[Angioimmunoblastic T-cell lymphoma with fever, arthritis and skin pigmentation: A case report].

Angioimmunoblastic T-cell lymphoma is a rare T-cell lymphoma. The clinical manifestations are not specific. In addition to the common clinical manifestations of lymphomas such as fever, weight loss, night sweats and lymphadenopathy, it may also have skin rashes, arthritis, multiple serous effusions, eosinophilia and other systemic inflammatory or immune symptoms. The lymphoma cells of angioimmunoblastic T-cell lymphoma originates from follicular helper T cells, and the follicular structure of lymph nodes disappears. In the tumor microenvironment, in addition to tumor cells, there are a large number of over-activated immune cells, such as abnormally activated B cells, which produce a series of systemic inflammation or immune-related symptoms. This disease is rare and difficult to diagnose. This article reports a 36-year-old female. She got fever, joint swelling and pain, skin pigmentation, accompanied by hepatomegaly, splenomegaly, lymphadenopathy, anemia and other multiple-systems manifestations. The clinical manifestations of this patient were similar to autoimmune diseases such as adult onset Still's disease, rheumatoid arthritis, and systemic sclerosis, which made the diagnosis difficult. At the beginning of the disease course, the patient got arthritis and fever. And her white blood cells were significantly increased. Adult onset Still's disease should be considered, but her multiple-systems manifestations could not be explained by adult onset Still's disease. And her arthritis of hands should be distinguished with rheumatoid arthritis. However, the patient's joint swelling could get better within 3-7 days, and there was no synovitis and bone erosion on joint imaging examination. The rheumatoid factor and anti-CCP antibody were negative. The diagnostic evidence for rheumatoid arthritis was insufficient. The patient's skin pigmentation and punctate depigmentation were similar to those of systemic sclerosis. But the patient had no Raynaud's phenomenon, and her sclerosis-related antibody was negative. The diagnostic evidence for systemic sclerosis was also insufficient. After 3 years, she was finally diagnosed with angioimmunoblastic T-cell lymphoma by lymph node biopsy aspiration. This case suggests that the clinical manifestations of angioimmunoblastic T-cell lymphoma are diverse, and some symptoms similar to immune diseases may appear. When the patient's clinical symptoms are atypical and immune diseases cannot explain the patient's condition, and further evidence should be sought to confirm the diagnosis.

Value of 18F-FDG PET/CT in detecting viable tumour and predicting prognosis of hepatocellular carcinoma after TACE.

AIM: To evaluate the efficacy of combined PET/CT in the detection of viable tumour in patients with hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE). The correlation between 2-[(18)F]-fluoro-2-deoxy-d-glucose (FDG) uptake during PET and prognosis was evaluated. MATERIALS AND METHODS: Seventy-three patients with 91 HCCs who had undergone TACE with lipiodol before (18)F-FDG PET/CT were retrospectively reviewed. The pattern of lipiodol deposition in the tumour was divided into three groups: grade I, lipiodol remaining in ≥60% of the tumour; grade II, 20-60%; and grade III, ≤20%. The performance of (18)F-FDG PET/CT in evaluating the viability of HCC was assessed and compared with that of contrast-enhanced CT (CECT). The predictive value of maximal tumoural standardized uptake value (SUV) to mean liver SUV (TSUVmax/LSUVmean) ratio was tested. RESULTS: Comparing the receiver-operating characteristic area, (18)F-FDG-PET/CT was found to be superior to CECT for the detection of viable tumour in patients with HCC after TACE (p = 0.04). A high SUV ratio (TSUVmax/LSUVmean ≥1.65) correlated significantly with tumour size (p = 0.0096), the grade of lipiodol deposition (p = 0.0387) and serum α-foetoprotein (AFP) level (p = 0.0142), but did not correlate with pathological grade (p = 0.2626). The overall survival rate was significantly higher in the low SUV ratio (TSUVmax/LSUVmean<1.65) group (p = 0.024). CONCLUSION: (18)F-FDG-PET/CT is efficient in assessing the viability of HCC after TACE and is superior to CECT in grades I and II, and similar in grade III. It provides valuable information for prediction of prognosis and may aid decisions regarding treatment strategy.

Nodal ratio of positive to excised nodes, but not number of positive lymph nodes is better to predict group to avoid chemotherapy among postmenopausal ER-positive, lymph node-positive T1-T2 breast cancer patients.

