Large loop excision of the transformation zone in patients with exocervical squamous intraepithelial lesions.

This study was undertaken to determine factors influencing the success of loop excisions. One hundred twenty-seven women with exocervical intraepithelial lesions underwent large loop excision of the transformation zone (LLETZ); 102 returned for evaluation at 3 months. The pretreatment biopsies were low grade squamous intraepithelial lesions (LGSIL) in 37 cases and high grade squamous intraepithelial lesions (HGSIL) in 90. For the 37 women with LGSIL, the LLETZ specimen revealed no residual SIL in 13 (35%), LGSIL in 16 (43%), and HGSIL in 8 (22%). For the 90 women with HGSIL on pretreatment biopsy, 17 (19%) had no SIL, 10 (11%) had LGSIL, and 63 (70%) had HGSIL. Of the 102 women who returned for reevaluation, colposcopy was satisfactory in 89. There were 9 failures and all of these occurred in women with HGSIL in the LLETZ specimen. In the 17 women with involved margins there were 6 failures (35%); in the 85 women with uninvolved margins there were 3 failures (4%) (p = 0.005). The success of loop excisions is influenced by the grade of intraepithelial neoplasia and status of the margins of the LLETZ specimen.

Dysgerminoma of the ovary associated with hypercalcemia.

A 19-year-old female presented with a 3-week history of abdominal swelling, polydipsia, and polyuria. Ultrasound examination disclosed a right adnexal mass. Preoperative workup showed that the serum calcium level was evaluated to 12.2 mg/dl. Laparotomy disclosed a right ovarian tumor and a right salpingo-oophorectomy was performed. The serum calcium level fell to within the normal range postoperatively. The ovarian tumor was a typical dysgerminoma on both gross and microscopic examination. The majority of ovarian tumors associated with paraneoplastic hypercalcemia in young females are small cell carcinomas of hypercalcemic type. It is important, however, for pathologists to be aware that the dysgerminoma is the second most common ovarian neoplasm associated with hypercalcemia in this age group, as diagnostic confusion between these two tumors may rarely occur on microscopic examination. The literature on ovarian tumors associated with hypercalcemia is briefly reviewed.

Enhancement of influenza virus infections by secalonic acid D.

Secalonic acid D (SAD), a hepatotoxic, teratogenic, and slightly mutagenic metabolite of Penicillium oxalicum has been identified as a natural contaminant of grain dust. Secalonic acid D was administered intraperitoneally to male ICR mice that were exposed to influenza virus aerosols 5 days earlier. The mortality rate was significantly higher (p less than 0.001) in mice subjected to both influenza and SAD than those subjected to influenza alone. Virus titers in lung tissue samples at selected time intervals appeared similar for both influenza and influenza-SAD treated groups of mice for 9 days after exposure to the virus. After 9 days, influenza-SAD treated mice appeared to have higher virus titers. No difference in the pathological progression of pneumonia was discernible between these two groups of mice. The influenza-SAD group, in addition to pneumonia, exhibited severe hepatic necrosis characteristic of SAD administration. Mice infected with influenza virus followed by administration of SAD responded with significantly lower (p less than 0.05) antibody titers to influenza virus than mice exposed to influenza virus alone.