Appearance of levator ani muscle subdivision defects on level III vaginal support structures in women with and without pelvic organ prolapse: an MRI study.

INTRODUCTION AND HYPOTHESIS: Injury of the levator ani muscle (LAM) is a significant risk factor for pelvic organ prolapse (POP). The puborectalis (PRM) and pubovisceral (PVM) subdivisions are level III vaginal support structures. The null hypothesis was that there is no significant difference in patterns of LAM subdivisions in healthy nulliparous women. Secondarily, we evaluated the presence of different LAM injury in a POP-symptomatic cohort. METHODS: This retrospective magnetic resonance imaging study included: 64 nulligravidae without any pelvic floor dysfunction (PFD) and 526 women of various parity with symptomatic POP. Primary outcome was PVM and PRM morphology on the axial planes: the attachment site on the pubic bone, and the visible separation/border between the PVM and PRM. The attachment was scored as "normal" or "abnormal". The "abnormal" attachment was divided in two types: "type I"-loss of the muscle substance, but preservation of the overall muscle architecture-and "type II"-muscle detachment from the pubic bone. RESULTS: The puboanal muscle (PAM) subdivision was evaluated as a representative part of the PVM. The PAM and PRM attachments and separation were distinguished in all asymptomatic nulliparae. PAM and PRM attachments did not significantly differ. POP group characteristics were parity 1.9 ± 0.8, instrumental delivery 5.6%, hysterectomy or POP surgery 60%, all Pelvic Organ Prolapse Quantification (POP-Q) stages, LAM defect 77.6% (PRM: 77.1%; PAM: 51.3%). Type I injuries were more frequent (PRM 54.7%; PAM 53.9%) compared with type II (PRM 29.4%; PAM 42.1%). CONCLUSIONS: A LAM defect was present in 77.6% of women with symptomatic POP. In PRM and PAM subdivisions type I injury was more frequent than type II.

[MRI analysis of the musculo-fascial component of pelvic floor in woman before planned vaginal reconstruction procedur for symptomatic pelvic organ prolapse]. / Analýza stavu muskulo-fasciální slozky pánevního dna pomocí MRI u pacientek pred plánovaným vaginálním rekonstrukcním výkonem pro symptomatický sestup pánevního dna.

OBJECTIVE: The aim of the study is to analyse the musculo-fascial component of the pelvic floor in symptomatic group of woman with pelvic organ prolapse before planned vaginal reconstruction using synthetic vaginal mesh. DESIGN: Observational cohort study. SETTING: Department of Obstetrics and Gynaecology, Hospital in Frýdek-Místek; GONA Ltd, Prague; Institute for Care of Mother and Child, Prague; 3rd Faculty of Medicine CHU Prague. METHODOLOGY: The study involved 285 female volunteers (6 nulliparous, all other patients gave birth vaginally at least once) that in the period 2008-2015 before the planned reconstructive vaginal operations have undergone a comprehensive urogynaecology examination supplemented by magnetic resonance imaging (MRI) of the pelvic floor. Assessed was musculofascial component of the pelvic floor containing -musculus levator ani (MLA), endopelvic fascia (EF) and sacrouterine ligaments (SUL). MLA and EF were evaluated at two levels. The first level corresponds to the puborectalis muscle (evaluation of MRI trauma stage and avulsion), the second level correspondes to the iliococcygeus muscule (evaluation only avulsion injury to the muscle). RESULTS: Normal appereance of musculus puborectalis (level 1) was captured only in 25 (8.8) women. In 117 (41.1%) of women were present MRI minor trauma, 143 (50,2%) women were present with MRI major trauma. Avulsion of the muscle was captured in 85 cases (29.8%) at level 1 and in 165 cases (57.9%) in level 2. Preserved architecture of the EF was caught only 99 (34.7%) of the cases in level 1 and in 47 cases (16.5%) in level 2. Sacrouterine ligaments showed normal morphology in 100 cases (35.1%).Conslusion: Defects of musculofascial component of the pelvic floor is found frequently in women with symptomatic pelvic organ prolapse. Often a combination of defects MLA, EF and SUL are found. These comprehensive pelvic floor defects require careful urogynecological examination and planing operating methods with a view to minimizing the likelihood of recurrence of the descent. In indicated cases the use of the synthetic vaginal mesh is as a method of first choice.

