[PROGNOSTIC MODELS IN MODERN MANAGEMENT OF VULVAR CANCER].

PubMed

Tsvetkov, Ch; Gorchev, G; Tomov, S; Nikolova, M; Genchev, G

2016-01-01

The aim of the research was to evaluate and analyse prognosis and prognostic factors in patients with squamous cell vulvar carcinoma after primary surgery with individual approach applied during the course of treatment. In the period between January 2000 and July 2010, 113 patients with squamous cell carcinoma of the vulva were diagnosed and operated on at Gynecologic Oncology Clinic of Medical University, Pleven. All the patients were monitored at the same clinic. Individual approach was applied to each patient and whenever it was possible, more conservative operative techniques were applied. The probable clinicopathological characteristics influencing the overall survival and recurrence free survival were analyzed. Univariate statistical analysis and Cox regression analysis were made in order to evaluate the characteristics, which were statistically significant for overall survival and survival without recurrence. A multivariate logistic regression analysis (Forward Wald procedure) was applied to evaluate the combined influence of the significant factors. While performing the multivariate analysis, the synergic effect of the independent prognostic factors of both kinds of survivals was also evaluated. Approaching individually each patient, we applied the following operative techniques: 1. Deep total radical vulvectomy with separate incisions for lymph dissection (LD) or without dissection--68 (60.18 %) patients. 2. En-bloc vulvectomy with bilateral LD without vulva reconstruction--10 (8.85%) 3. Modified radical vulvactomy (hemivulvectomy, patial vulvactomy)--25 (22.02%). 4. wide-local excision--3 (2.65%). 5. Simple (total /partial) vulvectomy--5 (4.43%) patients. 6. En-bloc resection with reconstruction--2 (1.77%) After a thorough analysis of the overall survival and recurrence free survival, we made the conclusion that the relapse occurrence and clinical stage of FIGO were independent prognostic factors for overall survival and the independent prognostic factors for recurrence free survival were: metastatic inguinal nodes (unilateral or bilateral), tumor size (above or below 3 cm) and lymphovascular space invasion. On the basis of these results we created two prognostic models: 1. A prognostic model of overall survival 2. A prognostic model for survival without recurrence. Following the surgical staging of the disease, were able to gather and analyse important clinicopathological indexes, which gave us the opportunity to form prognostic groups for overall survival and recurrence-free survival.

No (wo)man is an island--the influence of physicians' personal predisposition to labia minora appearance on their clinical decision making: a cross-sectional survey.

PubMed

Reitsma, Welmoed; Mourits, Marian J E; Koning, Merel; Pascal, Astrid; van der Lei, Berend

2011-08-01

Physicians are increasingly presented with women requesting a labia minora reduction procedure. To assess the influencing factor of personal predisposition in general practitioners, gynecologists, and plastic surgeons to labia minora appearance in relation to their willingness to refer for, or perform, a surgical labia minora reduction. Cross-sectional self-administered questionnaire survey. Between May 2009 and August 2009, 210 physicians were surveyed. Primary care: general practitioners working in the north of the Netherlands. Secondary care: gynecologists and plastic surgeons working in five hospitals in the north of the Netherlands. A five-point Likert scale appraisal of four pictures showing a vulva, each displaying different sizes of labia minora, indicating a physician's personal predisposition, manifesting as willingness to refer for, or perform, a labia minora reduction. A total of 164/210 (78.1%) physicians completed the questionnaire, consisting of 80 general practitioners, 41 gynecologists, and 43 plastic surgeons (96 males, 68 females). Ninety percent of all physicians believe, to a certain extent, that a vulva with very small labia minora represents society's ideal (2-5 on the Likert scale). More plastic surgeons regarded the picture with the largest labia minora as distasteful and unnatural, compared with general practitioners and gynecologists (P < 0.01), and regarded such a woman as a candidate for a labia minora reduction procedure (P < 0.001). Irrespective of the woman's labia minora size and the absence of physical complaints, plastic surgeons were significantly more open to performing a labia minora reduction procedure than gynecologists (P < 0.001). Male physicians were more inclined to opt for a surgical reduction procedure than their female colleagues (P < 0.01). The personal predisposition of physicians (taking account of their specific gender and specialty) concerning labia minora size and appearance influences their clinical decision making regarding a labia minora reduction procedure. Heightened awareness of one's personal predisposition vis-à-vis referral and willingness to operate is needed. © 2011 International Society for Sexual Medicine.

Deladenus cocophilus n. sp. (Nematoda: Hexatylina): A Mycetophagous and Entomoparasitic Nematode in Infested Coconut Fruits from Balochistan, Pakistan.

PubMed

Nasira, K; Shahina, F; Firoza, K

2013-06-01

Deladenus cocophilus n. sp. was isolated from infested coconut fruits in Winder, Balochistan, Pakistan. Descriptions are given of the entomophagous (insect-parasitic females) and mycetophagous (fungus-feeding) free-living females, males, and juveniles. The new species D. cocophilus resembles those species in which the excretory pore is situated anterior to the hemizonid, namely, D. apopkaetusChitambar, 1991; D. leptosomaGagarin, 2001; D. ipiniMassey, 1974; D. laricis (Blinova and Korentchenko, 1986) Ebsarry, 1991; D. (siricidicola) caniiBedding, 1974; D. (s) imperialisBedding, 1974; D. nevexiiBedding, 1974; D. (wilsoni) proximusBedding, 1974; D. (s) rudyiBedding, 1974; D. (s) siricidicolaBedding, 1968; D. (wilsoni) wilsoniBedding, 1968 and D. minimus Chizhov and Sturhan, 1998. The new species differs from D. ipini in the absence of a post uterine sac vs. present; a = 17 to 30 vs. 35 to 40; stylet = 8 to 10 vs. 11 to 12 μm and vulva-anus = 21 to 28 vs. 35 to 48 μm. From D. apopkaetus it differs in tail length in female 22 to 28 vs. 31 to 43 μm and in the male it is 24 to 32 vs. 30 to 46 μm. It differs from D. leptosoma in the c ratio in females, c = 21 to 37 vs. 16 to 22, presence of 6 lines in lateral field vs. 10 lines and slightly longer spicules 16 to 18 vs. 15 to 16 μm. From D. laricis it differs in a shorter stylet length 8 to 10 vs. 11 to 12 μm; in the c ratio in males 16 to 22 vs. 22 to 35 and hemizonid from anterior end 76 to 90 vs. 90 to 119 μm. It also differs from the following species: D. (siricidicola) canii; D. (s) imperialis; D. nevexii; D. (wilsoni) proximus; D. (s) rudyi; D. (s) siricidicola; D. (wilsoni) wilsoni and D. minimus in having shorter tail length, lower values of a,b,c ratios and a slightly anteriorly located vulva in females.

Deladenus cocophilus n. sp. (Nematoda: Hexatylina): A Mycetophagous and Entomoparasitic Nematode in Infested Coconut Fruits from Balochistan, Pakistan

PubMed Central

Nasira, K.; Shahina, F.; Firoza, K.

2013-01-01

Deladenus cocophilus n. sp. was isolated from infested coconut fruits in Winder, Balochistan, Pakistan. Descriptions are given of the entomophagous (insect-parasitic females) and mycetophagous (fungus-feeding) free-living females, males, and juveniles. The new species D. cocophilus resembles those species in which the excretory pore is situated anterior to the hemizonid, namely, D. apopkaetus Chitambar, 1991; D. leptosoma Gagarin, 2001; D. ipini Massey, 1974; D. laricis (Blinova and Korentchenko, 1986) Ebsarry, 1991; D. (siricidicola) canii Bedding, 1974; D. (s) imperialis Bedding, 1974; D. nevexii Bedding, 1974; D. (wilsoni) proximus Bedding, 1974; D. (s) rudyi Bedding, 1974; D. (s) siricidicola Bedding, 1968; D. (wilsoni) wilsoni Bedding, 1968 and D. minimus Chizhov and Sturhan, 1998. The new species differs from D. ipini in the absence of a post uterine sac vs. present; a = 17 to 30 vs. 35 to 40; stylet = 8 to 10 vs. 11 to 12 μm and vulva-anus = 21 to 28 vs. 35 to 48 μm. From D. apopkaetus it differs in tail length in female 22 to 28 vs. 31 to 43 μm and in the male it is 24 to 32 vs. 30 to 46 μm. It differs from D. leptosoma in the c ratio in females, c = 21 to 37 vs. 16 to 22, presence of 6 lines in lateral field vs. 10 lines and slightly longer spicules 16 to 18 vs. 15 to 16 μm. From D. laricis it differs in a shorter stylet length 8 to 10 vs. 11 to 12 μm; in the c ratio in males 16 to 22 vs. 22 to 35 and hemizonid from anterior end 76 to 90 vs. 90 to 119 μm. It also differs from the following species: D. (siricidicola) canii; D. (s) imperialis; D. nevexii; D. (wilsoni) proximus; D. (s) rudyi; D. (s) siricidicola; D. (wilsoni) wilsoni and D. minimus in having shorter tail length, lower values of a,b,c ratios and a slightly anteriorly located vulva in females. PMID:23833325

An AGEF-1/Arf GTPase/AP-1 ensemble antagonizes LET-23 EGFR basolateral localization and signaling during C. elegans vulva induction.

PubMed

Skorobogata, Olga; Escobar-Restrepo, Juan M; Rocheleau, Christian E

2014-10-01

LET-23 Epidermal Growth Factor Receptor (EGFR) signaling specifies the vulval cell fates during C. elegans larval development. LET-23 EGFR localization on the basolateral membrane of the vulval precursor cells (VPCs) is required to engage the LIN-3 EGF-like inductive signal. The LIN-2 Cask/LIN-7 Veli/LIN-10 Mint (LIN-2/7/10) complex binds LET-23 EGFR, is required for its basolateral membrane localization, and therefore, vulva induction. Besides the LIN-2/7/10 complex, the trafficking pathways that regulate LET-23 EGFR localization have not been defined. Here we identify vh4, a hypomorphic allele of agef-1, as a strong suppressor of the lin-2 mutant Vulvaless (Vul) phenotype. AGEF-1 is homologous to the mammalian BIG1 and BIG2 Arf GTPase guanine nucleotide exchange factors (GEFs), which regulate secretory traffic between the Trans-Golgi network, endosomes and the plasma membrane via activation of Arf GTPases and recruitment of the AP-1 clathrin adaptor complex. Consistent with a role in trafficking we show that AGEF-1 is required for protein secretion and that AGEF-1 and the AP-1 complex regulate endosome size in coelomocytes. The AP-1 complex has previously been implicated in negative regulation of LET-23 EGFR, however the mechanism was not known. Our genetic data indicate that AGEF-1 is a strong negative regulator of LET-23 EGFR signaling that functions in the VPCs at the level of the receptor. In line with AGEF-1 being an Arf GEF, we identify the ARF-1.2 and ARF-3 GTPases as also negatively regulating signaling. We find that the agef-1(vh4) mutation results in increased LET-23 EGFR on the basolateral membrane in both wild-type and lin-2 mutant animals. Furthermore, unc-101(RNAi), a component of the AP-1 complex, increased LET-23 EGFR on the basolateral membrane in lin-2 and agef-1(vh4); lin-2 mutant animals. Thus, an AGEF-1/Arf GTPase/AP-1 ensemble functions opposite the LIN-2/7/10 complex to antagonize LET-23 EGFR basolateral membrane localization and signaling.

Locally advanced vulva cancer: A single centre review of anovulvectomy and a systematic review of surgical, chemotherapy and radiotherapy alternatives. Is an international collaborative RCT destined for the "too difficult to do" box?

PubMed

O'Donnell, Rachel Louise; Verleye, Leen; Ratnavelu, Nithya; Galaal, Khadra; Fisher, Ann; Naik, Raj

2017-02-01

Treatment of locally advanced vulva cancer (LAVC) remains challenging. Due to the lack of randomised trials many questions regarding the indications for different treatment options and their efficacy remain unanswered. In this retrospective study we provide the largest published series of LAVC patients treated with anovulvectomy, reporting oncological outcomes and morbidity. Additionally, a systematic literature review was performed for all treatment options 1946-2015. In our case series, 57/70 (81%) patients were treated in the primary setting with anovulvectomy and 13 patients underwent anovulvectomy for recurrent disease. The median overall survival (OS) was 69months (1-336) with disease specific survival of 159months (1-336). Following anovulvectomy for primary disease, time to progression and OS were significantly higher in node negative disease (10 vs. 96months; 19 vs. 121months, p<0.0001). Post-surgical complications were observed in 36 (51.4%), the majority of which were Grade I/II infections. There was one peri-operative death. Review of the literature showed that chemotherapy, radiotherapy or combination treatments are alternatives to surgery. Evidence relating to all of these consisted mostly of small retrospective series, which varied considerably in terms of patient characteristics and treatment schedules. Significant patient and treatment heterogeneity prevented meta-analysis with significant biases in these studies. It was unclear if survival or morbidity was better in any one group with a lack of data reporting complications, quality of life, and long term follow-up. However, results for chemoradiation are encouraging enough to warrant further investigation. There remains inadequate evidence to identify an optimal treatment for LAVC. However, there is sufficient evidence to support a trial of anovulvectomy versus chemoradiation. Discussions and consensus would be needed to determine trial criteria including the primary outcome measure. Neoadjuvant chemotherapy or radiotherapy alone may be best reserved for the palliative setting or metastatic disease. Copyright © 2016 Elsevier Inc. All rights reserved.

An unusual presentation of pseudocowpox associated with an outbreak of pustular ulcerative vulvovaginitis in a Swedish dairy herd.

PubMed

Blomqvist, Gunilla; Ullman, Karin; Segall, Thomas; Hauzenberger, Elenor; Renström, Lena; Persson-Waller, Karin; Leijon, Mikael; Valarcher, Jean-Francois

2018-03-01

Species Pseudocowpox virus (PCPV; family Poxviridae) is known to cause pustular cutaneous disease in cattle. We describe an outbreak of pseudocowpox with an unusual clinical picture in a free-stall dairy herd of ~80 cows. Approximately 90% of the cows had vesicles, erosions, papules, and scabs on the vulva and vaginal mucosa. Histologic analysis of biopsy tissues indicated a primary, although not specified, viral infection. Transmission electron microscopy revealed parapoxvirus particles in both tissue and vesicular materials. Deep sequencing analysis of extracted DNA from swabbed vesicle areas gave a contig of nearly 120,000 nucleotides, matching the PCPV strain VR 634 with 100% identity. Analyses confirmed the absence of other potential causes of pustular vulvovaginitis such as bovine herpesvirus 1 and Ureaplasma diversum. A rolling cow brush was suspected to be the fomite.

Localized neurofibromatosis of the female genital system: a case report and review of the literature.

PubMed

Gómez-Laencina, Ana M; Martínez Díaz, Francisco; Izquierdo Sanjuanes, Blanca; Vicente Sánchez, Elena M; Fernandez Salmerón, Rosario; Meseguer Peña, Francisco

2012-06-01

Neurofibromatosis within the female genital tract is uncommon. The vulva is the most frequent genital location, but it has rarely been reported in the context of the vagina, uterine cervix or ovaries. In spite of its rarity, neurofibroma is a neoplasm that should be considered in the differential diagnosis of pelvic masses, especially in patients with neurofibromatosis. In this paper we describe the case of a 71-year-old patient with pelvic pain and a uterine mass who underwent a hysterectomy after having been diagnosed with an 11-cm neurofibroma occupying the myometrium of the entire uterine corpus. There were no neurofibromas in the endometrium, serosa, fallopian tubes or ovaries. The patient had an unknown von Recklinghausen's disease. © 2012 The Authors. Journal of Obstetrics and Gynaecology Research © 2012 Japan Society of Obstetrics and Gynecology.

A new species of Diomedenema (Nematoda, Rhabditida, Spiruromorpha) from Spheniscus magellanicus (Aves, Sphenisciformes) found on the southern coast of Brazil.

PubMed

Knoff, M; Santos, J N; Giese, E G; Gomes, D C; Silva-Souza, Â T

2018-07-01

A new species of the genus Diomedenema, a spiruromorph nematode, collected from the lung of Spheniscus magellanicus (Sphenisciformes) found on the southern coast of the state of Rio Grande do Sul, Brazil, is described. The new species is differentiated from the only previously described species of the genus, D. diomedeae Johston & Mawson, 1952, by males possessing a set of caudal papillae with three pairs of precloacal, two pairs of adcloacal and one pair of postcloacal papillae; precloacal papillae with the papillae of the first two pairs being closer to each other than those of the third pair; a longer and pointed tail in males; and females with the vulva at mid-body. This is the first report of a nematode infecting the lung of a sphenisciforme host.

[Superficial invasive squamous carcinoma of the vulva].

PubMed

Rosmanich, A; Briones, H; Espinoza, A; Dabancens, A

1994-01-01

We present our experience at University of Chile Clinical Hospital, about superficial scamous vulvar carcinoma, during January, 1967 and april, 1992. We studied eight patients, mean age 57.1 years. Diagnostic was histopathologic in all cases. Three patients were submitted to simple total vulvectomy; other three were treated by total vulvectomy and bilateral inguinal lymphadenectomy (classic form of treatment). The other two cases, were submitted to simple in one case and partial vulvectomy in other, with lymphadenectomy by separate bilateral inguinal incisions. Histopathological study proved in situ scamous carcinoma near invasive focus at 50% of all cases. Follow up was between 2 and 25 years, mean 10.5 years. In one patient, carcinoma in situ relapsed at 2 years and 8 months after treatment, and then, at 8 years after primitive treatment. In other patient, and anal carcinoma was demonstrated 20 years after vulvectomy.

Dirofilaria immitis infection of a snow leopard (Uncia uncia) in a Japanese zoo with mitochondrial DNA analysis.

PubMed

Murata, Koichi; Yanai, Tokuma; Agatsuma, Takeshi; Uni, Shigehiko

2003-08-01

Three dog heartworms (Dirofilaria immitis) were detected in the lumen of the right cardiac ventriculus and of the pulmonary artery of a captive female snow leopard (Uncia uncia) that died of pancreatic carcinoma at a zoo in Japan. Neither clinical respiratory nor circulatory symptoms caused by the heartworm infection were observed. The filarial worms were identified as D. immitis from the morphologic characteristics of the esophagus, the presence of faint longitudinal ridges on the cuticular surface, the situation of vulva posterior to the esophagus, and the measurements of the body. The heartworms from the snow leopard were identical to that of D. immitis from dogs in the sequence of the cytochrome oxidase I region in the mitochondrial DNA. This host record is the first of D. immitis in U. uncia.

Rhabdochona kharani sp. n. (Nematoda: Rhabdochonidae) from the fish Labeo gedrosicus Zugmayer, 1912 from Garruk, District Kharan, Balochistan, Pakistan.

PubMed

Asmatullah, Kakar; Bilqees, Fatima Mujib; Kakar, Juma Khan

2006-01-01

A new nematode species, Rhabdochona kharani sp. nov., has been isolated from the intestine, stomach and swim bladder of the fish Labeo gedrosicus Zugmayer, 1912 (Fam. Cyprinidae: Cypriniformes) from spring water at Garruk, District Kharan, Balochistan. The new species is characterized largely by the presence of eight anterior teeth in the prostom, inconspicuous deirids, by the shape and length of unequal spicules (0.08 - 0.09 and 2.9 - 3.1 mm), and by 17-18 pairs of caudal papillae including 6-7 postanal, one adanal, and 10 -11 preanal. Other characteristics include a pointed tail tip, non filamented eggs, a bulbous, voluminous, vaginal complex that is directed backward, and a vulva that is post-equatorial with a triangular large anterior lip and a smaller posterior lip.

Late injury of cancer therapy on the female reproductive tract

DOE Office of Scientific and Technical Information (OSTI.GOV)

Grigsby, P.W.; Russell, A.; Bruner, D.

1995-03-30

The purpose of this article is to review the late effects of cancer therapy on the female reproductive tract. The anatomic sites detailed are the vulva, vagina, cervix, uterus, fallopian tubes, and ovaries. The available pathophysiology is discussed. Clinical syndromes are presented. Tolerance doses of irradiation for late effects are rarely presented in the literature and are reviewed where available. Management strategies for surgical, radiotherapeutic, and chemotherapeutic late effects are discussed. Endpoints for evaluation of therapeutic late effects have been formulated utilizing the symptons, objective, management, and analytic (SOMA) format. Late effects on the female reproductive tract from cancer therapymore » should be recognized and managed appropriately. A grading system for these effects is presented. Endpoints for late effects and tolls for the evaluation need to be further developed. 61 refs., 9 figs., 13 tabs.« less

LIN-39/Hox triggers cell division and represses EFF-1/fusogen-dependent vulval cell fusion

PubMed Central

Shemer, Gidi; Podbilewicz, Benjamin

2002-01-01

General mechanisms by which Hox genes establish cell fates are known. However, a few Hox effectors mediating cell behaviors have been identified. Here we found the first effector of LIN-39/HoxD4/Dfd in Caenorhabditis elegans. In specific vulval precursor cells (VPCs), LIN-39 represses early and late expression of EFF-1, a membrane protein essential for cell fusion. Repression of eff-1 is also achieved by the activity of CEH-20/Exd/Pbx, a known cofactor of Hox proteins. Unfused VPCs in lin-39(−);eff-1(−) double mutants fail to divide but migrate, executing vulval fates. Thus, lin-39 is essential for inhibition of EFF-1-dependent cell fusion and stimulation of cell proliferation during vulva formation. Supplemental material is available at http://www.genesdev.org. PMID:12502736

LASER BIOLOGY AND MEDICINE: Combined application of optical methods to increase the information content of optical coherent tomography in diagnostics of neoplastic processes

NASA Astrophysics Data System (ADS)

Kuranov, R. V.; Sapozhnikova, V. V.; Shakhova, N. M.; Gelikonov, V. M.; Zagainova, E. V.; Petrova, S. A.

2002-11-01

A combined application of optical methods [optical coherent tomography (OCT), cross-polarisation optical coherent tomography, and fluorescence spectroscopy] is proposed for obtaining information on morphological and biochemical changes occurring in tissues in norm and pathology. It is shown that neoplastic and scar changes in esophagus can be distinguished using a combination of polarisation and standard OCT due to the difference between the depolarising properties of the tissues caused by the structural properties of collagenic fibres in stroma. It is shown that OCT combined with fluorescence spectroscopy with the use of 5-aminolevulinic acid is promising for determining the boundaries of carcinoma of the uterine cervix and vulva. It is found that the tumour boundary detected by optical methods coincides with the morphological boundary and extends beyond colposcopically determined boundary by about 2 mm.

Acute cervicitis and vulvovaginitis may be associated with Cytomegalovirus.

PubMed

Abou, Magali; Dällenbach, Patrick

2013-04-19

Cytomegalovirus (CMV) infection in immunocompetent hosts is generally asymptomatic or may present as a mononucleosic syndrome. Its association with acute cervicitis and vulvovaginitis has rarely been reported. A 24-year-old woman presented with pelvic pain, vulvodynia, abnormal vaginal discharge, burning with urination, fatigue, fever, vomiting and diarrhoea. The vulva and cervix were red with vesicular lesions on the cervix. Genital herpes simplex infection (HSV) was suspected and valacyclovir was given orally. However, serial viral cultures performed 7 weeks apart did not isolate HSV as suspected, but CMV was confirmed by immunofluorescence and early antigen research. Blood tests confirmed an acute CMV infection. Typical inclusions were found at histology. Symptoms resolved slowly with persistence of cervical lesions at 7 weeks from diagnosis. The frequency of CMV genital infection is probably underestimated. The infection is not always asymptomatic and might be confused with genital HSV infection. The clinical course is longer.

Acute cervicitis and vulvovaginitis may be associated with Cytomegalovirus

PubMed Central

Abou, Magali; Dällenbach, Patrick

2013-01-01

Cytomegalovirus (CMV) infection in immunocompetent hosts is generally asymptomatic or may present as a mononucleosic syndrome. Its association with acute cervicitis and vulvovaginitis has rarely been reported. A 24-year-old woman presented with pelvic pain, vulvodynia, abnormal vaginal discharge, burning with urination, fatigue, fever, vomiting and diarrhoea. The vulva and cervix were red with vesicular lesions on the cervix. Genital herpes simplex infection (HSV) was suspected and valacyclovir was given orally. However, serial viral cultures performed 7 weeks apart did not isolate HSV as suspected, but CMV was confirmed by immunofluorescence and early antigen research. Blood tests confirmed an acute CMV infection. Typical inclusions were found at histology. Symptoms resolved slowly with persistence of cervical lesions at 7 weeks from diagnosis. The frequency of CMV genital infection is probably underestimated. The infection is not always asymptomatic and might be confused with genital HSV infection. The clinical course is longer. PMID:23606387

Ochoterenella esslingeri n. sp. (Nematoda: Onchocercidae: Waltonellinae) from Bokermannohyla luctuosa (Anura: Hylidae) in Minas Gerais, Brazil, with notes on Paraochoterenella Purnomo & Bangs, 1999

PubMed Central

Souza Lima, S.; Marun, B.; Alves, P.V.; Bain, O.

2012-01-01

The waltonelline Ochoterenella esslingeri n. sp., a filarial parasite of the anuran Bokermannohyla luctuosa in Minas Gerais, Brazil is described. Several characters distinguish this new species from the 15 species presently included in the genus: the cuticular ornamentation of the female that is restricted to the posterior region of the body, the irregular arrangement of the small, rounded bosses, the postoesophageal vulva, the short glandular oesophagus, the size and shape of the microfilariae, the long left spicule and high spicular ratio. Irregularly arranged, tiny, rounded bosses are common in the monotypic genus Paraochoterenella from an Indonesian ranid, which is not well defined but likely valid. In the Neotropical Realm, the type hosts of the species of Ochoterenella are Hylidae (O. esslingeri n. sp.), Leptodactylidae (two species) and the remaining 13 species were described from the giant toad Rhinella marina (Bufonidae). PMID:23193518

The Roswell Park Cancer Institute experience with extramammary Paget's disease.

PubMed

Zollo, J D; Zeitouni, N C

2000-01-01

Extramammary Paget's disease (EMPD) is a rare intraepithelial neoplasm. Common sites of occurrence include the vulva, perianal region, perineum and scrotum. Despite frequent recurrences, surgery is the standard treatment. This study examines the recurrence rate for EMPD treated by conventional surgical management. Alternative and multimodal therapeutic approaches are reviewed. This retrospective analysis included all 30 patients treated for EMPD at Roswell Park Cancer Institute (RPCI) between 1970 and 1998. Following conventional surgical treatment, 44% of our patients developed recurrence. Vulvectomy provided the lowest recurrence rate, but involved extensive tissue loss and functional debility. Multimodal treatment using Mohs' micrographic surgery and photodynamic therapy has been used at RPCI to manage EMPD with minimal tissue loss and no functional impairment. Surgical treatment offers a moderate chance of EMPD cure. Long-term multimodal approaches require close follow-up, but may conserve both tissue and function.

First report of vaginal prolapse in a bitch treated with oestrogen.

PubMed

Sarrafzadeh-Rezaei, F; Saifzadeh, S; Mazaheri, R; Behfar, M

2008-06-01

Vaginal prolapse is the protrusion of edematous vaginal tissue into and through the opening of the vulva occurring during the pro-oestrus and oestrus stages of the sexual cycle. True vaginal prolapse may occur near parturition, as the concentration of serum progesterone declines and the concentration of serum oestrogen increases. In a bitch, true vaginal prolapse is a very rare condition. This case report describes an 18-month-old crossbreed bitch, weighing 40 kg presented with type III vaginal prolapse. The patient had developed vaginal prolapse after receiving oestrogen in order to oestrus induction. Subsequent to unsuccessful attempts for repositioning, ovariohysterectomy (OHE), circumferential excision of the prolapsed tissue and finally vulvoplasty were performed. There was no evidence of recurrence of the prolapse during 30 days after surgery. This case report describes type III vaginal prolapse as an unusual side effect of oestrus induction hormonal therapy in the bitch.

Vulvar disease in children: a clinical audit of 130 cases.

PubMed

Fischer, G; Rogers, M

2000-01-01

We evaluated 130 prepubertal girls presenting with a vulvar complaint to determine the spectrum and frequency of conditions seen in this age group. Of the patients, 41 (33%) had atopic or irritant dermatitis, 23 (18%) had lichen sclerosus, 21 (17%) had psoriasis, 15 (12%) had vulvar lesions, most often hemangiomas and nevi, and 13 (10%) had streptococcal vulvovaginitis. Diagnoses less frequently seen were staphylococcal folliculitis (four patients), labial fusion (three patients), genital warts (two patients), molluscum contagiosum of the vulva only (one patient), vulvar bullous pemphigoid (two patients), scabies nodules (one patient), erythema annulare centrifugum (one patient), tinea (two patients), and vitiligo (one patient). We also encountered vulvar presentations of systemic diseases (varicella, staphylococcal scalded skin syndrome, and Henoch-Schönlein purpura, all one patient each). We did not see candidal vulvovaginitis in this age group nor did we encounter bacterial infection with pathogens other than Staphylococcus aureus and S. pyogenes.

[Verrucous carcinoma of the vulva: a tailored treatment].

PubMed

Louis-Sylvestre, C; Chopin, N; Constancis, E; Plantier, F; Paniel, B-J

2003-11-01

Verrucous carcinoma is a rare form of vulvar squamous carcinoma, with particular clinical presentation and histological description. We analyze the specificity of the treatment of this form. We analyzed the records of 8 patients treated in our hospital between 1995 and 2001. In the absence of an associated lesion, the treatment was partial vulvectomy without lymph node dissection. A close follow-up was then organized. Mean age was 76 years (range 54 to 92). In 7 out of the 8 cases we found an associated lesion: invasive squamous carcinoma, VIN III or lichen. Two patients later developed a squamous carcinoma. Two others died because of intercurrent diseases. The last four patients are doing well. We confirm the efficacy of the treatment generally proposed: partial vulvectomy, without lymph node dissection and without complementary treatment but with a close follow-up. The coexistence of other vulvar lesions such as lichen is remarkable in our series.

New species of Oswaldocruzia (Nematoda: Molineoidae), new species of Rhabdias (Nematoda: Rhabdiasidae), and other helminths in Rana cf. forreri (Anura: Ranidae) from Costa Rica.

PubMed

Bursey, Charles R; Goldberg, Stephen R

2005-06-01

Oswaldocruzia costaricensis n. sp. (Strongylida: Molineidae) from the intestines and Rhabdias savagei n. sp. (Rhabditida: Rhabdiasidae) from the lungs of Rana cf. forreri (Anura: Ranidae) are described and illustrated. Oswaldocruzia costaricensis represents the 77th species assigned to the genus and differs from the other Neotropical species in the genus by possessing a Type II bursa and long cervical alae. Rhabdias savagei represents the 47th species assigned to the genus and differs from other Neotropical species in the genus by possession of 4 lips and a postequatorial vulva. Rana cf. forreri was also found to harbor the trematodes, Haematoloechus parcivitellarius and Megalodiscus temperatus, the nematodes, Aplectana incerta, Aplectana itzocanensis, Cosmocerca podicipinus, Foleyellides striatus, Subulascaris falcaustriformis, and a larva of the nematode Brevimulticaecum sp. Cosmocerca panamaensis is considered to be a synonym of Cosmocerca podicipinus.

Vittatidera zeaphila (Nematoda: Heteroderidae), a new genus and species of cyst nematode parasitic on corn (Zea mays)

PubMed Central

Handoo, Zafar A.; Powers, Thomas O.; Donald, Patricia A.; Heinz, Robert D.

2010-01-01

A new genus and species of cyst nematode, Vittatidera zeaphila, is described from Tennessee. The new genus is superficially similar to Cactodera but is distinguished from other cyst-forming taxa in having a persistent lateral field in females and cysts, persistent vulval lips covering a circumfenestrate vulva, and subventral gland nuclei of the female contained in a separate small lobe. Infective juveniles (J2) are distinguished from all previously described Cactodera spp. by the short stylet in the second-stage juvenile (14-17 μm); J2 of Cactodera spp. have stylets at least 18 μm long. The new species also is unusual in that the females produce large egg masses. Known hosts are corn and goosegrass. DNA analysis suggests that Vittatidera forms a separate group apart from other cyst-forming genera within Heteroderinae. PMID:22736850

Vittatidera zeaphila (Nematoda: Heteroderidae), a new genus and species of cyst nematode parasitic on corn (Zea mays).

PubMed

Bernard, Ernest C; Handoo, Zafar A; Powers, Thomas O; Donald, Patricia A; Heinz, Robert D

2010-06-01

A new genus and species of cyst nematode, Vittatidera zeaphila, is described from Tennessee. The new genus is superficially similar to Cactodera but is distinguished from other cyst-forming taxa in having a persistent lateral field in females and cysts, persistent vulval lips covering a circumfenestrate vulva, and subventral gland nuclei of the female contained in a separate small lobe. Infective juveniles (J2) are distinguished from all previously described Cactodera spp. by the short stylet in the second-stage juvenile (14-17 μm); J2 of Cactodera spp. have stylets at least 18 μm long. The new species also is unusual in that the females produce large egg masses. Known hosts are corn and goosegrass. DNA analysis suggests that Vittatidera forms a separate group apart from other cyst-forming genera within Heteroderinae.

Description of Alaeuris stehlini n. sp. and Alaeuris numidica canariensis n. ssp. (Nematoda, Pharyngodonidae), parasite of Gallotia stehlini, lacertid of Grand Canary Island (Spain).

PubMed

Zapatero, C; Castaño, C; Zapatero, L M

1999-03-01

Pharyngodonid nematodes (Oxyuroidea) belonging to the genus Alaeuris Thapar, 1925, were collected from the posterior gut of Gallotia stehlini (Lacertidae) from Grand Canary Island. Two species Alaeuris stehlini n. sp. and Alaeuris numidica canariensis n. ssp. were identified. The new species is described in which the long thin males are characterized by narrow caudal alae, a rounded first pair of adanal papillae non pedunculate, the second pair attached and elongate, the three pair teated; a short narrow V plate and a relatively long caudal appendage. The females are also long and thin with a slightly salient vulva, a conical pointed caudal appendage, oesophageal length approximately one third of body, excretory pore below the oesophageal bulb. The new subspecies most closely resembles Alaeuris numidica numidica. (Seurat, 1918) Petter, 1966 and Alaeuris numidica madagascariensis Petter, 1966.

[Grading of gynecological tumors : Current aspects].

