Colgajos cutaneomusculares del cutáneo del cuello: Su aplicación en el cierre de ostomas cervicales / Platysma colli musculocutaneous flaps. Their use in closure of cervical ostomies

Se presentan los resultados obtenidos en un grupo de 20 pacientes a quienes se les efectuaron cierres de ostomas cervicales por medio de colgajos cutáneomusculares del cutáneo del cuello. Se utilizaron 4 tipos de colgajos: zetaplastías, de tipo Limberg o Dufourmentel, en W o collarete de arlequín y en isla.Los resultados fueron satisfactorios en todos los casos, con excelente viabilidad de los colgajo índice de complicaciones, en su mayoría resueltas sin alterar el resultado final de la operación plástica. Los autores consideran que el uso de estos colgajos ofrece una excelente alternativa a las reconstrucciones con colgajos pectorales, con una técnica más sencilla, y reduciendo los riesgos, complicaciones y costos de las operaciones de mayor envergadura

Colgajos cutaneomusculares del cutáneo del cuello: Su aplicación en el cierre de ostomas cervicales / Platysma colli musculocutaneous flaps. Their use in closure of cervical ostomies

Se presentan los resultados obtenidos en un grupo de 20 pacientes a quienes se les efectuaron cierres de ostomas cervicales por medio de colgajos cutáneomusculares del cutáneo del cuello. Se utilizaron 4 tipos de colgajos: zetaplastías, de tipo Limberg o Dufourmentel, en W o collarete de arlequín y en isla.Los resultados fueron satisfactorios en todos los casos, con excelente viabilidad de los colgajo índice de complicaciones, en su mayoría resueltas sin alterar el resultado final de la operación plástica. Los autores consideran que el uso de estos colgajos ofrece una excelente alternativa a las reconstrucciones con colgajos pectorales, con una técnica más sencilla, y reduciendo los riesgos, complicaciones y costos de las operaciones de mayor envergadura

Conization for cervical intraepithelial neoplasia is followed by disappearance of human papillomavirus deoxyribonucleic acid and a decline in serum and cervical mucus antibodies against human papillomavirus antigens.

OBJECTIVE: Our purpose was to investigate whether conization for cervical intraepithelial neoplasia eliminates human papillomavirus deoxyribonucleic acid and effects the levels of serum and cervical mucus antibodies against human papillomavirus antigens. STUDY DESIGN: Analysis of paired cervical brush and serum samples taken from 23 women with cervical intraepithelial neoplasia before and 16 to 27 months after conization was performed for presence of human papillomavirus deoxyribonucleic acid by polymerase chain reaction and for human papillomavirus antibodies by enzyme-linked immunosorbent assay. RESULTS: Four women had recurrent cervical intraepithelial neoplasia, whereas 19 women were disease free. Eighteen of 23 women were positive for human papillomavirus deoxyribonucleic acid before treatment. At follow-up only the 4 women with recurrent cervical intraepithelial neoplasia were positive. Serum immunoglobulin G levels and A levels and immunoglobulin A levels in cervical mucus against most of the tested human papillomavirus antigens had declined at follow-up. CONCLUSIONS: Human papillomavirus deoxyribonucleic acid was regularly eliminated and human papillomavirus antibody levels, especially local immunoglobulin A, declined after efficient treatment, suggesting that conization may be effective for treating the underlying human papillomavirus infection.

Association of serum antibodies against defined epitopes of human papillomavirus L1, E2, and E7 antigens and of HPV DNA with incident cervical cancer.

In order to provide a large-scale evaluation of the association with cervical cancer of antibodies against human papillomavirus (HPV) antigens, sera from 233 patients with primary, untreated cervical cancer and from 157 healthy age- and sex-matched blood donors were analyzed for IgG and IgA antibodies against HPV-derived peptide antigens and against bovine papillomavirus. Several serological responses were strongly associated with cervical cancer, notably the IgG response against the HPV 16 epitopes L1:13 (Relative risk [RR]: 5.3), E2:9 (RR: 2.9), and E7:5 (RR: 4.3), and the IgA response against an HPV 18 E2-derived antigen (245:18, RR: 3.1). HPV DNA in corresponding cervical tumors was analyzed by Southern blotting (SB) and polymerase chain reaction (PCR) in 47 patients. Sixty-six percent of the patients carried HPV DNA as determined by SB, 91% of patients analyzed by PCR. Neither the antibody responses, nor the presence of HPV DNA were significantly associated with the biological properties of the tumors.

Routine use of endometrial cytology in clinical practice.

The aim of this study was to evaluate the long-term use of endometrial cytology with the Endopap sampler in clinical practice. Emphasis was placed on diagnostic accuracy, reduction of the number of curettages and cost per diagnostic test. Blind comparisons of two diagnostic tests were made during an observation period of five years. Endometrial cytology was compared with endometrial curettage as a standard if both samples had been taken within a six-month period and sufficient material had been obtained with both methods. A total of 468 women were studied. All had undergone endometrial curettage because of vaginal bleeding or impending hysterectomy. Abnormal endometrial cytology was found in 129 of 134 (96%) samples from patients with endometrial cancer, in 23 of 25 (92%) with invasive cervical cancer, in 30 of 31 (97%) with atypical endometrial hyperplasia and in 90 of 100 (90%) with endometrial hyperplasia but no atypia. Specificity was 84%. The annual numbers of fractional curettages decreased from 900 in 1986 to 298 in 1991. The study clearly showed that endometrial cytology is useful in clinical practice.