[The results of five years follow-up prospective study of vaginal prolapse repaired by prolift total mesh surgery or sacrospinous fixation]. / Resení sestupu trí kompartmentu pomocí syntetického implantátu a sakrospinózní fixace: kohortová prospektivní studie s délkou follow-up peti let.

OBJECTIVE: The aim of the study is to compare the results of five years follow-up prospective study of vaginal prolapse repaired by prolift total mesh surgery or sacrospinous fixation. STUDY DESIGN: A single-center prospective, cohort study, in patients with defect grade II and more by POP-Q. SETTING: The Institute for the Care of Mather and Child; 3rd Medical Faculty Charles university, Prague. METHODS: Comparison of the preoperative state and the five years after the operation according POP Q, ICIQ-SF, PISQ 12, VAS. Comparison of intraoperative and postoperative complications. RESULTS: The study was attended by 142 patients; 75 patients underwent surgery Prolift Total and 67 patients sacrospinous fixation by Amreich Richter. On clinical examination at 5-year follow-up, we observed 15 (20.0%) case of anatomical failure in the Prolift group and 30 (44.8%) in the SSF group. Anatomic failure was defined clinically as Ba, C or Bp at the hymen or below. In assessing the overall condition before and five years after surgery using a VAS occurred in patients in the cohort Prolift Total decrease to 2.9 (± 1.9) from the original 7.8 (± 1.8). VAS in SSF group decreased after 5 years to 4.2 (± 2.7) of the original 7.8 (± 1.4). Values ICIQ-SF, analyzing the state of voiding PT group showed a decline from the original 6.7 (± 6.9) to 5.5 (± 5.3). A similar trend was evident even after the SSF. Parameters questionnaire PISQ-12 showed a positive increase from the original 28.6 (± 9.5) to 31.8 (± 7.9) points. PISQ-12 was improved from 28.7 (± 9.8) to 32.2 (± 7.5). CONCLUSION: Recurrences were observed more frequently in patients after sacrospinous fixation, while the quality of life questionnaires yielded comparable postoperative results. Quantity of intraoperative complications is low and both groups do not differ.

[Reconstruction of the posterior and central compartment with the Prolift Posterior: cohort study with a 5-year follow-up]. / Rekonstrukce defektu zadního a stredního kompartmentu pomocí kotveného implantátu Prolift Posterior: kohortová studie s petiletým follow-up.

OBJECTIVE: To analyse the results of the long-term prospective follow-up study of vaginal prolapse reconstructed using a Prolift Posterior. STUDY DESIGN: Prospective, cohort study. SETTING: Institute for the Care of Mother and Child, Prague. METHODS: Over a 5-year period (I/2006 - XII/2011) we prospectively followed a cohort of patients with posterior vaginal wall defect who underwent surgical reconstruction using a monofilament polypropylene implant Prolift Posterior (Gynecare, Ethicon, Inc., Piscataway, NJ, USA). Patients were invited for review at six weeks, three months, six months, 12 months and then yearly up to five years. Postoperative follow-up included the clinical examination and subjective evaluation using VAS, PISQ 12 and ICIQ SF. RESULTS: One hundred twenty-four women were included in the study, of which 14 (11.3%) had no prolapse surgery in their health history. There were no concomitant vaginal procedures such as hysterectomy or another implant surgery. The average operation time and blood loss were 64.25 min (min. 10, max. 205 min) and 115 ml (min. 10 ml, max. 1000 ml), respectively. Only one patient had a blood loss 1000 ml. There were no injuries of the urinary bladder or intestines during the needle insertion of the mesh. In the five-year period, the recurrence of posterior vaginal wall defect was observed in 4 cases (3.3%). The average time to the posterior vaginal wall recurrence prolapse was 19.5 months (min. 6, max. 36). De novo prolapse in the anterior compartment was observed in 25 patients (20.5%). CONCLUSION: In this prospective single centre study, we observed anatomical improvement in the implanted compartment with low recurrence rate. During five years follow-up period there was de novo anterior vaginal wall defect observed in 20.5% cases. The question of implant employment in urogynecology remain to be answered, however, our results show that implants have their position in reconstructive surgery.