AIM OF STUDY: To identify whether nodal ratio (NR) of positive to excised nodes is superior to number of positive lymph nodes to predict group to avoid chemotherapy among postmenopausal ER-positive, lymph node-positive, T1-T2 breast cancer patients. MATERIALS AND METHODS: Postmenopausal estrogen receptor (ER)-positive, lymph node-positive patients who received endocrine therapy (n = 173) with complete baseline data in our hospital between 2000 and 2006 were included. The disease-free survival (DFS) was compared. Survival analysis was performed using Kaplan-Meier method. Cox proportional hazard models were used to evaluate the prognostic value of chemotherapy with different NR for DFS. P--values less than 0.05 were regarded as significant. RESULTS: The median follow-up was 72 months. Three of 13 variables analyzed remained significantly prognostic for survival in the Cox proportional hazards model. These included age (hazard ratio (HR) =1.642, 95% confidence interval (CI) =1.154-2.337, P = 0.006); histological grade (HR = 2.463,95% CI = 1.389-4.367, P = 0.002); and NR (HR = 2.280, 95% CI = 1.113-4.671, P = 0.024). Subgroup analysis by NR status showed that in patients with NR ≥ 0.20, chemotherapy significantly improves DFS (HR = 0.360, 95% CI = 0.195-0.663, P = 0.001); while in patients with NR < 0.20, chemotherapy did not significantly affect DFS (HR = 0.677, 95% CI = 0.227-2.107, P = 0.493). Radiotherapy is an important factor that improves DFS in lymph node-positive patients, so it is considered in all analysis. CONCLUSION: This retrospective analysis demonstrates that NR of positive to excised nodes, but not number of positive lymph nodes is better to predict group to avoid chemotherapy among postmenopausal ER-positive, lymph node-positive T1-T2 breast cancer patients.

Insomnia symptoms in South Florida military veterans with epilepsy.

BACKGROUND: Despite the high prevalence of insomnia in veterans with epilepsy, it remains understudied. Our aim was to identify the associations of insomnia with epilepsy, comorbidities, and treatment-related variables in South Florida veterans. METHODS: We performed a cross-sectional analysis of veterans attending an epilepsy clinic over 18 months. Participants completed standardized assessments of seizure and sleep. Insomnia was defined as 1) difficulty with sleep onset, maintenance, or premature awakenings with daytime consequences or 2) sedative-hypnotic use on most nights of the previous month. RESULTS: One hundred sixty-five veterans (87% male, age 56 ± 15 years) were included: 66 reporting insomnia (40%). In logistic regression analysis, insomnia was significantly associated with post-traumatic seizure etiology, lamotrigine prescription, and mood and psychotic disorders. Female gender and levetiracetam treatment were associated with lower odds for insomnia. CONCLUSION: Insomnia was associated with post-traumatic epilepsy, mood/psychotic comorbidities, and antiepileptic regimen. Insomnia represents an under-recognized opportunity to improve comprehensive epilepsy care.

Sentinel node biopsy and quality of life measures in a Chinese population.

BACKGROUND: Sentinel lymph node biopsy (SLNB) has become an alternative procedure of axillary lymph node dissection (ALND) with a lower risk of significant operative morbidity. The primary aim of the present study was to evaluate the morbidity and quality-of-life (QoL) after SLNB or ALND. The second aim was to analyze whether the number of SLNs removed was associated with an increased incidence of postoperative morbidity. METHODS: From Apr-2006 to Aug-2007, 140 patients treated with SLNB and 81 patients treated with ALND were enrolled in the study. Patients' data were collected preoperatively and at 1, 6, and 12 months after operation. Measurement of arm volume and shoulder function, evaluation of subjective sensory abnormality of both arms and chest wall were performed at every follow-up visit. Besides, patients were required to fill out the simplified Chinese version of the functional assessment of cancer therapy-breast questionnaire at 12 months after operation. RESULTS: Patients treated with SLNB suffered less morbidity compared with ALND. Elevated body mass index and ALND procedure were independent risk factors associated with postoperative lymphedema. Moreover, patients treated with wide local excision or SLNB had better QoL compared with those treated with mastectomy or ALND. No relationship was observed between the number of SLNs and the morbidity or QoL. CONCLUSION: SLNB is associated with a better QoL and less morbidity compared with ALND regardless of the number of SLNs in Chinese women with breast cancer. To limit the number of SLNs less than five did not show any evidence to reduce morbidity.

