Influence of co-infection complicated with human papillomavirus on cervical intraepithelial neoplasia development in patients with atypical squamous cells of undetermined significance.

AIM: Human papillomaviruses (HPV) infection is a primary cause of the development of cervical precancerous lesions and cervical cancer. However, the influence of other infections on intraepithelial neoplasia (CIN) development has not been fully elucidated. We evaluated the association between co-infection and CIN development in subjects with atypical squamous cells of undetermined significance (ASCUS). METHOD: Data for ASCUS subjects who had undergone testing for high risk HPV (HR-HPV) and pathological diagnosis were analyzed. From the CIN grade, HR-HPV and vaginal infection (VI) data, both the relationship between HPV infection and CIN development and the influence of co-infection on CIN were retrospectively evaluated. RESULTS: Data for 56 ASCUS subjects who had undergone HR-HPV testing and cytological diagnosis were analyzed. Positive rates were HPV (73.2%), HPV16 (21.4%), HPV18 (7.1%), and HPV16 and/or 18 (26.8%). Seventeen of the subjects were diagnosed as having one or more VI pathogen; the major pathogens found were Candida spp., Gardnerella vaginalis, group B streptococcus, coagulase negative Staphylococcus, and Chlamydia trachomatis. The rate of CIN 2 or worse (≥CIN 2) was significantly higher in subjects positive for HPV16 compared with HPV negative subjects, and was significantly higher in subjects with a VI complicated with HPV compared to those without a VI. Univariate and multivariate logistic regression analysis identified positive for HPV16 and/or 18 and positive for VI to be significant variables for ≥ CIN 2. CONCLUSION: Our results indicate that having a vaginal infection complicated with HR-HPV affects the development of CIN in subjects with ASCUS cytology.

Use of fibrin monomer complex for screening for venous thromboembolism in the late pregnancy and post-partum period.

AIM: We measured fibrin monomer complex (FMC) levels in all subjects who gave birth at our hospital and evaluated the feasibility of using FMC for screening for venous thromboembolism (VTE) in patients during late pregnancy and the post-partum period. METHODS: From August 2010 to January 2012, all women who gave birth at our hospital were included. FMC and D-dimer levels were determined during the late pregnancy and post-partum periods. Compression ultrasonography of the lower extremities was performed in women with high FMC values. RESULTS: Of the 673 women enrolled, measurements were performed in 595 women (88.4%) during late pregnancy and in 610 women (90.6%) during the post-partum period. The FMC levels were normal during late pregnancy in 400 women (67.2%) and during the post-partum period in 399 women (78.5%) having vaginal delivery and 83 women (81.4%) who underwent a cesarean section. The FMC levels were abnormal during late pregnancy in 50 women (8.4%) and during the post-partum period in nine women (1.8%) having vaginal delivery and in none (0%) who underwent a cesarean section. Ultrasonography detected thrombi in three (6.0%) women during late pregnancy. The FMC levels were strongly correlated with D-dimer levels (R = 0.726, P < 0.0001, in late pregnancy; and R = 0.888, P < 0.0001, in the post-partum period following vaginal delivery). CONCLUSION: FMC levels could identify pregnancy-related abnormalities requiring compression ultrasonography examination, without changing the cut-off values for non-pregnant individuals. Thus, this marker may be used to screen for VTE.

Expression of various types of alternatively spliced WAPL transcripts in human cervical epithelia.

We have previously identified a novel gene WAPL that is inducible by human papillomavirus (HPV) E6 and E7 oncoproteins, and is associated with uterine cervical carcinogenesis. A WAPL splice variant named Friend of EBNA2 (FOE) has also been characterized as a binding partner of the Epstein-Barr virus transformation-related protein EBNA2. On the other hand, recent studies have revealed that WAPL is a cohesin-binding protein and promotes sister-chromatid resolution in mitotic prophase. These data demonstrate that WAPL plays an important role in tumorigenesis and cell cycle progression. In this study, we have isolated a large number of additional alternatively spliced WAPL variants from various cervical epithelia. Each variant consists of a variable 5'-terminal region and the conserved remainder. In addition, we have confirmed the genomic organization of the 5'-region of the WAPL gene, and have investigated the characteristic features of the WAPL variants and their products. Furthermore, we have determined the HPV types of the expressed E6/E7 transcripts in the cervical epithelia with a novel PCR protocol. These results should shed light on a novel aspect of WAPL function.

Retained lipiodized oil misdiagnosed as residual metallic material.

Retained foreign material is one of the most common issues in medical malpractice lawsuits. We report here a case in which an extremely high-density material was found within the pelvis, which proved to be harmless residual lipiodized oil. Although there have been reports of lipiodized oil being retained within the fallopian tube for more than 25 years, to our knowledge there have been no previous reports of lipiodized oil retention in areas other than the genital tract.