Search for solar axions by the CERN axion solar telescope with 3He buffer gas: closing the hot dark matter gap.

The CERN Axion Solar Telescope has finished its search for solar axions with (3)He buffer gas, covering the search range 0.64 eV ≲ ma ≲ 1.17 eV. This closes the gap to the cosmological hot dark matter limit and actually overlaps with it. From the absence of excess x rays when the magnet was pointing to the Sun we set a typical upper limit on the axion-photon coupling of gaγ ≲ 3.3 × 10(-10) GeV(-1) at 95% C.L., with the exact value depending on the pressure setting. Future direct solar axion searches will focus on increasing the sensitivity to smaller values of gaγ, for example by the currently discussed next generation helioscope International AXion Observatory.

The SPEAK study rationale and design: A linguistic corpus-based approach to understanding thought disorder.

AIM: Psychotic symptoms are typically measured using clinical ratings, but more objective and sensitive metrics are needed. Hence, we will assess thought disorder using the Research Domain Criteria (RDoC) heuristic for language production, and its recommended paradigm of "linguistic corpus-based analyses of language output". Positive thought disorder (e.g., tangentiality and derailment) can be assessed using word-embedding approaches that assess semantic coherence, whereas negative thought disorder (e.g., concreteness, poverty of speech) can be assessed using part-of-speech (POS) tagging to assess syntactic complexity. We aim to establish convergent validity of automated linguistic metrics with clinical ratings, assess normative demographic variance, determine cognitive and functional correlates, and replicate their predictive power for psychosis transition among at-risk youths. METHODS: This study will assess language production in 450 English-speaking individuals in Australia and Canada, who have recent onset psychosis, are at clinical high risk (CHR) for psychosis, or who are healthy volunteers, all well-characterized for cognition, function and symptoms. Speech will be elicited using open-ended interviews. Audio files will be transcribed and preprocessed for automated natural language processing (NLP) analyses of coherence and complexity. Data analyses include canonical correlation, multivariate linear regression with regularization, and machine-learning classification of group status and psychosis outcome. CONCLUSIONS: This prospective study aims to characterize language disturbance across stages of psychosis using computational approaches, including psychometric properties, normative variance and clinical correlates, important for biomarker development. SPEAK will create a large archive of language data available to other investigators, a rich resource for the field.

Search for sub-eV mass solar axions by the CERN Axion Solar Telescope with 3He buffer gas.

The CERN Axion Solar Telescope (CAST) has extended its search for solar axions by using (3)He as a buffer gas. At T=1.8 K this allows for larger pressure settings and hence sensitivity to higher axion masses than our previous measurements with (4)He. With about 1 h of data taking at each of 252 different pressure settings we have scanned the axion mass range 0.39 eV≲m(a)≲0.64 eV. From the absence of excess x rays when the magnet was pointing to the Sun we set a typical upper limit on the axion-photon coupling of g(aγ)≲2.3×10(-10) GeV(-1) at 95% C.L., the exact value depending on the pressure setting. Kim-Shifman-Vainshtein-Zakharov axions are excluded at the upper end of our mass range, the first time ever for any solar axion search. In the future we will extend our search to m(a)≲1.15 eV, comfortably overlapping with cosmological hot dark matter bounds.

