Human papillomaviruses in oral squamous cell carcinoma and pre-cancerous lesions detected by PCR-based gene-chip array.

Human papillomavirus (HPV) infection is a significant risk factor for uterine cervical carcinoma. Many studies have also demonstrated the presence of HPV in oral epithelia tissue, but the role of HPV infection in oral squamous cell carcinoma (OSCC) is still controversial. The aim of this study was to determine the frequency and type of HPV in OSCC and oral pre-cancerous lesions. DNA samples were collected by cytobrushing from 51 patients with OSCC, 46 with oral pre-cancerous lesions and 90 normal controls. Nested polymerase chain reaction and gene-chip arrays were used to identify the HPV types in the samples. In pre-cancerous lesions, there was a higher frequency of HPV of any type (14/46, OR = 2.844, CI = 1.186-6.816, P = 0.0216) and of low-risk HPV types (9/46, OR = 5.529, CI = 1.597-19.14, P = 0.0096) than in control samples. The prevalence of high-risk types was significantly higher in OSCC than in control lesions (11/51 vs 8/90, OR = 2.819, CI = 1.051-7.558, P = 0.0420) but this was not the case for HPV of any type (13/51 vs 12/90, OR = 2.244, CI = 0.9266-5.337, P = 0.1066). High-risk HPV types are prevalent in OSCC and may play a role in its progression, while low-risk types are associated with oral pre-cancerous lesions.

Actinomycosis affecting the fallopian tube and ovary: report of 3 cases, with special reference to 2 cases following IUD application.

PIP: Since the late 1970s, pelvic actinomycosis in association with IUD use has been a not infrequent complication in the US and Europe. In contrast, only 3 cases of pelvic actinomycosis have been reported from Taiwan over the past 40 years. IUD use was present in 2 of these cases (for 13 months and 5 years, respectively); the 3rd patient had never been an IUD user. These 3 cases were detected by sulfur granules and histology. Pathologic signs included pymetra containing pus with sulfur granules, branching of actinomyces, chronic inflammation of the bilateral fallopian tubes and ovaries, liquefaction necrosis, and tubo-ovarian abscesses. Penicillin and tetracycline were administered; the postoperative course was uneventful. The longterm presence of an IUD is believed to facilitate actinomycosis given the preexistence of other anaerobic infection or endometrial injury. In the 1 Taiwanese case where there was a history of IUD use, infection may have penetrated from the anorectum; in the 2nd such case, the intestinal route seemed likely. The low incidence of pelvic actinomycosis in Taiwan occurs against a backdrop of widespread IUD use (136,200 IUD insertions in Taiwan Province in 1986). It remains unclear whether the rarity of pelvic actinomycosis in this setting reflects underdiagnosis, life style factors, or racial differences in sexual behavior.^ieng

Prevention of perinatally transmitted hepatitis B virus infections with hepatitis B immune globulin and hepatitis B vaccine.

A randomised blind controlled trial of hepatitis B immune globulin (HBIG) plus hepatitis B vaccine for the prevention of the perinatally transmitted HBsAg carrier state was conducted in Taipei. Infants of e-antigen-positive HBsAg carrier mothers were given HBIG immediately after birth, and then one of three schedules of vaccination. There was no difference in efficacy between the three schedules; the combined efficacy was 94%, compared with that of HBIG alone (71%) or of vaccination alone (75%). Persistent HBs antigenaemia developed in only 9 (6%) of the 159 infants receiving prophylaxis, but in 88% of the controls. Antibodies developed in all those who did not become antigenaemic and presumably will provide long-term protection from hepatitis B virus infection. HBIG should be given as soon as possible after birth and need not be given again if the infant is subsequently vaccinated. With HBIG coverage from birth, the timing of the start of vaccination does not seem to be of importance within the first month of life, but to maximise compliance and minimise costs hepatitis B vaccination should be initiated during the confinement.