Serological responses to human papillomavirus type 16 antigens in women before and after renal transplantation.

Female renal transplant recipients have an increased incidence of human papillomavirus (HPV) associated lesions, such as cervical dysplasia and neoplasia [Schneider et al., 1983]. In this study we tested the serological responses by enzyme-linked immunoadsorbent assays (ELISA) to 3 different antigenic regions of HPV type 16. Sera from 35 female renal transplant patients collected before and at different times, up to 3 years, after transplantation were collected and tested. Before transplantation IgG antibodies against peptide 49, corresponding to the HPV L2 region, were found in 21/35 of the patients' sera. Of the L2 positive sera, 16 also demonstrated activity with the HPV L1 region derived peptide 31. All sera that were active against peptide 31 (L1) were also reactive with peptide 49 (L2). After renal transplantation, the antibody levels against these 2 peptides (peptides 49 and 31) dropped significantly (OD > or = 0.2) in all previously positive sera and remained so throughout the study, which lasted up to 3 years. The proportion of patients with IgA activity against the E2 region (peptide 245), which is common among patients with cervical neoplasia, increased from 9/35 before transplantation to 18/35 after transplantation. In parallel, we monitored 25 of these patients' sera before and after transplantation for antibody activity against measles, adenoviruses, and cytomegaloviruses (CMV). The majority of these sera--17/25 (68%) and 18/25 (72%), respectively--had no titer changes against measles and adenoviruses. Furthermore, the changes in antibody titers observed with CMV in these patients were not correlated with the fate of the antibodies against the HPV peptides.(ABSTRACT TRUNCATED AT 250 WORDS)

Prevalence of genital papilloma virus infections in asymptomatic and symptomatic women, studied with a combined dot-blot and Southern blot procedure.

A technique for the detection and typing of genital infections with human papilloma virus (HPV) is described. Following a non-invasive sampling and a simplified preparation procedure, the analysis was performed as a combined dot-blot and Southern blot analysis, where the former test was used to exclude cases without demonstrable content of HPV DNA. The subgenomic probes used in the Southern blot analyses have a higher specificity than can be achieved with genomic ones, and only one band is obtained for each of HPV types 6, 11, 16, 18, 31, 33 and 35. Extra bands indicating the presence of cross-reacting HPV of undetermined type occurred in only 0.7% of the 1,268 cases tested. HPV was demonstrated in 7.8% of the 612 health control samples and in 16% of 634 consecutive samples from patients with symptoms. All but type 18 occurred more commonly in symptomatic than in asymptomatic patients. Presence of HPV also correlated to cervical intraepithelial neoplasia (CIN) in simultaneously collected smears. The HPV was demonstrated in 13% of patients with normal cytology, in 45% with CIN and in 82% of patients with invasive carcinoma. All types of HPV occurred more commonly in CIN patients, while only types 16, 18, 31 and 33 were found in the patients with cancer.

Detection of human papillomavirus (HPV) using dot blot and Southern blot, hybridizing with a mixture of seven probes.

A previously presented method for the detection and typing of human papillomavirus (HPV) DNA has been modified for the simultaneous analysis of HPV types 6, 11, 16, 18, 31, 33 and 35. The method has two steps, where a dot blot test is used to exclude cases that do not hybridize with HPV-DNA. The remaining cases are then analysed by a Southern blot procedure, using a mixture of subgenomic probes for the simple and accurate analysis of HPV types. When the procedure was used for the analysis of clinical samples, patient groups at varying risk were found to differ with regard to the prevalence of HPV infections. Thus, the virus was detected in only 8.8% of otherwise healthy young women - i.e. women without clinical signs of HPV-related disease - as compared to 48% of women who also had cervical intraepithelial neoplasia (CIN). A similarly high prevalence was found in patients in whom CIN persisted (42%) as compared to those in whom the morphological lesion regressed to normal (8%).

Use of cervical Cytobrush samples for dot-blot detection and Southern blot typing of human papillomaviruses using subgenomic probes.

The use of Cytobrush samples for the detection and typing of cervical human papillomavirus (HPV) infections was analyzed. The average yield of squamous cells from Cytobrush samples was on the order of 10(6) cells when the sample was collected in a lytic collection buffer, which was approximately double the content of (1) samples collected in ethanol and (2) an average biopsy specimen. The material obtained could be used for sensitive detection and typing of HPV infections using, respectively, a nonradioactive dot-blot method and the Southern blot procedure performed with subgenomic probes, which permitted a simple interpretation even in cases of mixed infections. A sample containing at least 500,000 viral copies was required for the detection and typing. At this level of sensitivity, the frequencies of HPV obtained in different risk groups varied from 6% (in "healthy" young women) to 53% (in women with abnormal cytologic findings in simultaneous smears). The noninvasive nature of the sampling procedure and the relative simplicity of the test should allow this method to be applied in large-scale studies.