[Prolene mesh comparing with sacrospinal fixation in the treatment of genital prolapse in women. Prospective multicentre randomized study]. / Alogenni prolenové implantáty ve srovnání se sakrospinální fixací v lécbe prolapsu; randomizovaná multicentrická prospektivní srovnávací studie.

OBJECTIVE: Polypropylene mesh in the treatment of genital prolapse in women was introduced at the turn of the millennium with the rationale of decreasing surgical invasiveness, reinforcing weak tissues and to possibly complement insufficient surgical techniques. Prospective randomized studies comparing traditional and modern operations are lacking. SUBJECT: Prospective multicentre randomized study. SETTING: Department of Obstetrics and Gynaecology, The First Faculty of Medicine, Charles University in Prague. SUBJECT AND METHOD: A prospective multicentre trial was approved by the Ministry of Health of the Czech Republic and registered with the FDA planning to recruit 500 patients with vaginal prolapse, 18 years of age and over, undergoing surgery at 5 major urogynaecologic centres. The patients were divided into three groups according to prolapse predominance. The surgical techniques used were: anterior and posterior prolift, and randomly allocated total prolift or sacrospinous fixation. The examination setup included lower urinary tract ultrasound, MRI, POP-Q assessment and QoL questionnaires before surgery and six and 24 month after the surgery. CONCLUSION: Preliminary analysis of partial data of 225 women showed an acceptable rate of complications and a better success rate in the mesh groups, whereas operation time and blood loss was lower in the classical operation group. Quality of life questionnaires documented that all the methods used have comparably good results. The surgical techniques used are acceptable methods for pelvic organ prolapse repair with low complication rates and excellent impact on the subjective perception of the patient's quality of life.

Oncogynaecological quadruplicity--case report.

A case of a 54-year-old woman with bilateral breast, endometrial, and ovarian cancer was referred to our clinic by the Oncology Department where she had been treated with chemotherapy for the breast cancer. The clinical aspects of this unique case and follow-up are presented. This is the first such serious case of primary oncogynaecological quadruplicity to be described in the literature. Forty-two months after the initial diagnosis, the patient is in good health with no signs of cancer recurrence.

[Choroid plexus cysts and risk of trisomy 18. Modifications regarding maternal age and markers]. / Cysty choroidálního plexu a riziko trizomie 18. Modifikace ve vztahu k veku a markerum.

OBJECTIVE: Our aim was to evaluate the risk of chromosomal abnormalities esp. trisomy 18, associated with isolated choroid plexus cyst(s) in pregnant women undergoing second-trimester ultrasonographic examination. DESIGN: A review article. SETTING: OBGYN clinic of the 1st faculty of medicine, Prague, Teaching hospital Bulovka. SUBJECT: Choroid plexus cyst(s) (CPC) are more common in fetuses with chromosomal aneuploidies, particularly trisomy 18. Although it is accepted that the risk of karyotypic abnormality justifies amniocentesis in the case of other associated abnormalities are present, disagreement continues as to the risk of trisomy 18 in a fetus with an isolated choroid plexus cyst. We evaluated additional consideration of maternal age and multiple-marker screening for chromosomal aneuploidy in the assessment of risk. CASE REPORT: We report a trisomy 18 case that was diagnosed on the basis of CPC detection by ultrasound, NMR, and further amniocentesis. CONCLUSION: It is well accepted that choroid plexus cyst(s) in association with other congenital anomalies warrant amniocentesis to determine fetal karyotype. The presence of isolated CPC varies around 1% in general population, but around 30% in fetuses with trisomy 18 where the prevalence is 3 per 10,000 pregnancies. Metaanalyses reported incidence of trisomy 18 of 1 in 374 in fetuses with isolated CPC. These risks do not exceed the 1:200 risk of pregnancy loss after amniocentesis and also the 1:270 risk of Down syndrome (DS) in a 35-year-old woman, but exceeds the risk for DS of a 37-year-old woman. Thus these findings suggest that amniocentesis should not be offered to pregnant women in the presence of isolated fetal choroid plexus cyst(s), but in the absence of other pathologies. Amniocentesis is then justified only in the patient with advanced maternal age.

