Are acetowhite lesions of the cervix correlated to the presence of Epstein-Barr virus DNA?

The purpose of this study was to investigate whether Epstein-Barr virus (EBV) is associated with acetowhite lesions of the portio cervix, demonstrating koilocytosis and/or cervical intraepithelial neoplasia (CIN) I-III. The study group comprised 37 women admitted to the Department of Gynaecology and Obstetrics, Sahlgrenska University Hospital, Göteborg because of pathological colposcopy or cytology of the portio cervix. Colposcopically, all exhibited acetowhite lesions of the portio cervix. Cells were sampled with a cytobrush for examination for EBV and human papillomavirus (HPV) DNA by polymerase chain reaction (PCR) and a biopsy was taken for histopathology. Biopsies from 5 patients positive for EBV by PCR in cervical cell samples were examined by an in situ hybridization technique for EBER (Epstein-Barr virus encoded RNA), RNAs expressed in latent EBV infection. The control group consisted of women attending the Department of Dermato-Venereology at the same hospital for STD check-up. These had a normal cytology and no signs of acetowhiteness of the portio cervix. In the study group, EBV DNA was found in 30% and HPV DNA in 51%. In the control group 57% exhibited EBV DNA and 23% HPV DNA. EBV was not found to be a predictive factor in the development of koilocytosis and/or CIN I-III. HPV was a predictive factor in acetowhite, koilocytotic lesions. No expression of EBER was found in the 5 biopsies examined by in situ hybridization.

Inflammatory signs in wet smear and Pap-smear compared with the histopathology from the female lower genital tract.

In order to define the relationship between various criteria of female lower genital tract inflammation, we examined wet smears, cervical smears and biopsies from 131 patients. The presence of clue cells in rehydrated dry smears showed a positive correlation to the presence of clue cells in Papanicolaou stained smears, and to some extent with cytological evidence of inflammation (Kappa 0.48). Cytological inflammatory findings correlated well with the presence of clue cells in rehydrated dry smears, but signs of inflammation diagnosed by histopathology did not correspond to findings in cytological smears, probably because these methods reveal inflammation at different sites.

Polymerase chain reaction for monitoring human papillomavirus contamination of medical personnel during treatment of genital warts with CO2 laser and electrocoagulation.

Genital warts and intraepithelial neoplasia caused by infection with human papillomavirus are usually treated with CO2 laser or electrocoagulation. In this study, contamination of personnel and operating theatres with human papillomavirus DNA during treatment sessions was investigated. Samples were taken from the nostrils, nasolabial folds and conjunctiva of the operating physician before and after operating sessions and from Petri dishes left open in the operating theatres. Human papillomavirus DNA was demonstrated by the polymerase chain reaction technique. The results show that there is a risk of contamination of the operator by human papillomavirus DNA, detectable with the polymerase chain reaction technique, during both CO2 laser and electrocoagulation treatment.

High prevalence of cervical dysplasia in female consorts of men with genital warts.

Altogether 51 regular female consorts of men attending a venereal disease clinic for genital warts were examined using colposcopy, vaginal cytology and--when needed--surgical biopsy. Abnormal cytological smears were found in 18 out of 49 consorts (37%), which should be compared with 8 out of 124 (6%) matched female controls from a family planning clinic (p less than 0.001). Possibly premalignant lesions, i.e. atypical condylomata and/or frank dysplasia, were found in 14 (27%) out of 51 consorts. The prevalence of abnormal smears or biopsy-proven dysplasia was approximately the same in consorts with and without external warts. These findings call for close attention to the risk of development of cervical dysplasia in female consorts of men with genital warts.

Vaginitis emphysematosa in a renal transplant patient.

Transplant surgery is now a widely established practice and the associated immunosuppressive treatment is followed by various complications. The present report on vaginitis emphysematosa in a woman with renal transplantation indicates that even this benign condition may have a connection with immunosuppressive therapy.

Histamine metabolism during the menstrual cycle.

The urinary excretion of histamine and its metabolites methylhistamine (MeHi) and methylimidazoleacetic acid (MeImAA) was measured during the menstrual cycle in nine healthy women, one allergic woman and three non-pregnant women with anovulatory regular cycles. Simultaneous urinary analyses of luteinizing hormone (LH) and total estrogens were performed. The healthy women showed individual variations in the excretion of histamine, MeHi and MeImAA. This observation has been interpreted as an expression of minor individual differences in the catabolism of histamine. At midcycle an increase in the urinary excretion of histamine metabolites was sometimes evident and a statistically significant correlation could be established between MeHi and estrogen in urine. These results may support previous findings of histamine release by estrogens in uterine tissue but may also reflect an elevated histamine formation. The allergic woman excreted constantly increased amounts of histamine and its metabolites, especially when her allergic symptoms became aggravated pre-menstrually. She did not exhibit any change in MeImAA excretion at midcycle but the MeHi-excretion varied with the excretion of estrogens in the urine. The subjects with anovulatory menstrual cycles had low values of histamine and metabolites although within the normal variations.

PIP: The urinary excretion of histamine and its metabolites methylhistamine (MeHi) and methylimidazoleacetic acid (MeImAA) was measured during the menstrual cycle in 9 healthy women, 1 allergic woman, and 3 nonpregnant women with anovulatory regular cycles. Simultaneous urinary analyses of luteinizing hormone (LH) and total estrogens were performed. The healthy women showed individual variations in the excretion of histamine, MeHi and MeImAA. This observation has been interpreted as an expression of minor individual differences in the catabolism of histamine. At midcycle an increase in the urinary excretion of histamine metabolites was sometimes evident and a statistically significant correlation could be established between MeHi and estrogen in urine. These results may support previous findings of histamine release by estrogens in uterine tissue but may also reflect an elevated histamine formation. The allergic woman excreted constantly increased amounts of histamine and its metabolites, especially when her allergic symptoms became aggravated premenstrually. She was without any change in MeImAA excretion at midcycle but the MeHi excretion varied with the excretion of estrogens in the urine. The subjects with anovulatory menstrual cycles had low values of histamine and metabolites although within the normal variations.

Histamine metabolism and female sex hormones in women.

Oral combined contraceptives did not seem to alter histamine metabolism in females. During treatment with gonadotrophic hormones in four amenorrhoeic patients there was a tendency towards increasing excretion of methylhistamine (MeHi) followed by a sudden decrease corresponding to changes in the urinary estrogen. The excretion of methylimidazoleacetic acid (MeImAA) seemed to parallel that of MeHi. The findings support the hypothesis that an endogenous surge of estrogen may influence histamine turnover in women. Women of post-menopausal age have about the same histamine metabolism as younger menstruating women. Estrogen medication relieved symptoms of hot flushes or sweats but did not seem to affect the histamine turnover.

Effects of female sex hormones on histamine metabolism in guinea-pigs.

Determination of the urinary excretion of histamine and methylhistamine was performed in intact and gonadectomized male and female guinea-pigs. The excretion of methylhistamine varied more than that of histamine both in the same animal and between different animals. The urinary excretion of histamine and methylhistamine reflects fairly well the total histamine turnover in the animal, provided that aminoguanidine is administered to inhibit diamine oxidase activity. There was no sex difference in the excretion of histamine and methylhistamine and gonadectomy did not influence the urinary output. Female sex steroids had little ifany effect upon histamine turnover in the guinea-pig which is in contrast to the situation in rats and mice.