Absence of human papillomavirus sequences in ovarian pathologies.

The role of human papillomaviruses (HPVs) in ovarian epithelium (either normal or neoplastic) remains controversial. We have investigated by PCR the presence of HPV DNA in fresh tissue from ovarian neoplasms and in primary cell cultures established from either normal, benign or malignant ovarian surface epithelia. None of the fresh samples and primary ovarian cultures contained HPV DNA sequences.

Vaginal intraepithelial neoplasia.

This study comprised the largest number (76) of cases of vaginal intraepithelial neoplasia (VaIN) so far reported. Women diagnosed with VaIN were older (mean age 50.2 years) than those diagnosed with cervical intraepithelial neoplasia (CIN). Many of the women had previously undergone (71.2%). In the majority of cases, the diagnosis was made after cytologic testing. In 92.4% of the cases, the lesions affected the upper third of the vagina. Grades of VaIN were distributed as follows: grade 1 52.6%, grade 2 191.%, grade 3 28.9%, with a 15-year interval between VaIN 1 and 2 as a group and VaIN 3 as another group. The cases of VaIN were divided into five groups: VaIN de novo; VaIN + CIN; VaIN postradiotherapy; VaIN + CIN + VIN; and incidental finding of VaIN on the surgical specimen. The therapeutic modalities were heterogeneous; CO2 laser therapy was used most frequently (54.2%). Failures are attributed mainly to the multifocal character of the lesions (particularly with human papilloma virus infection) or their localization in the vaginal angles. Overall, the number of cases, the duration of follow-up (39.2 months), and the unsatisfactory results with CO2 laser therapy have led us to propose a therapeutic decision tree where in which 5-fluorouracil plays a major role, CO2 laser and surgical therapeutic modalities having limited and precise indications.

[The maxillo-mandibular desmoid fibroma. Synthesis of knowledge about a rare entity. Apropos of 3 cases]. / Le fibrome desmoïde maxillo-mandibulaire. Synthèse des connaissances sur une entité rare. A propos de trois cas.

Three cases of maxillo-mandibular desmoplastic fibroma are added to the 41 cases already described in the literature. A synthesis of the actual knowledge concerning the tumor is presented. The tumor is mainly composed of fibrous tissue with bundles of mature collagen, and can be easily confused with a low grade fibrosarcoma. Most of the patients are caucasian males. It is a young people tumor (0 to 30 years) with a peak between 6 to 15 years. The mandible was involved in 36 cases and the maxilla in 8 cases. The left side was involved in a ratio of 2 to 1 compared to the right side. In the mandible, the tumor was observed most frequently in the body and at the angle of the jaw. Pain or tumefaction were the most prevalent clinical features. The etiology of the tumor is unclear but trauma is often implicated. When the treatment is conservative, recurrences are frequent. The maxillo-mandibular desmoplastic fibroma should be recognized early to avoid local tissue destruction.

[Burkitt's lymphoma. Survey and current data]. / Le lymphome de Burkitt. Synthèse et mise à jour.

The non endemic Burkitt lymphoma is compared to the endemic type with the help of the pertinent literature. A series of 9 cases of Burkitt lymphomas which were treated and retrieved during a 18 year period at the Notre-Dame Hospital of Montreal is presented. Some possibilities of viral propagation through the dental pulp to the bone are explained.

Choriocarcinoma associated with undetectable levels of human chorionic gonadotropin.

A case of choriocarcinoma is presented which developed during close follow-up for hydatidiform mole. Serum levels of beta subunits of human chorionic gonadotropin (beta-HCG) were assessed by radioimmunoassay (RIA) before, during, and after diagnosis of choriocarcinoma and remained below the sensitivity level of the assay. To our knowledge, this is the fourth reported case where choriocarcinoma was not associated with the presence of elevated beta-HCG levels.

[Cardiac rhabdomyomas and aortic valve atresia: an unusual association]. / Rhabdomyomes cardiaques et atrésie valvulaire aortique: une association exceptionnelle.

Necroptic examination of a male newborn baby revealed multiple anomalies of the heart, including multiple cardiac rhabdomyomas, aortic valvular atresia, left cardiac hypoplasia, hypoplasia of proximal aorta and hypertrophy of the right heart. Tuberous sclerosis was not present. In are instances, the association of cardiac rhabdomyomas and other congenital cardiac malformations have been reported but the association documented here has not been, to our knowledge, previously described.

Value of lymphography in Stage IB cancer of the uterine cervix.

In many neoplasms, lymphography is a reliable method with which lymph node metastases are demonstrated, but its accuracy in Stage IB cancer of the uterine cervix remains to be more firmly established. One hundred patients with Stage IB cancer of the uterine cervix underwent lymphography before radical hysterectomy with pelvic lymphadenectomy was contemplated. All the lymphographic findings were reviewed without knowledge of the pathologic parameters of the patients and were classified as being either positive (five cases), suspicious (15 cases), or negative (80 cases). The pathologic studies revealed lymph node metastases in 18 patients--in five with positive lymphographic findings, in three with suspicious findings, and in 10 with negative ones. The five true positive cases were compared to the 13 false negative or suspicious lymphographic results. It appears that the former have a greater number of involved lymph nodes and a greater mean size of the metastases. Thus, in Stage IB cancer of the uterine cervix, lymphography demonstrates an excellent specificity (100%) but a low sensitivity (27.8%).