[Analysis of a group of HIV positive women who gave birth in the Czech Republic]. / Analýza souboru HIV pozitivních rodicek v Ceské republice.

OBJECTIVE: An analysis of HIV positive women who gave birth between 1st January 1985 to 31st December 2006 in the Czech Republic. SUBJECT: A retrospective descriptive analysis. SETTING: Teaching Hospital Bulovka, 1st Faculty of Medicine, Charles University, Prague. SUBJECT AND METHODS: The study included HIV positive women that gave birth between 1st January 1985 to 31st December 2006 at Bulovka hospital. The group of 62 HIV positive women (including 7 secundiparae) gave birth to 71 new-borns (twice twins). The deliveries were performed by C-section. We interrupted breast-feeding by all these women. RESULTS: All new-borns were born alive, no one had Apgar score less than 7 at five minutes. No congenital disorders were found. Three new-borns were transfered to Intensive care unit for new-born babies, two due to dysmaturity and one due to abstinence syndrome. 3 new-borns out of total 71 new-borns were HIV positive (4.2%). CONCLUSION: Routine prenatal screening for HIV and high-quality cooperation between obstetricians and infection control doctors are the basic condition of low rate of vertical trasmission HIV infection in the Czech Republic.

[Hormonal contraception interactions]. / Moiné interakce hormonální antikoncepce.

OBJECTIVE: The purpose of this article is to discuss the probable ways of interactions between some drugs or remedies and steroid contraceptives. DESIGN: A review article. SETTING: OBGYN Clinic of the 1t Faculty of Medicine, Prague, Teaching Hospital Bulovka. SUBJECT: Low dose oral contraceptives are very popular these days. Some drugs and remedies could negatively influence the levels of ethinyl estradiol (EE) and/or progestins and thus increase the possibility of their failure. These drugs mostly implicate as an inducer of the CYP450 system (liver) and as an inducer of P-glycoprotein transport system (transmembrane drug pump in the intestines). We wanted to describe briefly the mechanism and the principles of their impact.

[Deliveries out of medical facilities]. / Porody mimo zdravotnická zarízení.

AIM OF STUDY: Analysis of reasons and risks of planned and unplanned deliveries out of medical facilities. TYPE OF STUDY: Review of literature and casuistry. NAME AND SITE OF DEPARTMENT: Department of Obstetrics and Gynaecology, Teaching Hospital Na Bulovce, 1st Faculty of Medicine, Charles University in Prague. MATERIAL AND METHOD: Authors of this paper are discussing published evidences concerning the reasons and the risks of planned and unplanned deliveries out of the medical facilities. They are pointing out at the activities of some independently practising midwives, who systematically encourage females against medically conducted deliveries during their prenatal courses, thus obtaining clients for home deliveries. At the end of the paper the authors present three casuistries from their own practice to document the outcomes of disinformation and prenatal courses guided in a wrong way. CONCLUSION: According to the results of foreign studies and own experience home deliveries are accompanied by senseless risks for mother and child. Dubitable benefits of the home surroundings cannot counterbalance these risks. Prenatally purposely misinformed woman and her partner often threaten themselves and their arriving child during labour with senseless risks.

[Possibilities of using ultrasound in the diagnosis of descended posterior compartment of female pelvic floor]. / Moznosti vyuzití ultrazvuku prfi diagnostice descenzu zadního kompartmentu zenského páinevního dna.

