Distribution of maternal and infant human papillomavirus: risk factors associated with vertical transmission.

OBJECTIVE: To evaluate the rate of human papillomavirus (HPV) infection in pregnant women and their neonates, and the risk factors associated with vertical transmission of HPV infection from mothers to neonates. STUDY DESIGN: Cervical HPV testing was undertaken in pregnant women over 36 weeks of gestation, and mouth secretions and oral mucosa of neonates were tested for HPV immediately after delivery. HPV-positive neonates were rechecked 2 months postpartum to identify the persistence of HPV infection. In HPV-positive mothers, the placenta, cord blood and maternal peripheral blood were also analysed for HPV to confirm whether transplacental HPV infection occurred. RESULTS: HPV was detected in 72 of 469 pregnant women (15.4%) and in 15 neonates (3.2%). Maternal HPV positivity was associated with primiparity and abnormal cervical cytology. The rate of vertical transmission was 20.8%, and all HPV-positive neonates were born from HPV-positive mothers. Vertical transmission was associated with vaginal delivery and multiple HPV types in the mother. Neonates with HPV showed a tendency for higher maternal total HPV copy number than neonates without HPV, but this difference was not significant (p=0.081). No cases of HPV infection were found in the infants at 2 months postpartum, and no HPV was detected in placenta, cord blood or maternal blood. CONCLUSIONS: Vertical transmission of HPV is associated with vaginal delivery and multiple HPV types in the mother; however, neonatal HPV infection through vertical transmission is thought to be a transient.

Decrease of initial CD4+ T-cell counts at the time of diagnosis of HIV infection in Korea; 1988-2006.

The aim of the study was to evaluate the trends of initial CD4+ T-cell counts (CD4+) at HIV diagnoses and to identify the factors influencing the annual changes of CD4+ cell counts in Korea during 1988-2006. As a retrospective study, 2613 individuals (>/=15 years at diagnosis, their CD4+ counts were measured within six months) were selected from all 4580 HIV-infected Koreans diagnosed between 1985 and 2006. The mean CD4+ cell counts in all the selected individuals was 312 cells/mm(3), and this value decreased significantly by 20.3 cells/mm(3)/year over the 19 year study period. Men had lower CD4+ cell count than women by 22.7 cells/mm(3), and age at HIV diagnosis had an inverse relationship with CD4+ cell counts of 23.5 cells/mm(3) lower per 10 years advancing age. Cases diagnosed in hospitals showed CD4+ cell count levels 33.9 cells/mm(3) lower than public institutions by 33.9 cells/mm(3). Gender and age seemed to affect trends of CD4+ count; however the institution where cases were diagnosed had the strongest effect on decreasing CD4+ cell counts. The results suggest that HIV diagnoses in recent years are being made in later stages of HIV infection and that it is imperative to develop more efficient programmes for early HIV diagnosis to prevent transmission.

The current status of HIV screening laboratories in Korea assessed by a questionnaire survey of participants in the KCDC HIV EQAS (2006).

Using a questionnaire, we assessed the current status of the quality management systems at HIV screening laboratories in Korea. The Korea Centres for Disease Control and Prevention HIV external quality assurance scheme (EQAS) questionnaire includes 18 items divided into five groups related to HIV testing: personnel, HIV test processes, participation in the Quality Assurance programme and HIV testing equipment. Five hundred and sixty-one HIV screening laboratories participated in this questionnaire investigation; data were collected from 233 public health centres, 309 hospitals or clinics, eight blood centres and 11 commercial laboratories. The total number of HIV screening tests was about 5.5 million in 2005. The average number of HIV tests per institution was highest in blood centres (308 561), followed by commercial laboratories (56 084), hospital or clinic laboratories (6756), and public health centres (1751). Equipment and HIV test methods varied between HIV screening laboratories, and, to manage the quality of their HIV testing, most laboratories participated in several evaluation programmes such as EQAS or a laboratory accreditation programme. This study is the first questionnaire survey of HIV testing laboratories in Korea. The results could be used to evaluate and promote the quality management of HIV testing laboratories.

Changes in Vertebral Column Height (VCH) at Different Distance Intervals During a 3-Mile Walk.