PubMed

Horn, L-C; Mayr, D; Brambs, C E; Einenkel, J; Sändig, I; Schierle, K

2016-07-01

Histopathological assessment of the tumor grade and cell type is central to the management and prognosis of various gynecological malignancies. Conventional grading systems for squamous carcinomas and adenocarcinomas of the vulva, vagina and cervix are poorly defined. For endometrioid tumors of the female genital tract as well as for mucinous endometrial, ovarian and seromucinous ovarian carcinomas, the 3‑tiered FIGO grading system is recommended. For uterine neuroendocrine tumors the grading system of the gastrointestinal counterparts has been adopted. Uterine leiomyosarcomas are not graded. Endometrial stromal sarcomas are divided into low and high grades, based on cellular morphology, immunohistochemical and molecular findings. A chemotherapy response score was established for chemotherapeutically treated high-grade serous pelvic cancer. For non-epithelial ovarian malignancies, only Sertoli-Leydig cell tumors and immature teratomas are graded. At this time molecular profiling has no impact on the grading of tumors of the female genital tract.

Pathology of Neuroendocrine Tumours of the Female Genital Tract.

PubMed

Howitt, Brooke E; Kelly, Paul; McCluggage, W Glenn

2017-09-01

Neuroendocrine tumours are uncommon or rare at all sites in the female genital tract. The 2014 World Health Organisation (WHO) Classification of neuroendocrine tumours of the endometrium, cervix, vagina and vulva has been updated with adoption of the terms low-grade neuroendocrine tumour and high-grade neuroendocrine carcinoma. In the endometrium and cervix, high-grade neoplasms are much more prevalent than low-grade and are more common in the cervix than the corpus. In the ovary, low-grade tumours are more common than high-grade carcinomas and the term carcinoid tumour is still used in WHO 2014. The term ovarian small-cell carcinoma of pulmonary type is included in WHO 2014 for a tumour which in other organs is termed high small-cell neuroendocrine carcinoma. Neuroendocrine tumours at various sites within the female genital tract often occur in association with other neoplasms and more uncommonly in pure form.

Photodynamic therapy in patients with recurrent gynecological carcinomas

NASA Astrophysics Data System (ADS)

Hetzel, Heinz; Mueller, Elisabeth; Kostron, Herwig

1993-03-01

Patients with recurrent gynecological carcinomas have a poor prognosis with a median survival time of 3 - 6 months. Four patients with recurrent vulva carcinomas, one patient with a recurrent breast cancer, and one with a recurrent cervical carcinoma underwent PDT after parenteral or topical sensitization with Photosan 3. Of those patients two women made a complete recovery with no evidence of disease 27 and 24 months after. One patient responded partially with two recurrences which were retreated twice after topical sensitization, she has survived 16 months. The remaining patients showed partial response and died 3 and 8 months after PDT. The energy delivered by an argon-dye-laser ranged between 225 and 750 J/cm2. Photosan 3 was given intravenously at a dose of 2.5 mg/kg body weight and was tolerated without any allergic reaction. A response rate of nearly 50% in recurrent gynecological malignancies encourages us to pursue PDT in gynecological diseases.

Combined application of optical methods to increase the information content of optical coherent tomography in diagnostics of neoplastic processes

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kuranov, R V; Sapozhnikova, V V; Shakhova, N M

2002-11-30

A combined application of optical methods [optical coherent tomography (OCT), cross-polarisation optical coherent tomography, and fluorescence spectroscopy] is proposed for obtaining information on morphological and biochemical changes occurring in tissues in norm and pathology. It is shown that neoplastic and scar changes in esophagus can be distinguished using a combination of polarisation and standard OCT due to the difference between the depolarising properties of the tissues caused by the structural properties of collagenic fibres in stroma. It is shown that OCT combined with fluorescence spectroscopy with the use of 5-aminolevulinic acid is promising for determining the boundaries of carcinoma ofmore » the uterine cervix and vulva. It is found that the tumour boundary detected by optical methods coincides with the morphological boundary and extends beyond colposcopically determined boundary by about 2 mm. (laser biology and medicine)« less

Description of Thecavermiculatus andinus n.sp. (Meloidoderidae), a Round Cystoid Nematode from the Andes Mountains of Peru.

PubMed

Golden, A M; Franco, J; Jatala, P; Astogaza, E

1983-07-01

Thecavermiculatus andinus n.sp. is described and illustrated from Oxalis tuberosa originally collected in the vicinity of Lake Titicaca high in the Andes mountains of southern Peru. This new species differs markedly front the other two species in the genus, especially in having a much greater female vulval-anal distance and annules with lined punctation on most of the female body with a lacelike pattern restricted to the posterior portion, particularly at the vulva and anus which do not protrude. Females are essentially spherical with protruding neck, white to yellowish in color, and can easily be mistaken for potato cyst nematodes. Among the dozen or more known weed and crop host plants are potato and eggplant. In order to accommodate this new species, the genus Thecavermieulatus is emended. A key to the species of this genus is presented.

Description of Thecavermiculatus andinus n.sp. (Meloidoderidae), a Round Cystoid Nematode from the Andes Mountains of Peru

PubMed Central

Golden, A. M.; Franco, J.; Jatala, P.; Astogaza, E.

1983-01-01

Thecavermiculatus andinus n.sp. is described and illustrated from Oxalis tuberosa originally collected in the vicinity of Lake Titicaca high in the Andes mountains of southern Peru. This new species differs markedly front the other two species in the genus, especially in having a much greater female vulval-anal distance and annules with lined punctation on most of the female body with a lacelike pattern restricted to the posterior portion, particularly at the vulva and anus which do not protrude. Females are essentially spherical with protruding neck, white to yellowish in color, and can easily be mistaken for potato cyst nematodes. Among the dozen or more known weed and crop host plants are potato and eggplant. In order to accommodate this new species, the genus Thecavermieulatus is emended. A key to the species of this genus is presented. PMID:19295818

The pharmacology of gynaecology.

PubMed

Tothill, A

1980-09-01

Focus in this discussion of the pharmacology of gynecology is on the following: vaginal infections; genital herpes; genital warts; pelvic inflammatory disease; urinary infections; pruritus vulvae; menstrual problems; infertility; oral contraception; and hormone replacement therapy. Doctors in England working in Local Authority Family Planning Clinics are debarred from prescribing, and any patient with a vaginal infection has to be referred either to a special clinic or to her general practitioner which is often preferable as her medical history will be known. Vaginal discharge is a frequent complaint, and it is necessary to obtain full details. 1 of the most common infections is vaginal candidosis. Nystatin pessaries have always been a useful 1st-line treatment and are specific for this type of infection. Trichomonas infection also occurs frequently and responds well to metronidazole in a 200 mg dosage, 3 times daily for 7 days. It is necessary to treat the consort at the same time. Venereal diseases such as syphilis and gonorrhea always require vigorous treatment. Patients are now presenting with herpes genitalis far more often. The only treatment which is currently available, and is as good as any, is the application of warm saline to the vaginal area. Genital warts may be discovered on routine gynecological examination or may be reported to the doctor by the patient. 1 application of a 20% solution of podophyllum, applied carefully to each wart, usually effects a cure. Pelvic inflammatory disease seems to be on the increase. Provided any serious disease is ruled out a course of systemic antibiotics is often effective. Urinary infections are often seen in the gynecologic clinic, and many of these will respond well to 2 tablets of co-trimoxazole, 2 times daily for 14 days. In pruritus vulvae it is important to determine whether the cause is general or local. Menstrual problems regularly occur and have been increased by the IUD and the low-dose progesterone pill. Infertility necessitates investigation. It is helpful to use the temperature chart method to determine whether the patient is ovulating. Oral contraception merits only passing mention, i.e., the introduction of a new sequential pill containing ethynloestradiol and levonorgestrol. There is always the question of a possible relationship between long-term OC use and the development of endometrial cancer. There are certain definite indications for hormone replacement therapy, i.e., hot flushes, sweating and atrophic vaginitis.

The detoxification effect of vitamin C on zearalenone toxicity in piglets.

PubMed

Su, Yang; Sun, Yuchen; Ju, Daxin; Chang, Siying; Shi, Baoming; Shan, Anshan

2018-08-30

Zearalenone (ZEN), one of the more virulent mycotoxins occurred in various cereals and feed during recent decades and made serious health hazards to plants, animals and humans. Vitamin C (Vc) has been shown to be an effective antidote to zearalenone. In this paper, the effects of diets containing zearalenone on the growth performance, genital organ and immunoglobulin of weaning piglets and the toxicity alleviation of vitamin C were studied. Piglets were weaned at 21 days of age and 32 healthy female hybrid weaning piglets (Duroc × Landrace × Large white) with a mean weight of 12.27 ± 0.30 kg were randomly selected. The thirty-two female weaning piglets were divided into four treatment groups according to body weight: control; basal diet + vitamin C (150 mg/kg); basal diet + 1.0 mg/kg ZEN; basal diet + 1 mg/kg ZEN+vitamin C (150 mg/kg). There were eight replicates in each group. The test period was twenty-eight days. The results demonstrated that dietary zearalenone could significantly increase the length, width and area of vulva (P < 0.05), the genital organ coefficient (P < 0.05), the level of IgA, IgG and IgM (P < 0.05), the level of BUN, CRE, AST and TBIL (P < 0.05), and significantly decrease the level of E2, PROG, LH and FSH (P < 0.05). However, the addition of 150 mg/kg vitamin C to dietary zearalenone prevented deformities in the vulva, decrease in immune response capacity, changes in serum biochemical indicators and disorders in hormones level of the piglets that received the diet containing only zearalenone. In conclusion, feeding ZEN of 1.0 mg/kg can result in a deleterious effect on piglets, which was totally or partly ameliorated by dietary supplementation of vitamin C at concentrations about 150 mg/kg diet. This study systematically investigated the inhibition mechanism of vitamin C on ZEN-induced reproductive toxicity, immunotoxicity and hematological toxicity of piglets, and which provided new ideas for reducing the harm of mycotoxins to the animals through means of nutrition regulation. Copyright © 2018 Elsevier Inc. All rights reserved.

Intravaginal practices and microbicide acceptability in Papua New Guinea: implications for HIV prevention in a moderate-prevalence setting

PubMed Central

2012-01-01

Background The acceptability of female-controlled biomedical prevention technologies has not been established in Papua New Guinea, the only country in the Pacific region experiencing a generalised, moderate-prevalence HIV epidemic. Socio-cultural factors likely to impact on future product uptake and effectiveness, such as women’s ability to negotiate safer sexual choices, and intravaginal hygiene and menstrual practices (IVP), remain unclear in this setting. Methods A mixed-method qualitative study was conducted among women and men attending a sexual health clinic in Port Moresby. During in-depth interviews, participants used copies of a hand-drawn template to indicate how they wash/clean the vulva and/or vagina. Interviewers pre-filled commercially available vaginal applicators with 2-3mL KY Jelly® to create a surrogate vaginal microbicide product, which was demonstrated to study participants. Results A total of 28 IDIs were conducted (women=16; men=12). A diverse range of IVP were reported. The majority of women described washing the vulva only with soap and water as part of their daily routine; in preparation for sex; and following sexual intercourse. Several women described cleaning inside the vagina using fingers and soap at these same times. Others reported cleaning inside the vagina using a hose connected to a tap; using vaginal inserts, such as crushed garlic; customary menstrual ‘steaming’ practices; and the use of material fragments, cloth and newspaper to absorb menstrual blood. Unprotected sex during menstruation was common. The majority of both women and men said that they would use a vaginal microbicide gel for HIV/STI protection, should a safe and effective product become available. Microbicide use was considered most appropriate in ‘high-risk’ situations, such as sex with non-regular, transactional or commercial partners. Most women felt confident that they would be able to negotiate vaginal microbicide use with male sexual partners but if necessary would be prepared to use product covertly. Conclusions Notional acceptability of a vaginal microbicide gel for HIV/STI prevention was high among both women and men. IVP were diverse in nature, socio-cultural dimensions and motivators. These factors are likely to impact on the future acceptability and uptake of vaginal microbicides and other biomedical HIV prevention technologies in this setting. PMID:23116431

Functional morphology of the female reproductive system of a crab with highly extensible seminal receptacles and extreme sperm storage capacity.

PubMed

Farias, Nahuel E; Spivak, Eduardo D; Luppi, Tomas A

2017-07-01

We studied the functional morphology of the female reproductive system of the purple stone crab Danielethus crenulatus. The most remarkable feature is the relative storage capacity and extensibility of the seminal receptacles. These receptacles are a pair of simple sacs that lack internal structures dividing the internal lumen. Differences in seminal receptacle size and contents are accompanied by conspicuous changes in receptacle lining at a tissue level. Full seminal receptacles contain discrete sperm masses formed by hardened fluid and densely packed spermatophores. Different sperm masses are likely from different mates and their stratified disposition within the seminal receptacles is compatible with rival sperm displacement and last sperm precedence. Additionally, the anatomical structure of the vulva and vagina suggest active female control over copula. We discuss our results in the general context of sperm storage in brachyurans and the implications for the mating system of this species. © 2017 Wiley Periodicals, Inc.

Activity of the C. elegans egg-laying behavior circuit is controlled by competing activation and feedback inhibition

PubMed Central

Collins, Kevin M; Bode, Addys; Fernandez, Robert W; Tanis, Jessica E; Brewer, Jacob C; Creamer, Matthew S; Koelle, Michael R

2016-01-01

Like many behaviors, Caenorhabditis elegans egg laying alternates between inactive and active states. To understand how the underlying neural circuit turns the behavior on and off, we optically recorded circuit activity in behaving animals while manipulating circuit function using mutations, optogenetics, and drugs. In the active state, the circuit shows rhythmic activity phased with the body bends of locomotion. The serotonergic HSN command neurons initiate the active state, but accumulation of unlaid eggs also promotes the active state independent of the HSNs. The cholinergic VC motor neurons slow locomotion during egg-laying muscle contraction and egg release. The uv1 neuroendocrine cells mechanically sense passage of eggs through the vulva and release tyramine to inhibit egg laying, in part via the LGC-55 tyramine-gated Cl- channel on the HSNs. Our results identify discrete signals that entrain or detach the circuit from the locomotion central pattern generator to produce active and inactive states. DOI: http://dx.doi.org/10.7554/eLife.21126.001 PMID:27849154

Labia Minora, Labia Majora, and Clitoral Hood Alteration: Experience-Based Recommendations.

PubMed

Hunter, John G

2016-01-01

Aesthetic alteration of the genitalia is increasingly sought by women unhappy with the size, shape, and appearance of their vulva. Although the labia minora are usually the focus of concern, the entire anatomic region--minora, labia majora, clitoral hood, perineum, and mons pubis--should be evaluated in a preoperative assessment of women seeking labiaplasty. Labiaplasty is associated with high patient satisfaction and low complication rates. The three basic labia minora reduction techniques--edge excision, wedge excision, and central deepithelialization--as well as their advantages and disadvantages are discussed to assist the surgeon in tailoring technique selection to individual genital anatomy and aesthetic desires. We present key points of the preoperative anatomic evaluation, technique selection, operative risks, perioperative care, and potential complications for labia minora, labia majora, and clitoral hood alterations, based on a large operative experience. Labiaplasty competency should be part of the skill set of all plastic surgeons. © 2015 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

Fluorescence diagnostics in oncological gynecology

NASA Astrophysics Data System (ADS)

Belyaeva, Ludmila A.; Adamyan, Leila V.; Kozachenko, Vladimir P.; Stratonnikov, Alexander A.; Stranadko, Eugene F.; Loschenov, Victor B.

2003-10-01

The method of fluorescent diagnostics (FD) of tumors is a promising tool that may allow to increase sensitivity of tumor detection especially at initial stages. One of the most promising photosensitizers today is 5-aminolevulinic acid (5-ALA) that, actually, is not photosensitizer itself but precursor of protoporphyrin IX (PpIX). This paper deals with cancer diagnostics in gynecology by means of ALA-induced Pp IX laser-fluorescence spectroscopy. The tissue fluorescence spectra in vivo were studied in patients with various pathologies of ovaries, uterine and vulva after 5-aminolevulinic acid administration. It was shown that different pathologies varies in accumulation of Pp IX. Coefficient of fluorescence kf for normal tissue is not high, but exceptions are endometrium and mucous membrane of uterine tubes. Benign tumors of uterus and ovary have low values of kf, but polyps of endometrium exhibit high kf. Optical express-biopsy is important for diagnosis of ovarian cancer and micrometastatic spread. Coefficients of diagnostic contrast were determined for cancer of endometrium, cervical cancer, vulvar cancer.

Toward Universal Forward Genetics: Using a Draft Genome Sequence of the Nematode Oscheius tipulae To Identify Mutations Affecting Vulva Development

PubMed Central

Besnard, Fabrice; Koutsovoulos, Georgios; Dieudonné, Sana; Blaxter, Mark; Félix, Marie-Anne

2017-01-01

Mapping-by-sequencing has become a standard method to map and identify phenotype-causing mutations in model species. Here, we show that a fragmented draft assembly is sufficient to perform mapping-by-sequencing in nonmodel species. We generated a draft assembly and annotation of the genome of the free-living nematode Oscheius tipulae, a distant relative of the model Caenorhabditis elegans. We used this draft to identify the likely causative mutations at the O. tipulae cov-3 locus, which affect vulval development. The cov-3 locus encodes the O. tipulae ortholog of C. elegans mig-13, and we further show that Cel-mig-13 mutants also have an unsuspected vulval-development phenotype. In a virtuous circle, we were able to use the linkage information collected during mutant mapping to improve the genome assembly. These results showcase the promise of genome-enabled forward genetics in nonmodel species. PMID:28630114

Seven new species of Psechrus and additional taxonomic contributions to the knowledge of the spider family Psechridae (Araneae).

PubMed

Bayer, Steffen

2014-01-27

Seven new Psechrus species are described from South East Asia: P. arietinus sp. nov.(♂♀, Vietnam), P. insulanus sp. nov.(♂, Thailand), P. ampullaceus sp. nov.(♂♀, Vietnam), P. omistes sp. nov.(♂, Indonesia, Sumatra), P. quasillus sp. nov.(♂♀, Malaysia, Borneo), P. huberi sp. nov.(♀, Philippines), and P. wade sp. nov.(♂, Philippines). For the following species, new records are listed and intraspecific variation is discussed and illustrated: P. libelti Kulczyński, 1908, P. norops Bayer, 2012, P. rani Wang & Yin, 2001, P. khammouan Jäger, 2007, P. luangprabang Jäger, 2007, P. jaegeri Bayer, 2012, P. obtectus Bayer, 2012, P. kenting Yoshida, 2009 and P. crepido Bayer, 2012, and Fecenia protensa Thorell, 1891. The latter species is recorded from Vietnam for the first time. P. norops, P. libelti and an unidentified Psechrus species from Baluno, Mindanao are for the first time characterised and illustrated by their pre-epigynes and pre-vulvae.

The anesthetic action of ethanol analyzed by genetics in Caenorhabditis elegans

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hong, Mingi; Choi, Myung Kyu; Lee, Junho

2008-02-29

Acute exposure to ethanol causes paralysis at high concentrations in the nematode Caenorhabditis elegans. We set out to elucidate the mechanism of the anesthetic action of ethanol by genetic approaches. We identified nine mutations that conferred reduced sensitivity to ethanol after chemical, irradiation, or transposon insertion mutagenesis. Of these nine, we further characterized five mutations that defined four genes, jud-1-jud-4. Analysis of the phenotypes of the animals heterozygous for two unlinked genes revealed that jud-1 and jud-3 act synergistically in a gene dose-dependent manner. We cloned jud-4 and found that it encodes a protein with limited homology to human Homermore » proteins. jud-4 was expressed in the hypodermis and vulva muscles, suggesting that this gene acts in tissues directly exposed to the external environment. Characterization of the other mutations identified in this study will facilitate the elucidation of the molecular mechanism for the anesthetic action of ethanol.« less

Gender-specific genital and subjective sexual arousal to prepotent sexual features in heterosexual women and men.

PubMed

Spape, Jessica; Timmers, Amanda D; Yoon, Samuel; Ponseti, Jorge; Chivers, Meredith L

2014-10-01

Heterosexual women respond genitally to stimuli featuring both their preferred and nonpreferred genders, whereas men's genital responses are gender-specific, suggesting that gender cues are less relevant to women's sexual response. Instead, prepotent sexual features (exposed and sexually aroused genitals), ubiquitous in audiovisual sexual stimuli, may elicit automatic genital responses, thereby leading to a nonspecific sexual arousal pattern in women. To examine the role of stimulus potency in women's sexual response, we assessed heterosexual women's and men's genital and subjective sexual arousal to slideshows of prepotent stimuli (erect penises and aroused vulvas), non-prepotent stimuli (flaccid penises and female pubic triangles), and sexually neutral stimuli. Contrary to our hypotheses, both women and men demonstrated gender-specific genital and subjective sexual arousal, such that sexual arousal was greatest to prepotent male and female stimuli, respectively. This is the first study to demonstrate gender-specific genital responding in heterosexual women. Copyright © 2014 Elsevier B.V. All rights reserved.

Toward Universal Forward Genetics: Using a Draft Genome Sequence of the Nematode Oscheius tipulae To Identify Mutations Affecting Vulva Development.

PubMed

Besnard, Fabrice; Koutsovoulos, Georgios; Dieudonné, Sana; Blaxter, Mark; Félix, Marie-Anne

2017-08-01

Mapping-by-sequencing has become a standard method to map and identify phenotype-causing mutations in model species. Here, we show that a fragmented draft assembly is sufficient to perform mapping-by-sequencing in nonmodel species. We generated a draft assembly and annotation of the genome of the free-living nematode Oscheius tipulae , a distant relative of the model Caenorhabditis elegans We used this draft to identify the likely causative mutations at the O. tipulae cov -3 locus, which affect vulval development. The cov-3 locus encodes the O. tipulae ortholog of C. elegans mig-13 , and we further show that Cel-mig-13 mutants also have an unsuspected vulval-development phenotype. In a virtuous circle, we were able to use the linkage information collected during mutant mapping to improve the genome assembly. These results showcase the promise of genome-enabled forward genetics in nonmodel species. Copyright © 2017 by the Genetics Society of America.

Primary clitoral adenocarcinoma with secondary hypercalcemia of malignancy in a dog.

PubMed

Neihaus, Steven A; Winter, Jennifer E; Goring, Robert L; Kennedy, F A; Kiupel, Matti

2010-01-01

This report describes a primary clitoral adenocarcinoma in a dog with secondary hypercalcemia of malignancy. A 10-year-old, spayed female basset hound was evaluated for a mass protruding from the vulva. The mass was excised, and a histological diagnosis of clitoral adenocarcinoma was made. No evidence of metastasis on thoracic radiographs or abdominal ultrasound was seen. Preoperative hypercalcemia resolved following excision of the mass. Cellular features were similar to an apocrine gland anal sac adenocarcinoma, and immunohistochemistry exhibited features noted with apocrine gland anal sac adenocarcinoma. No further treatment was elected by the owner. Internal iliac lymph-node metastasis was identified 4 weeks postoperatively, and hypercalcemia recurred 8 weeks postoperatively. The dog was euthanized 22 weeks postoperatively for signs related to hypercalcemia, including polyuria/polydipsia, lethargy, and weakness. A necropsy was performed and confirmed the presence of internal iliac lymph-node metastasis. The colon, rectum, and anal sacs were grossly and histologically normal. To our knowledge, this is the first reported case of clitoral neoplasia in the dog.

A clitoral verrucous carcinoma in an area of lichen planus has aggressive features.

PubMed

Tjalma, Wiebren A A; Siozopoulou, Vasiliki; Huizing, Manon T

2017-01-06

Verrucous carcinoma of the vulva is extremely rare. It is a slow growing, low malignant variant of a squamous cell carcinoma with a cauliflower appearance. Women with lichen planus have an increased risk of developing vulval cancer. A 79-year-old woman consulted for vulval itching. On clinical examination, a 3-cm large verrucous clitoral cancer in an area of lichen planus was seen. Based on her last clinical examination, the growth was estimated to be 1 cm 2 per month with an invasion depth after 6 months of 5 mm. A tumor developing in an area of lichen planus appears to have more aggressive features. This is the first time that the growth of a verrucous carcinoma has been documented in an area of lichen planus. Clinicians and patients should be aware of the aggressive behavior of cancers developing in areas of lichen planus and adjust their surgical management together with the follow-up strategy.

Assembling a Functional Clitoris and Vulva from a Pseudo-Penis: A Surgical Technique for an Adult Woman with Congenital Adrenal Hyperplasia.

PubMed

Tjalma, Wiebren A A

2017-06-01

Congenital adrenal hyperplasia (CAH) is associated with a genital deformation that might cause a negative body image. The genital ambiguity is generally "corrected" surgically during early infancy. The advantage is a psychological benefit. The disadvantages are multiple surgical procedures and the loss of orgasm. A 22-year-old woman with CAH consulted for genital reconstructive surgery. She had a pseudopenis of 4 cm and could achieve an orgasm by masturbating. During surgery, the penis was dismantled and with the preserved glans penis and the corpora cavernosa, a clitoris and vestibules were constructed, respectively. On the basis of the anamneses during the follow-up, she had a functional vagina and could still achieve orgasms. Genital correction surgery for CAH at an older age was easier, could be done in 1 step, and enabled the preservation of orgasm. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Antibody–drug conjugates and other nanomedicines: the frontier of gynaecological cancer treatment

PubMed Central

Howard, David; Garcia-Parra, Jetzabel; Healey, Gareth D.; Amakiri, Cynthia; Margarit, Lavinia; Francis, Lewis W.; Gonzalez, Deyarina

2016-01-01

Gynaecological cancers: malignancies of the cervix, uterus, ovaries, vagina and vulva, are responsible for over 1.1 million new cancer cases and almost half a million deaths annually. Ovarian cancer in particular is difficult to treat due to often being diagnosed at a late stage, and the incidence of uterine and vulvar malignancies are both on the rise. The field of nanomedicine is beginning to introduce drugs into the clinic for oncological applications exemplified by the liposomal drugs, Doxil and Myocet, the nanoparticle, Abraxane and antibody–drug conjugates (ADCs), Kadcyla and Adcetris. With many more agents currently undergoing clinical trials, the field of nanomedicine promises to have a significant impact on cancer therapy. This review considers the state of the art for nanomedicines currently on the market and those being clinically evaluated for the treatment of gynaecological cancers. In particular, it focuses on ADCs and presents a methodology for their rational design and evaluation. PMID:27920893

A new species of Procyrnea (Nematoda: Habronematidae) parasitic in Rhea pennata (Aves: Rheidae) from Patagonia, Argentina, with a key to species of the genus.

PubMed

Bagnato, E; Frixione, M; Digiani, M C; Cremonte, F

2017-07-31

Procyrnea choique n. sp. is described from the lesser rhea, Rhea pennata d´Orbigny (Aves: Rheidae), from the Protected Natural Area Península Valdés, Chubut province, Argentina. The new species resembles P. ficheuri, P. murrayi, P. excisiformis, P. dollfusi, P. haliasturi, P. anterovulvata, P. graculae, P. brevicaudata, P. uncinipenis, P. javaensis, P. ameerae, P. ornata, P. aegotheles, P. spiralis, P. ruschii and P. aptera, mainly in the absence of lateral alae; but differs from its congeners by having a left spicule without barbs, the position of the vulva which is post-equatorial, the absence of lateral ridges, absent median precloacal papilla, asymmetrical caudal alae, males more than 6 mm long, left spicule 1 mm long and spicule ratio 1:3. Our results extend the taxonomy of Procyrnea Chabaud, 1958 and comprise the first report of a habronematid from R. pennata. A key to species of Procyrnea is presented.

Population-based HPV vaccination programmes are safe and effective: 2017 update and the impetus for achieving better global coverage.

PubMed

Brotherton, Julia M L; Bloem, Paul N

2018-02-01

Persistent oncogenic human papillomavirus (HPV) is the cause of cervical cancer, as well as cancers of the anus, penis, vulva, vagina and oropharynx. There is good evidence that prophylactic HPV vaccines are immunogenic and effective against targeted-type HPV infections and type-specific genital lesions, including high-grade cervical intraepithelial neoplasia (CIN), when administered prior to HPV infection. There is good evidence that HPV vaccines are safe in population usage, with the most frequent adverse event being injection-site reactions. There is evidence to support some cross-protection against non-targeted types occurring following the administration of HPV vaccines. There is limited evidence suggesting that HPV vaccines may be beneficial in preventing future disease in women treated for high-grade CIN. This chapter focuses on the accumulated evidence regarding the global use of the three licensed HPV vaccines including safety, immunogenicity, duration of protection, effectiveness, coverage to date and barriers to higher coverage. Copyright © 2018 Elsevier Ltd. All rights reserved.

Cucullanid nematodes (Nematoda: Cucullanidae) from deep-sea marine fishes off New Caledonia, including Dichelyne etelidis n. sp.

PubMed

Moravec, František; Justine, Jean-Lou

2011-02-01

Three nematode species of the family Cucullanidae, intestinal parasites of marine perciform fishes, are reported from off New Caledonia: Cucullanus bourdini Petter & Le Bel, 1992 from the crimson jobfish Pristipomoides filamentosus (Valenciennes) and the goldflag jobfish Pristipomoides auricilla (Jordan, Evermann & Tanaka) (new host record) (both Lutjanidae); Dichelyne etelidis n. sp. from the deep-water red snapper Etelis carbunculus Cuvier (type-host) and the deep-water longtail red snapper Etelis coruscans Valenciennes (both Lutjanidae); and Dichelyne sp. (only one female) from the trumpet emperor Lethrinus miniatus (Forster) (Lethrinidae). Detailed light and electron microscopical studies revealed in C. bourdini some taxonomically important, previously unreported features, such as the location of the excretory pore, nature of the vulva and the size of fully-developed eggs. The new species, D. etelidis, is characterised mainly by the length of the spicules (462-748 μm), a single intestinal caecum, the location of the deirids and excretory pore, the arrangement of the genital papillae and the host group.

Anatomy of the clitoris and the female sexual response.

PubMed

Pauls, Rachel N

2015-04-01

The clitoris may be the most pivotal structure for female sexual pleasure. While its significance has been reported for hundreds of years, no complete anatomical description was available until recently. Most of the components of the clitoris are buried under the skin and connective tissues of the vulva. It comprises an external glans and hood, and an internal body, root, crura, and bulbs; its overall size is 9-11 cm. Clitoral somatic innervation is via the dorsal nerve of the clitoris, a branch of the pudendal nerve, while other neuronal networks within the structure are complex. The clitoris is the center for orgasmic response and is embryologically homologous to the male penis. While the source of vaginal eroticism might or might not be exclusively clitoral stimulation, it is necessary to understand the intricate anatomy of the organ to assess the data in this regard. Ultimately, sexual enjoyment entails a balance of physical and emotional factors and should be encouraged. © 2015 Wiley Periodicals, Inc.

Cluster Analysis of Longidorus Species (Nematoda: Longidoridae), a New Approach in Species Identification

PubMed Central

Ye, Weimin; Robbins, R. T.

2004-01-01

Hierarchical cluster analysis based on female morphometric character means including body length, distance from vulva opening to anterior end, head width, odontostyle length, esophagus length, body width, tail length, and tail width were used to examine the morphometric relationships and create dendrograms for (i) 62 populations belonging to 9 Longidorus species from Arkansas, (ii) 137 published Longidorus species, and (iii) 137 published Longidorus species plus 86 populations of 16 Longidorus species from Arkansas and various other locations by using JMP 4.02 software (SAS Institute, Cary, NC). Cluster analysis dendograms visually illustrated the grouping and morphometric relationships of the species and populations. It provided a computerized statistical approach to assist by helping to identify and distinguish species, by indicating morphometric relationships among species, and by assisting with new species diagnosis. The preliminary species identification can be accomplished by running cluster analysis for unknown species together with the data matrix of known published Longidorus species. PMID:19262809

Laser Doppler perfusion imaging: a method for measuring female sexual response.

PubMed

Styles, S J; Maclean, A B; Reid, W M N; Sultana, S R

2006-05-01

To develop a new noninvasive technique to measure vulval blood flow changes during sexual arousal; 18 healthy volunteers between the age of 20 and 33 years were studied. Each subject underwent two experimental sessions at least 2 weeks apart to coincide with the proliferative and luteal phases of her menstrual cycle. An initial laser Doppler perfusion imaging (LDPI) scan of the vulva was performed. The subject was then given a chapter of erotic fiction to read and a repeat LDPI scan was performed immediately after. The percentage change in flux were calculated: the clitoral skin blood flow increased by 26.4% (P < 0.05), labial skin blood flow by 24.9% (P < 0.05) and the posterior fourchette skin blood flow by 35.3% (P < 0.05). LDPI can detect changes in vulval perfusion during the sexual arousal response and could be used to compare healthy subjects with female sexual dysfunction patients, as well as for assessing the benefits of any treatment for this condition.

Parapoxviral vulvovaginitis in Holstein cows.

PubMed

Moeller, Robert B; Crossley, Beate; Adaska, John M; Hsia, Gary; Kahn, Richard; Blanchard, Patricia C

2018-05-01

A group of Holstein first-calved heifers developed small pustules and ulcers on the vulva and in the vagina during the first 1-4 wk postpartum. The lesions varied from small red pinpoint foci to pustules and ulcers, 3-5 mm diameter. Some ulcers coalesced to form large ulcerated areas up to 15 mm diameter. In some animals, these ulcers progressed to become deep ulceration of the vaginal and vulvar mucosa with >50% of the mucosa involved. Vaginal biopsies from 4 heifers and vaginal individual swabs from 8 heifers for a combined sampling of 9 heifers were taken for clinical assessment. Six of the 9 heifers had parapoxvirus based on histopathology and/or PCR. Histologic examination of the biopsies of the pustules identified ballooning degeneration of the epithelium with degenerate epithelium containing eosinophilic intracytoplasmic inclusions consistent with a parapoxvirus in 3 of 4 biopsies. Testing for bovine herpesvirus 1, 2, and 4, bovine viral diarrhea virus, bovine papular stomatitis virus, and orf virus remained negative.

Further description of Aspidodera raillieti (Nematoda: Aspidoderidae) from Didelphis marsupialis (Mammalia: Didelphidae) by light and scanning electron microscopy.

