Chlamydia trachomatis in cervical uterine irradiated cancer patients.

Twenty-two women with uterine carcinoma with morphological alterations postradiation treatment suggestive of Chlamydia trachomatis infection were analyzed by direct immunofluorescence. The diagnosis was confirmed in 12 (54.4%) cases. Discussions of the presence of Chlamydia in irradiated cells were not found in the literature. This finding may signify a posttherapeutic morbidity or a preradiation infection.

[Chlamydia trachomatis in smears of irradiated uterine cervix: cytologic and immunocytochemical aspects]. / "Chlamydia trachomatis" em esfregaços de colo uterino irradiado: aspectos citológicos e imunocitoquímicos.

Some authors recently suggested the role of Chlamydia trachomatis as a potentiating agent of female genital tract neoplasias. Cervicovaginal smears of women with uterine carcinoma treated with radiotherapy are analyzed in the present work. A series of such smears showed morphological changes suggestive of Chlamydia infection with the Papanicolaou stain. Confirmation of the presence of such agent was done using an avidin-biotin-peroxidase technique. A higher prevalence of Chlamydia in the group of patients with carcinoma of the uterus treated with irradiation than in the population without ionizing treatment was verified. The presence of cells with radiotherapic changes infected by Chlamydia is a new finding in cytology.

[Clinical evaluation of combined use of the spermicide Nonoxynol-9 and condoms]. / Avaliacao clinica da associacao do espermicida Nonoxinol-9 a preservativos.

PIP: Condoms represent an efficient family planning method. Their use was 1st described by the Italian anatomist Fallopio in 1564. Their effectiveness is considered to result in 0.5-2 births/100 years of marriage. 1st descriptions of vaginal contraceptives, by the Egyptians, date back to 1850 B.C. Their effectiveness is considered to be 5-10/100 years of marriage. A combined usage of condom and spermicides such as Nonoxynol-9 could thus elevate contraceptive effectiveness more than 20 times. A clinical test of such a combination product was conducted involving 2 groups consisting of 30 women each (1 control group) in order to evaluate possible alterations in vaginal mucus. By using questionnaires, women with a history of allergy to condoms or vaginal creams were excluded. However, those with symptoms of vulvovaginitis were not. The 2 groups were subjected to laboratory tests before and after usage: bacterioscopy, culture of vulvovaginal secretions, the saline drop method in order to diagnose Trichomonas, and the potassium hydroxide drop method in order to diagnose Gardnerella vaginalis and Candida albicans. Vaginal colposcopy and measuring of vulvovaginal pH were also performed. The results, before and after use, are listed for both groups in 3 tables, with reference to 2 clinical symptoms (itching of burning sensation), vaginal pH (normal, above, below), and various microorganisms being isolated. The tables do not allow for any interpretation of significant alterations resulting from the use of the combination product, e.g., the elevation of pH in some cases and 1 failure should be attributed to variations of flora not caused by the product, but being due to chance variations occurring in any given population. The absence of traumatic factors is due to the vaginal structure being functionally adapted, with numerous folds and wrinkles, to coitus. The effectiveness of the product is well documented in literature, and data listing decreased sperm motility is presented. It is concluded that no clinical adverse effects result with reference to the vulvovaginal epithelium or the penis.^ieng

Physical state and biological activity of human papillomavirus genomes in precancerous lesions of the female genital tract.

The DNA of distinct human papillomaviruses (HPVs) is regularly detected in the majority of human cervical carcinomas. In contrast to benign HPV-induced genital lesions, where the viral genomes are exclusively present as episomes, in cervical carcinomas HPV type 16 (HPV16) DNA was found to be integrated into the host DNA. In order to determine the physical state and expression of HPV DNA sequences at different stages of tumour development, we analysed a series of cervical lesions (mild, moderate and severe dysplasia and carcinoma in situ) that are considered precursors of carcinomas of the cervix. In 66.6% (18 of 27) of the tumours, HPV16 DNA was present. While in mild dysplasias only episomal HPV genomes were found, in all higher grade lesions integration of the viral DNA was detected. There was a close correlation between the episomal state and the expression of the HPV16 genomes: in 15 cases harbouring episomal HPV16 DNA (seven of which also contained integrated genomes) viral transcripts were present. We conclude that integration of HPV genomes takes place very early in cervical cancer development. In addition, the episomal state of the viral DNA depends on viral gene expression. The same conclusion, however, is not applicable in those lesions (three severe dysplasias) containing exclusively integrated HPV16 DNA. Thus, HPV16 DNA can persist in an integrated state without recognizable transcriptional activity. These results point to HPV16 as one potential prerequisite for the first steps in the multistage development of human cervical cancer.

Adenoid cystic carcinoma of Bartholin's gland: review of the literature and report of two cases.

Two patients with adenoid cystic carcinoma of Bartholin's gland and a review of the relevant literature are presented. With the inclusion of these two patients, there are now 24 cases reported. Both patients had large vulvar masses with a short clinical history, and several local tumor recurrences within the first 21/2 years after radical vulvectomy. The characteristic cribriform pattern and perineural involvement in addition to vascular invasion were present in the pathological material. No metastases were found in the inguino-femoral lymph nodes removed. Both patients are alive, without evidence of local recurrence but with lung metastases. A chemotherapeutic treatment scheme (adriamycin and cyclophosphamide) is underway but it is too early to evaluate its results.

O cancer microinvasor da vulva. / Microinvasive cancer of the vulva

Relatam-se 5 casos de carcinoma microinvasor da vulva tratados por vulvectomia ampliada. Tres casos evoluiram com metastases inguinais: em dois deles, no primeiro ano, e no outro, 4 anos apos a cirurgia.As duas clientes restantes estao vivas e assintomaticas ha mais de 5 anos. Julgam os autores, a partir dos dados coletados, ser a vulvectomia ampliada com linfadenectomia inguino-crural-iliaca bilateral a terapeutica ideal do carcinoma microinvasor da vulva