Migration of ventriculoperitoneal shunt into the stomach, presenting with gastric bleeding.

We present an extremely rare complication after ventriculoperitoneal shunting. The peritoneal tube migrated into the stomach 8 months after the operation and patient presented with gastric bleeding.

Alcohol consumption and erectile dysfunction: meta-analysis of population-based studies.

Alcohol is long regarded as a risk factor for erectile dysfunction (ED), but epidemiological evidence has been equivocal. We aimed to investigate the ED risk associated with various levels of alcohol consumption by meta-analysis. We searched for population-based studies on ED through Medline, PubMed, PsychInfo, and scanned through reference lists. Eleven cross-sectional studies were included and analyzed with random effects model. We reviewed the results from one cross-sectional study and two cohort studies. Regular alcohol consumption was negatively associated with ED (odds ratio (OR)=0.79; 99% confidence interval (CI), 0.67-0.92; P<0.001). Consumption of 8 or more drinks/week significantly reduced the risk of ED (OR=0.85; 99% CI, 0.73-0.99; P=0.007), but consumption of less alcohol (1-7 drinks/week) was not significant (OR=0.73; 99% CI, 0.44, 1.20; P=0.101). Begg's test and Egger's test detected no significant publication bias. Our estimates (in sensitivity analyses) were rendered nonsignificant when International Index of Erectile Function definition was used and when statistical adjustment was made only for age. Meta-analysis of cross-sectional studies yielded a protective association of alcohol on ED, but the two cohort studies did not demonstrate any significant findings for alcohol consumption. More research is needed to confirm whether alcohol is protective or is unrelated to ED development.

Body mass index, physical activity and erectile dysfunction: an U-shaped relationship from population-based study.

OBJECTIVE: To investigate the relationships between body mass index (BMI), physical activity and erectile dysfunction (ED). DESIGN AND SUBJECTS: A population representative cross-sectional analytic study of ED in Hong Kong, with two-stage stratified random sampling, and face-to-face interviews conducted by trained interviewers with structured questionnaires. Study subjects were 1506 men aged 26-70. RESULTS: Age (odds ratio (OR)=1.30; 95% confidence interval (CI) 1.20-1.40), physical activity (OR=0.91 per 500 kcal/week; 95% CI 0.84-0.98), and general psychological distress (OR=1.03 per GHQ score; 95% CI 1.00-1.06) were independently associated with ED after multivariate adjustments. An U-shaped relationship between BMI and ED was observed only among men with no exercise ( or =25.0 (OR=2.47; 95% CI 1.08-5.67) using BMI 21.0-21.9 as reference, adjusted for age, GHQ and smoking status. Being physically active (> or =1000 kcal/week) only reduced the risk of ED (OR=0.40, 95% CI 0.16-0.95) in men who were obese, adjusted for age, GHQ, smoking status and BMI. CONCLUSIONS: BMI and physical activity independently and differentially affected ED risk. BMI had greatest influence with low physical activity, and physical activity exerted greatest influence when BMI was high. This is the first study to demonstrate an U-shaped relationship between BMI and ED risk, but only in men with no exercise, and to identify underweight as a risk factor for ED. This relationship has clinical implications for obese as well as underweight individuals.

Monthly income, standard of living and erectile function in late life.

This was a cross-sectional study that enrolled 160 men aged 50 and above who were sexually active (sexual intercourse in the preceding 6 months) from a large primary care treatment centre. The subjects of interest were elderly aged 65 and above, and men aged 50-65 were used for comparison. The overall response rate was 66.9%. The men who participated were generally more affluent. Standard of living was measured by the presence of maid and housing type. Erectile function (EF) score was significantly higher in those who hired maids (P=0.02). Housing type was not associated with erectile dysfunction (ED). In Model A (included both monthly income and education), significant non-parametric correlations were found between monthly income and EF, intercourse satisfaction (IS), orgasmic function (OF) and sexual desire (SD) domains. After statistical adjustments, only EF (P<0.01) and IS (P=0.04) remained positively associated with monthly income. OF was negatively associated with age (P<0.01) and diabetes (P=0.04), whereas SD was negatively associated with age (P<0.01) in the multivariate analysis. Overall satisfaction was not significantly associated with any factor. In Model B (excluded monthly income from analysis), education attainment was positively associated with OF (P=0.04), but was not significant after adjustment for multiple testing. In the final multivariate model, only monthly income (P<0.01) and age (P<0.01), but not education (P=0.47), remained significantly associated with EF. This study suggests the influence of social determinants on EF and that this influence can extend into late life.