PubMed

Chagas-Moutinho, V A; Oliveira-Menezes, A; Cárdenas, M Q; Lanfredi, R M

2007-10-01

Nematodes of the family Aspidoderidae (Nematoda: Heterakoidea) Freitas 1956 are widely distributed from Americas. The species of the genus Aspidodera Railliet and Henry 1912 are parasites of mammals of the orders Edentata, Marsupialia, and Rodentia. In the present work, Aspidodera raillieti (L. Travassos, Mem Inst Oswaldo Cruz 5(3):271-318, 1913), collected from the large intestine of Didelphis marsupialis (Mammalia: Didelphidae) from Valle del Cauca, Colombia, is redescribed. The association of light and scanning electron microscopy (SEM) allowed a detailed analysis of the morphology and ultrastructure of this nematode. Some taxonomic features, such as cephalic region, topography of the cuticle, sucker, spicules, posterior end of males, localization of vulva, the anus, and posterior end of females were observed. Important structures such as amphid, details of cephalic region, phasmid, and number and localization of caudal papillae are documented by SEM, for the first time adding characters to identify this species. Colombia is a new geographical record for A. raillieti.

Differentiating vulvar intraepithelial neoplasia from nonneoplastic epithelial disorders. The toluidine blue test.

PubMed

Joura, E A; Zeisler, H; Lösch, A; Sator, M O; Müllauer-Ertl, S

1998-08-01

To determine the effectiveness of the toluidine blue test in the differentiation of vulvar intraepithelial neoplasia (VIN) and nonneoplastic epithelial disorders (NNEDs). This retrospective clinical study included all women with VIN (n = 24) and NNED (n = 72) referred to a vulvar clinic at a university hospital during a two-year period. Vulvoscopy, staining of vulvar epithelium with 1% toluidine blue and punch biopsy were performed. Vulvar epithelium demonstrated toluidine blue staining in 100% of the patients with VIN 3, in 83% of women with VIN 1-2, in 50% of the women with squamous cell hyperplasia and in 10% of the women with lichen sclerosus. The differences in staining between the groups were statistically significant (P < .001). The sensitivity of toluidine blue staining for the detection of VIN was 92%; the negative predictive value 96% in teh investigated cohort. The specificity for strong staining was 88%. The toluidine blue test is an inexpensive and reliable method of separating VIN from hyperplastic NNED areas and choosing a biopsy site on the vulva.

In Vitro Detection of Characteristic Differences in Radiation Sensitivity of Female Genital Cancers

DOE Office of Scientific and Technical Information (OSTI.GOV)

LUDOVICI, PETER P.; MILLER, NORMAN F.

1962-01-01

BS>By a standardized assay technic in which cell monolayers were irradiated at different dose levels (100 to 1200 r) on the 4th culture day and cell counts carried out 4 days later, the radiation sensitivities of 37 cell strains, derived from female patients with various genital cancers and from normal individuals, were assessed. These 37 cell strains had certain patterns of radiation sensitivity which, in general, appear to be consistent with the generally accepted radiosensitivity of the tumors from which the cell strains arose. Cell strains from squamous-cell carcinomas of the cervix as a group were at least twice asmore » sensitive as those from other squamous-cell carcinomas of the female genital tract. Cell strains derived from carcinomas of the ovary, vagina, and vulva were almost equally resistant to radiation. As expected, cell strains derived from benign tissues were the most highly resistant to radiation, normal fibroblastic strains being more resistant than normal epithelial strains. (H.H.D.)« less

Surgery of the vulva in vulvar cancer.

PubMed

Micheletti, Leonardo; Preti, Mario

2014-10-01

The standard radical mutilating surgery for the treatment of invasive vulval carcinoma is, today, being replaced by a conservative and individualised approach. Surgical conservative modifications that are currently considered safe, regarding vulval lesion, are separate skin vulval-groin incisions, drawn according to the lesion diameter, and wide local radical excision or partial radical vulvectomy with 1-2 cm of clinically clear surgical margins. Regarding inguinofemoral lymph nodes management, surgical conservative modifications not compromising patient survival are omission of groin lymphadenectomy only when tumour stromal invasion is ≤ 1 mm, unilateral groin lymphadenectomy only in well-lateralised early lesions and total or radical inguinofemoral lymphadenectomy with preservation of femoral fascia when full groin resection is needed. Sentinel lymph node dissection is a promising technique but it should not be routinely employed outside referral centres. Pelvic nodes are better managed by radiation. Locally advanced vulval carcinoma can be managed by ultraradical surgery, exclusive radiotherapy or chemoradiation. Copyright © 2014 Elsevier Ltd. All rights reserved.

Neoascarophis sinensis n. sp. (Nematoda: Cystidicolidae), a parasite of Conger myriaster (Brevoort) (Anguilliformes: Congridae) in Chinese waters.

PubMed

Chen, Hui-Xia; Zhang, Lu-Ping; Du, Xin; Li, Liang

2017-05-01

Neoascarophis sinensis n. sp. collected from the whitespotted conger Conger myriaster (Brevoort) (Anguilliformes: Congridae) in the Yellow and East China Seas, is described using both light and scanning electron microscopy. The new species is characterised mainly by the body size (8.5-10.5 mm in the males, 9.5-14.0 mm in the females), the location of the vulva (near equatorial region of the body), the non-bifurcate deirids, the lengths of the vestibule (40-50 µm in the males, 30-60 µm in the females) and glandular oesophagus (2.5-3.1 mm in the males, 3.1-3.5 mm in the females) and the morphology and length of the spicules (left spicule 400-410 µm, right spicule 130-150 µm). Neoascarophis sinensis n. sp. is the first species of Neoascarophis Machida, 1976 reported from the anguilliform fish and is also the only species of this genus found in the Chinese waters.

Ribosomal protein RPS-14 modulates let-7 microRNA function in Caenorhabditis elegans

PubMed Central

Chan, Shih-Peng; Slack, Frank J.

2009-01-01

The let-7 microRNA (miRNA) regulates developmental timing at the larval-to-adult transition in Caenorhabditis elegans. Dysregulation of let-7 results in irregular hypodermal and vulval development. Disrupted let-7 function is also a feature of human lung cancer. However, little is known about the mechanism and co-factors of let-7. Here we demonstrate that ribosomal protein RPS-14 is able to modulate let-7 function in C. elegans. The RPS-14 protein co-immunoprecipitated with the nematode Argonaute homolog, ALG-1. Reduction of rps-14 gene expression by RNAi suppressed the aberrant vulva and hypodermis development phenotypes of let-7(n2853) mutant animals and the mis-regulation of a reporter bearing the lin-41 3′UTR, a well established let-7 target. Our results indicate an interactive relationship between let-7 miRNA function and ribosomal protein RPS-14 in regulation of terminal differentiation that may help in understanding the mechanism of translational control by miRNAs. PMID:19627982

ACR Appropriateness Criteria® management of locoregionally advanced squamous cell carcinoma of the vulva.

PubMed

Kidd, Elizabeth; Moore, David; Varia, Mahesh A; Gaffney, David K; Elshaikh, Mohamed A; Erickson, Beth; Jhingran, Anuja; Lee, Larissa J; Mayr, Nina A; Puthawala, Ajmel A; Rao, Gautam G; Small, William; Wahl, Andrew O; Wolfson, Aaron H; Yashar, Catheryn M; Yuh, William; Cardenes, Higinia Rosa

2013-08-01

Locoregionally advanced vulvar cancer (LRAVC) is a rare disease that presents many challenging medical decisions. An expert panel was convened to reach consensus on the most appropriate pretreatment assessment and therapeutic interventions in LRAVC patients. The American College of Radiology Appropriateness Criteria are evidenced-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journal and the application of a well-established consensus methodology (modified Delphi) to rate appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to formulate recommendations. Three clinical variants were developed to address common scenarios in the management of LRAVC. Group members reached consensus on the appropriateness of specific evaluation and treatment approaches, with numerical ratings and descriptive commentary. In combining available medical literature and expert opinion, this manuscript may serve as an aid for other practitioners in the appropriate management of patients with LRAVC.

Congenital lymphangioma circumscriptum of vulva presenting as multiple giant mass lesions: a case report and literature review.

PubMed

Akhavan, Setareh; Agah, Jila; Nili, Fatemeh

2018-05-01

A G2L2 33-year-old woman presented to our clinic with large verrucous warty masses in labia major, perinea and the end portion of her spine measuring about 15 × 7, 9 × 7 and 8 × 8 cm, which had been enlarged following puberty and pregnancy. Her right upper and left lower limbs had gross congenital lymphedema. The masses were removed by superficial partial vulvectomy with a qualified margin and repaired without skin graft. Pathology report showed lymphangioma circumscriptum. Several months of follow up revealed normal healing and no recurrence. In conclusion, congenital vulvar lymphangioma, which is a rare disorder, can be highly triggered by hormonal-stimulating situations like puberty and pregnancy. Thus, it is better to visit the affected cases in a timely manner in order to excise these lesions before massive enlargement. In our experience, a superficial partial vulvectomy without skin graft can be a sufficient procedure. Obviously, an appropriate approach during and after surgery would be very important for obtaining a desirable healing. © 2018 Japan Society of Obstetrics and Gynecology.

[Human papillomavirus nonavalent vaccine. Update 2017].

PubMed

Bosch, F X; Moreno, D; Redondo, E; Torné, A

Human papillomavirus (HPV) is the causative agent of 5% of human cancers. HPV infection is necessary for the development of cervical cancer and is responsible of a variable percentage of cancers of anus, vulva, vagina, penis, and oropharynx. Since 2007, 2 vaccines against HPV have been commercially available in Spain: bivalent (HPV types 16/18), and tetravalent (HPV types 6/11/16/18). In order to extend the protection afforded by HPV vaccines, a clinical program was launched in 2006 for the new nonavalent vaccine, including 9 HPV types (6/11/16/18/31/33/45/52/58). These types are responsible for 90% of cervical cancers, 82% of high-grade ano-genital pre-cancerous lesions, and 90% of genital warts. The purpose of this publication is to provide healthcare professionals with the scientific evidence that supports the new vaccine, as well as the clinical value that it offers in our environment. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

Vulvar Lichen Sclerosus et Atrophicus

PubMed Central

Nair, Pragya Ashok

2017-01-01

Vulvar lichen sclerosus (VLS) is a chronic inflammatory dermatosis characterized by ivory-white plaques or patches with glistening surface commonly affecting the vulva and anus. Common symptoms are irritation, soreness, dyspareunia, dysuria, and urinary or fecal incontinence. Anogenital lichen sclerosus (LS) is characterized by porcelain-white atrophic plaques, which may become confluent extending around the vulval and perianal skin in a figure of eight configuration. Thinning and shrinkage of the genital area make coitus, urination, and defecation painful. LS is not uncommon in India and present as an itchy vulvar dermatosis which a gynecologist may mistake for candidal vulvovaginitis. There is often a delay in diagnosis of VLS due to its asymptomatic nature and lack of awareness in patients as well as physicians. Embarrassment of patients due to private nature of the disease and failure to examine the genital skin properly are the other reasons for delay in diagnosis. There is no curative treatment for LS. Various medications available only relieve the symptoms. Chronic nature of the disease affects the quality of life. Proper and regular follow-up is required as there are chances of the development of squamous cell carcinoma. PMID:28706405

Mindbomb 1, an E3 ubiquitin ligase, forms a complex with RYK to activate Wnt/β-catenin signaling

PubMed Central

Berndt, Jason D.; Aoyagi, Atsushi; Yang, Peitzu; Anastas, Jamie N.; Tang, Lan

2011-01-01

Receptor-like tyrosine kinase (RYK) functions as a transmembrane receptor for the Wnt family of secreted protein ligands. Although RYK undergoes endocytosis in response to Wnt, the mechanisms that regulate its internalization and concomitant activation of Wnt signaling are unknown. We discovered that RYK both physically and functionally interacts with the E3 ubiquitin ligase Mindbomb 1 (MIB1). Overexpression of MIB1 promotes the ubiquitination of RYK and reduces its steady-state levels at the plasma membrane. Moreover, we show that MIB1 is sufficient to activate Wnt/β-catenin (CTNNB1) signaling and that this activity depends on endogenous RYK. Conversely, in loss-of-function studies, both RYK and MIB1 are required for Wnt-3A–mediated activation of CTNNB1. Finally, we identify the Caenorhabditis elegans orthologue of MIB1 and demonstrate a genetic interaction between ceMIB and lin-18/RYK in vulva development. These findings provide insights into the mechanisms of Wnt/RYK signaling and point to novel targets for the modulation of Wnt signaling. PMID:21875946

Proximal-Type Epithelioid Sarcoma: Report of an Unusual Case in the Uterine Cervix.

PubMed

Suárez-Zamora, David Alfonso; Barrera-Herrera, Luis Eduardo; Rodríguez-Urrego, Paula Andrea; Palau-Lázaro, Mauricio Alfonso

2017-08-01

Epithelioid sarcoma is a rare malignant mesenchymal neoplasm (less than 1% of all sarcomas) with epithelioid morphology. Among the 2 subtypes, proximal represents only one-third of cases and commonly involves deep tissues of pelvic region, including the perineum, genital area, and groin, and occurs more frequently in older patients who present a more aggressive course. In the female genital tract, proximal-type epithelioid sarcoma (PES) mainly affects the vulva and is extremely uncommon in the uterus. To our knowledge, only a few cases of PES involving the cervix and uterine body have been previously reported in the literature. We report a 23-year-old woman who presented with abnormal vaginal bleeding. She was found to have a cervical mass, which was resected and diagnosed as a hemangioendothelioma. However, 2 months later, the mass recurred and the histopathological analysis at our institution demonstrated a PES confined to the uterine cervix. It is important to include this neoplasm in the differential diagnosis of epithelioid tumors that can involve the female genital tract because it has a significant impact on prognosis and treatment.

Caesarean in mare by Marcenac incision under local anaesthesia.

PubMed

Ninu, A R; Saxena, A C; Sivanarayanan, T B; Remya, V; Binsila, B K; Maiti, S K; Zama, M M S

2015-01-01

A nulliparous non-descript mare was presented with a complaint of dystocia. The mare was recumbent and physical examination revealed that the animal was in shock. There was no straining and foetal forelimbs were visible outside the vulva. The foetus was dead as there was no pedal reflex. Vaginal examination revealed anterior presentation with dorso-sacral position and rigid lateral head deviation. Pre-operatively, the mare was given 5 ml Tetanus toxoid and 3 g Ceftriaxone as intramuscular injection, and 5 ml Dexamethasone in 15 L of 5% Dextrose Normal Saline (DNS) as intravenous (i/v) infusion. As pelvic space was inadequate and the mal posture was not correctable, manual correction or foetotomy could not be attempted and therefore caesarean section was planned. Condition of the animal warranted the use of local anaesthetic infiltration instead of general anesthesia. Post-operative care included intravenous fluids, anti-inflammatory/analgesics and daily antiseptic dressing. The owner reported uneventful recovery. The authors would like to conclude the case as a rare emergency caesarean in equine where the surgery was done with animal in lateral recumbency employing a Marcenac incision under local anaesthesia.

Groin metastasis after extensive microinvasive vulvar cancer. A case report.

PubMed

Schausberger, Christiane; Six, Lucia; Horvat, Reinhard; Joura, Elmar A

2007-02-01

An increasing incidence of vulvar intraepithelial neoplasia and microinvasive vulvar cancer is being observed in younger patients. The treatment of choice is wide local excision. A 53-year-old woman had HPV-related disease for more than 20 years. Following several operations for cervical and vulvar intraepithelial lesions (CIN 3 and VIN 3) and genital warts, she presented with extensive, multifocal VIN 3 and microinvasion at the age of 50. Since a radical approach was not feasible, combined excision and laser therapy was performed, preceded by mapping of the abnormal areas of the vulva. Two years after surgery the patient presented with a mass in the right groin. Histopathologic examination following excision revealed a groin metastasis. Postoperative radiotherapy was performed. Three years after the last vulvar surgery and 1 year after groin excision, the patient was well and disease free. In high-risk patients with recurrent HPV-related disease of the lower genital tract and extensive microinvasive vulvar carcinoma, removal of the groin nodes should be considered. The sentinel node approach might be appropriate in the future.

VIN 3: a clinicopathologic review.

PubMed

McNally, O M; Mulvany, N J; Pagano, R; Quinn, M A; Rome, R M

2002-01-01

A retrospective review of the management of vulvar intraepithelial neoplasia 3 (VIN 3) over a 16-year period from 1981 to 1997 was conducted. Complete information was available for analysis on 101 patients. The mean age was 53.9 years (range 14-102 years). The mean duration of follow-up was 36 months (range 2-184 months). Fifty-eight percent of patients presented with pruritus. The disease was multifocal in 51% and unifocal in 49% of cases and the left labium majus was the most frequently affected site (27%). Co-existent or previous genital disease was identified in 39% of patients and 8% had a history of invasive gynecological cancer. Histologic evidence of human papillomavirus (HPV) infection was found in 31% of patients. Wide local excision was the most frequently used treatment modality (78%). Thirty-eight percent of patients required at least one further treatment for recurrent disease. Smoking, multifocality, HPV effect, and positive surgical margins were not found to be significant predictors of recurrence. There were three (3%) cases of progression to invasive squamous cell carcinoma of the vulva, one at 6, 7, and 7 years after initial treatment.

Epithelial alterations adjacent to invasive squamous carcinoma of the vulva.

PubMed

Gómez Rueda, N; García, A; Vighi, S; Belardi, M G; Cardinal, L; di Paola, G

1994-07-01

The slides of 64 vulvectomy specimens from vulvar squamous carcinoma were reviewed in order to study the histopathologic changes adjacent to the neoplasia. Normal epithelium was found in 7 cases (11%) and epithelial alterations adjacent to carcinoma in 59 (89%). The epithelial alterations found were: nonneoplastic epithelial disorder (NNDV) in 38 cases (59%) and vulvar intraepithelial neoplasia (VIN) in 19 (30%). The distribution of NNDV was: 20 cases of epithelial hyperplasia (EH) (31%), 6 of lichen sclerosus (9%) and 12 of the mixed type (19%). Sixteen cases of VIN 3 (25%) were undifferentiated, and three cases were differentiated VIN. Eighteen of 19 VIN cases were associated with NNDV, and 8 cases of undifferentiated VIN were associated with human papillomavirus infection. There was no apparent relationship between the associated lesions and tumor size, depth of invasion, lymph node metastases and clinical stage. Nevertheless, we found a significantly higher frequency of associated lesions in poorly differentiated tumors (P > .01). The most important finding was a high association between EH (50%) and VIN (30%) with carcinoma. VIN cases were almost always (95%) associated with EH.

Comparison of peroxidase-labeled DNA probes with radioactive RNA probes for detection of human papillomaviruses by in situ hybridization in paraffin sections.

PubMed

Park, J S; Kurman, R J; Kessis, T D; Shah, K V

1991-01-01

A study comparing in situ hybridization using nonradioactive DNA probes directly conjugated with horseradish peroxidase (HRP), and 35S-labeled antisense RNA probes for human papillomavirus (HPV) types 6/11, 16, and 18 was performed on formalin-fixed, paraffin-embedded tissue from 34 lesions of the cervix and vulva. These lesions included exophytic condylomas and intraepithelial and invasive neoplasms. HPV 6/11 was detected in two of four condylomata acuminata by both in situ techniques. HPV 16 was detected in 13 of 30 cases of intraepithelial and invasive neoplasms by both methods. Discordance between the two methods occurred in two instances. The radiolabeled probe but not the HRP probe detected HPV 16 in one case of cervical intraepithelial neoplasia (CIN 3), whereas the converse occurred in one case of vulvar intraepithelial neoplasia (VIN 3). HPV 18 was not detected in any of the specimens by either method. This study demonstrates that nonradioactive HRP-labeled probes for the detection of specific HPV types are as sensitive as the more laborious and potentially hazardous radioactive probes.

Photodynamic therapy for early malignancies in the lower female genital tract

NASA Astrophysics Data System (ADS)

Lobraico, Rocco V.

1990-09-01

A total of 14 patients who had failed all conventional modalities for cancer of the vulva vagina and perianal area were treated with photodynamic therapy PDT. The affinity of porphyrins to neopJ. astic tissue enables treatment to be concentrated at the tumor site. An Aurora FL Argon pumped dye laser (Cooper LaserSonics Inc. USA) was used to pump dicyanomethylene dye as an activating source for a red light at a wavelength of 630 nm. The combination of a tumor localizing photosensitizer and photoactivating red light produces a photo chemical reaction that is destructive to the cancerous lesion. The treatment time varied between 10-30 minutes. Vulvar sites ranged from 9-38 cm2. Delivered light doses were from 50-125 J/cm2 and power density from 50 to 75 mW/cm2. A complete response was obtained in 80 of the sites treated as evidenced by negative biopsies taken at 3 months post treatment. Adverse reactions to PDT included a transient cutaneous photosensitivity due to retention of the photosensitizers in the skin. This reaction usually persisted from 45-60 days. 1.

Dermatotoxicology: Historical perspective and advances

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ngo, Mai A.; Maibach, Howard I., E-mail: MaibachH@derm.ucsf.ed

2010-03-01

The fundamental principles underlying the study of dermatotoxicology were developed by Arnold Lehman and John Draize over a half century ago and remain applicable today. This discipline has proven indispensable for addressing the problems associated with skin exposure to chemicals. The 55th anniversary of Lehman's landmark publication on safety factors presents the opportunity to reflect upon the historical beginnings of dermatotoxicology and the role of regulatory policies on the development of this field over the years. The complexity and sheer volume of information that has been collected makes it difficult to comprehensively cover all aspects of this vast discipline. Thismore » overview will touch upon the general concepts of ADME, the various forms of contact dermatitis, and transdermal drug delivery systems. The traditional tests performed in animals and humans to identify allergic or irritant potential of chemicals, in addition to alternative methods such as QSAR modeling will be discussed. The subspecialties of infant and occupational dermatotoxicology, as well as dermatotoxicology of aged and ethnic skin, and skin of the vulva and vagina will also be noted.« less

Cellular angiofibroma with atypia or sarcomatous transformation: clinicopathologic analysis of 13 cases.

PubMed

Chen, Eleanor; Fletcher, Christopher D M

2010-05-01

Cellular angiofibroma is a mesenchymal neoplasm that is characterized by a bland spindle cell component, morphologically reminiscent of spindle cell lipoma, and thick-walled vessels. The tumor occurs equally in men and women and usually arises in the inguino-scrotal or vulvovaginal regions. An earlier study of 51 cases from our group showed that the tumor follows a benign course without any tendency for recurrence. In 1 case, an intralesional microscopic nodule of pleomorphic liposarcoma was observed. The biologic significance of atypia or sarcomatous transformation in cellular angiofibroma remains uncertain. In this study, we characterized clinicopathologic features in 13 cases of cellular angiofibroma with morphologic atypia or sarcomatous transformation. Thirteen cases with atypia or sarcomatous transformation among 154 usual cellular angiofibromas identified between 1993 and 2009 were retrieved from consultation files. There were 12 females and 1 male ranging in age from 39 to 71 years (median age, 46 y). Tumor size ranged from 1.2 to 7.5 cm. In 11 cases, the tumors occurred in the vulva. One case each occurred in the paratesticular and hip regions. Most tumors were located in subcutaneous tissue. There were 4 cases of cellular angiofibroma with atypia. Three showed severely atypical cells as scattered foci within the cellular angiofibroma. One case showed a discrete nodule of atypical cells. There were 9 cases of cellular angiofibroma with morphologic features of sarcomatous transformation. In each case, abrupt transition to a discrete sarcomatous component was seen. Of these 9 cases, the sarcomatous component in 2 cases showed features of pleomorphic liposarcoma with multivacuolated lipoblasts readily identified. Three of these 9 cases showed discrete nodule(s) closely resembling atypical lipomatous tumor within usual cellular angiofibroma. In the remaining 4 cases, the sarcomatous component was composed of pleomorphic spindle cells arranged in various patterns. By immunohistochemistry, atypical cells and sarcomatous areas showed either multifocal or more diffuse p16 expression compared with either scattered or negative expression in the conventional cellular angiofibroma. The 3 cases with atypical lipomatous tumor-like areas were negative for MDM-2 and CDK4. Follow-up information was available for 7 patients (range from 2 to 75 mo; median: 14 mo). Six patients did not develop recurrence or metastasis. One patient died of metastatic carcinoma of unknown primary site 27 months after the diagnosis of cellular angiofibroma with sarcomatous transformation. Cellular angiofibroma with atypia or morphologic sarcomatous transformation occurs predominantly in the subcutaneous tissue of the vulva and, as yet, shows no evident tendency to recur based on limited clinical follow-up available for 7 cases. The sarcomatous component can show variable features including atypical lipomatous tumor, pleomorphic liposarcoma, and pleomorphic sarcoma NOS. Overexpression of p16 in the atypical cells and sarcomatous component suggests a possible underlying molecular mechanism.

An evaluation of pulse oximeters in dogs, cats and horses.

PubMed

Matthews, Nora S; Hartke, Sherrie; Allen, John C

2003-01-01

Evaluation of five pulse oximeters in dogs, cats and horses with sensors placed at five sites and hemoglobin saturation at three plateaus. Prospective randomized multispecies experimental trial. Five healthy dogs, cats and horses. Animals were anesthetized and instrumented with ECG leads and arterial catheters. Five pulse oximeters (Nellcor Puritan Bennett-395, NPB-190, NPB-290, NPB-40 and Surgi-Vet V3304) with sensors at five sites were studied in a 5 x 5 Latin square design. Ten readings (SpO2) were taken at each of three hemoglobin saturation plateaus (98, 85 and 72%) in each animal. Arterial samples were drawn concurrently and hemoglobin saturation was measured with a co-oximeter. Accuracy of saturation measurements was calculated as the root mean squared difference (RMSD), a composite of bias and precision, for each model tested in each species. Accuracy varied widely. In dogs, the RMSD for the NPB-395, NPB-190, NPB-290, NPB-40 and V3304 were 2.7, 2.2, 2.4, 1.7 and 2.7% respectively. Failure to produce readings for the NPB-395, NPB-190, NPB-290, NPB-40 and V3304 were 0, 0, 0.7, 0, and 20%, respectively. The Pearson correlation coefficients for the tongue, toe, ear, lip and prepuce or vulva were 0.95, 0.97, 0.69, 0.87 and 0.95, respectively. In horses, the RMSD for the NPB-395, NPB-190, NPB-290, NPB-40 and V3304 were 3.1, 3.0, 4.7, 3.3 and 2.1%, respectively while rates of failure to produce readings were 10, 21, 0, 17 and 60%, respectively. The Pearson correlation coefficients for the tongue, nostril, ear, lip and prepuce or vulva were 0.98, 0.94, 0.88, 0.93 and 0.94, respectively. In cats, the RMSD for all data for the NPB-395, NPB-190, NPB-290, NPB-40 and V3304 were 5.9, 5.6, 7.9, 7.9 and 10.7%, respectively while failure rates were 0, 0.7, 0, 20 and 32%, respectively. The correlation coefficients for the tongue, rear paw, ear, lip and front paw were 0.54, 0.79,.0.64, 0.49 and 0.57, respectively. For saturations above 90% in cats, the RMSD for the NPB-395, NPB-190, NPB-290, NPB-40 and V3304 were 2.6, 4.4, 4.0, 3.5 and 4.8%, respectively, while failure rates were 0, 1.7, 0, 25 and 43%, respectively. Accuracy and failure rates (failure to produce a reading) varied widely from model to model and from species to species. Generally, among the models tested in the clinically relevant range (90-100%) RMSD ranged from 2-5% while failure rates were highest in the V3304.

Evaluation of acute and late radiation morbidity in patients with gynaecologic malignancy using the RTOG criteria and Franco-Italian glossary.

PubMed

Yildirim, G; Ozsaran, Z; Yalman, D; Kamer, S; Aras, A

2008-01-01

The purpose of this study was to evaluate acute and late radiation morbidity in patients with gynaecologic malignancy using the RTOG criteria and Franco-Italian glossary, and to compare the usefulness and disadvantages of each system. Between February 2001 and February 2003, 107 patients with gynaecologic malignancy who received either radical or djuvant external radiotherapy +/- intracavitary brachytherapy or radiochemotherapy were enrolled in this study. The patients were evaluated before radiotherapy and weekly during radiotherapy for acute morbidity using the RTOG grading system and Franco-Italian glossary. Postradiotherapy evaluation was done one month after radiotherapy and at 3-month intervals thereafter. Median follow-up duration was 17 months. Morbidity was graded and recorded according to each scoring system. Median age was 46 years (range 37-82). Sixty-four patients (59.8%) had endometrial cancer. Radical radiotherapy was applied to 26 patients because of inoperability and 81 patients received postoperative radiotherapy. Biologically effective doses for the bladder, rectum and vagina were 98.39, 103.54 and 121.81, respectively, for late morbidity (BED3); 70.88, 72.84 and 80.92, respectively, for acute morbidity (BED10). According to the RTOG grading system acute morbidity rate for the genitourinary and gastrointestinal systems, and skin were 52.3%, 83.2% and 63.5%, respectively. Late morbidity rate for the bladder, colon-rectum, skin and vagina were 16.8%, 20.6%, 47.7% and 51.4%, respectively. The morbidity rate for the bladder, nonspecific abdominal, hematopoietic system, uterus-vulva-vagina, skin and rectum were 35.4%, 29.9%, 5.6%, 60.8%, 40.1% and 32.7%, respectively using the Franco-Italian glossary. In patients with carcinoma of the vulva--whose treatment fields were wider--acute morbidity rate according to RTOG criteria was higher (p = 0.057); photon energy (6 Mv rather than 1.25 MV) (p = 0.01) and treatment interruption of more than eight days (p = 0.019) were correlated with decreased long-term morbidity. According to the Franco-Italian glossary morbidity rates were higher in patients who received chemotherapy (p = 0.047), both external radiotherapy and brachytherapy (p = 0.022) and treatment interruption of less than eight days (p = 0.019). There is no common language between the RTOG grading system and Franco-Italian glossary for defining and scoring radiation morbidity. Up to date no standard and well-defined system has been developed for recording and reporting acute and late radiation morbidity in gynaecologic malignancy, but rather it depends on the subjective evaluation and experience of a radiation oncologist and subjective complaints of the patient, and sometimes on clinical findings. A standard and well-defined user friendly objective scoring system is needed to define and predict the morbidity rate more properly.

Risk of human papillomavirus-associated cancers among persons with AIDS.

PubMed

Chaturvedi, Anil K; Madeleine, Margaret M; Biggar, Robert J; Engels, Eric A

2009-08-19

Although risk of human papillomavirus (HPV)-associated cancers of the anus, cervix, oropharynx, penis, vagina, and vulva is increased among persons with AIDS, the etiologic role of immunosuppression is unclear and incidence trends for these cancers over time, particularly after the introduction of highly active antiretroviral therapy in 1996, are not well described. Data on 499 230 individuals diagnosed with AIDS from January 1, 1980, through December 31, 2004, were linked with cancer registries in 15 US regions. Risk of in situ and invasive HPV-associated cancers, compared with that in the general population, was measured by use of standardized incidence ratios (SIRs) and 95% confidence intervals (CIs). We evaluated the relationship of immunosuppression with incidence during the period of 4-60 months after AIDS onset by use of CD4 T-cell counts measured at AIDS onset. Incidence during the 4-60 months after AIDS onset was compared across three periods (1980-1989, 1990-1995, and 1996-2004). All statistical tests were two-sided. Among persons with AIDS, we observed statistically significantly elevated risk of all HPV-associated in situ (SIRs ranged from 8.9, 95% CI = 8.0 to 9.9, for cervical cancer to 68.6, 95% CI = 59.7 to 78.4, for anal cancer among men) and invasive (SIRs ranged from 1.6, 95% CI = 1.2 to 2.1, for oropharyngeal cancer to 34.6, 95% CI = 30.8 to 38.8, for anal cancer among men) cancers. During 1996-2004, low CD4 T-cell count was associated with statistically significantly increased risk of invasive anal cancer among men (relative risk [RR] per decline of 100 CD4 T cells per cubic millimeter = 1.34, 95% CI = 1.08 to 1.66, P = .006) and non-statistically significantly increased risk of in situ vagina or vulva cancer (RR = 1.52, 95% CI = 0.99 to 2.35, P = .055) and of invasive cervical cancer (RR = 1.32, 95% CI = 0.96 to 1.80, P = .077). Among men, incidence (per 100 000 person-years) of in situ and invasive anal cancer was statistically significantly higher during 1996-2004 than during 1990-1995 (61% increase for in situ cancers, 18.3 cases vs 29.5 cases, respectively; RR = 1.71, 95% CI = 1.24 to 2.35, P < .001; and 104% increase for invasive cancers, 20.7 cases vs 42.3 cases, respectively; RR = 2.03, 95% CI = 1.54 to 2.68, P < .001). Incidence of other cancers was stable over time. Risk of HPV-associated cancers was elevated among persons with AIDS and increased with increasing immunosuppression. The increasing incidence for anal cancer during 1996-2004 indicates that prolonged survival may be associated with increased risk of certain HPV-associated cancers.

Candida vulvovaginitis: A store with a buttery and a show window.

PubMed

Donders, Gilbert G G; Sobel, Jack D

2017-02-01

Although being an utterly frequent, non-mortal, yet distressing disease, and despite good knowledge of the pathogenesis and the availability of specific and safe treatment, vulvovaginal Candida (VVC) infection remains one of the most enigmatic problems for both physicians and patients. Good treatment requires a proper diagnosis. Too many caregivers (and patients treating themselves) react too simple-minded on the symptoms of VVC and treat VVC where they see it on the vulva. In this opinion paper, we plea for a thorough examination of women with VVC, especially in those women who suffer from recurrent disease since a long time, sometimes decades, which necessitates intensive examination of the vaginal flora, as this is invariably the reservoir for relapses and recurrent vulvitis. Examination of such complicated cases requires experienced clinical judgement, expertise bedside phase contrast microscopy of fresh vaginal fluid, classical cultures on Sabouroud medium and, if still unresolved, repetitive cultures taken by the patient herself at moments of symptoms, and/or nuclear acid amplification techniques to detect Candida genes in the vaginal fluid. Even if only vulvitis is evident, thorough expert examination of vaginal fluid is obligatory to diagnose VVC. © 2016 Blackwell Verlag GmbH.

Microbicidal activity of neutrophils is inhibited by isolates from recurrent vaginal candidiasis (RVVC) caused by Candida albicans through fungal thioredoxin reductase.

