[Human papillomavirus types and cervical neoplasia]. / Tipovi humanih papiloma virusa i cervikalne neoplazije.

The pathological cells of the cervix uteri were examined for the presence of some types of human papilloma viruses (HPV) by DNA-hybridization and by the Southern blot method. Different degrees of neoplasia were found in the majority of these pathological changes of the uterus. The control group of patients included in the study had normal clinical, cytological and colposcopical results. Two parameters were identical both in the examined and the control patients. Types 6/11 were found in neither of the groups examined. The control patients had types 16/18 HPV in 8.3% of cases, while the frequency of these types was much higher in the examined group; it depended on the phase of the disease. These types were not detected in pathological lesions of CIN I; 40% of patients with CIN II had them, and 7.3% of patients with CIN III were positive to types 16/18 HPV. The majority (75%) of the examined samples of invasive neoplastic cervical lesions were positive to the presence of HPV 16/18.

Sensitive detection and typing of human papillomavirus DNA in gynecological cell scrapings by slot-blot hybridization.

A rapid and sensitive method for detecting and typing human papillomaviruses (HPVs) in cell scrapings is presented. DNA from scrapings is extracted and bound to nitrocellulose filters (Slot-Blot). By DNA-DNA hybridization with specific 32P-labelled HPV-probes (types 6/11 or 16/18) the patient's DNA is then analyzed for the presence of, and for the type of, HPV DNA sequences. A parallel hybridization with a human repetitive element (Alu sequence) allows quantitation of the different hybridization results. Experiments with HeLa cell DNA show that as little as 10(4) HPV sequences can be detected and typed specifically with this test. Evaluation of this test is completed within 6 to 7 days after cell collection. This Slot-Blot method was used to analyse 1330 specimens taken at the Bernese Dysplasia Outpatient Clinic. The results reveal a very high percentage (90%) of HPV-positive cases in the patient group examined.

Analysis of electronically pulsed versus quasi-continuous wave carbon dioxide lasers in an animal model.

In this study we sought to compare laser tissue interaction in both the quasi-continuous waveform and electronically pulsed waveform of the carbon dioxide laser. An intramode analysis of the electronically pulsed form (at 350 and 650 pulses per second) was also undertaken. Intraperitoneal laser incisions were made on New Zealand white female virginal rabbits and tested at days 0, 5, 15, and 20. Testing involved proximal and midsection analysis of the laser sites to evaluate total area of vaporization, total area of tissue thermal damage, maximum diameter of injury at epithelial surface, maximum depth of laser penetration, angle of vaporization crater edges, and angle of tissue thermal injury of the three modes. Analysis of proximal versus midsection preparation revealed different zones of vaporization and injury within the same laser site. The zone of injury with respect to time was nonuniform, suggesting that the laser output in the electronically pulsed mode was not constant. An in vivo tissue lens phenomenon was also detected, resulting in a compound thermal vaporization and injury pattern.

[Laser therapy in gynecology]. / Lasertherapie in der Gynäkologie.

Laser therapy is being implemented with increasing frequency in medicine. Carbon dioxide laser is the system most commonly used in gynaecology and the main indications are disease of the uterine cervix, vagina, vulva or perineum. When used in conjunction with the microscope or laparoscope during reconstructive operations on the adnexa, laser speeds up the surgical procedure and brings out the inherent advantages of this technique, namely, precise separation or destruction of tissue, absence of postoperative oedema, uncomplicated wound healing, minimal mechanical trauma, decreased postoperative pain and good haemostasis. With good maintenance and practice laser systems all work well. The only disadvantage is their high cost.

CO2 laser conization versus conventional conization: a clinico-pathologic appraisal.

Two groups of patients recently underwent either laser or conventional conization at the University Women's Hospital in Bern, Switzerland. Of the total 49 patients treated, 25 underwent laser conization and 24 underwent conventional conization. All patients admitted to the study had cytologic, colposcopic, and/or histologic evidence for cervical intraepithelial neoplasia or chronic cervicitis resistant to conservative therapy. In the conventionally treated group, conization was performed with surgical scalpel, and hemostasis was achieved by Sturmdorff, Bonney, or Kraus sutures. In the laser-treated group, conization was performed by using the combination method of Dorsey and Grundsel. Blood loss was minimal in the laser-coned patients, compared to 119 ml blood loss in the conventionally coned patients. Hospitalization for the laser-treated group was 5.2 days in contrast to 7.0 days for the conventionally treated group. Postoperative bleeding and discharge were also considerably smaller or did not occur in the laser-treated group as compared to the conventionally treated group. With postoperative and long-term follow-up now under way, initial results indicate that laser conization, in comparison to conventional conization, also provides greater visibility of the squamocolumnar junction and a reduced incidence of cervical strictures. The results of this study suggest that the CO2 laser beam, properly and cautiously applied, is an efficacious surgical modality for the treatment of cervical preneoplastic disease.