Physical activity and erectile dysfunction: meta-analysis of population-based studies.

We searched for population-based cross-sectional studies, cohort studies and randomized controlled trials (RCTs) on erectile dysfunction (ED) through Medline, PubMed, PsychInfo and scanned though reference lists. Studies that did not include adjusted odds ratios (OR) of physical activity were excluded. Seven cross-sectional studies were suitable for meta-analysis, and the results from one cross-section study, two cohort studies and one RCT were summarized. Pooling the ORs using random effects models, we derived summary estimate for adjusted OR of physical activity in those with ED compared with those without ED, which was 0.53 (0.31, 0.91). Moderate and high physical activities were associated with a lower risk of ED, with ORs at 0.63 (0.43, 0.93) and 0.42 (0.22, 0.82), respectively. Funnel plot by visual inspection, and Begg's test and Egger's test did not detect significant publication bias. Sensitivity analyses revealed that the summary estimate from the random effects model was robust to changes in study sample size and level of statistical adjustment, but not so robust to changes in ED definition, although the summary estimate for each ED definition did not differ significantly. Although causality cannot be demonstrated from cross-sectional studies, the apparent 'protective' effect of physical activity on ED should be further investigated using large-scale cohort studies or RCTs.

Prevalence of erectile dysfunction in Asian populations: a meta-analysis.

We searched for published studies on the prevalence of erectile dysfunction (ED) in Asian populations, through Medline, PubMed, PsychInfo and scanned through reference lists. Data on prevalence rates were obtained and summarized for each Asian region, and were used to calculate pooled prevalence estimates using fixed and random effects models. As significant heterogeneity existed in certain age group categories, the random effects model was preferred. Twenty general population studies were identified. Six studies were eligible to be entered into the pooling of results, and provided 8653 subjects for analysis. The prevalence of ED increased with age. Pooled random effects age-specific prevalence rates were 15.1% (12.2-18.1), 29.6% (19.7-39.6), 40.6% (23.6-57.7), 54.3% (36.0-72.6) and 70.0% (62.3-77.7) for age groups 20-29, 30-39, 40-49, 50-59 and 60-69 years, respectively. Homogeneity of results in age groups 20-29 and 60-69 years suggested equally low and high prevalences of ED across Asian regions in these age groups, respectively. The overall reported prevalence in individual studies ranged from 2 to 81.8%. Prevalence rates and related information were summarized for each Asian region and for each study.

Computational hydrodynamics of animal swimming: boundary element method and three-dimensional vortex wake structure.

The slender body theory, lifting surface theories, and more recently panel methods and Navier-Stokes solvers have been used to study the hydrodynamics of fish swimming. This paper presents progress on swimming hydrodynamics using a boundary integral equation method (or boundary element method) based on potential flow model. The unsteady three-dimensional BEM code 3DynaFS that we developed and used is able to model realistic body geometries, arbitrary movements, and resulting wake evolution. Pressure distribution over the body surface, vorticity in the wake, and the velocity field around the body can be computed. The structure and dynamic behavior of the vortex wakes generated by the swimming body are responsible for the underlying fluid dynamic mechanisms to realize the high-efficiency propulsion and high-agility maneuvering. Three-dimensional vortex wake structures are not well known, although two-dimensional structures termed 'reverse Karman Vortex Street' have been observed and studied. In this paper, simulations about a swimming saithe (Pollachius virens) using our BEM code have demonstrated that undulatory swimming reduces three-dimensional effects due to substantially weakened tail tip vortex, resulting in a reverse Karman Vortex Street as the major flow pattern in the three-dimensional wake of an undulating swimming fish.

Adenovirus-Mediated MUC1 gene transduction into human blood-derived dendritic cells.