PubMed

Ratti, Bianca Altrão; Godoy, Janine Silva Ribeiro; de Souza Bonfim Mendonça, Patrícia; Bidóia, Danielle Lazarin; Nakamura, Tânia Ueda; Nakamura, Celso Vataru; Lopes Consolaro, Marcia Edilaine; Estivalet Svidzinski, Terezinha Inez; de Oliveira Silva, Sueli

2015-01-01

Vulvovaginal candidiasis (VVC) is characterized by an infection of the vulva and vagina, mainly caused by Candida albicans, a commensal microorganism that inhabits the vaginal, digestive, and respiratory mucosae. Vulvovaginal candidiasis affects approximately 75% of women, and 5% develop the recurrent form (RVVC). The aim of the present study was to evaluate whether neutrophils microbicidal response is triggered when activated with RVVC isolates caused by C. albicans. Our results showed that RVVC isolates induced neutrophil migration but significantly decrease the microbicidal activity of neutrophils, compared with VVC and ASS isolates. The microbicidal activity of neutrophils is highly dependent on the production of reactive oxygen species/reactive nitrogen species (ROS/RNS). However, this isolate induced detoxification of ROS/RNS produced by neutrophils, reflected by the high level of thiol groups and by the oxygen consumption. Therefore, RVVC isolates induced biochemical changes in the inflammatory response triggered by neutrophils, and these effects were mainly related to the detoxification of ROS/RNS through the thioredoxin reductase (TR), a key antioxidant enzyme in fungi. This might be one of the resistance mechanisms triggered by RVVC caused by C. albicans. Copyright © 2014 Elsevier Inc. All rights reserved.

Polythelia: simple atavistic remnant or a suspicious clinical sign for investigation?

PubMed

Galli-Tsinopoulou, Assimina; Stergidou, Dorothea

2014-03-01

Supernumerary nipples (or polythelia) usually appear along the embryonic milk lines or in other sites including the back, thigh, vulva, neck etc. The frequency of polythelia ranges from 0.2% to 5.6%. Despite the plethora of published cases concerning its association with other congenital malformations or syndromes with different patterns of inheritance, polythelia still remains a controversial and theoretical issue. Although most reports describe a link between supernumerary nipples and kidney/urinary tract anomalies, a potential relationship with other congenital anomalies or malignancies has also been speculated. Additionally, polythelia has been associated with genodermatoses, thus being related with an increased malignant potential, as well as with an increased risk for solid tumors such as renal adenocarcinoma, testicular cancer, prostate cancer, and urinary bladder carcinoma. The fact that the Scaramanga (ska) mutant mice presented with ectopic breast tissue imply that misregulation of the neuregulin-3 signaling pathway may be critical in the occurrence of polythelia. This is an attempt to review existing literature in order to (a) draw reliable conclusions whether polythelia is a manifestation of simple atavism or may be associated with concomitant severe conditions needing further investigation and/or management, (b) elucidate its aetiology and (c) establish appropriate clinical and laboratory approach.

[Vulvar squamous cell carcinoma in young women with HPV negative].

PubMed

Gómez-Alarcon, A; Gómez-García, M T; García-de la-Torre, J P; Del Valle-Morón, M; Arones-Collantes, M A; González-de Merlo, G

2016-03-01

The vulvar cancer is the fourth more frequent neoplasia after the endometrial, cervix and ovarian cancer. Normally, it has been related to old women of ages from 70 to 80 years old. Rarely, it has been detected cases in adult or young women. However, its incidence has been increased in the last years and in more early years. It is for this change in the incidence and its appearance in early years why a possible etiology has been looked for, opening different hypothesis that go from that related to the HPV to those that study an inflammatory chronic process as the basis for the carcinogenesis. In this article, it has been presented the case of a woman who is 34 years old with negative VPH that made her debut with epidermoid carcinoma of the vulva moderately different and on purpose of the case, we do a revision of the literature existent. Vulvar cancer diagnosed in young women as in older, but with different trends, risk factors and natural history. The case reported here escapes the theories studied so far so needed new lines of inquiry to investigate this form of presentation young woman, without HPV infection.

Metastatic ovarian papillary cystadenocarcinoma to the small intestine serous surface: report of a case of high-grade histopathologic malignancy

PubMed Central

2014-01-01

Ovarian cystadenocarcinoma is characterized by marked heterogeneity and may be composed of an admixture of histologic growth patterns, including acinar, papillary and solid. In the present study, a case of isolated small intestine metastasis of ovarian papillary cystadenocarcinoma was reported. A 7-year-old female mixed-breed dog presented with a mass in the left upper quadrant with progressive enlargement of the abdomen, periodic bloody discharge from the vulva and incontinence. The tumor was histologically characterized by the presence of cysts and proliferation of papillae, both lined by single- or multi-layered pleomorphic epithelial cells. Furthermore, the mass was composed by intense cellular and nuclear pleomorphism and numerous mitotic figures. These findings indicate a tumor of high-grade malignancy with infiterative tumor cells resembling the papillary ovarian tumor in the serosal surface of the small intestine along with an intact serosa. Immunohistochemically, tumor was positive for CK7 and negative immunoreactivity for CK20. The histopathologic features coupled with the CK7 immunoreactivity led to a diagnosis of high grade ovarian papillary cystadenocarcinoma. To the best of our knowledge, this is the first case of small intestine serousal surface metastasis from ovarian papillary cystadenocarcinoma. PMID:24636424

First report of Schulzia travassosi (Nematoda, Trichostrongylina, Molineoidea) for amphibians of the Chaco region in Argentina and proposal of Oswaldocruzia melanostictusi nov. comb.

PubMed

González, Cynthya E; Hamann, Monika I

2015-12-01

This is the first record of the nematode parasite Schulzia travassosi (Trichostrongylina, Molineidae) in two Argentinean amphibians, Leptodactylus bufonius and Rhinella major, collected in two localities of the Chaco region, Las Lomitas (Formosa Province) and Taco Pozo (Chaco Province). The species was observed using light and scanning electron microscopy (SEM) and compared with previous studies of Paraguayan specimens. Regarding metric characters, the measurements found in Argentinean specimens generally did not differ from those of Paraguayan specimens; some differences were observed in the total length of males and females (some longer and some shorter than Paraguayan specimens), length of the oesophagus (in almost all specimens shorter than in Paraguayan ones) and position of the vulva (nearer to posterior end in Argentinean specimens). The branches and sphincter of ovejector are slightly longer than in Paraguayan female specimens. In males, ray 4 is almost the same length as rays 2, 3 and 5, 6. Cephalic end, cephalic vesicle, synlophe and vulvar depression were viewed under SEM. Schulzia melanostictusi Chopra, Shing and Kumar, 1986 is reassigned as Oswaldocruzia melanostictusi (Chopra, Shing and Kumar, 1986) nov. comb.

Cutaneous field cancerization: clinical, histopathological and therapeutic aspects*

PubMed Central

Torezan, Luís Antônio Ribeiro; Festa-Neto, Cyro

2013-01-01

The concept of "field cancerization" was first introduced by Slaughter in 1953 when studying the presence of histologically abnormal tissue surrounding oral squamous cell carcinoma. It was proposed to explain the development of multiple primary tumors and locally recurrent cancer. Organ systems in which field cancerization has been described since then are: head and neck (oral cavity, oropharynx, and larynx), lung, vulva, esophagus, cervix, breast, skin, colon, and bladder. Recent molecular studies support the carcinogenesis model in which the development of a field with genetically altered cells plays a central role. An important clinical implication is that fields often remain after the surgery for the primary tumor and may lead to new cancers, designated presently as "a second primary tumor" or "local recurrence," depending on the exact site and time interval. In conclusion, the development of an expanding pre-neoplastic field appears to be a critical step in epithelial carcinogenesis with important clinical consequences. Diagnosis and treatment of epithelial cancers should not only be focused on the tumor but also on the field from which it developed. The most important etiopathogenetic, clinical, histopathological and therapeutic aspects of field cancerization are reviewed in this article. PMID:24173184

Description of a new species, Trichuris ursinus n. sp. (Nematoda: Trichuridae) from Papio ursinus Keer, 1792 from South Africa.

PubMed

Callejón, Rocío; Halajian, Ali; Cutillas, Cristina

2017-07-01

In the present work, we carried out a morphological, biometrical and molecular study of whipworms Trichuris Roederer, 1761 (Nematoda: Trichuridae) parasitizing Papio ursinus Keer 1792 (Chacma baboon). Biometrical and molecular data suggest a new species of Trichuris parasitizing baboons. In addition of main morphological features (spicule, spicule sheath, spicule tube, proximal cloacal tube, distal cloacal tube, vulva, vagina), the mean values of individual variables between Trichuris colobae, Trichuris suis, Trichuris trichiura examined by Student's t tests suggest that T. ursinus n. sp. constitutes a new species. The combined analysis of three markers (cox1, cob and ITS2) revealed a sister relationships between T. colobae and T. ursinus n. sp. Mitochondrial sequences revealed a higher inter-specific similarity between T. ursinus n. sp., T. suis and T. colobae. Phylogenetic hypotheses for both mitochondrial genes strongly supported distinct genetic lineages corresponding to different species of the genus Trichuris associated with certain hosts. Thus, T. suis, T. colobae and T. ursinus n. sp. appeared as a sister group and separated from Trichuris spp. from humans and other species of primates. Copyright © 2017 Elsevier B.V. All rights reserved.

Numerical simulation of a two-sex human papillomavirus (HPV) vaccination model

NASA Astrophysics Data System (ADS)

Suryani, I.; Adi-Kusumo, F.

2014-02-01

Human Papillomavirus (HPV) is a major cause of cervical cancer, precancerous lesions, cancer and other disease. HPV is the most common sexually transmitted infection. Although HPV virus primarily affects woman but it can also affects man because it cause of cancer of the anus, vulva, vagina, penis and some other cancers. HPV vaccines now used to prevent cervical cancer and genital warts because the vaccine protect against four types of HPV that most commonly cause disease are types 6, 11, 16, and 18. This paper is sequel work of Elbasha (2008). Difference with Elbasha (2008) are give alternative proof global stability, numerical simulation and interpretation. Global stability of the equilibrium on the model of a two-sex HPV vaccination were explored by using Lyapunov. Although we use the same lyapunov function, we use the largest invariant set to proof the global stability. The result show that the global stability of the equilibrium depends on the effective reproduction number (R). If R < 1 then the infection-free equilibrium is asymptotically stable globally. If R > 1 then endemic equilibrium have globally asymptotically stable properties. Then equilibrium proceed with the interpretation of numerical simulation.

Condyloma acuminata in child end laser therapy: a case report

PubMed Central

2009-01-01

Background Condyloma acuminata are soft, skin colored, fleshy warts that are caused by the Human Papilloma Virus (HPV). The disease is highly contagious, can appear singly or in groups, small or large. The incubation period may be from 1–6 months. Although anogenital warts are considered to be sexually transmitted in adults, this may not be the case for children. Genital warts in children may result from several modes of transmission: from the maternal genital tract autoinoculation, from finger warts and nonsexual transmission from members/careers. Case presentation The presented case is a 13-month-old girl. She was hospitalized at the Clinic of Dermatovenerology in 2001 due to papillomatosis changes on the genital area. The changes had started to appear in the sixth month of life, light purple in color, smooth and combined in a tumorous mass, in the vulva and anal areas. Conclusion From this case we can come to the conclusion that condyloma acuminate are not only transmitted sexually but through nonsexual ways as well, such is this case, from the infected mother to the infant. Laser therapy is preferred when multiple warts are spread over a large area as though in our case. PMID:19193210

[HPV (Human Papilloma Virus) implication in other cancers than gynaecological].

PubMed

Badoual, C; Tartour, E; Roussel, H; Bats, A S; Pavie, J; Pernot, S; Weiss, L; Mohamed, A Si; Thariat, J; Hoffmann, C; Péré, H

2015-08-01

Worldwide, approximately 5 to 10% of the population is infected by a Human Papilloma Virus (HPV). Some of these viruses, with a high oncogenic risk (HPV HR), are responsible for about 5% of cancer. It is now accepted that almost all carcinomas of the cervix and the vulva are due to an HPV HR (HPV16 and 18) infection. However, these viruses are known to be involved in the carcinogenesis of many other cancers (head and neck [SCCHN], penis, anus). For head and neck cancer, HPV infection is considered as a good prognostic factor. The role of HPV HR in anal cancer is also extensively studied in high-risk patient's population. The role of HPV infection in the carcinogenesis of esophageal, bladder, lung, breast or skin cancers is still debated. Given the multiple possible locations of HPV HR infection, the question of optimizing the management of patients with a HPV+ cancer arises in the implementation of a comprehensive clinical and biological monitoring. It is the same in therapeutics with the existence of a preventive vaccination, for example. Copyright © 2015 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Challenges of Human Papillomavirus Infection and Associated Diseases in Low-Resource Countries.

PubMed

Nweke, Michael Chukwugoziem; Okolo, Clement Abu; Daous, Yara; Esan, Olukemi Ayotunde

2018-06-01

- The prevalence of human papillomavirus (HPV) infection varies worldwide. The high-risk viruses are usually associated with cancers of the cervix, vagina, and vulva in women, cancer of the penis in men, and cancers of the anus, tonsils, oropharynx, and base of the tongue in both sexes. - To review literature about the challenges and burden associated with HPV infection in low-resource (ie, developing) countries, focusing on sub-Saharan Africa. To review the prevention, incidence, prevalence, morbidity, and mortality of HPV infections in sub-Saharan Africa. To review the therapy and management of HPV infections in low-resource countries in comparison to developed countries. - Peer-reviewed literature and experience of some of the authors. - Sub-Saharan Africa has high HPV infection prevalence rates, with predominance of high-risk subtypes 16, 18, and 45. The difficulty of access to health care has led to higher morbidity and mortality related to HPV-related cancers. Improvement in screening programs will help in monitoring the spread of HPV infections. Survival studies can be more informative if reliable cancer registries are improved. HPV vaccination is not yet widely available and this may be the key to curtailing the spread of HPV infections in resource-poor countries.

Description and SEM Observations of Meloidogyne sasseri n. sp. (Nematoda: Meloidogynidae), Parasitizing Beachgrasses

PubMed Central

Handoo, Zafar A.; Huettel, Robin N.; Golden, A. Morgan

1993-01-01

Meloidogyne sasseri n. sp. is described and illustrated from American beachgrass (Ammophila breviliffulata) originally collected from Henlopen State Park and Fenwick Island near the Maryland state line in Delaware, United States (6). Its relationship to M. graminis, M. spartinae, and M. californiensis is discussed. Primary distinctive characters of the female perineal pattern were a high to rounded arch with shoulders, widely spaced lateral lines interrupting transverse striations, a sunken vulva and anus, and coarse broken striae around the anal area. Second-stage juvenile body length was 554 μm (470-550), stylet length 14 μm (13-14.5), tail length 93 μm (83-115), tapering to a finely rounded terminus. Male stylet length 20 μm (19-21.5), spicule length 33 μm (30-36). Scanning electron microscope observations provided additional details of perineal patterns and face views of the female, male, and J2 head. Wheat, rice, oat, Ammophila sp., Panicum sp., bermudagrass, zoysiagrass and St. Augustinegrass were tested as hosts. Distribution of the species was the coasts of Delaware and Maryland. The common name "beachgrass root-knot" is proposed for M. sasseri n. sp. PMID:19279820

Vaginal biological and sexual health--the unmet needs.

PubMed

Graziottin, A

2015-01-01

The vagina is a most neglected organ. It is usually clinically considered with a minimalistic view, as a 'connecting tube' for a number of physiologic functions: passage of menstrual blood, intercourse, natural conception and delivery. Unmet needs include, but are not limited to, respect of vaginal physiologic biofilms; diagnosis and care of the optimal tone of the levator ani, which surrounds and partly support it; care of its anatomic integrity at and after delivery and at pelvic/vaginal surgery; care of long-term consequences of pelvic radiotherapy; long-term care of the atrophic changes it will undergo after the menopause, unless appropriate, at least local, estrogen therapy is used; appreciation and respect of its erotic meaning, as a loving, receptive, 'bonding' organ for the couple. The vaginal erotic value is key as a non-visible powerful center of femininity and sexuality, deeply and secretly attractive in terms of taste, scent (together with the vulva), touch and proprioception. The most welcoming when lubrication, softness and vaginal orgasm award the woman and the partner with the best of pleasures. Prevention of sexual/vaginal abuse is a very neglected unmet need, as well. Who cares?

Comparison of peroxidase-labeled DNA probes with radioactive RNA probes for detection of human papillomaviruses by in situ hybridization in paraffin sections

DOE Office of Scientific and Technical Information (OSTI.GOV)

Park, J.S.; Kurman, R.J.; Kessis, T.D.

1991-01-01

A study comparing in situ hybridization using nonradioactive DNA probes directly conjugated with horseradish peroxidase (HRP), and {sup 35}S-labeled antisense RNA probes for human papillomavirus (HPV) types 6/11, 16, and 18 was performed on formalin-fixed, paraffin-embedded tissue from 34 lesions of the cervix and vulva. These lesions included exophytic condylomas and intraepithelial and invasive neoplasms. HPV 6/11 was detected in two of four condylomata acuminata by both in situ techniques. HPV 16 was detected in 13 of 30 cases of intraepithelial and invasive neoplasms by both methods. Discordance between the two methods occurred in two instances. The radiolabeled probe butmore » not the HRP probe detected HPV 16 in one case of cervical intraepithelial neoplasia (CIN 3), whereas the converse occurred in one case of vulvar intraepithelial neoplasia (VIN 3). HPV 18 was not detected in any of the specimens by either method. This study demonstrates that nonradioactive HRP-labeled probes for the detection of specific HPV types are as sensitive as the more laborious and potentially hazardous radioactive probes.« less

Clinical trials of a new chlorin photosensitizer for photodynamic therapy of malignant tumors

NASA Astrophysics Data System (ADS)

Privalov, Valeriy A.; Lappa, Alexander V.; Seliverstov, Oleg V.; Faizrakhmanov, Alexey B.; Yarovoy, Nicolay N.; Kochneva, Elena V.; Evnevich, Michail V.; Anikina, Alla S.; Reshetnicov, Andrey V.; Zalevsky, Igor D.; Kemov, Yuriy V.

2002-06-01

Photodynamic therapy (PDT) was performed with a new photosensitizer, a water soluble form of chlorins (Radachlorin, Russia) possessing an absorption peak around 662 nm. As light source there was used the diode laser (ML-662-SP, Russia) with 662 nm wavelength and 2.5 W optical power. The sensitizer had passed broad pre-clinical in vitro and in vivo studies, which showed safety and efficiency of it. PDT was applied to 51 patients with basal cell cancer of the skin (about 60% of all cases), breast cancer, lip cancer, melanoma, cancer of esophagus, stomach, and rectum, cancer and leucoplacia of vulva, malignant ganglioneuroma, sarcoma of soft tissue, cancer and reticular sarcoma of thyroid gland, cancer of ductus choledochus. Most of non-basalioma patients had either forth stage or recurrence of disease. The sensitizer was injected intravenously or applied externally (Radachlorin gel). There were used surface, endoscopic, and interstitial ways of irradiation. Full tumor regression with excellent cosmetic effect was reached in 100% cases of 1-3 stage basal cell cancer patients treated with intravenous Radachlorin injection. In most other (non-basalioma) cases significant regression of tumors and improvement of life quality of patients (recanalization and regain of conductivity) was obtained.

Preoperative radiotherapy followed by radical vulvectomy with inguinal lymphadenectomy for advanced vulvar carcinomas

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rotmensch, J.; Rubin, S.J.; Sutton, H.G.

1990-02-01

A therapeutic alternative to exenteration for large locally advanced vulvar carcinoma involving the rectum, anus, or vagina is the use of preoperative radiation followed by radical surgery. Between 1980 and 1988, 13 patients with Stage III and 3 with Stage IV vulvar carcinoma involving the rectum/anus, urethra, or vagina were treated with 4000 rad to the vulva and 4500 rad to the inguinal and pelvic nodes followed by a radical vulvectomy and inguinal lymphadenectomy 4 weeks later. The overall 5 year cumulative survival was 45%. Twelve tumors regressed after radiation with 62.5% of the patients having visceral preservation while inmore » 4 patients there was no major response to radiation and urinary or fecal diversion was required. Of the 6 recurrences 4 were central and 2 distant. Three patients with central recurrences had tumor within 1 cm of the vulvectomy margin. Complications included wet desquamation, inguinal wound separation, lymphedema, and urethral strictures. There were no operative deaths. It is concluded that the use of preoperative radiation followed by radical vulvectomy may be an alternative to pelvic exenteration in selected patients with advanced vulvar lesions.« less

Histone Methylation Restrains the Expression of Subtype-Specific Genes during Terminal Neuronal Differentiation in Caenorhabditis elegans

PubMed Central

Chiang, Victor; Chalfie, Martin

2013-01-01

Although epigenetic control of stem cell fate choice is well established, little is known about epigenetic regulation of terminal neuronal differentiation. We found that some differences among the subtypes of Caenorhabditis elegans VC neurons, particularly the expression of the transcription factor gene unc-4, require histone modification, most likely H3K9 methylation. An EGF signal from the vulva alleviated the epigenetic repression of unc-4 in vulval VC neurons but not the more distant nonvulval VC cells, which kept unc-4 silenced. Loss of the H3K9 methyltransferase MET-2 or H3K9me2/3 binding proteins HPL-2 and LIN-61 or a novel chromodomain protein CEC-3 caused ectopic unc-4 expression in all VC neurons. Downstream of the EGF signaling in vulval VC neurons, the transcription factor LIN-11 and histone demethylases removed the suppressive histone marks and derepressed unc-4. Behaviorally, expression of UNC-4 in all the VC neurons caused an imbalance in the egg-laying circuit. Thus, epigenetic mechanisms help establish subtype-specific gene expression, which are needed for optimal activity of a neural circuit. PMID:24348272

Elective ilioingunial lymph node irradiation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Henderson, R.H.; Parsons, J.T.; Morgan, L.

1984-06-01

Most radiologists accept that modest doses of irradiation (4500-5000 rad/4 1/2-5 weeks) can control subclinical regional lymph node metastases from squamous cell carcinomas of the head and neck and adenocarcinomas of the breast. There have been few reports concerning elective irradiation of the ilioinguinal region. Between October 1964 and March 1980, 91 patients whose primary cancers placed the ilioinguinal lymph nodes at risk received elective irradiation at the University of Florida. Included are patients with cancers of the vulva, penis, urethra, anus and lower anal canal, and cervix or vaginal cancers that involved the distal one-third of the vagina. Inmore » 81 patients, both inguinal areas were clinically negative; in 10 patients, one inguinal area was positive and the other negative by clinical examination. The single significant complication was a bilateral femoral neck fracture. The inguinal areas of four patients developed mild to moderate fibrosis. One patient with moderate fibrosis had bilateral mild leg edema that was questionably related to irradiation. Complications were dose-related. The advantages and dis-advantages of elective ilioinguinal node irradiation versus elective inguinal lymph node dissection or no elective treatment are discussed.« less

Late effects of radiation therapy for cancer of the uterine cervix

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zippin, C.; Lum, D.; Kohn, H.I.

1981-01-01

This report presents follow-up information on 497 women diagnosed with cancer of the uterine cervix in Connecticut and California between 1932 and 1951 who received only radiation as their initial course of therapy. Patients entered into the study were all treated before age 55 and all were five-year-survivors following treatment in order to eliminate early deaths due to the cervical cancer. Three radiologic dosage groups (high, medium, and low) were formed with 93, 244, and 160 patients, respectively. For all dosage groups combined 108 subsequent cancers were observed more than 5 yr after cancer treatment compared with 64 expected (Pmore » less than 0.01). Sites for which subsequent cancers were significantly (P less than 0.05) in excess of expectation were rectum, ovary, lung, vulva and vagina, small intestine, oropharynx, and central nervous system excluding brain. The ratio of observed to expected cases of subsequent cancers rose only slightly with increasing radiologic dose. No significant differences in overall survival patterns for the three dosage groups were found. For all dosage groups survival was poorer than in the corresponding segment of the general population.« less

Morphology and morphometrics of Heterodorus qinghaiensis n. sp. (Dorylaimida, Nordiidae) from soil samples in China.

PubMed

Wu, W J; Yan, L; Xu, C L; Yu, L; Wang, K; Jin, S Y; Xie, H

2016-07-01

One new species of the family Nordiidae Jairajpuri & Siddiqi, 1964 from the enclosure grassland of Qinghai Province, China, Heterodorus qinghaiensis n. sp., is described and illustrated. The new species is characterized by the slender body, 1.29-1.46 mm in length; the granular lateral chord with numerous large depression plaques throughout its entirety; the lip region offset by a distinct depression; amphid goblet-shaped with aperture about half to two-thirds of corresponding body diameter; odontostyle 11-13 μm long; rod-like odontophore without basal flanges; pharyngeal basal expansion about one-third of the total neck length; didelphic genital system containing sperm; ovaries generally not reaching the sphincter level; vulva transversed and sclerotized; female tail conoid with round terminus; 3-5 spaced ventromedial supplements and spicule 32-41 μm long. It is close to H. liangi (Ahmad, Wu & Shaheen, 2002) Andrássy, 2009, H. brevidentatus (Thorne, 1939) Andrássy, 2009, H. monticola Andrássy, 2011, H. morgensis (Loof, 1988) Andrássy, 2009 and H. meghalayensis (Mushtaq, Baniyamuddin & Ahmad, 2007) Andrássy, 2009 in having inconspicuous or no lateral body pores, smaller odontostyle and ventrally curved tail.

Effects of Genital Response Measurement Device and Stimulus Characteristics on Sexual Concordance in Women.

PubMed

Bouchard, Katrina N; Chivers, Meredith L; Pukall, Caroline F

2017-01-01

Investigations of sexual concordance suggest that, on average, women exhibit a low, positive correlation between their subjective sexual arousal and genital response. However, this relationship appears to be stronger, on average, when genital response is measured via the external tissues of the vulva than within the vagina walls. Given the methodological variations, such as stimulus content and duration, in studies of vulvar and vaginal concordance, direct comparisons between individual studies are limited. In the current study, sexual concordance was examined using concurrent measures of vulvar blood flow (using laser Doppler imaging) and vaginal vasocongestion (using vaginal photoplethysmography) to investigate potential differences in vulvar and vaginal concordance. Twenty-five women viewed two erotic films that differed in sexual activity content (foreplay and intercourse) while their subjective sexual arousal and genital response was measured. In support of previous meta-analytic findings, results suggest that subjective sexual arousal is more strongly correlated with vulvar blood flow than with vaginal vasocongestion. Likewise, perceived genital response and actual vulvar blood flow are more strongly related than are vaginal vasocongestion and self-reported genital sensations. Practical implications for the study of women's sexual concordance as well as broader implications for the understanding of female sexuality are considered.

Punishment of Minor Female Genital Ritual Procedures: Is the Perfect the Enemy of the Good?

PubMed

Jacobs, Allan J; Arora, Kavita Shah

2017-08-01

Female genital alteration (FGA) is any cutting, removal or destruction of any part of the external female genitalia. Various FGA practices are common throughout the world. While most frequent in Africa and Asia, transglobal migration has brought ritual FGA to Western nations. All forms of FGA are generally considered undesirable for medical and ethical reasons when performed on minors. One ritual FGA procedure is the vulvar nick (VN). This is a small laceration to the vulva that does not cause morphological changes. Besides being performed as a primary ritual procedure it has been proposed as a substitute for more extensive forms of FGA. Measures advocated or taken to reduce the burden of FGA can be punitive or non-punitive. Even if it is unethical to perform VN, we argue that it also is unethical to attempt to suppress it through punishment. First, punishment of VN is likely to cause more harm than good overall, even to those ostensibly being protected. Second, punishment is likely to exceed legitimate retributive ends. We do not argue in favor of performing VN. Rather, we argue that non-punitive strategies such as education and harm reduction should be employed. © 2016 John Wiley & Sons Ltd.

Candida transmission and sexual behaviors as risks for a repeat episode of Candida vulvovaginitis.

PubMed

Reed, Barbara D; Zazove, Philip; Pierson, Carl L; Gorenflo, Daniel W; Horrocks, Julie

2003-12-01

To assess associations between female and male factors and the risk of recurring Candida vulvovaginitis. A prospective cohort study of 148 women with Candida vulvovaginitis and 78 of their male sexual partners was conducted at two primary care practices in the Ann Arbor, Michigan, area. Thirty-three of 148 women developed at least one further episode of Candida albicans vulvovaginitis within 1 year of follow-up. Cultures of Candida species from various sites of the woman (tongue, feces, vulva, and vagina) and from her partner (tongue, feces, urine, and semen) did not predict recurrences. Female factors associated with recurrence included recent masturbating with saliva (hazard ratio 2.66 [95% CI 1.17-6.06]) or cunnilingus (hazard ratio 2.94 [95% CI 1.12-7.68]) and ingestion of two or more servings of bread per day (p

Sublethal injury and virulence changes in Listeria monocytogenes and Listeria innocua treated with antimicrobials carvacrol and citral.

PubMed

Silva, A; Genovés, S; Martorell, P; Zanini, S F; Rodrigo, D; Martinez, A

2015-09-01

The aim of this study was to evaluate the effect of two antimicrobial substances, carvacrol and citral, on Listeria monocytogenes and Listeria innocua cells, as well as possible virulence changes in injured cells, using Caenorhabditis elegans as a model test. The results indicated that the percentage of sublethal damage was higher in L. monocytogenes than in L. innocua. The results of the study carried out by using C. elegans indicated that C. elegans fed in a lawn of L. monocytogenes previously treated with carvacrol showed a loss in life span (p ≤ 0.05) as compared with L. monocytogenes treated with citral, Escherichia coli OP50 as a negative control, and treated and untreated L. innocua. Egg laying was also affected: worms fed in a lawn of treated and untreated L. monocytogenes laid fewer eggs than those fed in a lawn of treated and untreated L. innocua or fed with OP50 as a negative control. Worms fed in a lawn of treated and untreated L. innocua also laid fewer eggs than those fed with OP50 as a negative control. A phenotype named bag of worms and an undescribed new one, "vulva inflammation", were also observed. Copyright © 2015 Elsevier Ltd. All rights reserved.

Morphological, molecular and biological characterization of Mehdinema alii (Nematoda: Diplogasterida) from the decorated cricket (Gryllodes sigillatus).

PubMed

Luong, L T; Platzer, E G; De Ley, P; Thomas, W K

1999-12-01

The nematode Mehdinema alii was recovered from the decorated cricket Gryllodes sigillatus (Walker). Morphometric comparisons are presented from 3 populations. The nematode is characterized by dense arrays of spines on the cuticle of the anterior half of the body and a highly elongate, tubular stoma with a dorsal denticle in the glottoid region. Females have a protruding vulva. Young females are amphidelphic, but the anterior ovary disappears in older females bearing multiple developing juveniles. The male is monorchic with asymmetrically placed genital papillae, distally fused spicules, and a highly complex gubernaculum bearing 2 cuticularized thorns that protrude through a separate, postcloacal opening. Adult nematodes are located primarily in the hindgut, whereas juveniles or dauers occur mainly in the genital chamber of both male and female crickets. Male crickets are significantly more likely to be infected than females. This male-biased infection may be linked to the venereal transmission mechanism of the dauers. Although morphologically unusual in many respects, placement of M. alii in Diplogasterida is supported by both the morphology of the anterior digestive tract as well as analysis of its 18S rDNA sequence. These sequence data suggest that M. alii groups most closely with members of the Cylindrocorporidae.

Functional Genomic Analysis of the let-7 Regulatory Network in Caenorhabditis elegans

PubMed Central

Zisoulis, Dimitrios G.; Lovci, Michael T.; Melnik-Martinez, Katya V.; Yeo, Gene W.; Pasquinelli, Amy E.

2013-01-01

The let-7 microRNA (miRNA) regulates cellular differentiation across many animal species. Loss of let-7 activity causes abnormal development in Caenorhabditis elegans and unchecked cellular proliferation in human cells, which contributes to tumorigenesis. These defects are due to improper expression of protein-coding genes normally under let-7 regulation. While some direct targets of let-7 have been identified, the genome-wide effect of let-7 insufficiency in a developing animal has not been fully investigated. Here we report the results of molecular and genetic assays aimed at determining the global network of genes regulated by let-7 in C. elegans. By screening for mis-regulated genes that also contribute to let-7 mutant phenotypes, we derived a list of physiologically relevant potential targets of let-7 regulation. Twenty new suppressors of the rupturing vulva or extra seam cell division phenotypes characteristic of let-7 mutants emerged. Three of these genes, opt-2, prmt-1, and T27D12.1, were found to associate with Argonaute in a let-7–dependent manner and are likely novel direct targets of this miRNA. Overall, a complex network of genes with various activities is subject to let-7 regulation to coordinate developmental timing across tissues during worm development. PMID:23516374

[Experiences with the use of xylazine for sacral epidural anesthesia in cattle].

PubMed

Rehage, J; Kehler, W; Scholz, H

1994-01-01

The effect of epidural administered xylazine was investigated in 10 mature Holstein cows (mean age: 5.4 +/- 1.2 years, mean BW: 572 +/- 23 kg): 5 cows were treated with xylazine in a low dose of 0.05 mg/kg body weight, 3 cows in a medium dose (0.07 mg/kg BW) and 2 cows in a high dose (0.1 mg/kg BW). Xylazine dosages were diluted in sterile saline to a final volume of 5 ml. As a control, lidocaine (5 ml of a 2% solution) was given to 5 cows epidurally. Duration of regional anaesthesia after low dose of xylazine (0.05 mg/kg BW) was significant longer (mean: 2.2 hours) compared to lidocaine treated cows (mean: 1.1 hour). Regional extension of anaesthesia was comparable after dosing with xylazine and lidocaine (tail, after, vulva and perineum). All cows remained standing, but in xylazine treated cows systemic effects, e.g. mild sedation, decreased heart- and respiratory rates, decreased rumen motility and mild bloat were observed. With increased dosages of xylazine a prolongation of epidural anaesthesia up to 3 hours was achieved, but regional extension of this effect remained nearly unchanged. With increased xylazine dosages, cows showed marked sedation and ataxia and sternal recumbency were induced.