OBJECTIVE: Find out the features of descending posterior vaginal wall using ultrasonography and set the objective diagnostic criteria. DESIGN: Prospective comparative study. SETTING: Department of Obstetrics and Gynaecology, Teaching Hospital Bulovka, First Medical Faculty, Charles University in Prague. METHODS: We included 39 attendants, 19 with clinicaly proven descent of posterior vaginal wall; 20 as a negative control group. We observed the ultrasonographical features of descending posterior vaginal wall according to the horisontal line crossing the inferior margin of pubic bone (PM) and central anorectal angle (PARA) at rest and during Valsalva manoevre with and without intrarectal application of sonographic yelly. Student's t-Test was used for statistical evaluation. RESULTS: We proved the statisticaly significant increase in the distances PM and PM' in the group of females suffering from the descent compared to the group of healthy women. Values of PARA were also signifinatly hightened in the group of patients with the descent compared to healthy females. CONCLUSIONS: The ultrasonographical evaluation of descending posterior vaginal wall appears to be promising chance in diagnostics of female's pelvic floor pathology.

[A survey of surgical techniques used for the correction of statics disorders of pelvic floor]. / Prehled operacních technik uzívaných ke korekci poruch statiky pánevního dna.

OBJECTIVE: To present an overview of current procedures used in female pelvic floor reconstructive surgery. SUBJECT: Review article. SETTING: Teaching Hospital Bulovka, 1st Faculty of Medicine, Charles University, Prague. SUBJECT AND METHOD: Pelvic organ prolapse (POP) in women including associated disorders belong to the top problems in current urogynecology. During the last decade a substantial progress in elucidation of detail morphology and function of each pelvic floor compartments had been made. These new findings could be rapidly implemented into clinical medicine, mainly as application of new mesh implants. The results of reconstructive operations are variable, one of the reason is the existence of many operation techniques. This review article represents a short overview of those methods. CONCLUSION: Wide range of current operation procedures must be re-evaluated respecting the existence of new techniques based on recent anatomical studies.

Some immunological characteristics of subjects suffering from frequent herpes simplex virus recrudescences.

Some parameters of specific and non-specific immunity were tested in a group of 44 subjects suffering from frequent herpes simplex type 1 (HSV-1) or herpes simplex type 2 (HSV-2) recrudescences. The tests performed included determinations of (i) HSV complement-independent and complement-dependent neutralizing antibodies, (ii) antibodies to glycoprotein C of HSV-1 and glycoprotein G of HSV-2, (iii) antibodies to viral capsid and early antigens of Epstein-Barr virus, (iv) antibodies to tetanus toxoid, (v) serum levels of IgM, IgG, IgA, transferrin, prealbumin and C'3 and C'4 components of complement, (vi) active and total T lymphocytes, (vii) phagocyting activity of polymorphonuclear neutrophils, eosinophils and mononuclear cells, (viii) skin reactivity to tuberculin, toxoplasmin, candidin, tetanus and diphtheria toxoids. In the patients the following deviations from the control groups were noted: (i) Antibody levels to homotypic but not to heterotypic HSV were enhanced, (ii) serum IgM levels were elevated, (iii) percentages and numbers of active and total T lymphocytes were decreased, (iv) phagocyting activity of neutrophils was depressed but that of eosinophils was increased.

[Potential carcinogenic factors in cervical intraepithelial neoplasia]. / Studie potenciálních karcinogenních faktoru u cervikálních intraepitelových neoplazií.

In a group of 22 women with cervical intraepithelial neoplasia and carcinoma of the cervix uteri and in a control group of 37 healthy women, a number of anamnestic and objective data about factors influencing these women and about consequences of such influence were analysed. Statistically significant differences between patients and controls were found in the character of work performed (physical vs. intellectual, p = 0.0312), the presence of stressing factors at the workplace (p = 0.02), a higher number of consumed meals per day in the control group (p = 0.0009), daily consumption of beer in a higher percentage of patients (p = 0.0015), the frequency of sexual intercourse in the last 2-3 months before the diagnosis of disease or examination (higher in controls, p = 0.0164) and subjective rating of sexual life in the fourth decade (better rating in controls, p = 0.0005). No differences were found between patients and controls in the number of sexual partners, the presence of antibodies against HSV-2 and other factors. According to data presented and data in the literature, external environment, some of the characteristics of sexual life and particularly infection with certain types of papillomaviruses have a certain influence on the development of cervical neoplasias.