MUC1 protein is widely expressed on various human cancer cells and has a specific highly glycosylated core structure with multiple tandem repeats, which may include an immunogenic peptide sequence. The potency of MUC1 protein to induce human histocompatibility leukocyte antigen-class I-restricted cytotoxic T-lymphocyte (CTL) induction remains to be fully clarified in human beings. In the current study, we made MUC1-expressing human dendritic cells (DCs) using recombinant adenovirus vector. Adenovirus vector plasmid containing human MUC1 cDNA, pAdHM4-MUC1 was constructed using in vitro ligation with a shuttle vector, pHMCMV5. Adenovirus vector expressing MUC1 was generated by the transfection of PacI-digested recombinant vector plasmid into 293 cells. Human blood DCs were obtained from 7-day culture of monocytes with recombinant human (rh) granulocyte-macrophage (GM) colony-stimulating factor (CSF) and (rh)interleukin (IL)-4. Then, 1 x 10(6) DCs were incubated with viral supernatant at a multiplicity of infection of 200 for 24 h in the presence of rhGM-CSF and rhIL-4. Flow cytometric analysis showed that 30% to 40% of the transduced DCs expressed MUC I protein; by contrast, nontransduced or transduced DCs with mock virus expressed only small amounts of MUC1 protein. Adenovirus-mediated MUC1 gene transduction into DCs had no significant effect on DC surface marker expressions or functions such as mixed leukocyte reaction. Furthermore, MUCI-specific CD8+ CTLs could be induced from healthy donor blood lymphocytes using MUC1-expressing DCs as stimulators. These results suggested that MUC1 gene-transduced DCs are a functional and potent tool for triggering a CTL response against MUC1 cancer cells.

Height and weight change across menarche of schoolgirls with early menarche.

OBJECTIVE: To describe growth before and after menarche. DESIGN: Nine hundred five fourth grade school girls were identified as a closed cohort from the first semester of 1993 for the observational study of the onset of menarche and its predictive factors. SETTINGS: Eight elementary schools in Taipei City and Taipei County, Taiwan. MAIN OUTCOME MEASURES: Data were collected from self-administered questionnaires and school records. Height and weight were measured in September, January, February, and June, or only in September and February of each year. RESULTS: All subjects remained in the cohort until sixth grade, 410 of whom had their first menstruation before graduating from elementary school. Height, weight, and body mass index (calculated as weight in kilograms divided by the square of height in meters) at each time point were plotted against 2 time scales: chronological age and time from the onset of menarche. Growth velocity of height and weight across the onset of menarche was assessed with slope change using the mixed-effect model analysis. CONCLUSIONS: The results support the hypothesis that height velocity reaches a peak 1 year before menarche but height velocity stopped increasing within 1 year after menarche. The change in weight velocity reveals no obvious growth spurt at age of menarcheal onset.

Molecular defects in variant forms of mannose-binding protein associated with immunodeficiency.

Distinct molecular mechanisms underlying immunodeficiency caused by three different naturally occurring point mutations within the collagen-like domain of human mannose-binding protein (MBP; also known as mannose-binding lectin) have been revealed by introduction of analogous mutations into rat serum MBP. The change Arg23-->Cys results in a lower proportion of the large oligomers most efficient at activating the complement cascade. The presence of cysteine at position 23, which forms aberrant interchain disulfide bonds, causes disruption of the normal oligomeric state. The deficiency in MBPs containing Gly25-->Asp and Gly28-->Glu substitutions also results in part from reduced formation of higher oligomers. However, decreased ability to interact with downstream components of the complement cascade due to changes in both the N-terminal disulfide-bonding arrangement and the local structure of the collagenous domain make more important contributions to the loss of activity in these mutants.

Epstein-Barr virus LMP1 modulates the malignant potential of gastric carcinoma cells involving apoptosis.