Primary mucosal melanomas: a comprehensive review

PubMed Central

Mihajlovic, Marija; Vlajkovic, Slobodan; Jovanovic, Predrag; Stefanovic, Vladisav

2012-01-01

Primary mucosal melanomas arise from melanocytes located in mucosal membranes lining respiratory, gastrointestinal and urogenital tract. Although a majority of mucosal melanomas originate from the mucosa of the nasal cavity and accessory sinuses, oral cavity, anorectum, vulva and vagina, they can arise in almost any part of mucosal membranes. Most of mucosal melanomas occur in occult sites, which together with the lack of early and specific signs contribute to late diagnosis, and poor prognosis. Because of their rareness the knowledge about their pathogenesis and risk factors is insufficient, and also there are not well established protocols for staging and treatment of mucosal melanomas. Surgery is the mainstay of treatment, with trends toward more conservative treatment since radical surgery did not show an advantage for survival. Radiotherapy can provide better local control in some locations, but did not show improvement in survival. There is no effective systemic therapy for these aggressive tumors. Compared with cutaneous and ocular melanoma, mucosal melanomas have lowest percent of five-year survival. Recently revealed molecular changes underlying mucosal melanomas offer new hope for development of more effective systemic therapy for mucosal melanomas. Herein we presented a comprehensive review of various locations of primary melanoma along mucosal membranes, their epidemiological and clinical features, and treatment options. We also gave a short comparison of some characteristics of cutaneous and mucosal melanomas. PMID:23071856

Primary mucosal melanomas: a comprehensive review.

PubMed

Mihajlovic, Marija; Vlajkovic, Slobodan; Jovanovic, Predrag; Stefanovic, Vladisav

2012-01-01

Primary mucosal melanomas arise from melanocytes located in mucosal membranes lining respiratory, gastrointestinal and urogenital tract. Although a majority of mucosal melanomas originate from the mucosa of the nasal cavity and accessory sinuses, oral cavity, anorectum, vulva and vagina, they can arise in almost any part of mucosal membranes. Most of mucosal melanomas occur in occult sites, which together with the lack of early and specific signs contribute to late diagnosis, and poor prognosis. Because of their rareness the knowledge about their pathogenesis and risk factors is insufficient, and also there are not well established protocols for staging and treatment of mucosal melanomas. Surgery is the mainstay of treatment, with trends toward more conservative treatment since radical surgery did not show an advantage for survival. Radiotherapy can provide better local control in some locations, but did not show improvement in survival. There is no effective systemic therapy for these aggressive tumors. Compared with cutaneous and ocular melanoma, mucosal melanomas have lowest percent of five-year survival. Recently revealed molecular changes underlying mucosal melanomas offer new hope for development of more effective systemic therapy for mucosal melanomas. Herein we presented a comprehensive review of various locations of primary melanoma along mucosal membranes, their epidemiological and clinical features, and treatment options. We also gave a short comparison of some characteristics of cutaneous and mucosal melanomas.

Process of infection of armored scale insects (Diaspididae) by an entomopathogenic Cosmospora sp.

PubMed

Mauchline, Nicola; Hallett, Ian; Hill, Garry; Casonato, Seona

2011-09-01

Several species in the fungal genus Cosmospora (synonym Nectria) (anamorph Fusarium) are specialist entomopathogens of armored scale insects (Diaspididae), known to cause periodic epizootics in host populations. Inconsistent mortality rates recorded under laboratory conditions prompted a study into the process of infection of armored scale insects by this fungus. Scale insect mortality following exposure to a Cosmospora sp. (Culture Collection Number: CC89) from New Zealand was related to insect age, with reproductively mature insects having a significantly higher infection rate than immature insects. Examination using scanning electron microscopy found no evidence that the fungus penetrated directly through the wax test (cap) of the scale insect or through the un-lifted interface between the test and the substrate on which the insect resided. However, fungal hyphae were observed growing beneath the test when the test of the reproductively mature insect lifted away from the substrate for the purpose of releasing crawlers, the mobile pre-settled juveniles. Once the hyphae of CC89 advanced under the test, germ-tubes readily penetrated the insect body through a number of natural openings (e.g. spiracles, vulva, stylet), with mycosis observed within seven days after inoculation. Direct penetration through the cuticle of the scale insect was not observed. Copyright © 2011 Elsevier Inc. All rights reserved.

Synchronous of breast and vulvar Paget's disease: a case report.

PubMed

Cooper, J C; Hew, K E; Audlin, K M; Im, D D; Matsuo, K

2012-01-01

Synchronous Paget's disease of breast and vulva is extremely rare and has only been reported in the literature in one other case. A 58-year-old postmenopausal woman was found to have crusting, bleeding, and discharge from left nipple, as well as vulvar pruritis at the same time. Biopsy of breast lesion demonstrated Paget's disease with an underlying foci of ductal carcinoma in-situ that required total mastectomy of left breast with sentinel node biopsy and breast reconstruction. For vulvar symptoms, the patient was initially diagnosed with dermatitis and topical ointment was prescribed. However, her symptoms persisted for the next several months, and she underwent vulvar biopsy that demonstrated Paget's disease. She underwent partial vulvectomy. Multiple episodes of recurrent vulvar Paget's disease were noted in the postoperative course that medical therapy with Imiquimod and a second partial vulvectomy was performed. Synchronous of breast and vulvar Paget's disease is presented. There was a delay in diagnosing vulvar Paget's disease in this experienced case. While coincidence of breast and vulvar Paget's disease is likely, ectopic mammary tissue in vulvar as well as secondary metastasis from a focal lesion of breast Paget's disease needs to be carefully evaluated whenever the patient complains of vulvar symptoms in the setting of breast Paget's disease.

Management of vulvar melanoma.

PubMed

Trimble, E L; Lewis, J L; Williams, L L; Curtin, J P; Chapman, D; Woodruff, J M; Rubin, S C; Hoskins, W J

1992-06-01

Considerable debate centers on the optimal treatment for vulvar melanoma, as well as those clinicopathological factors influencing prognosis. We reviewed 80 patients with vulvar melanoma seen between 1949 and 1990. Primary tumors were assessed according to Chung (47 patients) and Breslow (65 patients) microstaging systems. Fifty-nine patients (76%) underwent radical vulvectomy, ten patients (13%) had a partial vulvectomy, and nine patients (12%) had a wide local excision. Fifty-six also underwent inguinal node dissection. Median follow-up was 193 months. Median survival was 63 months. Ten-year survival by Chung level was as follows: I 100%; II, 81%; III, 87%; IV, 11%; V, 33%. Ten-year survival by tumor thickness was as follows: 0.75 mm, 48%; 0.75-1.5 mm, 68%; 1.51-3.0 mm, 44%; greater than 3.0 mm, 22%. Increased depth of invasion was associated with increased incidence of inguinal node metastasis. Cox regression analysis demonstrated prognostic significance for tumor thickness (P less than 0.001), inguinal node metastasis (P less than 0.001), and older age at diagnosis (P less than 0.001). Radical vulvectomy did not seem to improve survival over less radical procedures. Based on this experience, we recommend radical local excision for patients with malignant melanoma of the vulva. Patients who have more than a superficially invasive melanoma should also have inguinal lymph node dissection.

Therapy of vulvar carcinoma.

PubMed

Haberthür, F; Almendral, A C; Ritter, B

1993-01-01

83 vulvar carcinoma patients were originally treated in the period between 1970 and 1990. 82 patients presented with squamous cell carcinoma. 70% of the patients were in Stage I or II. It was originally possible to operate on 74 of the 83 patients. A simple or partial vulvectomy was applied 17 times. A bilateral inguinal lymph node excision additionally took place in 6 cases. 51 patients were subjected to radical vulvectomy with inguinofemoral lymph node excision. In 13 cases, pelvic lymph node extirpation was also performed. A posterior pelvic exenteration was performed in 6 cases presenting extensive carcinoma involvement of the vulva. In the remaining 9 patients, either it was not possible to operate, or a nonradical operation could be performed. The primary morbidity, consisting of wound healing disturbances and infections, amounted to 50% in our group. We observed lymphedema in 47% of the cases, although it was clinically important in only 10%. We did not have any primary surgical mortality. The 5-year survival rate was 82% in our patients without inguinofemoral lymph node involvement and only 40% in lymph node metastatic cases. The absolute 5-year cure rate was 66%, or 69% corrected. To be able to give increased preference to less invasive methods an improved prevention and clarification procedure for physicians and patients is necessary.

Laser CO2 treatment for vulvar lymphedema secondary to gynecological cancer therapy: A report of two cases and review of the literature.

PubMed

Sopracordevole, Francesco; Mancioli, Francesca; Canzonieri, Vincenzo; Buttignol, Monica; Giorda, Giorgio; Ciavattini, Andrea

2015-04-01

Vulvar lymphedema is an uncommon and disabling side-effect of pelvic lymphadenectomy and pelvic radiotherapeutic treatment for invasive genital cancer. Lymphorrhea, a complication of lymphedema, may be extremely distressing for patients due to the requirement to wear sanitary towels and as the pain and loss of elasticity of the vulvar skin and mucosa can cause discomfort during coitus. Surgical treatments of lymphorrhea and vulvar lymphedema secondary to gynecological cancer treatments remain controversial and are not currently considered to be the standard therapy. The present study reports two cases of vulvar lymphedema complicated by vulvar lymphorrhea in females who had undergone treatment for cervical and endometrial cancer, respectively; a review of the literature is also included. In the two present cases, vulvar lymphedemas were refractory to standard treatments, including decongestive therapy, manual lymph drainage, elastic bandaging, low-stretch bandaging, exercises and skin care. Laser CO 2 excision and vaporization of the whole skin and mucosal tissue of the vulva was successfully performed to treat the lymphorrhea and improve quality of life. Thus, the present two cases indicated that laser CO 2 surgery may present an additional therapy for the treatment of genital lymphedema that is refractory to other treatments.

A new species of Moennigia (Trichostrongylina: Molineidae) a parasite of Chaetophractus spp. (Xenarthra: Dasypodidae) from Argentina.

PubMed

Ezquiaga, María C; Navone, Graciela T

2014-08-01

Moennigia celinae n. sp. collected from the small intestine of Chaetophractus vellerosus and Chaetophractus villosus (Xenarthra, Dasypodidae) from Argentina is herein described. This new species belongs to the genus Moennigia because it possesses a short uterus with few eggs, atrophied distal branch of the ovejector, vulva near the anus, and a conical tail. The new species has a synlophe with 17 symmetrical ridges and slight ventro-dorsal orientation. The spicule length:body length ratio is similar to that of the other species parasitic of Dasypodidae; however, Moennigia celinae n. sp. differs from Moennigia pintoi and Moennigia lutzi because the latter lack a gubernaculum, and from Moennigia complexus, Moennigia moennigi, Moennigia filamentosus, Moennigia intrusa, Moennigia littlei, Moennigia pulchra and Moennigia dessetae by the latter having very complex spicules with 2 or 3 points at the distal extremity. Moreover, Moennigia celinae n. sp. differs from Moennigia virilis by the length and shape of its spicules. Moennigia celinae n. sp. can be distinguished from Moennigia travassosi by the shape of the dorsal ray of the caudal bursa. Moennigia celinae n. sp. resembles Moennigia pseudopulchra but the gubernaculum of the latter is V-shaped. This is the second report of a species of Moennigia in Argentina and the first for the genus Chaetophractus.

A new species of Parodontophora (Nematoda: Axonolaimidae) from the intertidal zone of the East China Sea

NASA Astrophysics Data System (ADS)

Wang, Haixia; Huang, Yong

2016-02-01

This study described a new species of free-living nematode discovered in the intertidal mudflat of Ximen Island, East China Sea. The new species, designated Parodontophora longiamphidata sp. nov., was characterized by a cylindrical body with tapering extremeties; cuticle smooth without somatic setae; four short cephalic setae; cylindrical buccal cavity with six clawlike teeth at the top of stoma; pharynx cylindrical with widened base; amphidial fovea crook-shaped with elongated scalariform branch extending past level of base of pharynx and ventral gland; ventral gland cell long-oval shaped located posterior to pharyngo-intestinal junction; excretory pore at level of middle of buccal cavity; tail conico-cylindrical with enlarged tip; three caudal gland cells, male spicules arched with cephalic proximal end and tapered distal end; gubernaculum with dorso-caudal apophysis; female with two opposed outstretched ovaries; and vulva at slightly post-midpoint of body length. This new species was close to P. wuleidaowanensis Zhang, 2005 and P. polita Gerlach, 1955 in terms of long amphidial fovea branch. The newly found species was easily distinguishable from the two documented; its amphidial fovea branch (255-290 µm versus 72-106 and 125-150 µm) was obviously longer. Key to the Parodontophora species with a longer amphidial fovea branch was given.

New species of Trichuris (Nematoda:Trichuridae) from Akodon montensis, Thomas, 1913, of the Paranaense Forest in Argentina.

PubMed

Robles, María del Rosario

2011-04-01

Species of Trichuris (Nematoda:Trichuridae) parasitize a broad range of mammalian hosts. To date, 21 Trichuris species infecting nine families of rodents have been found in North and South America. Trichuris navonae n. sp. is described on the basis of specimens recovered from a species of forest-dwelling mice, Akodon montensis (Cricetidae: Sigmodontinae), from nine localities of Misiones Province, Argentina. A comparison with all the species of Trichuris from North and South American rodents is given. The separation of the new species of Trichuris is based on morphologic and morphometrica features, such as the absence of a spicular tube, the presence of a cylindrical spicular sheath with sharp spines, a non-protrusive vulva, a long anterior-posterior portion of the body, a lengthy spicule, and a proximal and distal cloacal tube. This is the third record of this genus in rodents of the Sigmodontinae from Argentina and the fifth record from South American rodents. Despite the large number of potential host species, only about 1.9% of sigmodontine rodent species have been reported as hosts of Trichuris spp. It is suggested that this number represents but a small fraction of Trichuris spp. that occur in sigmodontine rodents, and that additional survey of this group should yield additional species.

[Investigation on the incidence of genital herpes in different professional groups in Qingdao].

PubMed

Quan, L

1993-10-01

Genital herpes is one of 8 legally reportable sexually transmitted diseases (STD) in China. Using a HSV antigen ELISA kit we detected and typed HSV antigen in 1,148 clinical specimens collected from the genital organs (penis, cervix, vagina and vulva) of 446 men and 702 women in Qindao and divided into 11 different professional and 2 special groups (patients with cervical cancer and pregnant women). The highest positive rate of HSV antigen was found among long-distance transport drivers (48.0%). The second and third high positive rates were among waiters and waitresses in private, restaurants (39.2%) and patients with cervical cancer (38.2%). The positive rates among self-employed retailers and employees in private inns and restaurants were notably higher than those among employees in state-run shops, restaurants and hotels. And, the positive rate among workers was higher than that among peasants. There was no notable difference between the positive rate of HSV antigen among men (24.2%) and that among women (21.5%). But the incidence of HSV-2 infection was much higher than that of HSV-1 infection. The results indicate that some special professional groups have high rates of genital HSV infection. More attention needs to be paid to these special groups in order to control sexually transmitted herpes diseases.

[The comparative morphology of Trichinella spiralis and Trichinella pseudospiralis].

PubMed

Skvortsova, F K; Veretennikova, N L

1997-01-01

The comparative study of the morphology of invasive larvae and mature males and females T. spiralis and T. pseudospiralis at the head end of the parasites has revealed 14 papillae which are located in 3 circles and 2 which are placed bilaterally, 2 amphidae, and a lanceolar stiletto with a spicular cutting edge. There are no differences in the structure of the heads of these two Trichinella species. The larval cuticle is decorated only with cross folds while longitudinal small-sized folds which are arranged in regular rows appeared in mature species. The vulva in females is located at the levels of a fifth of the body from the head, it is slit-like and oval, that in T. pseudospiralis is situated at the cuticular projection. The anus in T. pseudospiralis larvae is as a cross oval slit, that in adult females is as a hemisphere, and in adult males it is coincident with the copulation pore. As for the structure of the pseudobursa, differences are found in the size and shape of copulation processes, in the arrangement of pre- and postanal papillae against the cloaca, in the size of the formed cuticular projections in T. spiralis, in the shape of the cloacal hole. In the unscrewed copulatory bell, it opens transversely in T. spiralis and vertically in T. pseudospiralis.

[New colposcopic terminology: Rio de Janeiro--2011].

PubMed

Zlatkov, V; Kostova, P

2014-01-01

The purpose of this work is to review the new colposcopic classification of the International Federation for Cervical Pathology and Colposcopy (IFCPC) from 2011 and the possibilities for its application in diagnostic and treatment processes and research. It fulfills the necessity for a modern and widely applicable nomenclature of the findings and it is based on the latest knowledge in this area. Colposcopic terminology of the vagina, as part of the pathology of the lower genital tract, is included as well, while the vulva and perineum terminology is not yet finally adopted. Furthermore, the various cervical excisional techniques are evaluated and described. According to experts, the popularity of colposcopy will not diminish and it will continue to be used as a routine technique in daily practice. In a critical sense, despite its descriptive and punctual character, the accepted terminology classification does not give a new interpretation of the severity of changes, and as such, it does not significantly modify the diagnostic and therapeutic approach. The lack of a scoring system that would allow the dynamic comparison of the severity of symptoms and the categories over time is a serious weakness. This limits the new colposcopic classification as no more than a working sheet that descriptively assesses the findings of the lower genital tract.

Measuring the regulation of keratin filament network dynamics

PubMed Central

Moch, Marcin; Herberich, Gerlind; Aach, Til; Leube, Rudolf E.; Windoffer, Reinhard

2013-01-01

The organization of the keratin intermediate filament cytoskeleton is closely linked to epithelial function. To study keratin network plasticity and its regulation at different levels, tools are needed to localize and measure local network dynamics. In this paper, we present image analysis methods designed to determine the speed and direction of keratin filament motion and to identify locations of keratin filament polymerization and depolymerization at subcellular resolution. Using these methods, we have analyzed time-lapse fluorescence recordings of fluorescent keratin 13 in human vulva carcinoma-derived A431 cells. The fluorescent keratins integrated into the endogenous keratin cytoskeleton, and thereby served as reliable markers of keratin dynamics. We found that increased times after seeding correlated with down-regulation of inward-directed keratin filament movement. Bulk flow analyses further revealed that keratin filament polymerization in the cell periphery and keratin depolymerization in the more central cytoplasm were both reduced. Treating these cells and other human keratinocyte-derived cells with EGF reversed all these processes within a few minutes, coinciding with increased keratin phosphorylation. These results highlight the value of the newly developed tools for identifying modulators of keratin filament network dynamics and characterizing their mode of action, which, in turn, contributes to understanding the close link between keratin filament network plasticity and epithelial physiology. PMID:23757496

Keratosis reduces sensitivity of anal cytology in detecting anal intraepithelial neoplasia.

PubMed

ElNaggar, Adam C; Santoso, Joseph T; Xie, Huiwen Bill

2012-02-01

To identify factors that may contribute to poor sensitivity of anal cytology in contrast to the sensitivity of anoscopy in heterosexual women. We analyzed 324 patients with biopsy confirmed diagnosis of genital intraepithelial neoplasia (either vulva, vaginal, or cervical) from 2006 to 2011 who underwent both anal cytology and anoscopy. Cytology, anoscopy, and biopsy results were recorded. Biopsy specimens underwent independent analysis for quality of specimen. Also, biopsy specimens were analyzed for characteristics that may contribute to correlation, or lack thereof, between anal cytology and anoscopic directed biopsy. 133 (41%) patients had abnormal anoscopy and underwent directed biopsy. 120 patients with normal anal cytology had anoscopy directed biopsies, resulting in 58 cases of AIN (sensitivity 9.4%; 0.039-0.199). This cohort was noted to have extensive keratosis covering the entire dysplastic anal lesion. 18 patients yielded abnormal anal cytology. Of these patients, 13 had anoscopic directed biopsies revealing 6 with AIN and absent keratosis (specificity 88.6%; 0.78-0.95). The κ statistic for anal cytology and anoscopy was -0.0213 (95% CI=-0.128-0.086). Keratosis reduces the sensitivity of anal cytology. Furthermore, anal cytology poorly correlates with anoscopy in the detection of AIN (κ statistic=-0.0213). Copyright © 2011 Elsevier Inc. All rights reserved.

Molecular basis of the copulatory plug polymorphism in C. elegans

PubMed Central

Palopoli, Michael F.; Rockman, Matthew V.; TinMaung, Aye; Ramsay, Camden; Curwen, Stephen; Aduna, Andrea; Laurita, Jason; Kruglyak, Leonid

2008-01-01

Heritable variation is the raw material for evolutionary change, and understanding its genetic basis is one of the central problems in modern biology. We investigated the genetic basis of a classic phenotypic dimorphism in the nematode Caenorhabditis elegans. Males from many natural isolates deposit a copulatory plug after mating, whereas males from other natural isolates—including the standard wild-type strain (N2 Bristol) that is used in most research laboratories—do not deposit plugs1. The copulatory plug is a gelatinous mass that covers the hermaphrodite vulva, and its deposition decreases the mating success of subsequent males2. We show that the plugging polymorphism results from the insertion of a retrotransposon into an exon of a novel mucin-like gene, plg-1, whose product is a major structural component of the copulatory plug. The gene is expressed in a subset of secretory cells of the male somatic gonad, and its loss has no evident effects beyond the loss of male mate-guarding. Although C. elegans descends from an obligate-outcrossing, male-female ancestor3, 4, it occurs primarily as self-fertilizing hermaphrodites5–7. The reduced selection on male-male competition associated with the origin of hermaphroditism may have permitted the global spread of a loss-of-function mutation with restricted pleiotropy. PMID:18633349

Cutaneous lesions in pet rabbits following subcutaneous administration of a novel bivalent vaccine against myxomatosis and rabbit haemorrhagic disease.

PubMed

Selleri, Paolo; Di Girolamo, Nicola; Vögtlin, Andrea; Fileccia, Ivan; Hoop, Richard; Bongiovanni, Laura

2014-12-01

A novel bivalent vaccine to protect against myxomatosis and rabbit haemorrhagic disease is commercially available for pet rabbits. To describe the appearance of cutaneous lesions arising in pet rabbits positive for myxoma virus (MV) by RT-PCR evaluation shortly after vaccination. Four pet rabbits presenting with papular, crusting skin lesions ~10 days after vaccination. Histological evaluation of formalin-fixed skin biopsies obtained from lesional skin (case 1). Real-time polymerase chain reaction (RT-PCR) evaluation of paraffin-embedded tissue from skin biopsies (case 1) and crusts obtained from the lesion surface (cases 2-4) for myxoma virus are reported as cycle threshold (Ct ) values. Lesions affecting the ear pinna, dorsal aspect of the nose, vulva and/or conjunctiva are reported. Histopathological findings included severe ulcerative, necrotizing dermatitis and intralesional cytoplasmic inclusion bodies in myxoma cells. DNA was amplified from all the paraffin-embedded skin biopsies (Ct  = 34-35) and crusts (Ct  = 20-24). Although a wild virus challenge cannot be definitively excluded, veterinarians and pet-owners should be aware that cutaneous lesions have been observed after vaccination with this novel vaccine in low numbers of rabbits. © 2014 ESVD and ACVD.

Papillary urothelial carcinoma with squamous differentiation in association with human papilloma virus: case report and literature review.

PubMed

Guma, Sergei; Maglantay, Remegio; Lau, Ryan; Wieczorek, Rosemary; Melamed, Jonathan; Deng, Fang-Ming; Zhou, Ming; Makarov, Danil; Lee, Peng; Pincus, Matthew R; Pei, Zhi-Heng

2016-01-01

The human papilloma virus (HPV) is a carcinogen known for its strong association with cervical cancers and cervical lesions. It is also known to be associated with a variety of squamous cell carcinomas in other areas, such as the penis, vulva, anus and head and neck. However, the association with urothelial carcinoma remains controversial. Here, we report a case of urothelial carcinoma with squamous differentiation associated with HPV-6/HPV-11. This is a case of a 70 year old man who presented with nocturia and pressure during urination. During the TURP procedure for what was clinically thought to be benign prostate hyperplasia with pathologic diagnosis as prostate carcinoma, a 2 cm papillary mass was found in the distal penile urethra. The papillary mass was found to be a high grade urothelial carcinoma positive for GATA 3 expression, with focal areas of squamous differentiation. The areas with squamous differentiation demonstrated koilocytic differentiation, which were positive for strong p16 expression. The tumor was found to harbor low risk HPV 6/11 by in situ hybridization. This study case demonstrates HPV infection with a low risk subtype (HPV 6/11) associated with an urothelial carcinoma with squamous differentiation and condylomatous features.

Laboratory diagnosis and epidemiology of herpes simplex 1 and 2 genital infections.

PubMed

Glinšek Biškup, Urška; Uršič, Tina; Petrovec, Miroslav

2015-01-01

Herpes simplex virus types 1 and 2 are the main cause of genital ulcers worldwide. Although herpes simplex virus type 2 is the major cause of genital lesions, herpes simplex virus type 1 accounts for half of new cases in developed countries. Herpes simplex virus type 2 seroprevalence rises with sexual activity from adolescence through adulthood. Slovenian data in a high-risk population shows 16% seroprevalence of HSV-2. HSV-1 and HSV-2 DNA in genital swabs was detected in 19% and 20.7%, respectively. In most cases, genital herpes is asymptomatic. Primary genital infection with herpes simplex virus types 1 and 2 can be manifested by a severe clinical picture, involving the vesicular skin and mucosal changes and ulcerative lesions of the vulva, vagina, and cervix in women and in the genital region in men. Direct methods of viral genome detection are recommended in the acute stage of primary and recurrent infections when manifest ulcers or lesions are evident. Serological testing is recommended as an aid in diagnosing genital herpes in patients with reinfection in atypical or already healed lesions. When herpes lesions are present, all sexual activities should be avoided to prevent transmission of infection. Antiviral drugs can reduce viral shedding and thus reduce the risk of sexual transmission of the virus.

Photodynamic therapy (PDT) of malignant tumors by photosensitzer photosens: results of 45 clinical cases

NASA Astrophysics Data System (ADS)

Sokolov, Victor V.; Chissov, Valery I.; Yakubovskaya, Raisa I.; Aristarkhova, E. I.; Filonenko, E. V.; Belous, T. A.; Vorozhtsov, Georgy N.; Zharkova, Natalia N.; Smirnov, V. V.; Zhitkova, Margarita B.

1996-01-01

Photosensitizer Photosens is a mixture of sulphonated Al-phthalocyanines with a different number of substituents per phthalocyanine molecule. In the beginning of 1994, this photosensitizer was approved for clinical trials. Since that time till May 1995, 45 patients with 120 tumors were treated by PDT-Photosens. The main tumor localizations were lung (5/6), head and neck (4/4), esophagus (8/8), stomach (2/2), vulva (2/2), bladder (1/1), breast cancer (3/3), skin (basalioma, melanoma, sarcoma Kaposi, mts breast cancer) (20 patients/94 tumors). The lesions were photoirradiated 48-72 h after intravenous injection of Photosens in doses from 0.5 to 2.0 mg/kg b.w. (1.0 mg/kg b.w., on average). PDT was performed by laser power density from 20 to 1400 mW/sq cm (300 mW/sq.cm, on average), energy density varying from 15 to 200 J/sq cm (100 J/sq.cm, on average). The therapeutical effect of PDT was evaluated histologically, endoscopically, roentgenologically and sonographically 3 - 4 weeks after the treatment. Complete regression of tumors was reached in 56%, significant remission was reached in 34%, and partial remission was observed in 10% of cases. The follow-up of patients with complete tumor regression was to 15 months.

Plastic surgery trends parallel Playboy magazine: the pudenda preoccupation.

PubMed

Placik, Otto J; Arkins, John P

2014-09-01

Aesthetic vulvovaginal procedures are being performed with increased frequency. Many experts have suggested that the growing demand for these procedures relates to the availability and revealing nature of nude images on the Internet and in other media. The authors examined chronologically organized nude photographs from a popular magazine and objectively measured the position of the vulva relative to the center of focus to observe trends for the past 6 decades. Playboy magazine centerfold photographs from 1954 to 2013 were analyzed and categorized. The positions of the vaginal area (V-line) and the breast area (N-line) were measured in relation to the horizontal midline of the photograph. Images also were assessed for degree of grooming and exposure of the breast and pubic areas, as well as visibility of the pudendal cleft, labia majora, and labia minora. Four hundred ninety images met inclusion criteria for the analysis. Full exposure of the V-line increased from 0 instances in the 1950s to 78.6% of images from 2010 through 2013 (P<.001). Moreover, the V-line position became 41.0% closer to the photographic midline (P=.045). The results demonstrate a trend toward increased visibility and prominence of the female genitalia as the focal point of popular nude photographs. © 2014 The American Society for Aesthetic Plastic Surgery, Inc.

False beliefs predict increased circumcision satisfaction in a sample of US American men.

PubMed

Earp, Brian D; Sardi, Lauren M; Jellison, William A

2017-12-06

Critics of non-therapeutic male and female childhood genital cutting claim that such cutting is harmful. It is therefore puzzling that 'circumcised' women and men do not typically regard themselves as having been harmed by the cutting, notwithstanding the loss of sensitive, prima facie valuable tissue. For female genital cutting (FGC), a commonly proposed solution to this puzzle is that women who had part(s) of their vulvae removed before sexual debut 'do not know what they are missing' and may 'justify' their genitally-altered state by adopting false beliefs about the benefits of FGC, while simultaneously stigmatising unmodified genitalia as unattractive or unclean. Might a similar phenomenon apply to neonatally circumcised men? In this survey of 999 US American men, greater endorsement of false beliefs concerning circumcision and penile anatomy predicted greater satisfaction with being circumcised, while among genitally intact men, the opposite trend occurred: greater endorsement of false beliefs predicted less satisfaction with being genitally intact. These findings provide tentative support for the hypothesis that the lack-of-harm reported by many circumcised men, like the lack-of-harm reported by their female counterparts in societies that practice FGC, may be related to holding inaccurate beliefs concerning unaltered genitalia and the consequences of childhood genital modification.

Large Vaginal Varicosities in the Setting of Pregnancy without Known Hepatic or Vascular Risks: A Case Report and Review of the Literature.

PubMed

Sueyoshi, Mark; Clevenger, Steven; Hart, Elaine

2018-01-01

Pregnancy may cause the onset of vaginal or vulvar varicosities that may be a concern for hemorrhage risk during childbirth. A 38-year-old female G4P1112 at 34 weeks and 1 day was referred to an outpatient OB/Gyn clinic for evaluation of a large vaginal mass. The referring provider had concern for malignancy. Lesions of the vulva were biopsied and found to be benign. For two months prior to presentation, she was experiencing discomfort with walking, yellow vaginal discharge, and dysuria. Treatment with fluconazole showed no improvement. She denied any personal or family history of malignancies, varicosities, or hepatic issues. Past surgical history was significant for laparoscopic cholecystectomy and two cesarean sections. A large vaginal mass during pregnancy is a concern whether it is malignancy or large vaginal varicosities that may put the patient at risk of severe hemorrhage during childbirth. We concluded that the mass was large vaginal varicosities as there was no discernible etiology. A repeat cesarean section was recommended due to the risk of hemorrhage during childbirth. For long-term management, close observation postpartum was recommended. Spontaneous resolution is a potential outcome and this is what our patient experienced. Without an underlying etiology, supportive measures are the best options.

Squamous precursor lesions of the vulva: current classification and diagnostic challenges

PubMed Central

Hoang, Lien N.; Park, Kay J.; Soslow, Robert A.; Murali, Rajmohan

2017-01-01

Summary Growing evidence has established two major types of vulvar intraepithelial neoplasia (VIN), which correspond to two distinct oncogenic pathways to vulvar squamous cell carcinoma (VSCC). While the incidence of VSCC has remained relatively stable over the last three decades, the incidence of VIN has increased. VIN of usual type (uVIN) is human papillomavirus (HPV)-driven, affects younger women and is a multicentric disease. In contrast, VIN of differentiated type (dVIN) occurs in post-menopausal women and develops independent of HPV infection. dVIN often arises in a background of lichen sclerosus and chronic inflammatory dermatoses. Although isolated dVIN is significantly less common than uVIN, dVIN bears a greater risk for malignant transformation to VSCC and progresses over a shorter time interval. On histological examination, uVIN displays conspicuous architectural and cytological abnormalities, while the morphological features that characterise dVIN are much more subtle and raise a wide differential diagnosis. On the molecular level, dVIN is characterised by a higher number of somatic mutations, particularly in TP53. Here we review the classification, epidemiology, clinical features, histomorphology, ancillary markers and molecular genetics of both types of VIN, and discuss the morphological challenges faced by pathologists in interpreting these lesions. PMID:27113549

Caenorhabditis elegans vulval cell fate patterning

NASA Astrophysics Data System (ADS)

Félix, Marie-Anne

2012-08-01

The spatial patterning of three cell fates in a row of competent cells is exemplified by vulva development in the nematode Caenorhabditis elegans. The intercellular signaling network that underlies fate specification is well understood, yet quantitative aspects remain to be elucidated. Quantitative models of the network allow us to test the effect of parameter variation on the cell fate pattern output. Among the parameter sets that allow us to reach the wild-type pattern, two general developmental patterning mechanisms of the three fates can be found: sequential inductions and morphogen-based induction, the former being more robust to parameter variation. Experimentally, the vulval cell fate pattern is robust to stochastic and environmental challenges, and minor variants can be detected. The exception is the fate of the anterior cell, P3.p, which is sensitive to stochastic variation and spontaneous mutation, and is also evolving the fastest. Other vulval precursor cell fates can be affected by mutation, yet little natural variation can be found, suggesting stabilizing selection. Despite this fate pattern conservation, different Caenorhabditis species respond differently to perturbations of the system. In the quantitative models, different parameter sets can reconstitute their response to perturbation, suggesting that network variation among Caenorhabditis species may be quantitative. Network rewiring likely occurred at longer evolutionary scales.

THE EFFECT OF ENDOCRINE CHANGES, OF IRRADIATION AND OF ADDITIONAL TREATMENT OF THE SKIN ON THE INDUCTION OF TUMOURS IN THE FEMALE GENITAL TRACT OF RATS BY CHEMICAL CARCINOGENS

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cherry, C.P.; Glucksmann, A.

1960-09-01

Ovariectomy reduced the incidence of vaginal tumors after intravaginal application of 9,10-dimethyl-1,2benzanthracene (DMBA), and administration of oestrogen or of progesterone raised the incidence of tumors only slightly. Repeated whole-body exposures to x rays also lowered the rate of tumor incidence after painting and so to a lesser extent did repeated pelvic irradiation of virgin rats and the application of DMBA to an additional dorsal skin region. In surgical castrates adrenalectomy or repeated pelvic irradiation restored the level of tumor incidence to that of intact and pregnant rats. Three levels of vaginal tumor incidence were found, and the distribution of tumormore » types and the length of the average induction time varied with the level: at the lowest level there were only sarcomas, at the intermediate level fibromas and presarcomatous lesions were found in addition to the sarcomas; and at the highest level the incidence of sarcomas is increased and epithelial tumors appear. Tumor induction in the vulva is not affected by castration, radiation, or hormone treatment but varies at certain dose levels with the dose of the carcinogen. (auth)« less

ON THE PROGNOSTIC SIGNIFICANCE OF THE ERYTHROCYTE SEDIMENTATION RATE, THE LEUKOCYTE COUNT, THE HEMOGLOBIN VALUE, AND BODY WEIGHT IN IRRADIATED AND NONIRRADIATED CANCER PATIENTS (in German)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hofmann, D.

