Nature of cervical cancer and other HPV - associated cancers.

Papillomaviruses are small DNA viruses that infect and multiply in cutaneous or mucosal epithelial tissue. Human papillomavirus (HPV) 16 and 18 cause more than 99% of cervical carcinomas. Simultaneous presence of HPV is found in cervical intraepithelial neoplasia, vaginal intraepithelial neoplasia, vaginal and anal cancer. Invasive vulvar squamous cell carcinoma in younger women under the age of 50 are also associated with HPV. Most of the penile lesions are subclinical and the high prevalence of high-risk HPV suggests that they constitute a reservoir for high-risk HPV. Bowens disease and Buschke-Lowenstein tumors are associated with particular low- and high-risk HPV types. The potential role of HPV infection in the carcinogenic steps of breast, prostate, colorectal and lung cancers should be further tested. HPV-DNA might be transported from the original site of infection to the breast tissue by the bloodstream, and therefore is possibly involved in the carcinogenesis of breast neoplasia in some patients. HPV-DNA is detected in 40-70% of head and neck squamous cell carcinomas and in only 1% in normal epithelial cells. In this paper we propose the hypothesis that many epithelial normal cells are susceptible to HPV infection, which are the most sexually transmitted viruses. Experimental and epidemiological data imply a causative role for HPVs and they appear to be the second most important risk factor for cancer development in humans, exceeded only by tobacco usage.

A woman with synchronous cervical, vaginal and laryngeal squamous cell carcinomas and positive human papillomavirus type 16; case presentation with literature review.

During the last 25 years the development of cervical cancer and cancer of the anorectum has been related to human papillomavirus (HPV) infection. HPV infection is found in up to 99.7% of all cervical cancers. Head and neck squamous cell carcinomas (HNSCC) have also been related to HPV infection. In this communication we present a 67-year-old female patient, nonsmoker, diagnosed with 3 synchronous cancers--squamous cell carcinoma of the uterine cervix, vagina and larynx. The patient was found positive for immunoglobulin HPV 16 L1 using ELISA method. We believe that in the presented case, the high risk HPV subtype 16 was implicated in the etiology of laryngeal, cervical and vaginal cancers. We also think that HPV infection and related cancers could be prevented effectively by immunization.

Large bowel endoscopy and management of colorectal cancer and its premalignant forms--endoscopy survey.

PURPOSE: To estimate the relationships between patients' clinical variables like age and sex with the endoscopical and histological findings of colorectal lesions and to assess the efficacy of endoscopy in diagnosing and treating polyps and early forms of colorectal cancer (CRC). PATIENTS AND METHODS: Analyzed were patients included in our database who were subjected to lower gastrointestinal tract endoscopy at our department for the last 15 years. RESULTS: 5107 patients were examined. In almost 1/5 (955) of them, the examination was for surveillance purposes. Women/men: 55%/45%. The number of patients with polyps was 1180. Polyps were diagnosed most frequently in patients aged 51-60 years and were located mostly in the sigmoid colon (43%). Patients with CRC were 613 and were diagnosed predominantly in the age group of 60-70 years (32%), most frequently in the rectum (38%), followed by the sigmoid colon (32%). 128 patients were diagnosed with early CRC. In 52 (40.62%) of them successful endoscopic therapy was carried out. No serious complications were observed except one case of late perforation after polypectomy, with a successful outcome. CONCLUSION: Lower gastrointestinal endoscopy is a highly efficient method for screening, diagnosis and therapy of colorectal polyps and early forms of CRC. It is still underused for screening purposes in patients after the age of 50 years.

Acute heart failure after treatment with 5-fluorouracil.

Anthracycline cardiotoxicity is cumulative and can cause congestive heart failure. The cardiotoxicity caused by 5-fluorouracil (5-FU) is acute and is usually observed during the first cycle of chemotherapy. We present the case of a female patient operated on for colorectal cancer and receiving her first postoperative chemotherapy cycle. Three hours after the initiation of continuous 5-FU infusion she developed signs of acute heart failure (AHF) and pulmonary edema. The patient did not have any previous history of heart disease. Symptoms resolved 24 hours from the onset of the episode after the initiation of the relevant emergency therapy. One of the most common symptoms related to 5-FU cardiotoxicity is chest pain. In case of such a toxicity treatment should be switched to another antineoplastic agent.

Monitoring enzymatic reactions in nanolitre wells.

We have developed a laboratory-on-a-chip microarray system based on nanolitre-capacity wells etched in silicon. We have devised methods for dispensing reagents as well as samples, for preventing evaporation, for embedding electronics in each well to measure fluid volume per well in real-time, and for monitoring the fluorescence associated with the production or consumption of NADH in enzyme-catalysed reactions. Such reactions can be found in the glycolytic pathway of yeast. We describe the design, construction and testing of our laboratory-on-a-chip. We also describe the use of these chips to measure both fluorescence (such as that evidenced in NADH) as well as bioluminescence (such as evidenced in ATP assays). We show that our detection limit for NADH fluorescence is 5 micro m with a microscope-based system and 100 micro m for an embedded photodiode system. The photodiode system also provides a detection limit of 2.4 micro m for ATP/luciferase bioluminescence.

Broad indications for the application of simultaneous oral-nasal manometering method.

UNLABELLED: The purpose of the study is to enlarge and define the perimeter of application of manometrical method for investigation of nasal breathing. METHOD: We studied patients with congenital or acquired pathological communications of the maxilla as well as patients with perforation of the sinus after teeth extractions that have been treated by prostheses. An original electronic pneumatic device was constructed for our method. RESULTS: Because of the objectiveness of the method and the device we obtained good results in closing the pathological communications in all of the patients. When used in the diagnosis of sinus perforations the method and the device showed the same effectiveness, CONCLUSION: When realization is possible the method guarantees absolute effectiveness in defining leakage of breathed air through pathological communications of the maxilla. With this device, constructed for the study we optimized the application of the method.