Frequency of human papillomavirus infection and genotype distribution among women with known cytological diagnosis in a Southern Italian region.

INTRODUCTION: In the Puglia region (South Italy) about 200 new hospitalizations for cervical cancer are registered every year. The study investigated the frequency of Human Papillomavirus (HPV) infection and the genotype distribution of HPV in a sample of women with known cytology attending the outpatient clinics of four Gynecological Departments of the University of Bari over a four-year period (2005-2008). METHODS: Cervical samples from 1,168 women were analyzed for the presence of HPV-DNA through Polymerase Chain Reaction (PCR) in L1 region and reverse hybridization. The cytological results were associated with HPV positivity and type-specific prevalence. RESULTS: Overall, HPV infection was found in 355 (30.4%) women. HPV-DNA was found in 34.4% of women with a cytological diagnosis of ASCUS, in 46.8% of women with Low-grade Squamous Intraepithelial Lesion (LSIL) and in 87.0% of women with High-grade Squamous Intraepithelial Lesion (HSIL)/carcinoma. Also 16.0% of women with normal Pap smear were found to be HPV-DNA positive. The most common HPVgenotype was type 16 found in 27.3% of positives, followed by type 53 (11.5%), type 66 (9.2%) and type 31 (9.0%). HPV genotype 18 was found in 6.4% of positives. Types 16 or 18 were detected in about 34% (120/355) of all infected women, in about 33% of LSIL and in 60% of HSIL/ carcinoma HPV-positive women. Among low risk (LR) genotypes, type 61 was found in 10.7% of HPV positive women, type 62 in 8.4%, type 42 in 8.1% and type CP6108 in 7.8%. DISCUSSION AND CONCLUSIONS: The findings of the study give evidence that HPV infection is frequent in the studied cohort of women. The most widespread genotypes found were 16 and 53. These data may represent a benchmark for future evaluation after the recent introduction of vaccination against HPV in 12-year-old girls.

The clivus-supraocciput angle: a useful measurement to evaluate the shape and size of the fetal posterior fossa and to diagnose Chiari II malformation.

OBJECTIVE: To obtain a nomogram of the clivus-supraocciput angle as a basis for the diagnosis of Chiari II malformation in fetuses with ventriculomegaly. METHODS: A cross-sectional study was undertaken on 310 normal pregnant women of 16-34 weeks' gestation. A mid-sagittal section of the fetal skull was obtained and the angle between the clivus and the supraocciput was measured. Forty-four fetuses with ventriculomegaly due to various causes (13 Chiari II malformation, 12 dysgenesis of the corpus callosum, 7 aqueductal stenosis, 6 borderline ventriculomegaly, 3 Dandy-Walker malformation, 2 porencephaly, 1 schizencephaly) were also included in the study and the values of the angle found in the pathological cases were compared with those found in the normal population. RESULTS: The clivus-supraocciput angle did not change during gestation and was almost constant with an average value of 79.3 +/- 6 degrees. All cases of Chiari II malformation showed a value below the 5th centile of our nomogram. CONCLUSIONS: The evaluation of the posterior fossa and particularly the measurement of the clivus-supraocciput angle is a useful parameter to differentiate the various causes of fetal ventriculomegaly and particularly to recognize Chiari II malformation.

[Peroperative diagnosis of pure retroperitoneal neurinoma misdiagnosed as uterine leiomyoma]. / Diagnosi intraoperatoria di neurinoma puro a sviluppo retroperitoneale pelvico confuso con leiomioma uterino.

A case of pure neurinoma of the retroperitoneal space developing in the pelvis is described. This tumor (phi max, 15 cm) responsible for intense compressive symptomatology involving the pelvic organs, was at first mistaken for a uterine fibroid. The ultimate diagnosis both of neurinoma as well as every other neoplasm originating in the retroperitoneum can sometimes be very hard to obtain. Those tumors can indeed be misdiagnosed for other more common conditions both clinically and instrumentally and the rarity of this particular localization adds further trouble to the matter.

