Prediction of recurrent disease by cytology and HPV testing after treatment of cervical intraepithelial neoplasia.

OBJECTIVE: To assess the role of human papillomavirus (HPV) testing and cytology as predictors of residual/recurrent disease after treatment of high-grade cervical intraepithelial lesions. METHODS: One hundred and thirty-eight women with cervical intraepithelial neoplasia (CIN) grade 2/3 lesion on biopsy were included in a prospective follow-up study in Belgium and Nicaragua. All women were treated with loop electrosurgical excision procedure (LEEP) and follow-up visits took place at 6 weeks, 6 months, 1 year and 2 years. During these visits, a Papanicolaou (Pap) smear test was taken, colposcopy was performed and specimens were collected for HPV testing. Cytology, high-risk (HR) HPV presence, persistent HR HPV infection and combinations of these tests at different time points during follow-up were correlated with histologically confirmed residual/recurrent disease. RESULTS: Thirteen patients (9%) developed residual/recurrent disease during follow-up. Abnormal cytology at 6 weeks after treatment was significantly correlated with residual/recurrent disease. Nine of thirty-seven patients with abnormal cytology at 6 weeks had recurrent disease versus three of seventy with a normal cytology [odds ratio (OR): 7.2; 95% confidence interval (CI): 1.8-28.5; P = 0.003). Sensitivity of this test was 75.0%, specificity 70.5%. Combining abnormal cytology and the presence of HR HPV within the first 6 months after treatment gave the best correlation with residual/recurrent disease: of the 54 women with abnormal cytology and/or HR HPV presence within the first 6 months, 11 developed residual/recurrent disease (OR 10.2; 95% CI: 2.2-48.3). Sensitivity of this combination was 84.6% and specificity 65.0%. CONCLUSION: Cytology remains the cornerstone in the early follow-up after LEEP for CIN lesions of the cervix. HPV testing can add value as it increases the sensitivity of cytology in concomitant testing within the first 6 months.

Human papillomavirus DNA detection in women with primary abnormal cytology of the cervix: prevalence and distribution of HPV genotypes.

OBJECTIVES: In this study, we focus on the prevalence and occurrence of different anogenital human papillomavirus (HPV) genotypes in a first abnormal cervical screening test, and correlate HPV genotyping with the cytological diagnosis on thin-layer liquid-based preparations in routine gynaecological screening. METHODS: Out of 780 abnormal smears, 513 tested positive for HPV. All 25 different HPV types were identified by Line Probe Assay. RESULTS: The prevalence of high-risk HPV types increased from 72% in atypical squamous cell of undetermined significance to 94.5% in high-grade intra-epithelial lesion (HSIL). Co-infection with multiple HPV types was predominantly found in HSIL (35.8%). In the HSIL group the most common HPV types were 16, 52, 51 and 31; type 18 was rarely present. CONCLUSION: The role of types 31, 51 and 52 should be considered in future studies on vaccine development.

Bilateral open breast coil and compatible intervention device.

Dynamic contrast-enhanced breast MRI is an extremely sensitive method for breast lesion detection. For MR-only detected lesions it is essential that needle biopsy or localization prior to surgery is carried out under MR guidance. This work describes a bilateral open breast coil and prototype intervention device, which may be used in these situations. Results demonstrate that the open coil provides images superior to those obtained with a conventional closed breast coil. Initial phantom tests with the intervention device indicate a potential for this system to be used in the MR-guided localization of breast lesions. J. Magn. Reson. Imaging 2000;12:984-990.

Possible systematic errors in measurements of skin colour using the EEL reflectance spectrophotometer.

Reflectance readings with the EEL Reflectance Spectrophotometer, used in many studies of human skin colour, depend on the spatial orientation of the applicator head of the instrument. Variations of over 15% of the calibration value have been observed. The present paper shows that this orientation dependence is due to the influence of gravity on the glowing spiral of the light bulb. The effect has an electrical and an optical component. It is concluded that the orientation effect will manifest as a systematic error in skin colour studies when calibration and measurement are performed at different orientations of the applicator head. The magnitude of this systematic error may be in the order of 10% and comparisons between different studies may be inaccurate.

Complement components in blood serum and suction blister fluid in erythropoietic protoporphyria.

Complement factor's C3c, C4, factor B, C3d and the immunoglobulin IgA were determined in suction blister fluid of patients with erythropoietic protoporphyria and in normal controls. The levels increased when the skin of the patients had been previously irradiated with 'white light', but with Kromayer radiation, and were interpreted as being the result of increased vasopermeability.

A non-invasive microscopic method for measuring epidermal thickness in vivo.

Some improvements are reported of a relatively unknown method for measuring the thickness of the epidermis in vivo. The excursion of a microscope tube is measured when focussing respectively on the summits of the dermal capillary loops and on the epidermal surface. With this method values may be produced with a standard deviation in the order of 10 micron. Averaged epidermal thickness on the flexor forearm was 60 +/- 1 micron, the spread being the standard error of the mean. In principle the thickness of the horny layer can be determined with this method by measuring thicknesses before and after stripping of the horny layer.

Rapid regeneration of the dermal-epidermal junction after partial separation by vacuum: an electron microscopic study.

A process of rapid repair of dermal-epidermal adherence, as found in experiments with interrupted suction, was investigated electron microscopically. Biopsies in different stages of the process of suction blister formation and of the repair process were studied. Results show that suction blister formation occurs by successive detachment of hemidesmosomes from the basement membrane, and that, after partial separation of the epidermis from the dermis, a rapid regeneration of the dermal-epidermal junction takes place. This regeneration process apparently consists of two steps: realignment of basal cells to the basement membrane accompanied by autophagocytosis of detached hemidesmosomes, and de novo formation of hemidesmosomes. The time required for this structural regeneration corresponds well with the speed of the functional repair of dermal-epidermal adherence measured with the technique of interrupted suction.