The effect of family violence on children's academic performance and behavior.

Homicide perpetrated by an acquaintance or a close family member is the leading cause of death among blacks. Black children adversely affected by these violent occurrences suffer posttraumatic stress disorder. The purpose of this study is to illustrate how damage caused to black children from exposure to violence is reflected in behavior problems and poor school performance.

Human papillomavirus types 6 and 16 in multifocal intraepithelial neoplasias of the female lower genital tract.

Five women with multifocal intraepithelial neoplasia of the lower genital tract were investigated for the presence of human papillomavirus (HPV) infection by the method of DNA-DNA hybridization which detects the viral DNA. The DNA sequences of HPV types 6 and 16 were detected in each of the five patients and in each of the areas biopsied: cervix, vagina and vulva. DNA sequences of both viral types were also found in vulval intraepithelial neoplasia grades I-III and in cervical intraepithelial neoplasia grades I and III. The detection of HPV DNAs in multifocal lesions suggests a possible common aetiology for the lower genital tract intraepithelial neoplasias.

Human papillomavirus infection of the uterine cervix: histological appearances in 28 cases identified by immunohistochemical techniques.

Twenty eight biopsy specimens of the cervix showed positive immunohistochemical staining when treated with an antiserum raised against an internal capsid antigen of human papillomavirus (HPV). Histological examination of adjoining sections from the same blocks showed a much wider range of abnormalities than those already described in association with HPV infection. The picture was usually diagnostic. It rested chiefly on identifying the koilocyte--the cell with the perinuclear halo that carries the viral antigen in its nucleus--but abnormal keratinisation was also a feature. The accompanying epithelial findings ranged from normal to CIN III (cervical intraepithelial neoplasia). The latter was of an unusual but distinct appearance, in which cytoplasmic maturation was preserved to some degree but in which gross nuclear atypia was seen in all layers of the epithelium.

Colposcopy in the diagnosis of papillomavirus infection of the uterine cervix.

Morphological criteria are described for the diagnosis of papillomavirus lesions at colposcopy. Using these criteria, evidence of cervical papillomavirus infection was found in 58 (29.0%) of 200 women referred for colposcopy because of an abnormal cytology report. Directed biopsies were obtained from 152 of these patients and histological changes suggestive of papillomavirus infection were found in 47 (30.9%); additional biopsy material from 139 was studied using an immunohistochemical technique and human papillomavirus antigen was demonstrated in 28 (20.1%). Comparison between the colposcopic results and those obtained by histology suggests that whereas it is not possible to make a distinction at colposcopy between lesions due to papillomavirus and those of cervical intraepithelial neoplasia, it is possible to identify those epithelial abnormalities that are most likely to be associated with a papillomavirus infection.

Natural history of cervical epithelial abnormalities in patients with vulval warts. A colposcopic study.

The natural history of intraepithelial abnormalities of the cervix associated with human papillomavirus infection was investigated in a prospective study of 50 women with vulval warts, of whom 28 had colposcopic evidence of a cervical epithelial abnormality and 22 a normal cervix. Of the 28 with a cervical abnormality, 26 were re-examined by colposcopy after three months; the epithelial abnormality had persisted in 23 women. Nineteen women who had initially shown abnormality by colposcopy were re-examined six months after their first attendance; the epithelial abnormality had persisted in 14 women. Of the 22 women who initially had a normal cervix, 19 were re-examined after three months; the cervix remained normal in 18, but an epithelial abnormality had developed in one. Fourteen women who initially had a normal cervix were re-examined six months after their first attendance; the cervix was still normal in 11, but an epithelial abnormality had developed in three. Colposcopically directed biopsy specimens were obtained from 21 women who showed an epithelial abnormality; of these, evidence of wart virus infection was present in four, cervical intraepithelial neoplasia in two, both conditions in 13, and no abnormality in two. It is concluded that lesions of the cervix associated with wart virus infection show little evidence of short term regression.

Presence of human papillomavirus DNA sequences in cervical intraepithelial neoplasia.

Twenty two patients referred to a district colposcopy clinic because of an abnormal cervical cytology report or a suspicious cervix and found to have a cervical epithelial abnormality were studied. The techniques of cytology, histology, immunohistochemistry, and DNA-DNA hybridisation were used to detect infection by human papillomavirus. Using an indirect immunoalkaline phosphatase technique human papillomavirus antigen was found in biopsy specimens from six of the 22 patients and DNA of papillomavirus type 6 in biopsy specimens from 13 of these women, including four out of six whose histological diagnosis was cervical intraepithelial neoplasia grade 3. In eight cases where cytological, colposcopical, and histological investigations all indicated the presence of wart virus infection, papillomavirus type 6 DNA was found in seven. Papillomavirus type 6 DNA was found in more than half of the proved cases of cervical intraepithelial neoplasia. The presence of this viral DNA in women with no cervical abnormality is to be studied.

Herniation of mucosal epithelium into the submucosa in chronic ulcerative colitis.

Herniation of the glandular epithelium into the submucosa has been observed in 11 out of 27 cases of chronic ulcerative colitis. Glandular herniation was associated with thickening of the muscularis mucosae, with interruption of the muscularis mucosae by lymphoid follicles, and, in five of the 11 cases, with significant crowding of the glands of the mucosa. This study strongly suggests that sustained contraction of the muscularis mucosae, which has been shown by others to be a major feature of chronic ulcerative colitis, is the prime factor in the formation of downgrowths or herniations of the glandular epithelium into the submucosa. Comparison of the cases in which cancer developed with those where there was glandular herniation led to the conclusion that they are independent associations of chronic ulcerative colitis, and that glandular herniation plays no part in the development of dysplasia or cancer.

Factors influencing survival in carcinoma of the ovary.

Three hundred and nineteen patients with primary adenocarcinoma of the ovary were studied to define those factors, many of them histopathological, which influence survival. The paper considers the stage of spread at the time of operation, the histological type of the tumour, its grade and in particular its mitotic activity, which proved a significant feature per se in assessing prognosis in ovarian cancer.