About 10% of gastric carcinomas including lymphoepithelioma-like carcinoma and adenocarcinoma are associated with Epstein-Barr virus (EBV) infection. In EBV-associated gastric carcinomas, the tumor cells express Epstein-Barr nuclear antigen 1 (EBNA-1) but not EBNA-2, -3A, -3B, or -3C, leader protein, or latent membrane proteins (LMPs) because of gene methylation. Only a few exceptional cases have LMP1 expression in tumor cells as demonstrated by immunohistochemical studies. To elucidate the biological effects of LMP1 and the significance of its restricted expression in EBV-associated gastric carcinomas, the LMP1 gene was transferred into EBV-negative gastric carcinoma cell lines (SCM1 and TMC1) and into EBV-negative nasopharyngeal carcinoma (NPC) cells (HONE-1) as a control. The biological effects of LMP1 in gastric carcinoma cells were monitored in vitro and in vivo. These results showed that the consequence of LMP1 expression is a growth enhancement in NPC cells, but it is a growth suppression in gastric carcinoma cells. The LMP1-expressing gastric carcinoma cells had a reduced growth rate, colony-forming efficiency, mean colony size, and tumorigenicity and a lower malignant cytological grade. The reduced growth rate, colony-forming efficiency, and mean colony size were partially reversible in vitro with treatment with LMP1 antisense oligonucleotide. In addition, enhanced apoptosis was found in the LMP1-expressing gastric carcinoma cells. This suggests that LMP1 may negatively modulate the malignant potential of gastric carcinoma cells via an enhancement of apoptosis. We concluded that the restriction of LMP1 expression in EBV-associated gastric carcinomas may lead to a growth advantage for tumor cells by avoiding LMP1 apoptotic effects and immunologically mediated elimination.

Expression of p53 protein in colorectal carcinoids.

OBJECTIVE: To determine the frequency and prognostic significance of p53 protein expression in colorectal carcinoid tumors. DESIGN: Thirty-one paraffin-embedded specimens of colorectal carcinoid tumor were studied by immunohistochemical staining to detect p53 protein expression. The association of p53 expression with tumor site, tumor size, invasion level, tumor stage, DNA pattern, and patient survival were analyzed. RESULTS: p53 protein was detected in five (16%) of 31 colorectal carcinoid tumors. There was a correlation between p53 overexpression and tumor site, tumor size, tumor stage, and DNA ploidy (P < .05) but not for the depth of tumor invasion (P = .06). In addition to tumor size, invasion, stage, and DNA aneuploidy, p53 protein overexpression was also indicative of a poor prognosis (P < .001). CONCLUSIONS: The overexpression of p53 protein is uncommon in colorectal carcinoid tumors. However, the expression of p53 protein has a correlation with clinicopathologic-predicting criteria in colorectal carcinoid tumors and may be used as an associated prognostic parameter to assess patient survival.

Optimal dose of garlic to inhibit dimethylhydrazine-induced colon cancer.

This study was designed to investigate the optimal dose of garlic during long-term feeding and its preventive and therapeutic effects on colon cancer in rats induced by 1,2-dimethylhydrazine (DMH). A total of 240 male Sprague-Dawley rats were grouped and fed with either a basal or a garlic diet of different concentration, and some groups were subcutaneously injected with DMH 20 mg/kg once a week for 20 weeks. The incidence of colon tumor was significantly decreased in the groups fed with 2.5%, 5%, and 10% garlic diets (p < 0.001). There was no distinct difference among these concentrations (p > 0.05). Therefore the minimal optimal dose of garlic to inhibit colon cancer was 2.5%. The equivalent dose of this concentration in humans is 4.76 g/m2 body surface/day. In a therapeutic study, the tumor-inducing interval in nude mice subcutaneously injected with colon cancer cells (CC-M2) was prolonged by a 2.5% garlic diet (p < 0.01). Thus smaller tumor volume and longer survival time were found in the garlic group than in the controls (p < 0.01). However, the growth rate of tumors was not markedly inhibited by garlic. All rats finally died within 18 weeks. This study suggested that a 2.5% garlic dose may be used mainly as an inhibitor to prevent colon cancers and improve survival time.

Detection of human papillomavirus DNA in colorectal carcinomas by polymerase chain reaction.

Human papillomaviruses (HPVs) are associated with a number of benign and malignant neoplasms. To substantiate the relationship between HPV DNA and colorectal carcinomas, 70 carcinomas and 37 adenomas were analysed in this study. Specific types of HPV DNA in colorectal tumours were detected by polymerase chain reaction (PCR) and Southern blot hybridisation. HPV DNA was detected in 11 of 37 (29.7%) adenomas and in 52.9% 37 of 70 (52.9%) of carcinomas. The expression of HPV DNA in adenomas and carcinomas, especially that of HPV 16 in HPV positive cases (4 of 11 v 26 of 37), was significantly different (p < 0.05). There was no correlation, however, between HPV and the location, differentiation, stage, or survival of malignant neoplasms. These data suggest that HPV DNA, especially type 16, is associated with colorectal carcinogenesis.