Pulmonary cytology in chrysotile asbestos workers.

The prevalence of atypical cytology has been determined in relation to age, smoking and asbestos exposure for male workers employed in 3 mines in the Province of Quebec. Overall participation was 71%. Out of 867 participating workers, 626 (72%) presented a deep cough specimen within normal limits, 74 (8.5%) a specimen with mild atypical metaplasia and 10 (1.2%) a specimen with moderate atypical metaplasia. Four lung carcinoma were identified. Five percent of the workers initially interviewed did not return their specimen and 12.7% had unsatisfactory test results. Proportions of cellular atypia increased with age and asbestos exposure. Using logistic regression analysis, estimated probabilities of abnormal cytology for workers aged 25 years when started mining increased with both years of asbestos exposure and exposure index measured in fibres per cubic centimeter.

Pathophysiology of rupture of the pulmonary artery by pulmonary artery balloon-tipped catheters.

High pressures have been reported in pulmonary artery catheter balloons. This study was undertaken to determine the in vitro rupturing pressures of human peripheral pulmonary arteries and to evaluate whether such pressures could be generated under clinical conditions. The in vitro model then was confirmed in vivo in the dog and the evolution of a rupture of a peripheral pulmonary artery studied. In vitro, pulmonary arteries of subjects under age 60 yr are remarkably resistant and tolerate intra-balloon pressures of 2700 mm Hg in the one mid-pulmonary artery studied and up to 4219 +/- 720 mm Hg (mean +/- SD) in the distal pulmonary artery. Subjects over the age of 60 yr have significantly lower rupturing pressures (1965 +/- 540 mm Hg in the mid-pulmonary artery, and 2498 +/- 600 mm Hg in the distal pulmonary artery), (P less than 0.05). Thus overdistension by the balloon may explain most ruptures. Preexisting pulmonary hypertension did not affect in vitro rupturing pressures. Clinicians generated intraballoon mean pressures of 795 +/- 130 mm Hg, with 20% of them generating higher and potentially dangerous pressures (1000 mm Hg or more). The in vitro model was confirmed by in vivo studies in dogs with pressures that cause pulmonary artery rupture. Furthermore, in normal dogs, rupture of a peripheral pulmonary artery was without complications. This suggests that rupture of the peripheral pulmonary artery may occur clinically more frequently than reported. The user of flotation pulmonary arterial catheters should be aware of the dangers associated with this diagnostic tool. In particular, liquids must never be used to inflate pulmonary arterial catheter balloons.

Pulmonary cytology in foundry workers.

The prevalence of cellular atypias has been determined in relation to smoking history, age and type of work of male foundry workers in different departments of a foundry. Participation of the workers was 95%. Out of 677 workers, 528 had results within normal limits, 36 showed mild atypical metaplasia while 4 persons got moderate atypias; 48 individuals showed unsatisfactory results and 61 did not complete the tests. Prevalence of abnormal findings ranged from 4.2% in non-smokers to 7.8% in smokers of more than 21 cigarettes. The prevalence also increased with age in smokers only. Variations in prevalence associated with employment in different departments of the foundry varied little and were not statistically significant.

[A case of cylindroma of the cervix (author's transl)]. / A propos d'un cas de cylindrome du col utérin.

The authors, in this article, report on a case of the relatively rare condition of cylindroma of the cervix (adenoid cystic carcinoma). The typical features as seen under the optical and electron microscope are broadly as well as the different techniques available to treat this rare lesion, which is more fulminating in its evolution than the similar condition when it occurs in the skin or the breast.

Endometrial pattern in patients with primary hypoestrogenic amenorrhea receiving estrogen replacement therapy.

The histologic pattern of the endometrium was studied in 38 patients, 19 to 44 years old, with primary hypoestrogenic amenorrhea treated by estrogen replacement therapy. At the time of endometrial biopsy 3 patients were receiving estrogens only and 35 patients were taking 1 of the following cyclic estrogen-progestogen combinations: 1) conjugated estrogens, 1.25 or 2.5 mg per day, combined with medroxyprogesterone, 5 or 10 mg for the last 5 to 10 days; 2) ethinyl estradiol, 50 microgram per day, combined with medroxyprogesterone, 5 mg per day for the last 5 days; or 3) mestranol, 40 microgram per day, in combination with norethindrone, 0.5 mg for the last 7 days. Evidence of endometrial hyperplasia was found in 3 patients. Two of them were taking unopposed estrogens and developed cystic hyperplasia; the other patient, treated with norethindrone in addition to mestranol, disclosed focal cystic glandular hyperplasia. This study and the review of the available data reported in the literature on the endometrial response to estrogen therapy in patients with gonadal dysgenesis stress the importance of appropriate estrogen and progestogen dosage to avoid the hazards of abnormal endometrial pattern in young patients receiving estrogen replacement therapy.