[The hiatus urogenitalis and its dorsal component--its importance in urinary and fecal continence in women]. / Hiatus urogenitalis a jeho dorzální soucást--význam pro kontinenci moci a stolice u zen.

OBJECTIVE: Numerous anatomical studies over the last years resulted in a principal shift in the view of the area of female pelvic floor. These studies also deal with the area of posterior compartment, i.e. a region which used to be of little interest to urogynecologists. This article presents a brief outline of anatomical and physiological knowledge as well as a brief survey of most important methods of examination and basic clinical symptoms associated with disorders of posterior part of hiatus urogenitalis. The presently accepted concept of a complex approach to disorders of female pelvic floor will probably require increased interest in this area among urogynecologists. The article is aimed at summarizing elementary knowledge necessary for adequate clinical care of patients suffering from disorder in posterior compartment function. SUBJECT: Review article. SETTING: Department of Gynecology and Obstetric, Faculty Hospital Na Bulovce, 1st Medical Faculty, Prague, Czech Republic.

[Detection and typing of HPV DNA in situ--improvement in diagnosis of lesions of the uterine cervix]. / Prukaz a typizace HPV DNA in situ--príspevek ke zlepsení diagnostiky lézí delozního cípku.

We examined the cervical samples from 63 female patients with various grades of cervical intraepithelial neoplasia (CIN), invasive squamous cell carcinoma (INCA) or inflammation. All the women with the diagnosis of CIN were selected on the basis of cytological prediction of HPV infection (koilocytosis, dyskeratosis). The analysis of human papillomavirus (HPV) genome by DNA hybridization in situ was done in all cases. Simultaneously, the immunohistochemical expression of papillomavirus common antigen (PVCA) and proliferating cell nuclear antigen PCNA/cykline was determined. The results confirm the correlation between high risk HPV types 16, 18, 33 and higher grade of dysplasia (CIN) as well as higher proliferative activity. On the other hand, the detection of HPV DNA does not correlate with PVCA expression or with cytological/histological diagnosis of koilocytosis. This finding shows that common cytological or histological examinations may be unreliable and in particular the significance of koilocytosis must be reevaluated.

[Correlation of clinical and virologic diagnosis of cervical infection with human papillomaviruses]. / Korelace klinické a virologické diagnostiky infekce cervixu lidskými papilomaviry.

The presented investigation is concerned with contemporary diagnostic possibilities of HPV Infection of the Cervix. The authors present the results of virological examinations of 228 female patients in the Centre for Oncological Prevention. The examination was made by hybridization techniques, using probes specific for HPV 6, 11, 16 and 18 and by serological methods where IgG antibodies were assessed against synthetic peptides, corresponding to several HPV epitopes, as antigens. 156 women (68.4%) were virologically positive, 72 (31.6%) were negative. Subsequently the authors investigated the diagnostic accuracy of HPV changes of the cervix by clinical methods, i.e. colposcopy and cytology, as compared with virological methods. On colposcopic examination uncertain--i.e. insignificant--results were recorded in 24.6%, on cytological examination in 19.7%. In patients where these methods gave unequivocal results (either + or-) a correct forecast of the presence of HPV during colposcopic examination was recorded in 71.1%, in cytological examinations in 66.9%. At least one of the clinical methods assessing papilloma virus infection was prognostically correct in 90.4%. From the investigation ensures that prebioptic methods provide the clinician with relatively reliable information on the presence of HPV infection and enable him to select a therapeutic and dispensarization procedure adequate to the finding. However, they cannot replace virological examination among other reasons also because they cannot assess the HPV type.