1962-06-01

Changes in these parameters were followed in 672 women with genital carcinoma during and after radiotherapy to determine whether any of them could be used to predict the eventual success of the treatment. All of these parameters were found to be of prognostic value in the 394 patients with carcinoma of the uterine cervix of grades I, II, and III. Erythrocyte sedimentation rate (ESR) was initially elevated in these patients, and in those without recurrence, irradiation caused a prompt and progressive drop in ESR. It continued to rise after radiotherapy in those who later showed tumor recurrence. Similar changes inmore » leukocyte count were seen in this group, the counts falling and staying down after successful treatment or rising when the treatment failed. An inverse relation with respect to the hemoglobin level and body wt was seen, both values progressively increasing in cases later shown to be cured and falling in those which were not. These relations did not hold or were of less prognostic value in patients with carcinomas of the body of the uterus, ovary, or vulva. However, in general, a gradual continual fall in ESR and a rapid fall in leukocyte count were favorable signs following irradiation. (BBB)« less

Steinernema poinari sp. n. (Nematoda: Steinernematidae) a new entomopathogenic nematode from the Czech Republic.

PubMed

Mráček, Zdeněk; Nermuť, Jiří

2014-02-03

A new steinernematid nematode, herein described as Steinernema poinari sp. n., was recovered by baiting soil samples with the last instar wax moth larvae Galleria mellonella in three localities of southwest Bohemia, Czech Republic. Morphological and molecular data confirmed this nematode as a new species which belongs to the affine/intermedium group. S. poinari sp. n. was characterized by male, female and infective juvenile morphological observations. Male spicules are robust with a pointed tip, SW% = 109 (98-123) and GS% = 70 (58-87). The tail terminus of the first generation have a papillated mucron, whereas in the second generation a short filamentous mucron sometimes develops. Females of the first generation have a moderately protruding vulva, postanal swelling absent or slightly developed. Second generation females have a long filamentous mucron on the tail tip. Infective juvenile have a body length of 768 µm, lateral field formula 2, 5, 6, 5, 2, 1, ratio D% of 46 (40-55), E% of 84 (76-95) and H% of 50 (43-56). The new species was characterized by sequences of ITS and D2D3 regions of ribosomal DNA. S. poinari sp. n. can also be separated from S. affine and S. intermedium by cross-breeding tests.

Morphology of Labronemella major n. sp. (Nematoda: Dorylaimida), a soil-dwelling nematode from China, including a revised key to species of the genus.

PubMed

Wu, W J; Yan, L; Xie, H; Xu, C L; Wang, K; Jin, S Y

2017-01-01

One new species from Qinghai Province, China, Labronemella major n. sp., is described. The new species is characterized by a body length of 3.03-3.34 mm; lip region wide, offset by a distinct depression, disc-like with six separated inner liplets; amphid fovea funnel-shaped, distinctly bulged on body surface in scanning electron micrographs; odontostyle long (35-39 μm) with distinct lumen, aperture about 39-47% of its length; odontophore rod-like and long; guiding ring double; pharyngeal basal expansion about half of the total neck length; uterus relatively long and tripartite; vulva transverse and sclerotized; spicules 81-90 μm long; ventromedial supplements 19-23; tail short, rounded to conoid. It can be differentiated from all other species of the genus by its relatively longer body, odontostyle and spicules, and wider lip region. Due to the lip region being offset by a deep constriction, and the long (three or more times the body diameter at mid-body) tripartite uterus, the new species is close to Labronemella czernowitzensis (Micoletzky, 1922) Andrássy, 2002 and Labronemella labiata Andrássy, 1985. An improved key to the genus including the new species is provided.

Non-mosaic monosomy 59,X in cattle: a case report.

PubMed

Romano, Juan E; Raussdepp, Terje; Mulon, Pierre Y; Villadóniga, Graciela B

2015-05-01

A 3-year-old Longhorn heifer was referred to the Veterinary Medical Teaching Hospital of Texas A&M University for inability to get pregnant. Physical examination revealed a small-sized female for age and breed with a normal vulva, vaginal length, and external cervical os. Further assessment by per rectum palpation and trans-rectal ultrasonography revealed a small uterine cervix and cord-like uterine horns with no identifiable ovaries. Additional evaluation including laparoscopy, hormonal evaluation, and genetic analysis allowed ruling out conditions commonly associated with a phenotypic female with infantile or underdeveloped reproductive organs such as freemartin, XY gonadal dysgenesis, testicular feminization, and bilateral ovarian agenesis. Laparoscopy confirmed the presence of a small cervix with small uterine horns and absence of ovaries. Testosterone, progesterone, and 17-β estradiol concentrations were 200.0pg/mL, 1.48ng/mL, and undetectable, respectively. Genetic evaluation determined that the karyotype was 59,X non-mosaic. Evaluation of phenotypically female cattle with infertility and infantile genital organs and absence of ovaries should include cytogenetic analysis to test for possible X monosomy. The 59,X condition should be considered in the differential diagnoses together with freemartin, dysgenesis XY, testicular feminization, and bilateral ovarian agenesis. Copyright © 2015 Elsevier B.V. All rights reserved.

Dermoscopic findings in Laugier-Hunziker syndrome.

PubMed

Gencoglan, Gulsum; Gerceker-Turk, Bengu; Kilinc-Karaarslan, Isil; Akalin, Taner; Ozdemir, Fezal

2007-05-01

Laugier-Hunziker syndrome (LHS) is a rare, acquired mucocutaneous hyperpigmentation often associated with longitudinal melanonychia. The clinical behavior of mucocutaneous pigmented lesions ranges from benign to highly malignant. Therefore, in most cases, the clinical diagnosis should be confirmed by further diagnostic methods. Dermoscopy is a noninvasive technique that has been used to make more accurate diagnoses of pigmented skin lesions. Nevertheless, to our knowledge, the dermoscopic features of the pigmented lesions in LHS have not been described previously. Herein, we report a case of LHS together with its dermoscopic features. The clinical examination revealed macular hyperpigmentation on the oral and genital mucosa, conjunctiva, and palmoplantar region together with longitudinal melanonychia. Dermoscopic examination of mucosal lesions on the patient's lips and vulva revealed a parallel pattern. Longitudinal homogeneous pigmentation was observed on the toenails. The pigmented macules on the palms and the sole showed a parallel furrow pattern. A skin biopsy sample taken from the labial lesion was compatible with a diagnosis of mucosal melanosis. By means of this case report, the dermoscopic features of the pigmented lesions in LHS are described for the first time, which facilitates diagnosis with a noninvasive technique. Future reports highlighting the dermoscopic features of this syndrome may simplify the diagnosis of LHS, which is thought to be underdiagnosed.

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.

Reproductive System of Brown-throated Sloth (Bradypus variegatus, Schinz 1825, Pilosa, Xenarthra): Anatomy and Histology.

PubMed

Favoretto, S M; daSilva, E G; Menezes, J; Guerra, R R; Campos, D B

2016-08-01

In recent years, habitat degradation led to the decline of some populations of brown-throated sloth. The aim of this study was to describe morphological features of the female reproductive system of the species. The oval ovaries were partially surrounded by ovarian bursa. An external cortex and an inner medulla were present. Corpora lutea and corpora albicans together with follicles at various stages of development each with a single oocyte were found in the cortex. Uterine tubes were tortuous, tubular, travelled around the perimeter of the ovary and possessed a folded mucosa with ciliated pseudostratified epithelium. Uterus was simplex, with no horns and divided into three parts: a pear-shaped cranial segment and a long caudal uterine segment (both forming the body of the uterus) and two cervices. Uterus presented three layers: mucosa, lined by pseudostratified epithelium, muscular and serosa. The cervices connected the uterus to the urogenital sinus, a distensible cavity with longitudinal mucosal folds lined by transitional epithelium that extended from the external urethral orifice and the external uterine ostia to the vulva, which was lined by a keratinized stratified squamous epithelium. Brown-throated sloth presented a bipartite clitoris with paired crura, bodies and glandes. The presence of a double cervix and a bipartite clitoris was unique features of the species. © 2015 Blackwell Verlag GmbH.

Searching: the lived experience of women with cancer of the vulva.

PubMed

Jefferies, Hilary; Clifford, Collette

2009-01-01

Although the physical adverse effects following surgery for vulval cancer may readily be described, little is known about the psychological, emotional, and social impact. A review of the literature revealed a paucity of studies, as this condition is rare. To explore the lived experiences of women in the United Kingdom with vulval cancer, a qualitative research study was undertaken using the research methodology of interpretive phenomenology, based on the work of Heidegger (The Essence of Human Freedom. London: Continuum; 2005) and van Manen (Researching Lived Experience. Human Science for an Action Sensitive Pedagogy. New York: State University of New York Press; 1990). Thirteen women younger than 50 years were interviewed between 6 months and 5 years after their surgery, and the data were analyzed using framework analysis (Qualitative data analysis for applied policy research. In: Analysing Qualitative Data. London: Routledge; 1994:173-194). This article describes how the concept of searching emerged from the data. It also describes the manner in which the women searched to control their symptoms by their own efforts and by undergoing surgery. The search to understand the truth about their condition and their access to information in the search for meaning and the time element in which this was undertaken was also raised. An underlying consideration is the need for health professionals to help provide the information and support needed to manage this condition.

Spirocerca vulpis sp. nov. (Spiruridae: Spirocercidae): description of a new nematode species of the red fox, Vulpes vulpes (Carnivora: Canidae).

PubMed

Rojas, Alicia; Sanchis-Monsonís, Gloria; Alić, Amer; Hodžić, Adnan; Otranto, Domenico; Yasur-Landau, Daniel; Martínez-Carrasco, Carlos; Baneth, Gad

2018-05-21

Previous studies have reported nematodes of the Spirocercidae family in the stomach nodules of red foxes (Vulpes vulpes) described as Spirocerca sp. or Spirocerca lupi (Rudolphi, 1819). We characterized spirurid worms collected from red foxes and compared them to S. lupi from domestic dogs by morphometric and phylogenetic analyses. Nematodes from red foxes differed from S. lupi by the presence of six triangular teeth-like buccal capsule structures, which are absent in the latter. Additionally, in female worms from red foxes, the distance of the vulva opening to the anterior end and the ratio of the glandular-to-muscular oesophagus lengths were larger than those of S. lupi (P < 0.006). In males, the lengths of the whole oesophagus and glandular part, the ratio of the glandular-to-muscular oesophagus and the comparison of the oesophagus to the total body length were smaller in S. lupi (all P < 0.044). Phylogenetic analyses revealed that S. lupi and the red foxes spirurid represent monophyletic sister groups with pairwise nucleotide distances of 9.2 and 0.2% in the cytochrome oxidase 1 and 18S genes, respectively. Based on these comparisons, the nematodes from red foxes were considered to belong to a separate species, for which the name Spirocerca vulpis sp. nov. is proposed.

The nematode Pristionchus pacificus as a model system for integrative studies in evolutionary biology.

PubMed

Sommer, Ralf J; McGaughran, Angela

2013-05-01

Comprehensive studies of evolution have historically been hampered by the division among disciplines. Now, as biology moves towards an '-omics' era, it is more important than ever to tackle the evolution of function and form by considering all those research areas involved in the regulation of phenotypes. Here, we review recent attempts to establish the nematode Pristionchus pacificus as a model organism that allows integrative studies of development and evo-devo, with ecology and population genetics. Originally developed for comparative study with the nematode Caenorhabditis elegans, P. pacificus provided insight into developmental pathways including dauer formation, vulva and gonad development, chemosensation, innate immunity and neurobiology. Its subsequent discovery across a wide geographic distribution in association with scarab beetles enabled its evaluation in a biogeographic context. Development of an evolutionary field station on La Réunion Island, where P. pacificus is present in high abundance across a number of widespread habitat types, allows examination of the microfacets of evolution - processes of natural selection, adaptation and drift among populations can now be examined in this island setting. The combination of laboratory-based functional studies with fieldwork in P. pacificus has the long-term prospective to provide both proximate (mechanistic) and ultimate (evolutionary and ecological) causation and might therefore help to overcome the long-term divide between major areas in biology. © 2013 Blackwell Publishing Ltd.

Activating mutations in RRAS underlie a phenotype within the RASopathy spectrum and contribute to leukaemogenesis

PubMed Central

Flex, Elisabetta; Jaiswal, Mamta; Pantaleoni, Francesca; Martinelli, Simone; Strullu, Marion; Fansa, Eyad K.; Caye, Aurélie; De Luca, Alessandro; Lepri, Francesca; Dvorsky, Radovan; Pannone, Luca; Paolacci, Stefano; Zhang, Si-Cai; Fodale, Valentina; Bocchinfuso, Gianfranco; Rossi, Cesare; Burkitt-Wright, Emma M.M.; Farrotti, Andrea; Stellacci, Emilia; Cecchetti, Serena; Ferese, Rosangela; Bottero, Lisabianca; Castro, Silvana; Fenneteau, Odile; Brethon, Benoît; Sanchez, Massimo; Roberts, Amy E.; Yntema, Helger G.; Van Der Burgt, Ineke; Cianci, Paola; Bondeson, Marie-Louise; Cristina Digilio, Maria; Zampino, Giuseppe; Kerr, Bronwyn; Aoki, Yoko; Loh, Mignon L.; Palleschi, Antonio; Di Schiavi, Elia; Carè, Alessandra; Selicorni, Angelo; Dallapiccola, Bruno; Cirstea, Ion C.; Stella, Lorenzo; Zenker, Martin; Gelb, Bruce D.; Cavé, Hélène; Ahmadian, Mohammad R.; Tartaglia, Marco

2014-01-01

RASopathies, a family of disorders characterized by cardiac defects, defective growth, facial dysmorphism, variable cognitive deficits and predisposition to certain malignancies, are caused by constitutional dysregulation of RAS signalling predominantly through the RAF/MEK/ERK (MAPK) cascade. We report on two germline mutations (p.Gly39dup and p.Val55Met) in RRAS, a gene encoding a small monomeric GTPase controlling cell adhesion, spreading and migration, underlying a rare (2 subjects among 504 individuals analysed) and variable phenotype with features partially overlapping Noonan syndrome, the most common RASopathy. We also identified somatic RRAS mutations (p.Gly39dup and p.Gln87Leu) in 2 of 110 cases of non-syndromic juvenile myelomonocytic leukaemia, a childhood myeloproliferative/myelodysplastic disease caused by upregulated RAS signalling, defining an atypical form of this haematological disorder rapidly progressing to acute myeloid leukaemia. Two of the three identified mutations affected known oncogenic hotspots of RAS genes and conferred variably enhanced RRAS function and stimulus-dependent MAPK activation. Expression of an RRAS mutant homolog in Caenorhabditis elegans enhanced RAS signalling and engendered protruding vulva, a phenotype previously linked to the RASopathy-causing SHOC2S2G mutant. Overall, these findings provide evidence of a functional link between RRAS and MAPK signalling and reveal an unpredicted role of enhanced RRAS function in human disease. PMID:24705357

Establishment of a standard operating procedure for predicting the time of calving in cattle

PubMed Central

Sauter-Louis, Carola; Braunert, Anna; Lange, Dorothee; Weber, Frank; Zerbe, Holm

2011-01-01

Precise calving monitoring is essential for minimizing the effects of dystocia in cows and calves. We conducted two studies in healthy cows that compared seven clinical signs (broad pelvic ligaments relaxation, vaginal secretion, udder hyperplasia, udder edema, teat filling, tail relaxation, and vulva edema) alone and in combination in order to predict the time of parturition. The relaxation of the broad pelvic ligaments combined with teat filling gave the best values for predicting either calving or no calving within 12 h. For the proposed parturition score (PS), a threshold of 4 PS points was identified below which calving within the next 12 h could be ruled out with a probability of 99.3% in cows (95.5% in heifers). Above this threshold, intermitted calving monitoring every 3 h and a progesterone rapid blood test (PRBT) would be recommended. By combining the PS and PRBT (if PS ≥ 4), the prediction of calving within the next 12 h improved from 14.9% to 53.1%, and the probability of ruling out calving was 96.8%. The PRBT was compared to the results of an enzyme immunoassay (sensitivity, 90.2%; specificity, 74.9%). The standard operating procedure developed in this study that combines the PS and PRBT will enable veterinarians to rule out or predict calving within a 12 h period in cows with high accuracy under field conditions. PMID:21586878

The first report of new species: Trichuris landak n. sp

PubMed Central

Purwaningsih, Endang

2013-01-01

Objective To study nematode parasites morphology of Hystrix javanica (H. javanica), both through the feces and internal organs. Methods Feces were observed by direct smear method, internal organs were observed after dissecting the host. Specimens for light microscopy examination were fixed with 70% warm alcohol, cleared and mounted in lactophenol for wet mounting. Specimens for SEM examination were postfixed in cacodylate buffer and glutaraldehyde, dehydrated through a graded series of alcohol and freeze dried. The specimens were attached to stubs with double cello-tape, coated with gold and observed with a JSM5310 LV electron microscope. Figures were made with the aid of a drawing tube attached to Olympus compound microscope, other figures were photographs of scanning electron microscope images. Measurements were given in micrometers as the mean followed by the range in parentheses, unless otherwise stated. Results The nematode species found in the intestine of H. javanica are Gireterakis girardi and a new species, Trihuris landak. The new species differs with previously reported species from Hystrix because of having stylet and short cervical alae. The pattern of bacillary band is closed to Trichuris trichiurus, the species that infect human, but differs because the surface of its vulva is not covered with densely spine. Conclusions The species of nematodes found on H. javanica were Gireterakis girardi and a new species Trichuris landak n.sp. Those two species are newly recorded in Indonesia. PMID:23593584

Studies of the genus Enchodelus Thorne, 1939 (Nematoda, Nordiidae) from Arctic polar deserts. 1. Species with long odontostyle: E. makarovae sp. n. and E. groenlandicus (Ditlevsen, 1927) Thorne, 1939, with an identification key to the species of the E. macrodorus group

PubMed Central

Elshishka, Milka; Lazarova, Stela; Peneva, Vlada K.

2012-01-01

Abstract Two nematode species of the genus Enchodelus Thorne, 1939, one new and one known from Arctic polar deserts were studied. Enchodelus makarovae sp. n. is an amphimictic species, characterised by females with body length of 1.57–2.00 mm, lip region 15–17.5 µm wide, amphid duplex, odontostyle 38–43 µm long or 2.3–2.8 times lip region diam. Odontophore with flanges, 1.2–1.4 times as long as odontostyle; pharynx length 320–377 µm, pharyngeal expansion 113–130 µm long or 32–37% of total pharynx length; female genital system amphidelphic, uterus tripartite, pars refringens vaginae with two trapezoid sclerotisations, vulva a transverse slit (V=45–51%); tail bluntly conoid (25–35 µm, c=45.8–70.3, c’=0.6–0.9 in females, and 29–33 µm, c=46.4–58.9, c’=0.7–0.8 in males). Males with 65–74 µm long spicules and 10–12 spaced ventromedian supplements. Additional information for Enchodelus groenlandicus is provided, this being a new geographic record for the Putorana Plateau, Russian Arctic. PMID:22933846

Heterodera guangdongensis n. sp. (Nematoda: Heteroderinae) from bamboo in Guangdong Province, China--a new cyst nematode in the Cyperi group.

PubMed

Zhuo, Kan; Wang, Honghong; Zhang, Hongling; Liao, Jinling

2014-11-07

Heterodera guangdongensis n. sp. is described from bamboo (Phyllostachys pubescens Mazel) based on morphology and molecular analyses of rRNA D2D3 expansion domains of large subunit (LSU D2D3) and internal transcribed spacer (ITS) sequences. This new species can be classified in the Cyperi group. Cysts are characterized by a prominent, ambifenestrate vulval cone with weak underbridge, a vulva-anus distance of 28.9-35.9 μm and a vulval slit of 31.1-41.0 μm, but without bullae. Females are characterized by a 25.1-27.6 μm stylet with rounded knobs sloping slightly posteriorly. Males are characterized by a 21.5-23.0 μm stylet with knobs slightly projecting or flat anteriorly, lateral field with four lines, and a 22.0-26.0 μm spicule with bifurcate tip. Second-stage juveniles are characterized by a 19.3-21.3 stylet with slightly projecting or anteriorly flattened knobs, lateral field with three lines, a 41.7-61.3 μm tail with finely rounded terminus and hyaline portion forming 43.0-57.1% of the tail length. Molecular analyses show that the species has unique D2D3 and ITS rRNA sequences and RFLP-ITS-rRNA profiles.

Homologues of the human multidrug resistance genes MRP and MDR contribute to heavy metal resistance in the soil nematode Caenorhabditis elegans.

PubMed Central

Broeks, A; Gerrard, B; Allikmets, R; Dean, M; Plasterk, R H

1996-01-01

Acquired resistance of mammalian cells to multiple chemotherapeutic drugs can result from enhanced expression of the multidrug resistance-associated protein (MRP), which belongs to the ABC transporter superfamily. ABC transporters play a role in the protection of organisms against exogenous toxins by cellular detoxification processes. We have identified four MRP homologues in the soil nematode Caenorhabditis elegans, and we have studied one member, mrp-1, in detail. Using an mrp::lacZ gene fusion, mrp-l expression was found in cells of the pharynx, the pharynx-intestinal valve and the anterior intestinal cells, the rectum-intestinal valve and the epithelial cells of the vulva. Targeted inactivation of mrp-l resulted in increased sensitivity to the heavy metal ions cadmium and arsenite, to which wild-type worms are highly tolerant. The most pronounced effect of the mrp-1 mutation is on the ability of animals to recover from temporary exposure to high concentrations of heavy metals. Nematodes were found to be hypersensitive to heavy metals when both the MRP homologue, mrp-1, and a member of the P-glycoprotein (Pgp) gene family, pgp-1, were deleted. We conclude that nematodes have multiple proteins, homologues of mammalian proteins involved in the cellular resistance to chemotherapeutic drugs, that protect them against heavy metals. Images PMID:8947035

Recurrent paediatric pinworm infection of the vagina as a potential reservoir for Enterobius vermicularis.

PubMed

Kashyap, B; Samantray, J C; Kumar, S; Jhamb, R; Singh, A K; Kaur, I R

2014-09-01

Enterobius vermicularis infection remains one of the most common parasitic infections, particularly prevalent in children. Enterobiasis, although not usually dangerous, may cause significant morbidity. Elimination of the parasite from a family or an institution often poses problems, either because of an incomplete cure or re-infection. While there have been limited reports of ectopic enterobiasis throughout the world, ours is probably one of the rarest reports of recurrent vaginal E. vermicularis infection in the absence of any gastrointestinal symptoms despite complete treatment. A 4-year-old girl presented with recurrent episodes of vulval itching on 3-4 occasions over 2 years. There was no pruritis ani nor urinary/gastrointestinal complaints. The vulva was inflamed with 4-5 living worms, 6-7 mm in length, emerging from the anterior vaginal fornix, but with no vaginal discharge. Direct microscopic examination of vaginal swabs revealed adult worms of Enterobius but no eggs. Repeated stool samples from the patient, parents and a sibling were negative. The patient was treated orally with 100 mg of mebendazole for 3 days followed by two more courses at 3-week intervals over a period of 3 months. Recurrent vaginal enterobiasis despite complete treatment and in the absence of any gastrointestinal involvement suggests that the vagina is a potential reservoir for E. vermicularis, which supports the theory of rare ectopic enterobiasis through the ascending pathway of the female genital tract.

cdc-25.4, a Caenorhabditis elegans Ortholog of cdc25, Is Required for Male Mating Behavior

PubMed Central

Oh, Sangmi; Kawasaki, Ichiro; Park, Jae-Hyung; Shim, Yhong-Hee

2016-01-01

Cell division cycle 25 (cdc25) is an evolutionarily conserved phosphatase that promotes cell cycle progression. Among the four cdc25 orthologs in Caenorhabditis elegans, we found that cdc-25.4 mutant males failed to produce outcrossed progeny. This was not caused by defects in sperm development, but by defects in male mating behavior. The cdc-25.4 mutant males showed various defects during male mating, including contact response, backing, turning, and vulva location. Aberrant turning behavior was the most prominent defect in the cdc-25.4 mutant males. We also found that cdc-25.4 is expressed in many neuronal cells throughout development. The turning defect in cdc-25.4 mutant males was recovered by cdc-25.4 transgenic expression in neuronal cells, suggesting that cdc-25.4 functions in neurons for male mating. However, the neuronal morphology of cdc-25.4 mutant males appeared to be normal, as examined with several neuronal markers. Also, RNAi depletion of wee-1.3, a C. elegans ortholog of Wee1/Myt1 kinase, failed to suppress the mating defects of cdc-25.4 mutant males. These findings suggest that, for successful male mating, cdc-25.4 does not target cell cycles that are required for neuronal differentiation and development. Rather, cdc-25.4 likely regulates noncanonical substrates in neuronal cells. PMID:27770028

cdc-25.4, a Caenorhabditis elegans Ortholog of cdc25, Is Required for Male Mating Behavior.

PubMed

Oh, Sangmi; Kawasaki, Ichiro; Park, Jae-Hyung; Shim, Yhong-Hee

2016-12-07

Cell division cycle 25 (cdc25) is an evolutionarily conserved phosphatase that promotes cell cycle progression. Among the four cdc25 orthologs in Caenorhabditis elegans, we found that cdc-25.4 mutant males failed to produce outcrossed progeny. This was not caused by defects in sperm development, but by defects in male mating behavior. The cdc-25.4 mutant males showed various defects during male mating, including contact response, backing, turning, and vulva location. Aberrant turning behavior was the most prominent defect in the cdc-25.4 mutant males. We also found that cdc-25.4 is expressed in many neuronal cells throughout development. The turning defect in cdc-25.4 mutant males was recovered by cdc-25.4 transgenic expression in neuronal cells, suggesting that cdc-25.4 functions in neurons for male mating. However, the neuronal morphology of cdc-25.4 mutant males appeared to be normal, as examined with several neuronal markers. Also, RNAi depletion of wee-1.3, a C. elegans ortholog of Wee1/Myt1 kinase, failed to suppress the mating defects of cdc-25.4 mutant males. These findings suggest that, for successful male mating, cdc-25.4 does not target cell cycles that are required for neuronal differentiation and development. Rather, cdc-25.4 likely regulates noncanonical substrates in neuronal cells. Copyright © 2016 Oh et al.

The first report of new species: Trichuris landak n. sp.

PubMed

Purwaningsih, Endang

2013-02-01

To study nematode parasites morphology of Hystrix javanica (H. javanica), both through the feces and internal organs. Feces were observed by direct smear method, internal organs were observed after dissecting the host. Specimens for light microscopy examination were fixed with 70% warm alcohol, cleared and mounted in lactophenol for wet mounting. Specimens for SEM examination were postfixed in cacodylate buffer and glutaraldehyde, dehydrated through a graded series of alcohol and freeze dried. The specimens were attached to stubs with double cello-tape, coated with gold and observed with a JSM5310 LV electron microscope. Figures were made with the aid of a drawing tube attached to Olympus compound microscope, other figures were photographs of scanning electron microscope images. Measurements were given in micrometers as the mean followed by the range in parentheses, unless otherwise stated. The nematode species found in the intestine of H. javanica are Gireterakis girardi and a new species, Trihuris landak. The new species differs with previously reported species from Hystrix because of having stylet and short cervical alae. The pattern of bacillary band is closed to Trichuris trichiurus, the species that infect human, but differs because the surface of its vulva is not covered with densely spine. The species of nematodes found on H. javanica were Gireterakis girardi and a new species Trichuris landak n.sp. Those two species are newly recorded in Indonesia.

An update on vulvar intraepithelial neoplasia: terminology and a practical approach to diagnosis.

PubMed

Reyes, M Carolina; Cooper, Kumarasen

2014-04-01

There are two distinct types of vulvar intraepithelial neoplasia (VIN), which differ in their clinical presentation, aetiology, pathogenesis and histological/immunophenotypical features. One form driven by high-risk human papilloma virus infection usually occurs in young women and has been termed classic or usual VIN (uVIN). The other, not related to viral infection, occurs in postmenopausal women with chronic skin conditions such as lichen sclerosus and lichen simplex chronicus and is termed differentiated or simplex-type VIN. The latter is the precursor lesion of the most common type of squamous cell carcinoma (SCC) in the vulva, namely keratinizing SCC (representing 60% of cases). In contrast, uVIN usually gives rise to basaloid or warty SCC (40% of cases). The histological features of uVIN are similar to those of high grade lesions encountered in other lower anogenital tract sites (hyperchomatic nuclei with high nuclear to cytoplasmic ratios and increased mitotic activity). However, differentiated VIN has very subtle histopathological changes and often escapes diagnosis. Since uVIN is driven by high-risk human papilloma virus infections, p16 immunohistochemistry is diffusely positive in these lesions and is characterized with a high Ki-67 proliferation index. In contrast, differentiated or simplex-type VIN is consistently negative for p16 and the majority of the cases harbour TP53 mutations, correlating with p53 positivity by immunohistochemistry.

[Anatomy and physiology of sexuality].

PubMed

Cour, F; Droupy, S; Faix, A; Methorst, C; Giuliano, F

2013-07-01

Knowledge of the physiology of male and female sexuality has advanced considerably. Initially there is always desire with its biological neuroendocrine components and its emotional field which is particularly marked in women. There is a distinction between "spontaneous" sexual desire related to intrinsic affective, cognitive stimuli, and fantasies, and "reactive" sexual desire in response to physical arousal. There are similarities between men and women concerning the activation of cerebral zones in sexual arousal contexts in laboratory conditions. The neural pathways for sexual arousal are similar between men and women, bringing into play the sympathetic centres of the thoracic and lumbar spinal cord and, at the sacral level, the parasympathetic center and the motoneurons controlling the muscular contractions of the pelviperineal striated muscles. Genital sensitivity is mainly transmitted by the pudendal nerve in both men and women. Sexual arousal in men consists of penile erection, and ejaculation accompanied with orgasm. In women, sexual arousal causes increase in blood to flow to the vagina leading to lubrication and to the vulva leading to the erection of the clitoris and vulvar hyperaemia. The orgasm which can be multiple in women is accompanied by contractions of the striated perineal muscles. Several neurotransmitters are closely involved in the control of sexuality at the central level: dopamine, ocytocin, serotonin, and peripheral: nitric oxide and noradrenaline in men, vasoactive intestinal peptide and neuropeptide Y in women. Copyright © 2012. Published by Elsevier Masson SAS.

Making up koro: multiplicity, psychiatry, culture, and penis-shrinking anxieties.

PubMed

Crozier, Ivan

2012-01-01

Koro is a syndrome in which the penis (or sometimes the nipples or vulva) is retracting, with deleterious effects for the sufferer. In modern psychiatry, it is considered a culture-bound syndrome (CBS). This paper considers the formation and development of psychiatric conceptions of koro and related genital retraction syndromes from the 1890s to the present. It does so by examining the different explanations of koro based on shifting conceptions of mental illness, and considers the increased recognition of the role culture has to play in psychiatric concepts. Conceptions of culture (deriving from colonial psychiatry as well as from anthropology) actively shaped the ways in which psychiatrists conceptualized koro. Cases under consideration, additional to the first Dutch descriptions of koro, include the ways in which koro was identified in white western cases, and the 1967 Singaporean koro epidemic. Following a number of psychiatrists and psychologists who have addressed the same material, attention is also paid to the recent genital-theft panics in sub-Saharan Africa, considering the implications of the differences between koro and other genital-theft panics. Finally, the paper addresses the role played by koro in the development of the concept of CBSs, which was first presented in the DSM IV in 1994. This is explored against the backdrop of emerging ideas about culture and psychiatry from the late colonial period, especially in Africa, which are central to modern ideas about transcultural psychiatry.

Prediction of calving time in dairy cattle.

PubMed

Mahmoud, Fadul; Christopher, Bogdahn; Maher, Alsaaod; Jürg, Hüsler; Alexander, Starke; Adrian, Steiner; Gaby, Hirsbrunner

2017-12-01

This prospective study was carried out to predict the calving time in primiparous (n=11) and multiparous (n=22) Holstein-Friesian cows using the combination of data obtained from the RumiWatch noseband-sensor and 3D-accelerometer. The animals included in the study were fitted with the RumiWatch noseband-sensor and 3D-accelerometer at least 10days before the expected calving day. The calving event was defined as the time of the first appearance of the calves' feet outside the vulva, and this moment was determined by farm staff and/or confirmed by video monitor. As primiparous and multiparous cows behaved differently, two models including data of noseband-sensors and 3D-accelerometers were used to predict the calving time in each group. Lying bouts (LB) increased and rumination chews (RC) decreased similarly in both groups; besides that, boluses (B) decreased and other activities (OA) increased significantly in multiparous and primiparous cows, respectively. The sensitivity (Se) and specificity (Sp) for prediction of the onset of calving within the next 3h were determined with the logistic regression and ROC analysis (Se=88.9%, 85% and Sp=93.3%, 74% for multiparous and primiparous cows, respectively). This pilot study revealed that the RumiWatch system is a useful tool to predict calving time under farm conditions. Copyright © 2017 Elsevier B.V. All rights reserved.

The Added Value of Pathology Review in Vulvar Cancer: Results From a Population-based Cohort Study.

PubMed

Barbera, Lisa; Gien, Lilian T; Sutradhar, Rinku; Thomas, Gillian; Covens, Al; Elit, Laurie; Fyles, Anthony; Rakovitch, Eileen; Liu, Ying; Khalifa, Mahmoud

2017-03-01

We conducted a population-based patterns of care study of vulvar carcinoma. This paper describes the changes in reporting based on pathology review. This is a retrospective population-based cohort study. We obtained all pathology records available from the provincial cancer registry for primary invasive squamous cell carcinoma of the vulva diagnosed between 1998 and 2007. Pathology reviews were conducted centrally by a group of gynecologic pathologists and were identified during abstraction. Corresponding original reports were matched to pathology review reports based on accession numbers. We compared the reported value for presence/absence of invasion, grade, depth, thickness, size, lymphovascular space invasion, peripheral margin status, and deep margin status in the original and review report. A total of 1011 vulvar resection reports were identified. From these, we identified 316 pairs of original/review reports. Missing data were common but improved in the reviews. In total, 55 (17%) reports had at least 1 change from the original to the review based on presence of invasion, depth, lymphovascular space invasion, or margin. When we included reports where a variable was missing in the original but then completed in the review, there were clinically relevant changes in 210 reports (66%). Vulvar carcinoma is a rare diagnosis and pathology reviews resulted in potentially important clinical changes in a significant proportion of cases. Referral pathologists play an important role in contributing to high-quality clinical decisions.