Simplified ondansetron regimens for antiemetic prophylaxis in cisplatin-based chemotherapy of ovarian cancer.

In past years prevention of emesis and nausea induced by antiblastics has been based on extremely heterogeneous protocols with little efficacy. However, by the use of selective antagonists of serotonin S3 receptors there has been a remarkable improvement in the control of side effects. Among these antagonists ondansetron has been till now the most studied. The dosage protocols with which it has usually been employed establish an i.v. administration of the drug of 1 mg/h for 24 hours or the repetition of ondansetron 0.15 mg/kg x 2 every 2-4 hours after the end of chemotherapy. In our study, carried out from September 1991 till September 1992, 21 patients affected by ovarian carcinoma and treated by cisplatin chemotherapy protocols were evaluated (for a total of 63 cycles). Ten patients were under first line adjuvant chemotherapy treatment, whereas 11 patients were in relapse and had already undergone previous antiblastic treatments with serious side effects. In 18 out of 21 patients cyclophosphamide which has a strong emetic factor was associated with cisplatin. According to the total quantity of cisplatin contained in each cycle (in all < or =/> 100 mg) we used ondansetron in two different dosages simplified and shortened in time. They have been illustrated with particular details in the text. The control of nausea and vomiting during the first 24 hours was similar to the controls obtained in other studies in which ondansetron was administered according to the "traditional schemes".(ABSTRACT TRUNCATED AT 250 WORDS)

[A case of primary ovarian pregnancy in an IUD-wearing patient]. / Un caso di gravidanza ovarica primaria in una paziente portatrice di IUD.

A case of primary ovarian pregnancy in a patient fitted with an IUD is reported. Anatomic, pathological, clinical, etiological and therapeutical aspects of ovarian pregnancy are discussed with reference to published data. The case study presented in this paper shows the characteristics aspects of this pathology of pregnancy: the patient is a multipara, fitted with an IUD; clinical diagnosis was intraoperatively and adnexectomy was chosen as the most appropriate treatment. Anatomic and pathological tests were used to confirm the diagnosis of ovarian pregnancy.

[AIH and AID. Review of the literature: results and observations]. / IAO e IAD. Revisione della letteratura: risultati e considerazioni.

The literature on homologous artificial insemination and artificial insemination by donor is reviewed. In AIH the importance of the seminal factor and the influence of the induced superovulation are taken into account in determining the success of insemination. The important factors in AIH are: the type of sperm used (fresh or frozen), the characteristics of the female recipient, the method of insemination and its timing in relation to superovulation, and unwillingness to continue therapy. In line with other studies, it is emphasised that the factors involved in insemination must be standardised and defined according to recognised statistical principles in order to allow a meaningful comparison of data reported in the literature.

Valuation of some markers in the malignant neoplastic pathology of the female genital tract.

The Authors studied the presence of some markers in different gynaecological tumours, by radioimmunoassay. Beta-HCG, 1-alfa-FP, CA 125, GICA and TPA were assayed in 76 patients. Eight of the patients were affected by CIN III, 38 presented a cervical carcinoma (10 at stage I, 14 at stage II, 10 at stage III, 4 at stage IV); 14 patients had an endometrial adenocarcinoma (3 at stage I, 7 at stage II, 2 at stage III and II at stage IV); 12 cases consisted of an ovarian carcinoma with 2 patients at stage I, 5 at stage II and 5 at stage III; 2 patients had a peritoneal diffusion, whereas two women presented a vulvar carcinoma; the control group was formed by 10 patients with no malignant or benign pathology. The results show that tumoral markers, studied in the blood of patients affected by malignant gynaecological tumours, represent a great advantage in the evaluation of both the response to the therapy and of an eventual remission or tumoral recurrence.

Chemotherapy with CDDP.