High-grade squamous intraepithelial lesion arising adjacent to vulvar lymphangioma circumscriptum: a tertiary institutional experience

PubMed Central

Bae, Go Eun; Yoon, Gun; Song, Yong Jung; Kim, Hyun-Soo

2016-01-01

Lymphangioma circumscriptum of the vulva occurs in patients who have undergone radical hysterectomy, lymph node dissection, or radiation therapy for management of advanced uterine cancer. Since vulvar lymphangioma circumscriptum typically presents as multiple, grossly verrucous vesicles of various sizes, it may be impossible to clinically distinguish vulvar lymphangioma circumscriptum from other vulvoperineal cutaneous diseases. In the present study, 16 (1.6%) out of the 1,024 vulvar biopsy or excision specimens were diagnosed as lymphangioma circumscriptum. In two (12.5%) out of the 16 cases, unusual histopathological findings were observed. Both patients had previously undergone radical hysterectomy with lymph node dissection and postoperative radiation therapy or concurrent chemoradiation therapy for advanced cervical cancer. Microscopic examination revealed high-grade squamous intraepithelial lesions, which were located immediately adjacent to the normal squamous epithelium covering the dilated subepithelial lymphatic vessels. Further, human papillomavirus genotyping confirmed that both patients were infected with high-risk human papillomavirus. High-grade squamous intraepithelial lesion cannot be grossly distinguished from vulvar lymphangioma circumscriptum because the multiple, verrucous vesicles that constitute the characteristic gross appearance of vulvar lymphangioma circumscriptum hinder its distinction. In this regard, our cases of high-grade squamous intraepithelial lesion, located adjacent to vulvar lymphangioma circumscriptum, support the notion that active surgical excision is necessary for the treatment of vulvar lymphangioma circumscriptum. PMID:27329721

Vaginismus and dyspareunia: is there a difference in clinical presentation?

PubMed

de Kruiff, M E; ter Kuile, M M; Weijenborg, P T; van Lankveld, J J

2000-09-01

The purpose of this exploratory study was to identify clinical similarities and differences in patients with vaginismus and dyspareunia. Thirty patients who were referred to an outpatient clinic for psychosomatic gynecology and sexology, with either of these two diagnoses, were investigated by means of a standardized interview, physical examination and self-rating questionnaires. Based on the interview, no significant differences were demonstrated between patients with vaginismus and dyspareunia, in the ability to insert a finger into the vagina or to have a gynecological examination. No differences were found in the reported level of pain during coitus (or attempted coitus), inserting one finger into the vagina, or during gynecological examination. Patients with vaginismus, however, more often reported that coitus was impossible. The physical examination and self-rating questionnaires showed no differences at all between patients with vaginismus and dyspareunia in palpated vaginal muscular tension and reported anxiety or tension during the examination. Moreover, in both groups redness and painful areas on the vulva were equally common. Redness and pain on the same location were more frequently present in the dyspareunia group. Patients with dyspareunia reported higher levels of pain during the examination. In conclusion, neither the interview nor the physical examination produced useful criteria to distinguish vaginismus from dyspareunia. A multi-axial description of these syndromes is suggested, rather than viewing them as two separate disorders.

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

Toxicological Effects of Fullerenes on Caenorhabditis elegans

NASA Astrophysics Data System (ADS)

Schomaker, Justin; Snook, Renee; Howell, Carina

2014-03-01

The nematode species Caenorhabditis elegans is a useful genetic model organism due to its simplicity and the substantial molecular, genetic, and developmental knowledge about the species. In this study, this species was used to test the toxicological effects of C60 fullerene nanoparticles. In previous studies using rats, a solution of C60 fullerenes in olive oil proved to extend the life of the subjects. The purpose of this experiment was to subject C. elegans to varying concentrations of C60 fullerenes and observe their toxicological effects. Initial findings indicate a link between fullerene exposure and enlargement of the vulva as well as the formation of a small nodule at the base of the tail in some individuals. While the fullerenes are not lethally toxic in C. elegans, results will be presented that pertain to changes in life span and progeny of the nematodes exposed to varying concentrations of fullerenes as well as the mechanisms of toxicity. High magnification imaging via SEM and/or AFM will be used to characterize the fullerene nanoparticles. Testing the toxicity of fullerenes in a wide variety of organisms will lead to a more complete understanding of the effects of fullerenes on living organisms to ultimately understand their effects in humans. This work was supported by National Science Foundation grants DUE-1058829, DMR-0923047, DUE-0806660 and Lock Haven FPDC grants.

Squamous precursor lesions of the vulva: current classification and diagnostic challenges.

PubMed

Hoang, Lien N; Park, Kay J; Soslow, Robert A; Murali, Rajmohan

2016-06-01

Growing evidence has established two major types of vulvar intraepithelial neoplasia (VIN), which correspond to two distinct oncogenic pathways to vulvar squamous cell carcinoma (VSCC). While the incidence of VSCC has remained relatively stable over the last three decades, the incidence of VIN has increased. VIN of usual type (uVIN) is human papillomavirus (HPV)-driven, affects younger women and is a multicentric disease. In contrast, VIN of differentiated type (dVIN) occurs in post-menopausal women and develops independent of HPV infection. dVIN often arises in a background of lichen sclerosus and chronic inflammatory dermatoses. Although isolated dVIN is significantly less common than uVIN, dVIN bears a greater risk for malignant transformation to VSCC and progresses over a shorter time interval. On histological examination, uVIN displays conspicuous architectural and cytological abnormalities, while the morphological features that characterise dVIN are much more subtle and raise a wide differential diagnosis. On the molecular level, dVIN is characterised by a higher number of somatic mutations, particularly in TP53. Here we review the classification, epidemiology, clinical features, histomorphology, ancillary markers and molecular genetics of both types of VIN, and discuss the morphological challenges faced by pathologists in interpreting these lesions. Copyright © 2016 Royal College of Pathologists of Australasia. Published by Elsevier B.V. All rights reserved.

[KAPOSI'S SARCOMA OF THE VULVA].

PubMed

Chokoeva, Aa; Tchernev, G; Wollina, U

2015-01-01

Kaposi's sarcoma represents multiple idiopathic hemorrhagic sarcoma--a mesenchymal tumor that affects the blood and lymph vessels. Its performance is associated with an infection with human herpes virus type 8--the so called KSHV (Kaposi's sarcoma -associated virus), and with the human immunodeficiency virus. Kaposi's sarcoma is considered as a typical clinical manifestation in male homosexuals suffering from acquired immune deficiency syndrome (AIDS), while his performance in HIV-positive women is unusual, with a ratio of men to women--10-15: 1. Vulvar localization is much rarer. It is up to 5 times more frequent in HIV- positive patients. It is clinically represented in most of the cases by the clinical picture of nonspecific tumor mass. Biopsy and further virological testing for establishing KSHV in lesional tissue is essential for confirming the diagnosis. Serological testing for HIV/AIDS in affected patients is required. Local treatment includes surgical excision of solitary lesions, cryotherapy as well as radiotherapy. The use of interferon alpha resulted in complete remission in approximately 40% of the affected patients. New trends in treatment tend to be pathogenetically directed as in the process of studies to date are inhibitors of angiogenesis. Due to the rarity of the occurrence, non-specific clinical picture and histological findings, Kaposi's sarcoma should be considered in the differential diagnosis of tumor masses with vulvar localization, especially in HIV-positive patients.

Morphology and morphometry of the reproductive system of female Saguinus midas (Linnaeus, 1758).

PubMed

Monteiro, Nathaly Cristine Da Silva; De Lima, Ana Rita; De Carvalho, Ana Flávia; De Carvalho Garcia, Rafael; Therrier, Joanne; Souza, Ana Carla Barros; Pereira, Luiza Correia; Branco, Erika

2012-06-01

In this article, the reproductive system's morphology of three young animals of the species Saguinus midas, from the bauxite mine in Paragominas, is described. The specimens were fixed and preserved in a solution of 10% aqueous formaldehyde, followed by dissection, measurement of the genital organs (uterus, vagina, ovaries, and uterine tubes), and histological processing. The vulva is delimited by the labia, with a clitoris. It is lined by keratinized stratified squamous epithelium with sebaceous glands of holocrine secretion. The vagina is an elongated tube with an average length of 26 mm and diameter of 1 mm, presenting a non-keratinized squamous epithelium, disposed between the vestibule of the vagina and cervix, the latter being relatively short. The uterus is simple, has globular shape and is located in the caudal portion of the abdominal cavity, with an average length of 14 mm and average width of 7 mm. It is formed by vascular and serous layers of muscles, and undergoes a bifurcation to form two structures on the bottom of blind sac. The uterine tubes are long and convoluted with an average length of 35 mm (right) and 36 mm (left), consisting of loose connective tissue and muscle layer lined by simple ciliated columnar epithelium. The ovaries are large and ellipsoid with smooth surface. Histologically, one animal showed ovulation fosse. Copyright © 2011 Wiley Periodicals, Inc.

Short time efficacy and safety of focused monopolar radiofrequency device for labial laxity improvement-noninvasive labia tissue tightening. A prospective cohort study.

PubMed

Fistonić, Ivan; Sorta Bilajac Turina, Iva; Fistonić, Nikola; Marton, Ingrid

2016-03-01

To evaluate safety and efficacy of focused monopolar radio frequency (RF) device for non-invasive labia tissue tightening and improvement of labial laxity. This prospective cohort study participants were 17 female subjects aged between 27 and 56 years with lax skin at the labia area. All subjects received four consecutive treatments at 7-day intervals with RF device (Exilis Protege IntimaR, BTL Industries Inc., Boston, MA). The primary efficacy outcome measure was defined as one or more point improvement on 1-4 scale for vulva appearance determined by three blinded evaluators. Digital photographs were taken at the baseline and 1 month after the last treatment. Sexual gratification was assessed with Female Sexual Functioning Index (FSFI) and patient discomfort by Visual Analogue Scale (VAS). An average 2.9 (of maximum 4) points improvement rate in vulvar appearance was observed (P < 0.01). Mean of the total FSFI score enhanced from initial 75-87% (P < 0.001). Resultant 4.7 (18%) points increase was achieved. Ninety four percent of subjects reported mild to none discomfort during the treatment. No adverse events during the study course were reported. The present study demonstrates the positive effect of focused monopolar RF device for non-invasive labia tissue tightening. The treatment is effective and safe with high patient satisfaction. © 2016 Wiley Periodicals, Inc.

HPV in genital cancers (at the exception of cervical cancer) and anal cancers.

PubMed

de Sanjosé, Silvia; Bruni, Laia; Alemany, Laia

2014-12-01

Human papillomavirus (HPV) infection has been firmly established as a central and necessary cause of invasive cervical cancer and it has been etiologically linked to other anogenital (vulva, vagina, anus and penis) and head and neck cancers, particularly oropharyngeal. Although being rare, the incidence of some of these cancers in some countries has increased in the last decades. HPV-related anogenital tumors share many risk factors with cervical cancer. The HPV aetiological contribution differs in each anatomical location reflecting differences in the natural history and viral tissue tropism. The highest prevalence of HPV DNA in cancers other than cervix has been described for anal, followed by vagina, penile and vulvar cancers. HPV16 has been described as the most common type detected in all cancer sites with different contributions being the highest in anal carcinoma (around 80% of HPV DNA positive anal cancers) and the lowest in vaginal cancers with a contribution similar to that found in cervical cancers (around 60%). Current HPV vaccines have already demonstrated their efficacy in preventing anogenital pre-neoplastic lesions caused by vaccine HPV types. HPV-based prevention tools like HPV vaccination and to a lesser extend screening (e.g. for anal cancer) can be useful measures for reducing the burden of these anogenital cancers. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Determination of Oncogenic Human Papillomavirus (HPV) Genotypes in Anogenital Cancers in Myanmar.

PubMed

Mu Mu Shwe; Hlaing Myat Thu; Khin Saw Aye; Aye Aye Myint; Mya Thida; Khin Shwe Mar; Khin Khin Oo; Khin Sandar Aye; Okada, Shigeru; Kyaw Zin Thant

2016-01-01

Molecular and epidemiologic investigations suggest a causal role for human papillomavirus (HPV) in anogenital cancers. This study identified oncogenic HPV genotypes in anogenital cancers among men and women in a 2013 cross-sectional descriptive study in Myanmar. In total, 100 biopsy tissues of histologically confirmed anogenital cancers collected in 2008-2012 were studied, including 30 penile and 9 anal cancers from Yangon General Hospital and 61 vulvar cancers from Central Women's Hospital, Yangon. HPV-DNA testing and genotyping were performed by polymerase chain reaction-restriction fragment length polymorphism. Overall, 34% of anogenital cancers were HPV-positive. HPV was found in 44.4% of anal (4/9), 36.1% of vulvar (22/61), and 26.7% of penile (8/30) cancers. The most frequent genotypes in anal cancers were HPV 16 (75% ) and 18 (25% ). In vulvar cancers, HPV 33 was most common (40.9% ), followed by 16 (31.8% ), 31 (22.7% ), and 18 (4.6% ). In penile cancers, HPV 16 (62.5% ) was most common, followed by 33 (25% ) and 18 (12.5% ). This is the first report of evidencebased oncogenic HPV genotypes in anogenital cancers among men and women in Myanmar. This research provides valuable information for understanding the burden of HPV-associated cancers of the anus, penis, and vulva and considering the effectiveness of prophylactic HPV vaccination.

Mammary and extramammary Paget's disease*

PubMed Central

Lopes, Lauro Lourival; Lopes, Ione Maria Ribeiro Soares; Lopes, Lauro Rodolpho Soares; Enokihara, Milvia M. S. S.; Michalany, Alexandre Osores; Matsunaga, Nobuo

2015-01-01

Paget's disease, described by Sir James Paget in 1874, is classified as mammary and extramammary. The mammary type is rare and often associated with intraductal cancer (93-100% of cases). It is more prevalent in postmenopausal women and it appears as an eczematoid, erythematous, moist or crusted lesion, with or without fine scaling, infiltration and inversion of the nipple. It must be distinguished from erosive adenomatosis of the nipple, cutaneous extension of breast carcinoma, psoriasis, atopic dermatitis, contact dermatitis, chronic eczema, lactiferous ducts ectasia, Bowen's disease, basal cell carcinoma, melanoma and intraductal papilloma. Diagnosis is histological and prognosis and treatment depend on the type of underlying breast cancer. Extramammary Paget's disease is considered an adenocarcinoma originating from the skin or skin appendages in areas with apocrine glands. The primary location is the vulvar area, followed by the perianal region, scrotum, penis and axillae. It starts as an erythematous plaque of indolent growth, with well-defined edges, fine scaling, excoriations, exulcerations and lichenification. In most cases it is not associated with cancer, although there are publications linking it to tumors of the vulva, vagina, cervix and corpus uteri, bladder, ovary, gallbladder, liver, breast, colon and rectum. Differential diagnoses are candidiasis, psoriasis and chronic lichen simplex. Histopathology confirms the diagnosis. Before treatment begins, associated malignancies should be investigated. Surgical excision and micrographic surgery are the best treatment options, although recurrences are frequent. PMID:25830993

Two rare species of tylenchids, Discotylenchus biannulatus n. sp. and Labrys chinensis Qing Bert, 2018 (Nematoda: Tylenchidae) from western Iran.

PubMed

Konani, Ehsan; Panahandeh, Yousef; Pourjam, Ebrahim; Álvarez-Ortega, Sergio; Pedram, Majid

2018-04-23

Two rare species of the family Tylenchidae are described and illustrated based on morphological and morphometric characters. Scanning electron microscope (SEM) studies provided details of anterior end structures, helpful in generic identification of the studied populations. Discotylenchus biannulatus n. sp. is characterized by its dorso-ventrally flattened smooth cephalic region having two proximal annuli and a rectangular perioral disc, short longitudinal amphidial slits, lateral field with four incisures, stylet 9-10 μm long, with the conus shorter than half the total stylet length and with posteriorly directed knobs, well-developed median bulb, mono-prodelphic reproductive system with rounded empty spermatheca and short postvulval uterine sac (PUS), and filiform tail with pointed end. It is compared with other species of Discotylenchus having four lines in the lateral field. The Iranian population of Labrys chinensis is characterized by its long and slender (a = 45.2-57.2) body, smooth rounded cephalic region and an offset disc-like apical labial plate, short longitudinal lateral amphidial slits, lateral field with two incisures, moderately developed stylet with the conus less than half the total length and posteriorly directed knobs, median bulb fusiform with distinct but weak valve, gradually joining the isthmus, vulva at 57.2-59.1% with small flaps, elongate conoid tail, uniformly and slightly narrowing toward end with broadly rounded terminus and rare males. The minor morphological differences of the recovered population with the type population are discussed.

Case series of child sexual abuse: Abia State University Teaching Hospital experience.

PubMed

Okoronkwo, N C; Ejike, O

2014-01-01

Child sexual abuse remains a serious infringement on the rights of the child. Though it appears to be viewed less seriously among adolescents, the consequences may be more severe and less obvious for the younger child. Age of the child appears notto be a deterrent. There is paucity of local data in the sub-region on this important social problem. The circumstance surrounding child sexual abuse in our environment needs to be reviewed. This study sets out to evaluate the characteristics of victims of child sexual abuse and to proffer solutions on how to stem the tide of the crime. To examine the characteristics of sexually abused children presenting to the paediatrics department of Abia State UniversityTeaching hospital, Aba. The case records of 10 consecutive cases of sexually abused children that presented to the Children Outpatient Department of Abia State University Teaching Hospital (ABSUTH) Aba, from January to June 2006 were prospectively reviewed and the parents/child/abuser interviewed where possible. All the victims were females aged 3-11 yrs, while all the abusers were males 14-29 yrs. Both parties were of low socio-economic class. 50% of the victims reported the incident. Mental and psychological state of the perpetrators appears to be a factor. Physical injuries to the vulva-vaginal areas were common. This study shows that child sexual abuse may not be uncommon in our environment. The exact prevalence remains unknown.The perpetrators of child sexual abuse should be prosecuted as a deterrent and rehabilitated whenever possible.

[Efficiency of fenticonazole for the treatment of vaginal candidiasis].

PubMed

2012-01-01

Uncomplicated vulvovaginal candidiasis appears in 75% women of reproductive age. The most frequent causes are Candida albicans (85-95%) or C. glabrata, and infrequently C. krusei, C. tropicalis, C. parapsilosis, C. pseudotropicalis, etc. The aim of the study was to investigate efficiency and safety of fenticonazole for vaginal candidiasis treatment. Therapeutic effect of a single 600 mg fenticonasole vaginal capsule was observed in 417 women, aged 16-67, in five centers in Serbia. In all women, before the treatment, vaginal candidiasis was confirmed by testing of vaginal smear. Based on smear findings and associated symptoms observed on the 7th and 28th day after therapy administration, treatment results were evaluated. On the next day after drug application the patients recorded by using a questionnaire their own feelings on withdrawal symptoms and possible side effects in the period prior to the first control. Control after seven days showed a statistically significant decrease of symptoms. In 385 women, vaginal smear was found negative to yeast and yeast blastospores. Within the first seven days after treatment 84 women had to repeat therapy due to the persistence of symptoms or positive vaginal smear. After 28 days we recorded full recovery in 392 patients, clinical improvement in eight, no change in 16, and deterioration in one patient only. Side effects were very seldom, mostly in the form of a slight redness of the vulva and vagina, and mild itching during several days. Our observations confirmed good efficacy and safety of fenticonazole in the treatment of vaginal candidiasis.

Use of exfoliative cytology for diagnosis of transmissible venereal tumour and controlling the recovery period in the bitch.

PubMed

Erünal-Maral, N; Findik, M; Aslan, S

2000-05-01

Transmissible venereal tumour (TVT) is a rare vaginal tumour that can be treated surgically or cryosurgically as well as by radiotherapy or chemotherapy. Vincristine has been found to be very effective for treating TVT. Since vaginal secretion or discharge may contain neoplastic cells, the cytological identification of TVT cells is possible. The present study was carried out in 12 bitches. Vaginal smears were obtained with cotton swab from the anterior vagina and TVT suspected structures. The smears were stained according to Papanicolaou and assessed by light microscopy. Additionally the general condition of the patients was evaluated by haematological and radiographic examinations. In bitches with TVT vincristine sulphate was administered intravenously at weekly intervals. The total treatment period was three to six weeks until no atypical cells were found in the smear. This was the case after an average of 3.2 +/- 1.3 applications. Tumour masses became smaller and by this non-visible from the rima vulva after 4.2 +/- 0.7 applications. During the treatment, two of the 12 bitches (16.7%) suffered from vomiting and diarrhoea while three (25%) showed neutropenia. Twelve months after completion of treatment, the bitches were examined again and vaginal smears were taken in order to control the recovery process or a possible recurrence of TVT. No atypical cells were found in any vaginal smear. By this exfoliative cytology has proved to be a safe and easy method for TVT diagnosis and for observing the recovery process.

A hybrid microfluidic device for on-demand orientation and multidirectional imaging of C. elegans organs and neurons

PubMed Central

Ardeshiri, Ramtin; Mulcahy, Ben; Zhen, Mei; Rezai, Pouya

2016-01-01

C. elegans is a well-known model organism in biology and neuroscience with a simple cellular (959 cells) and nervous (302 neurons) system and a relatively homologous (40%) genome to humans. Lateral and longitudinal manipulation of C. elegans to a favorable orientation is important in many applications such as neural and cellular imaging, laser ablation, microinjection, and electrophysiology. In this paper, we describe a micro-electro-fluidic device for on-demand manipulation of C. elegans and demonstrate its application in imaging of organs and neurons that cannot be visualized efficiently under natural orientation. To achieve this, we have used the electrotaxis technique to longitudinally orient the worm in a microchannel and then insert it into an orientation and imaging channel in which we integrated a rotatable glass capillary for orientation of the worm in any desired direction. The success rates of longitudinal and lateral orientations were 76% and 100%, respectively. We have demonstrated the application of our device in optical and fluorescent imaging of vulva, uterine-vulval cell (uv1), vulB1\\2 (adult vulval toroid cells), and ventral nerve cord of wild-type and mutant worms. In comparison to existing methods, the developed technique is capable of orienting the worm at any desired angle and maintaining the orientation while providing access to the worm for potential post-manipulation assays. This versatile tool can be potentially used in various applications such as neurobehavioral imaging, neuronal ablation, microinjection, and electrophysiology. PMID:27990213

Redescriptions and comments on the validity of Acuaria subula and A. skrjabini (Nematoda, Spirurida, Acuariidae), parasites of passerine birds.

PubMed

Mutafchiev, Yasen; Kontrimavichus, Vytautas L; Georgiev, Boyko B

2013-09-01

Acuaria subula (Dujardin, 1845) is redescribed by light microcopy (LM) and scanning electron microscopy (SEM) on the basis of specimens from its type host, Erithacus rubecula (Passeriformes, Muscicapidae), from Curonian Spit (Kaliningradskaya Oblast', Russia) and Bulgaria. Acuaria skrjabini (Ozerskaya, 1926) is redescribed by LM and SEM on the basis of specimens from Passer domesticus (type host) and P. hispaniolensis (Passeriformes, Passeridae) from Bulgaria. Contrary to previous opinions recognizing A. skrjabini as a junior synonym of A. subula, the present study confirms that they are distinct species. They can be distinguished on the basis of the ratio between the length of cordons and the body length, the ratio between the length of muscular oesophagus and glandular oesophagus, and the ratio between the total length of oesophagus and the body length. In addition, the plates forming the cordons in these two species exhibit different morphological characters. Another difference between these two species is associated with the particular irregular mosaic ornamentation of the cuticle on the ventral and lateral sides of body around the region of vulva of A. subula and its absence in A. skrjabini. Data on their host and geographical ranges are surveyed. The type series of Acuaria buttnerae Chabaud et Petter, 1961, described as a parasite of Calandrella brachydactyla (Passeriformes, Alaudidae) in France, is re-examined; the latter species is recognized as a junior synonym of A. skrjabini (new synonymy).

Care Seeking Behaviour and Barriers to Accessing Services for Sexual Health Problems among Women in Rural Areas of Tamilnadu State in India.

PubMed

Puthuchira Ravi, Rejoice; Athimulam Kulasekaran, Ravishankar

2014-01-01

Background. Sexually transmitted infections (STIs) may be either asymptomatic or symptomatic. Regardless of the presence or absence of symptoms all STIs can lead to major complications if left untreated. Objective. To assess the care seeking behaviour and barriers to accessing services for sexual health problems among young married women in rural areas of Thiruvarur district of Tamil Nadu state in India. Methods. A community based cross-sectional study was conducted in 28 villages selected using multistage sampling technique for selecting 605 women in the age group of 15-24 years during July 2010-April 2011. Results. The prevalence rate of reproductive tract infections (RTIs) and STIs was observed to be 14.5% and 8.8%, respectively, among the study population. Itching/irritation over vulva, thick white discharge, discharge with unpleasant odor, and frequent and uncomfortable urination were most commonly experienced symptoms of sexual health problems. Around three-fourth of the women received treatment for sexual health problems. Perception of symptoms as normal, feeling shy, lack of female health workers, distance to health facility, and lack of availability of treatment were identified as major barriers for not seeking treatment for RTIs/STIs. Conclusion. Family tradition and poor socioeconomic conditions of the family appear to be the main reasons for not utilizing the health facility for sexual health problems. Integrated approach is strongly suggested for creating awareness to control the spread of sexual health problems among young people.

[Acute urinary retention secondary to giant prolapsed ureterocele in a young adult woman. Case report].

PubMed

Villagómez-Camargo, Roberto; Chopin-Gazga, Marco; Saucedo-Bravo, Jonathan; García-Cano, Eugenio; Montiel-Jarquín, Álvaro

2016-01-01

Ureterocele is a cystic dilation of the distal ureteral segment. The incidence in women ranges from 1/5,000 to 1/12,000. In adults, they are poorly diagnosed and are asymptomatic. Prolapse through the urethra is uncommon, and involves acute urine retention and a reducible vulvar tumour. Woman of 24 years old, two previous caesarean and two abortions. She had incomplete bladder emptying, intermittent voiding, bladder straining and tenesmus, three months before admission. After the voiding effort she presented with acute urine retention with sudden onset of tumour in the vulva. The tumour was manually reduced under regional anaesthesia. A cystoscopy was performed, finding an ischaemic de-roofing of the anterior wall of the ureterocele, causing vesicoureteral reflux grade IV. Surgical correction was performed with Cohen re-implantation and insertion of a double-J catheter. The catheter was removed 30 days later, with a successful post-operative course. Its aetiology is unclear, and most are diagnosed by ultrasound in the prenatal period. The clinical presentation is variable, from urinary tract infection to prolapse. Despite its size, it may cause complications such as ischaemic de-roofing, which if diagnosed soon may be resolved successfully, as with this patient. The results and treatment may be favourable when no renal impact or concomitant anatomical changes are present, as is the case of this patient. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

The Prevalence of Lichen Sclerosus in Patients With Vulvar Squamous Cell Carcinoma.

PubMed

Davick, Jonathan J; Samuelson, Megan; Krone, James T; Stockdale, Colleen K

2017-07-01

Women with vulvar lichen sclerosus (LS) have an increased risk of developing differentiated vulvar intraepithelial neoplasia and vulvar squamous cell carcinoma (SCC). Our primary aim was to determine the prevalence of LS among women with vulvar SCC. All patients who underwent excision for invasive SCC of the vulva from January 1, 2009 to December 31, 2013 were identified by searching our institution's electronic laboratory information system (n=111). The vulvar excision specimens from these patients were reviewed for the presence of adjacent LS. The grade of the SCC and clinical data were also documented for each case. The proportion of vulvar SCCs with adjacent LS identified on the excision specimen was 0.29 (95% confidence interval, 0.21-0.38). The proportion of patients in our study population who have ever had a histopathologic diagnosis of LS was 0.36 (95% confidence interval, 0.28-0.45). The presence of LS was not associated with the grade of the adjacent SCC. Patients with synchronous LS on excision were older on average than patients without LS. Tobacco users in our population were more likely to have a history of lower genital tract dysplasia, more likely to be younger, and less likely to have LS identified on the vulvar SCC excision specimen. Given the strong association between LS, differentiated vulvar intraepithelial neoplasia, and vulvar SCC, we recommend careful evaluation of these patients from a clinical and pathologic standpoint.

Meloidogyne daklakensis n. sp. (Nematoda: Meloidogynidae), a new root-knot nematode associated with Robusta coffee (Coffea canephora Pierre ex A. Froehner) in the Western Highlands, Vietnam.

PubMed

Trinh, Q P; Le, T M L; Nguyen, T D; Nguyen, H T; Liebanas, G; Nguyen, T A D

2018-04-05

The root-knot nematode species Meloidogyne daklakensis n. sp. was discovered on the roots of Robusta coffee (Coffea canephora Pierre ex A. Froehner) in Dak Lak Province, Vietnam. This species is characterized by the females having rounded or oval perineal patterns, smooth, regular, continuous striae, and reduced lateral lines. The dorsal arch is low, rounded and encloses a quite distinct vulva and tail tip. The stylet is normally straight with well-developed and posteriorly sloped knobs. The males have a rounded cap that extends posteriorly into the lip region. The procorpus is outlined distinctly, and is three times longer than the metacorpus. The metacorpus is ovoid, with a strong valve apparatus. The species closely resembles M. marylandi, M. naasi, M. ovalis, M. panyuensis, M. lopezi, M. mali and M. baetica in the perineal pattern of the females, and the morphology of the males and the second-stage juveniles. Nonetheless, it can be differentiated from other species by a combination of morphometric, morphological and molecular characteristics. Phylogenetic analysis was conducted based on the internal transcribed spacer (ITS) and 28S rDNA as well as the region between the cytochrome c oxidase I (COI) and cytochrome c oxidase II (COII) mitochondrial genes. Herein, this nematode is described, illustrated, and designated as a new species, Meloidogyne daklakensis sp. n., based on morphometric, morphological and molecular analyses.

A modified catheterization procedure to reduce bladder damage when collecting urine samples from Holstein cows.

PubMed

Tamura, Tetsuo; Nakamura, Hiroshi; Sato, Say; Seki, Makoto; Nishiki, Hideto

2014-06-01

This study proposed a modified procedure, using a small balloon catheter (SB catheter, 45 ml), for reducing bladder damage in cows. Holstein cows and the following catheters were prepared: smaller balloon catheter (XSB catheter; 30 ml), SB catheter and standard balloon catheter (NB catheter; 70 ml, as the commonly used, standard size). In experiment 1, each cow was catheterized. The occurrence of catheter-associated hematuria (greater than 50 RBC/HPF) was lower in the SB catheter group (0.0%, n=7) than in the NB catheter group (71.4%, n=7; P<0.05). In experiment 2, general veterinary parameters, urine pH, body temperature and blood values in cows were not affected before or after insertion of SB catheters (n=6). The incidence of urinary tract infection (UTI) was 3.0% per catheterized day (n=22). In experiment 3, feeding profiles, daily excretion of urinary nitrogen (P<0.05) and rate from nitrogen intake in urine (P<0.01), were higher with use of the SB catheter (n=13) than with the use of the vulva urine cup (n=18), indicating that using the SB catheter can provide accurate nutritional data. From this study, we concluded that when using an SB catheter, the following results occur; reduction in bladder damage without any veterinary risks and accuracy in regard to feeding parameters, suggesting this modified procedure using an SB catheter is a useful means of daily urine collection.

The relationship of silicone breast implants and cancer at other sites.

PubMed

Brinton, Louise A

2007-12-01

Although most attention regarding the effects of silicone breast implants on cancer risk has focused on breast cancer, there have also been concerns regarding effects on other cancers. This includes malignancies that could occur as a result of foreign-body carcinogenesis (sarcomas) or immune alterations (hematopoietic malignancies), or cancers suggested as possibly elevated on the basis of previous epidemiologic studies (cancers of the cervix, vulva, lung, and brain). Searches of the English language literature on the topic of silicone breast implants and cancer risk were conducted and reviewed to determine relationships that might have etiologic relevance. Epidemiologic studies provide no support for an increased risk of either sarcoma or multiple myeloma among breast implant recipients, disputing clinical and laboratory findings suggesting such a link. Although a number of epidemiologic studies have demonstrated elevated risks of cervical, vulvar, and lung cancers among breast implant patients, it is likely that these excesses relate more to lifestyle characteristics (e.g., cigarette smoking, sexual behavior) than to the effects of the implants. Brain cancer excesses, suggested in one study, have not been confirmed in either an update of the mortality experience in this study or on the basis of other investigations. At present, there is no convincing evidence that breast implants alter the risk of nonbreast malignancies. Breast implant patients should continue to be monitored for longer term risks and to assess whether cancer risk is influenced by various patient and implant characteristics.

Differentiated intraepithelial neoplasia of the vulva.

PubMed

Mulvany, Nicholas J; Allen, David G

2008-01-01

We present the clinical and pathological findings of 6 women with intraepithelial neoplasia of differentiated or simplex type (DVIN). The mean age was 68 years (range 55-82). One lesion was still in situ, whereas 5 were associated with squamous carcinoma, 4 of well-differentiated keratinizing type and 1 of poorly differentiated spindle-cell type. The invasive depth of the squamous carcinomas ranged from 0.6 to 8 mm and the surgical margins of all of the resection specimens were uninvolved by neoplastic cells. In contrast, DVIN involved the surgical margins in 5 specimens while the remaining specimen had normal surgical margins. In all 6 vulvar specimens, DVIN showed intense immunoreactivity for Ki-67 in the basal and parabasal cells while only 4 specimens showed reactivity for p53. In 5 surgical specimens with DVIN the number of CD1a cells was increased but little if any immunoreactivity could be found amongst the corresponding invasive neoplastic cells. Four squamous carcinomas also showed diffuse p53 reactivity. There was little difference in the pattern of Ki-67 expression between DVIN and squamous carcinoma. For a number of reasons, DVIN present diagnostic difficulty and considerable interobserver variation also exists. Our study suggests that Ki-67 and p16 are useful for distinguishing DVIN and classical VIN 3, whereas p53 and CD1a are useful for distinguishing DVIN and invasive squamous carcinoma. Furthermore, p53 appears to have higher specificity than sensitivity for distinguishing DVIN from normal squamous epithelium.