The Authors report the results obtained in 30 patients affected by ovarian carcinoma and treated with chemotherapy using the parenteral route in 27 cases and the intraperitoneal one in 3 women. Parenteral chemotherapy following surgical staging and extensive tumour removal with the last residual tumour, consisted of a therapeutic scheme of mono- and poli-chemotherapy. The doses of cisplatin (CDDP) in mono-chemotherapy were correlated to the intensive anatomical-radiological-surgical staging. The patients treated with poli-chemotherapy underwent cycles with CDDP + alkylating agents. Moreover, 3 of the patients received low doses of cisplatin by intraperitoneal administration. In 27 cases pre- and post-therapy enzymuria was evaluated: it represents, in fact, the most reliable laboratory test to discover an acute tubulo-toxicity and is able to reveal chronic tubular damage. Our results demonstrate that a suitable nephrologic monitoring of the patients allows a more accurate use of the cisplatin with a better cost-benefit relation.

Role of radiotherapy in the management of cervical carcinoma.

Different therapy schemes related with the stage of tumours are reported, after general considerations on the topic. We have evaluated various criteria for the choice of methods, pointing out the complications of therapy. Lithium-carbonate action during radiation therapy has been studied, valuing the positive effect on leukopoiesis and the consequent better clinical conditions of the patients in course of treatment. In this study we report our experience with regard to 21 patients affected by cervical neoplasia, histologically diagnosed. The stages of neoplasia in the 21 patients were so distributed: 10 at stage I B, 8 at stage II A, 3 at stage II B. Treatment consisted of three therapeutical techniques: 1) application of radium in the cervical canal and in the vaginal fornices; 2) surgical procedure; 3) application of radium against the vaginal vault. In agreement with other author's results, the histological exam of the surgical specimen confirmed in different cases the complete absence of neoplastic aspects following the pre-operative radiotherapy. Although our experience is limited, we hold that radio-surgical "sandwich" treatment of cervical carcinoma may represent an excellent therapy in young women and in patients with associated systemic diseases. The follow-up of the 21 patients has excluded up to this day any neoplasia. In this program pre-operative intracavitary radiotherapy is a primary step allowing, in the majority of the cases, the reduction of surgical radicality. In so doing, effective therapeutical results associated with a better quality of life are obtained.

Virus in gynaecological oncology.

We measured the antibody presence of eventual viral infections (Parotiditis, Cytomegalovirus, Herpes Simplex and Hepatitis B) in 51 patients affected by malignant gynaecological tumours. Ninety five women composing the control group not affected by any pathology, underwent the same tests. Even if research has utilized various indirect methods for the antibody dosage of each viral infection, we have not confirmed other Authors' reports. It might be referable to the limited number of cases in our study up to date. In order to make a comparison among different reports we look forward to a uniformity of various laboratory methods. Reliable results will be obtained only by increasing the number of clinical cases and by utilizing the method of determination of viral genome in tumoral cells. The technique is the only reliable among different methods for determining a previous viral infection.

[Organogenesis of cranial ganglia in the chick embryo: a comparison of the development of blood vessels and neurocytodifferentiation]. / L'organogenesi in gangli encefalici dell'embrione di pollo : confronto tra sviluppo dei vasi sanguiferi e neurocitodifferenziazione.

Neurohistogenetic and vasculogenetic processes have been analytically compared in several cranial ganglia, ciliary (III nerve), semilunar (V nerve), vestibulocochlear (VIII nerve), petrosal (IX nerve) and nodose (X nerve), of chicken embryos from the 3rd to the 12th incubation day. The results indicate that during the organogenesis of these ganglia the formation of the first intrinsic vessels and the successive development of vascular networks follow the beginning and, respectively, the main steps of the neuroblast morphological maturation. The differences noticed by the Authors as concerns the chronological sequence showed by the vasculogenetic events in the various ganglia have been ascribed to the different proceeding of the neurohistogenesis since blood vessels first appear and build networks where the ganglionic development and differentiation are more precocious.