Molecular identification and distribution profile of Candida species isolated from Iranian patients.

PubMed

Mohammadi, Rasoul; Mirhendi, Hossein; Rezaei-Matehkolaei, Ali; Ghahri, Mohammad; Shidfar, Mohammad Reza; Jalalizand, Nilufar; Makimura, Koichi

2013-08-01

A total of 855 yeast strains isolated from different clinical specimens, mainly nail (42%) and vulva-vagina (25%) were identified by a set of polymerase chain reaction-restriction fragment length polymorphisms (PCR-RFLP). Genomic DNA was extracted from fresh colonies using Whatman FTA Card technology. PCR assays were performed on the complete ribosomal DNA internal transcribed spacer (rDNA-ITS) region for all isolates and species identification was carried out through their specific electrophoretic profiles after digestion with the enzyme MspI. Those isolates suspected as Candida parapsilosis group were then subjected to amplification of the secondary alcohol dehydrogenase (SADH) gene and restriction digestion with NlaIII enzyme. In total, 71.1% of the strains were obtained from females and 28.9% from males. The age group of 31-40 years consisted of the highest frequency of patients with candidiasis. Candida albicans was the predominant species (58.6%) followed by C. parapsilosis (11.0%), C. glabrata (8.3%), C. tropicalis (7.0%), C. kefyr (5.8%), C. krusei (4.4%), C. orthopsilosis (2.1%), and C. guilliermondii (0.6%). A few strains of C. lusitaniae, C. rugosa, C. intermedia, C. inconspicua, C. neoformans and S. cerevisiae were isolated. We could not identify 8 (0.9%) isolates. Candida albicans remains the most frequently species isolated from Iranian patients; however, the number of non-C. albicans Candida species looks to be increasing. The simple and reliable PCR-RFLP system used in the study has the potential to identify most clinically isolated yeasts.

Spatiotemporal dynamics of androgen signaling underlie sexual differentiation and congenital malformations of the urethra and vagina

PubMed Central

Larkins, Christine E.; Enriquez, Ana B.; Cohn, Martin J.

2016-01-01

Disorders of sex development (DSDs) are congenital anomalies that affect sexual differentiation of genitourinary organs and secondary sex characters. A common cause of female genital virilization is congenital adrenal hyperplasia (CAH), in which excess androgen production during development of 46XX females can result in vaginal atresia, masculinization of the urethra, a single urogenital sinus, and clitoral hypertrophy or ambiguous external genitalia. Development of the vagina depends on sexual differentiation of the urogenital sinus ridge, an epithelial thickening that forms where the sex ducts attach to the anterior urethra. In females, the sinus ridge descends posteriorly to allow the vaginal opening to form in the vulva, whereas in males and in females with CAH, androgens inhibit descent of the sinus ridge. The mechanisms that regulate development of the female urethra and vagina are largely unknown. Here we show that the timing and duration of, and the cell population targeted by, androgen signaling determine the position of vaginal attachment to the urethra. Manipulations of androgen signaling in utero reveal a temporal window of development when sinus ridge fate is determined. Cell type-specific genetic deletions of androgen receptor (Ar) identify a subpopulation of mesenchymal cells that regulate sinus ridge morphogenesis. These results reveal a common mechanism that coordinates development of the vagina and feminization of the urethra, which may account for development of a single urogenital sinus in females exposed to excessive androgen during a critical period of prenatal development. PMID:27821748

Ontogenetic anatomy of the distal vagina: relevance for local tumor spread and implications for cancer surgery.

PubMed

Höckel, Michael; Horn, Lars-Christian; Illig, Romana; Dornhöfer, Nadja; Fritsch, Helga

2011-08-01

We have suggested to base cancer surgery on ontogenetic anatomy and the compartment theory of tumor permeation in order to improve local tumor control and to lower treatment-related morbidity. Following the validation of this concept for the uterine cervix, proximal vagina and vulva, this study explores its applicability for the distal vagina. Serial transverse sections of female embryos and fetuses aged 8-17 weeks were assessed for the morphological changes in the region defined by the deep urogenital sinus-vaginal plate complex. Histopathological pattern analysis of local tumor spread was performed with carcinomas of the lower genital tract involving the distal vagina to test the compartment theory. Ontogenetically, the female urethra, urethrovaginal septum, distal vagina and rectovaginal septum represent a morphogenetic unit derived from the deep urogenital sinus-vaginal plate complex. Herein, the posterior urethra, the urethrovaginal septum and the distal vagina form a distinct subcompartment differentiated from the dorsal wall of the urogenital sinus. From 150 consecutive patients with distal vaginectomy as part of their surgical treatment 26 carcinomas of the lower genital tract had infiltrated the distal vagina. All 22 tumors involving the ventral wall invaded the urethra/periurethral tissue. Of the five carcinomas involving the dorsal wall none invaded the rectum/mesorectum. The pattern of local tumor permeation of lower genital tract cancer in the distal vagina can be consistently explained with ontogenetic anatomy and the compartment theory. Copyright © 2011 Elsevier Inc. All rights reserved.

The NM23-H1/H2 homolog NDK-1 is required for full activation of Ras signaling in C. elegans

PubMed Central

Masoudi, Neda; Fancsalszky, Luca; Pourkarimi, Ehsan; Vellai, Tibor; Alexa, Anita; Reményi, Attila; Gartner, Anton; Mehta, Anil; Takács-Vellai, Krisztina

2013-01-01

The group I members of the Nm23 (non-metastatic) gene family encode nucleoside diphosphate kinases (NDPKs) that have been implicated in the regulation of cell migration, proliferation and differentiation. Despite their developmental and medical significance, the molecular functions of these NDPKs remain ill defined. To minimize confounding effects of functional compensation between closely related Nm23 family members, we studied ndk-1, the sole Caenorhabditis elegans ortholog of group I NDPKs, and focused on its role in Ras/mitogen-activated protein kinase (MAPK)-mediated signaling events during development. ndk-1 inactivation leads to a protruding vulva phenotype and affects vulval cell fate specification through the Ras/MAPK cascade. ndk-1 mutant worms show severe reduction of activated, diphosphorylated MAPK in somatic tissues, indicative of compromised Ras/MAPK signaling. A genetic epistasis analysis using the vulval induction system revealed that NDK-1 acts downstream of LIN-45/Raf, but upstream of MPK-1/MAPK, at the level of the kinase suppressors of ras (KSR-1/2). KSR proteins act as scaffolds facilitating Ras signaling events by tethering signaling components, and we suggest that NDK-1 modulates KSR activity through direct physical interaction. Our study reveals that C. elegans NDK-1/Nm23 influences differentiation by enhancing the level of Ras/MAPK signaling. These results might help to better understand how dysregulated Nm23 in humans contributes to tumorigenesis. PMID:23900546

Interstitial therapy of perineal and gynecological malignancies

DOE Office of Scientific and Technical Information (OSTI.GOV)

Martinez, A.; Herstein, P.; Portnuff, J.

1983-03-01

Thirty-five patients, 38 to 88 years of age, were treated with 125-Iodine or 192-Iridium interstitial implants at Stanford University Medical Center between July 1974, and December, 1978. There were 25 primary epithelial malignancies, eight extensions from intrapelvic organs and two metastatic tumors (hypernephroma and Hodgkin's disease). The involved sites were: urethra (6 patients); vulva (9 patients); vagina (8 patients); anus (7 patients); cervix (5 patients). Implantation was usually performed to treat evident or microscopic disease in conjunction with external beam pelvic treatment with or without local excision. Computerized implant preplanning was used.125-Iodine seeds were inserted either directly or within absorbablemore » suture Polyglactin 910; 192-Iridium in nylon carriers was placed by suture or transperineal template. Two patients were lost to follow-up leaving 33 patients, 27 of whom are alive and free of local disease from 37 to 76 months. The overall local control rate was 88%, or 29/33 patients. All four local recurrences appeared before 24 months. Minor complications included: 10 patients with transient mucositis, four with superficial ulcers, and one patient with infection at the implanted site. Two major complications occurred: a necrotic rectal ulcer requiring a colostomy and a contracted, painful bladder necessitating a urinary diversion. It is concluded that in selected cases interstitial irradiation provides good local control of perineal and gynecological malignancies with low morbidity in this elderly and quite often fragile group of patients.« less

Spatiotemporal dynamics of androgen signaling underlie sexual differentiation and congenital malformations of the urethra and vagina.

PubMed

Larkins, Christine E; Enriquez, Ana B; Cohn, Martin J

2016-11-22

Disorders of sex development (DSDs) are congenital anomalies that affect sexual differentiation of genitourinary organs and secondary sex characters. A common cause of female genital virilization is congenital adrenal hyperplasia (CAH), in which excess androgen production during development of 46XX females can result in vaginal atresia, masculinization of the urethra, a single urogenital sinus, and clitoral hypertrophy or ambiguous external genitalia. Development of the vagina depends on sexual differentiation of the urogenital sinus ridge, an epithelial thickening that forms where the sex ducts attach to the anterior urethra. In females, the sinus ridge descends posteriorly to allow the vaginal opening to form in the vulva, whereas in males and in females with CAH, androgens inhibit descent of the sinus ridge. The mechanisms that regulate development of the female urethra and vagina are largely unknown. Here we show that the timing and duration of, and the cell population targeted by, androgen signaling determine the position of vaginal attachment to the urethra. Manipulations of androgen signaling in utero reveal a temporal window of development when sinus ridge fate is determined. Cell type-specific genetic deletions of androgen receptor (Ar) identify a subpopulation of mesenchymal cells that regulate sinus ridge morphogenesis. These results reveal a common mechanism that coordinates development of the vagina and feminization of the urethra, which may account for development of a single urogenital sinus in females exposed to excessive androgen during a critical period of prenatal development.

A Modified Catheterization Procedure to Reduce Bladder Damage when Collecting Urine Samples from Holstein Cows

PubMed Central

TAMURA, Tetsuo; NAKAMURA, Hiroshi; SATO, Say; SEKI, Makoto; NISHIKI, Hideto

2014-01-01

ABSTRACT This study proposed a modified procedure, using a small balloon catheter (SB catheter, 45 ml), for reducing bladder damage in cows. Holstein cows and the following catheters were prepared: smaller balloon catheter (XSB catheter; 30 ml), SB catheter and standard balloon catheter (NB catheter; 70 ml, as the commonly used, standard size). In experiment 1, each cow was catheterized. The occurrence of catheter-associated hematuria (greater than 50 RBC/HPF) was lower in the SB catheter group (0.0%, n=7) than in the NB catheter group (71.4%, n=7; P<0.05). In experiment 2, general veterinary parameters, urine pH, body temperature and blood values in cows were not affected before or after insertion of SB catheters (n=6). The incidence of urinary tract infection (UTI) was 3.0% per catheterized day (n=22). In experiment 3, feeding profiles, daily excretion of urinary nitrogen (P<0.05) and rate from nitrogen intake in urine (P<0.01), were higher with use of the SB catheter (n=13) than with the use of the vulva urine cup (n=18), indicating that using the SB catheter can provide accurate nutritional data. From this study, we concluded that when using an SB catheter, the following results occur; reduction in bladder damage without any veterinary risks and accuracy in regard to feeding parameters, suggesting this modified procedure using an SB catheter is a useful means of daily urine collection. PMID:24561376

Care Seeking Behaviour and Barriers to Accessing Services for Sexual Health Problems among Women in Rural Areas of Tamilnadu State in India

PubMed Central

Puthuchira Ravi, Rejoice; Athimulam Kulasekaran, Ravishankar

2014-01-01

Background. Sexually transmitted infections (STIs) may be either asymptomatic or symptomatic. Regardless of the presence or absence of symptoms all STIs can lead to major complications if left untreated. Objective. To assess the care seeking behaviour and barriers to accessing services for sexual health problems among young married women in rural areas of Thiruvarur district of Tamil Nadu state in India. Methods. A community based cross-sectional study was conducted in 28 villages selected using multistage sampling technique for selecting 605 women in the age group of 15–24 years during July 2010–April 2011. Results. The prevalence rate of reproductive tract infections (RTIs) and STIs was observed to be 14.5% and 8.8%, respectively, among the study population. Itching/irritation over vulva, thick white discharge, discharge with unpleasant odor, and frequent and uncomfortable urination were most commonly experienced symptoms of sexual health problems. Around three-fourth of the women received treatment for sexual health problems. Perception of symptoms as normal, feeling shy, lack of female health workers, distance to health facility, and lack of availability of treatment were identified as major barriers for not seeking treatment for RTIs/STIs. Conclusion. Family tradition and poor socioeconomic conditions of the family appear to be the main reasons for not utilizing the health facility for sexual health problems. Integrated approach is strongly suggested for creating awareness to control the spread of sexual health problems among young people. PMID:26316973

New perineal injection technique for pudendal nerve infiltration in diagnostic and therapeutic procedures.

PubMed

Weinschenk, Stefan; Hollmann, Markus W; Strowitzki, Thomas

2016-04-01

Pudendal nerve injection is used as a diagnostic procedure in the vulvar region and for therapeutic purposes, such as in vulvodynia. Here, we provide a new, easy-to-perform perineal injection technique. We analyzed 105 perineal injections into the pudendal nerve with a local anesthetic (LA), procaine in 20 patients. A 0.4 × 40 mm needle was handled using a stop-and-go technique while monitoring the patient's discomfort. The needle was placed 1-2 cm laterally to the dorsal introitus. After aspiration, a small amount of LA was applied. After subcutaneous anesthesia, the needle was further advanced step-by-step. Thus, 5 ml could be applied with little discomfort to the patient. Anesthesia in the pudendal target region was the primary endpoint of our analysis. In 93 of 105 injections (88.6 %), complete perineal anesthesia was achieved with a single injection. 12 injections were repeated. These injections were excluded from the analysis. Severity of injection pain, on visual analog scale (VAS) from 0 to 100, was 26.8 (95 % CI 7.2-46.4). Age (β = 0.33, p < 0.01) and the number of previous injections (β = 0.35, p < 0.01) inversely correlated with injection pain. Injection pain and anesthesia were not affected by BMI, the number and the side of previous injections, or order of injection. A reversible vasovagal reaction was common, but no serious adverse effects occurred. Perineal pudendal injection is an effective and safe technique for anesthesia in diagnostic (vulva biopsy) and therapeutic indications (pudendal neuralgia), and regional anesthesia in perinatal settings.

Dystocia following prolonged retention of a dead fetus in an Asian elephant (Elephas maximus).

PubMed

Thitaram, Chatchote; Pongsopawijit, Pornsawan; Thongtip, Nikorn; Angkavanich, Taweepoke; Chansittivej, Sarun; Wongkalasin, Waroot; Somgird, Chalermchart; Suwankong, Niyada; Prachsilpchai, Worapat; Suchit, Kittiphat; Clausen, Bjarne; Boonthong, Pinich; Nimtrakul, Kannika; Niponkit, Charawee; Siritepsongklod, Somchai; Roongsri, Ronnachit; Mahasavankul, Sittidet

2006-09-15

A 32-year-old nulliparous female Asian elephant (Elephas maximus) showed signs of parturition 8 months later than predicted from the breeding records. However, while serosanguineous fluid, necrotic tissue and pieces of amnion were expelled, second-stage labor did not progress. Since the fetus was not found during an endoscopic examination of the vestibule, it was assumed that the elephant had calved unseen and she was returned to the forest to recuperate. Twelve months later, the elephant showed clear signs of second-stage labor accompanied by a bulge in the perineum and passage of keratinized nail through the vulva. A 35 cm episiotomy incision was made in the perineum just below the anus, via which chains were attached to the forelimbs of the fetus. Traction on the forelimbs alone proved insufficient to achieve delivery because the fetal head kept rotating and impacting in the pelvis. However, traction applied via a hook inserted behind the mandibular symphysis allowed the head to be elevated and extended, and the fetus to be delivered. The episiotomy wound was sutured in two layers and although the skin did not heal during primary closure it subsequently healed uneventfully by second intention. Retrospective evaluation of the elephant's serum progestagens profile demonstrated a fall to baseline at the suspected onset of parturition, supporting the supposition that the fetus was retained in the uterus for 12 months after parturition began. It is suggested that serum progestagens concentrations should be monitored regularly in mated elephant cows to verify the establishment of pregnancy and to better estimate the expected timing, and the onset of calving.

Clinical responses to focused ultrasound applied to women with vulval intraepithelial neoplasia.

PubMed

Jia, Ying; Wu, Jin; Xu, Man; Tang, Liangdan; Li, Chengzhi; Luo, Ming; Lou, Meng

2014-11-01

Focused ultrasound waves penetrate superficial tissues and are aimed toward the target tissues at specific depths to exert their biological effects. Focused ultrasound has been applied for a number of clinical indications, including vulval dystrophies and low-grade vulval disease. This study aimed to assess the efficacy and safety of focused ultrasound treatment of high-grade vulval intraepithelial neoplasia (VIN). Eighteen women with high-grade VIN were recruited and treated with focused ultrasound. During each posttreatment follow-up, the safety of, side effects of, and clinical responses to focused ultrasound were evaluated by a standardized protocol, including symptoms, clinical appearance, and histologic findings. All patients completed the designed follow-ups. In most cases, superficial mild to moderate swelling and blisters were seen in the focused ultrasound-treated skin but not in adjacent normal skin. Of the 18 patients, 16 showed complete histologic regression and resolution of symptoms 6 months after treatment. Of the other 2 patients, 1 showed complete regression after a second focused ultrasound treatment. The other patient did not respond to the focused ultrasound treatment and underwent a partial vulvectomy 6 months after treatment. None of the patients developed invasive carcinoma of the vulva during the follow-up period. One patient had local pruritus that was not alleviated by anti-inflammatory medication and local care. The complete responses observed in women with high-grade VIN treated by focused ultrasound, together with the preservation of adjacent normal tissue, suggest that focused ultrasound may be considered for treatment of high-grade VIN. © 2014 by the American Institute of Ultrasound in Medicine.

Surgical therapy of vulvar cancer: how to choose the correct reconstruction?

PubMed Central

2016-01-01

Objective To create a comprehensive algorithmic approach to reconstruction after vulvar cancer ablative surgery, which includes both traditional and perforator flaps, evaluating anatomical subunits and shape of the defect. Methods We retrospectively reviewed 80 cases of reconstruction after vulvar cancer ablative surgery, performed between June 2006 and January 2016, transferring 101 flaps. We registered the possibility to achieve the complete wound closure, even in presence of very complex defects, and the postoperative complications. On the basis of these experience, analyzing the choices made and considering the complications, we developed an algorithm to help with the selection of the flap in vulvoperineal reconstruction after oncologic ablative surgery for vulvar cancer. Results We employed eight types of different flaps, including 54 traditional fasciocutaneous V-Y flaps, 23 rectus abdominis myocutaneous flaps, 11 anterolateral thigh flaps, three V-Y gracilis myocutaneous flaps, three free style perforators V-Y flaps from the inner thigh, two Limberg flaps, two lotus flaps, two deep inferior epigastric artery perforator flap, and one superficial circumflex iliac artery perforator flap. The structures most frequently involved in resection were vulva, perineum, mons pubis, groins, vagina, urethra and, more rarely, rectum, bladder, and lower abdominal wall. Conclusion The algorithm we implemented can be a useful tool to help flap selection. The key points in the decision-making process are: anatomical subunits to be covered, overall shape and symmetry of the defect and some patient features such as skin laxity or previous radiotherapy. Perforator flaps, when feasible, must be considered standard in vulvoperineal reconstruction, although in some cases traditional flaps remain the best choice. PMID:27550406

Clinical scoring system to detect malignant and premalignant vulval lesions.

PubMed

Tyagi, Shakun; Tripathi, Reva; Batra, Swaraj

2014-02-01

To construct a simple clinical scoring system for evaluation of vulval lesions that will be helpful in clinically detecting the premalignant or malignant lesions of vulva. Seventy women referred for vulval examination at a tertiary care centre in north India were examined over a period of 2 years. Biopsy was performed in 66 consenting women. Association of high-grade vulval lesion with various clinical parameters such as age, duration of symptoms, presenting complaints, the presence of depigmentation, ulceration, hyperkeratosis, acetowhite changes on acetic acid application, asymmetrical distribution of the lesion, surface elevation on naked eye or colposcopy, induration on palpation and toluidine blue stain retention was studied. The significantly associated factors were assigned a value of 0 or 1 depending on whether they were present or absent. Score was then formulated for detection of high-grade lesion defined as moderate to severe dysplasia and early malignancy. Histopathology. Out of the various parameters that were studied, duration of symptoms more than 6 months, hyperkeratosis, asymmetrical distribution of the lesion, surface elevation on naked eye or colposcopy, induration on palpation and positive toluidine blue stain retention of the lesion were found to be significantly associated with a malignant or premalignant lesion. It was found that a score of equal to or greater than 3/6 was significantly associated with a malignant or premalignant lesion. This simple scoring system has a potential to identify the high-grade lesions and can be used to identify the vulval lesion requiring a biopsy or further referral to higher centre.

Ipsilateral superficial inguinal lymphadenectomy for the treatment of early cancer of the vulva.

PubMed

Gori, Jorge R; Fritsches, Heriberto W; Castaño, Roberto; Toziano, Mariano; Habich, Diego

2002-07-01

This study compared the rates of survival, recurrence, and the occurrence of complications after surgery for vulvar cancer in selected patients treated by simple vulvectomy or wide local excision (WLE) and ipsilateral superficial inguinal lymphadenectomies (ISIL) and who were in a representative group of previous patients treated by standard radical surgery (control). Superficial inguinal lymphadenectomies were performed in 32 patients with laterally localized squamous cell tumors of 1 to 3 cm in size and without palpable lymph nodes. Eight cases, which showed histological evidence of lymph node metastasis, were submitted to conventional radical treatment and excluded from the study. Of the remaining 24 patients, 12 underwent vulvectomy, 7 hemivulvectomy, and 5 WLE. The results of this group were compared with those of 21 historical controls who previously had tumors of 1 to 3 cm and had been treated by radical vulvectomy with superficial and deep bilateral inguinal lymphadenectomy. Dehiscence of the flaps occurred in 66.6% of the control patients and in 8.3% of the ISIL group (chi , p <.0001). There was lymphedema in 13.8% of the controls and none in the ISIL group (Fisher exact test, p <.02). Upon follow-up (3 to 8 years, results are reported for 3 years of follow-up), there were 9.5% vulvar recurrences in the controls and 12.5% in the ISIL group (Fisher exact test, p <.652 not significant). WLE and deep local excision of the primary lesion and ISIL in selected patients with early vulvar cancer seems to be a safe alternative to the traditional radical method.

Reproductive Tract Infections and Treatment Seeking Behavior among Married Adolescent Women 15-19 Years in India.

PubMed

Prusty, Ranjan Kumar; Unisa, Sayeed

2013-01-01

India is home to the highest number of adolescents in the world. Adolescents in India suffer from lack of knowledge and empowerment to make informed sexual and reproductive health decisions. This paper analyses the prevalence of reproductive tract infections and sexually transmitted infections (RTI/STI) and treatment seeking behavior among married adolescent women in India aged 15-19 years. Data from the District Level Household Survey (DLHS, 2007-08) of India were used. The prevalence of RTIs symptoms and treatment seeking behavior among women by different socio-demographic characteristics was analyzed. Factor analysis was utilized to create an index using information about 11 symptoms of RTI/STI collected in the survey. Linear and binary logistic regressions were used to know the association between infections and treatment seeking behavior with socio-demographic factors. About 15 percent of adolescent women reported having any symptoms of RTI/STI. The main symptoms reported were low backache, pain in the lower abdomen, pain during intercourse and itching or irritation around the vulvar region. Factor analysis showed the concentration of diseases in three clusters - infection in around the vulva, other reproductive infection and abnormal discharge; and intercourse related problems. Major predictors of both symptoms of reproductive infections and treatment seeking behavior from multivariate analysis are age, education, wealth, region and awareness about RTI/STI. Knowledge and treatment seeking behavior is poor among adolescent women in India. There is need for programmatic and policy emphasis on increasing knowledge and awareness through family life education including in educational curriculum at school level.

Anatomical organization and somatic axonal components of the lumbosacral nerves in female rabbits.

PubMed

Cruz, Yolanda; Hernández-Plata, Isela; Lucio, Rosa Angélica; Zempoalteca, René; Castelán, Francisco; Martínez-Gómez, Margarita

2017-09-01

To determine the anatomical organization and somatic axonal components of the lumbosacral nerves in female rabbits. Chinchilla adult anesthetized female rabbits were used. Anatomical, electrophysiological, and histological studies were performed. L7, S1, and some fibers from S2 and S3 form the lumbosacral trunk, which gives origin to the sciatic nerve and innervation to the gluteal region. From S2 to S3 originates the pudendal nerve, whose branches innervates the striated anal and urethra sphincters, as well as the bulbospongiosus, ischiocavernosus, and constrictor vulvae muscles. The sensory field of the pudendal nerve is ∼1800 mm 2 and is localized in the clitoral sheath and perineal and perigenital skin. The organization of the pudendal nerve varies between individuals, three patterns were identified, and one of them was present in 50% of the animals. From S3 emerge the pelvic nerve, which anastomoses to form a plexus localized between the vagina and the rectum. The innervation of the pelvic floor originates from S3 to S4 fibers. Most of the sacral spinal nerves of rabbit are mixed, carrying sensory, and motor information. Sacral nerves innervate the hind limbs, pelvic viscera, clitoris, perineal muscles, inguinal and anal glands and perineal, perigenital, and rump skin. The detailed description of the sacral nerves organization, topography, and axonal components further the knowledge of the innervation in pelvic and perinal structures of the female rabbit. This information will be useful in future studies about the physiology and physiopathology of urinary, fecal, reproductive, and sexual functions. © 2017 Wiley Periodicals, Inc.

Normal findings in vulvar examination and vulvoscopy.

PubMed

van Beurden, M; van der Vange, N; de Craen, A J; Tjong-A-Hung, S P; ten Kate, F J; ter Schegget, J; Lammes, F B

1997-03-01

To determine the normal vulvar findings by naked eye examination and by vulvoscopy in healthy women without vulvar complaints. Observational study. Forty healthy volunteers without vulvar complaints recruited via a newspaper advertisement. Vulvar examination, human papillomavirus (HPV) polymerase chain reaction of vulvar and cervical swabs, saline and KOH smears and vulvoscopy before and after the application of 5% acetic acid. Prevalence of vestibular erythema, vestibular papillomatosis, HPV infection on the vulva and in the cervix and vulvoscopic findings. The mean age of the women was 37.8 years (median 38.0, range 21-56). Nine women were current smokers and 21 had previously smoked. Naked eye vulvar examination showed vestibular papillomatosis in 13 women (33%) and vestibular erythema in 17 women (43%). The touch test was positive in 9 of the 17 women (53%) with vestibular erythema. Vulvoscopy after the application of acetic acid 5% showed an acetowhite vestibule in all women. Twelve women (30%) had acetowhite lesions outside the vestibule. Six women (15%) were positive for HPV DNA. The presence of HPV DNA did not correlate with vestibular erythema or vestibular papillomatosis. There was a weak association between HPV DNA and acetowhite lesions outside the vestibule (P = 0.055, Fisher's exact test). In this group the younger women significantly more often had vestibular papillomatosis (t-statistic = 3.07; P = 0.003) and women who smoke more often had a genital HPV infection (P = 0.016, Fisher's exact test). Vestibular erythema, vestibular papillomatosis, and acetowhite lesions are common in this group of healthy women without vulvar complaints.

Meteterakis saotomensis n. sp. (Nematoda: Heterakidae) from Schistometopum thomense (Bocage) (Gymnophiona: Dermophiidae) on São Tomé Island.

PubMed

Junker, Kerstin; Mariaux, Jean; Measey, G John; Mutafchiev, Yasen

2015-10-01

Meteterakis saotomensis n. sp. is described from Schistometopum thomense (Bocage), a gymnophionan endemic to the oceanic island of São Tomé in the Gulf of Guinea. The specimens were assigned to Meteterakis Karve, 1930, based on the possession of a head with three rounded lips, not set-off from the body, the absence of interlabia and cordons, females with a long vagina and males with a preanal sucker, surrounded by a cuticularised rim and caudal alae that are supported by fleshy papillae. The new species is characterised by: body length 4.2-4.5 mm (males) and 5.1-6.4 mm (females); total length of oesophagus, including pharyngeal portion and oesophageal bulb, 820-856 µm (males) and 898-1,070 µm (females); length of pharynx 57-58 µm (males) and 65-68 µm (females); spicules equal, 410-521 µm long, with tessellated ornamentation throughout their length and alae, and with bevelled tip; gubernaculum or 'gubernacular mass' absent; tail length 164-176 µm (males) and 214-239 µm (females), with elongated tip; vulva at 2.3-2.8 mm from anterior end, with anterior lip forming small flap. This is the second species of Meteterakis reported from gymnophionan hosts and the first from the Afrotropical region. Selected comparative morphological data for Meteterakis spp. are presented, and data on host range and geographic distribution are updated. The name M. striaturus Oshmarin & Demshin, 1972 is corrected to M. striatura to reflect the female gender of the genus name.

Genitourinary tract injuries in girls.

PubMed

Okur, H; Küçïkaydin, M; Kazez, A; Turan, C; Bozkurt, A

1996-09-01

To evaluate lower genitourinary tract injuries in girls and to propose guidelines for the investigation and initial management of this unusual injury. The hospital records of 38 girls (aged 2-13 years) treated in our institution because of lower genitourinary (LG) tract injury between 1988 and 1995 were reviewed retrospectively. Urethral ruptures were detected in six patients, but the most frequent injuries were to the vulva (63%) and vagina (53%). There were pelvic fractures in eight patients and femoral fractures in a further five. Eight patients had concomitant anorectal lacerations. Vaginal and perineal lacerations were repaired primarily and a temporary urethral catheter was placed for a mean of 3 days. Partial urethral disruptions were repaired primarily over a stenting catheter in three patients. In one case, vaginal laceration and proximal complete rupture of the urethra was managed through a transvaginal approach with end-to-end urethral anastomosis over a stenting catheter. There was a complete rupture of the distal urethra and avulsion of the external meatus in two cases and these patients were managed by urethral advancement and meatoplasty. Perineal physical signs did not reflect the severity of the lesions and cystovaginoscopy allowed localization of lacerations in some cases. Primary repair was possible in all cases. Three patients (8%) had wound infection after surgery. One patient had temporary urinary incontinence which was managed conservatively and one patient had faecal incontinence which needed secondary surgery. All female paediatric patients with suspected LG tract injury should undergo examination under anaesthesia to determine the degree of injury or possible concomitant injury to the urethra, bladder or rectum. Primary repair of these injuries is recommended.

Predictors and Patterns of Local, Regional, and Distant Failure in Squamous Cell Carcinoma of the Vulva.

PubMed

Bogani, Giorgio; Cromi, Antonella; Serati, Maurizio; Uccella, Stefano; Donato, Violante Di; Casarin, Jvan; Naro, Edoardo Di; Ghezzi, Fabio

2017-06-01

To identify factors predicting for recurrence in vulvar cancer patients undergoing surgical treatment. We retrospectively evaluated data of consecutive patients with squamous cell vulvar cancer treated between January 1, 1990 and December 31, 2013. Basic descriptive statistics and multivariable analysis were used to design predicting models influencing outcomes. Five-year disease-free survival (DFS) and overall survival (OS) were analyzed using the Cox model. The study included 101 patients affected by vulvar cancer: 64 (63%) stage I, 12 (12%) stage II, 20 (20%) stage III, and 5 (5%) stage IV. After a mean (SD) follow-up of 37.6 (22.1) months, 21 (21%) recurrences occurred. Local, regional, and distant failures were recorded in 14 (14%), 6 (6%), and 3 (3%) patients, respectively. Five-year DFS and OS were 77% and 82%, respectively. At multivariate analysis only stromal invasion >2 mm (hazard ratio: 4.9 [95% confidence interval, 1.17-21.1]; P=0.04) and extracapsular lymph node involvement (hazard ratio: 9.0 (95% confidence interval, 1.17-69.5); P=0.03) correlated with worse DFS, although no factor independently correlated with OS. Looking at factors influencing local and regional failure, we observed that stromal invasion >2 mm was the only factor predicting for local recurrence, whereas lymph node extracapsular involvement predicted for regional recurrence. Stromal invasion >2 mm and lymph node extracapsular spread are the most important factors predicting for local and regional failure, respectively. Studies evaluating the effectiveness of adjuvant treatment in high-risk patients are warranted.

HIV-associated hypertrophic herpes simplex genitalis with concomitant early invasive squamous cell carcinoma mimicking advanced genital cancer: case report and literature review.

PubMed

Strehl, Johanna D; Mehlhorn, Grit; Koch, Martin C; Harrer, Ellen G; Harrer, Thomas; Beckmann, Matthias W; Agaimy, Abbas

2012-05-01

Hypertrophic herpes simplex genitalis (HHSG) is an uncommon anogenital manifestation of herpes simplex virus (HSV) infection in immunocompromised patients. To date, 24 cases of HHSG have been reported; 23 of them were affected human immune deficiency virus (HIV) type 1-positive patients. We describe the case of a 44-year-old African HIV-1-positive woman who presented with painful ulcerated nodular lesions of the vulva and perianal area measuring up to 7 cm in diameter. Macroscopically, the lesions were highly suspicious of widely invasive cancer. The histologic workup of the resection specimen revealed patchy high-grade vulvar intraepithelial neoplasia Grade 3 (VIN 3) and 2 microscopic foci of superficially invasive squamous cell carcinoma. The nodular lesions were caused by massive tumefactive plasma cell-rich inflammatory infiltrates extending into the subcutis. Multinucleated herpes simplex virus 1 and herpes simplex virus 2-positive epithelial cells with glassy intranuclear inclusions were detected at the borders of the ulcerations, consistent with HHSG. Despite repeated surgery and medical treatment, the patient had 3 recurrences of HHSG within 18 months. The presence of intraepithelial neoplasia in HHSG lesions is relatively rare and has been described in 6 of 18 resected HHSG lesions in the literature so far. With regard to invasive malignancy, the present case is the first report of a superficially invasive squamous cell carcinoma associated with HHSG. Awareness of this condition is necessary to avoid misinterpretation of HHSG as widely invasive squamous cell carcinoma with the hazard of surgical and oncological overtreatment.