BACKGROUND: The purpose of this study was to determine the changes in vertebral column height (VCH) of males and females, at every one-half mile, for a total walking distance of 3 miles. METHODS: Twenty males and twenty females between the ages of 21 and 40 years walked 3 miles on a treadmill maintaining a walking speed that the subject rated between 12 and 14 on Borg's rate of perceived exertion scale. Blood pressure, heart rate, and VCH measurements were taken initially and at each half-mile interval throughout the three-mile walk. Vertebral column height (VCH) was measured from the spinous process of C7 to S2 using a standard tape measure. RESULTS: Significant differences existed in vertebral column height according to sex (F = 16.18; p < .05) and significant differences in vertebral column height at the different distances (F = 65.02: p < .0001). Significant changes occurred in the VCH between half-mile intervals only between 0.5 miles and 1.0 mile and between 1.0 mile and 1.5 miles during the walk. As found with a regression analysis, curvilinear relationship exists between the distance walked and VCH; with VCH decreasing throughout the distance of the walk. CONCLUSIONS: Vertebral column height decreased in a curvilinear relationship throughout the distance of walking 3 miles in both males and females.

Fetal growth restriction is associated with increased apoptosis in the chorionic trophoblast cells of human fetal membranes.

The aim of the study was to determine the incidence and spatial distribution of apoptotic cell in fetal membranes obtained from human pregnancies complicated with fetal growth restriction (FGR) for which there was no established cause. Fetal membrane samples from normal (n=10) and FGR-affected (n=10) pregnancies were collected and stored following delivery. The incidence of apoptosis and the number of apoptotic cells in normal and FGR-affected fetal membranes were determined using immunohistochemistry and a monoclonal antibody for neo-epitope of cytokeratin-18, M30. The level of apoptotic proteins in FGR-fetal membranes compared to the normal tissue was determined using Western immunoblotting analysis. Multiple labeling of trophoblast cells using immunofluorescence markers was used to investigate regional differences in localization of apoptotic cells between normal and FGR-affected fetal membranes. Apoptosis was detected in both normal and FGR-affected fetal membranes. However, quantitative analysis of apoptotic cells by immunohistochemistry showed a significant increase in FGR-affected fetal membranes compared to normal (p<0.005). Furthermore, it was observed that apoptotic cells were predominantly localized to chorio-decidual layer of the fetal membrane. By using semi-quantitative analysis of Western immunoblotting, a significant increase in the levels of the apoptotic marker proteins poly-ribo (ADP) polymerase (PARP) and the neo-epitope of cytokeratin-18 were observed in FGR-affected fetal membranes compared to normal (p<0.005). Immunofluorescence studies further confirmed the restriction of the apoptotic cells to the chorionic trophoblast cells in FGR-affected fetal membranes. Our results document for the first time an increased incidence of apoptosis in FGR-affected fetal membranes, with the apoptotic cells restricted primarily to the chorionic trophoblast layer of the fetal membranes. Increased apoptosis in FGR-affected fetal membranes may impair functions of the fetal membranes that are important for normal fetal development and growth. Elucidation of the molecular mechanisms involved in the control of apoptosis in the chorionic trophoblast layer in the FGR-affected fetal membranes may provide further insights into the etiology of FGR.

Selective oxidation of allylic sulfides by hydrogen peroxide with the trirutile-type solid oxide catalyst LiNbMoO(6).

Chemoselective sulfur oxidation of allylic sulfides containing double bonds of high electron density due to multiple alkyl substituents or extended conjugation was developed using the composite metal oxide catalyst, LiNbMoO(6), without any epoxidation of the electron-rich double bond(s). Selective oxidation to either the corresponding sulfoxides or the sulfones was realized by controlling the stoichiometry of the quantitative oxidant, H(2)O(2). This new oxidant system had general applicability for chemoselective oxidation of various allylic, benzylic, or propargylic sulfides containing unsaturated carbon-carbon bonds with different electron properties. Various functional groups including hydroxy, formyl, and ethers of THP or TBDMS are compatible under this mild oxidation reaction condition.

Culturally related anxiety and ethnic identity in Navajo college students.

The Cultural Involvement and Detachment Anxiety Questionnaire (D. W. McNeil, C. A. Porter, M. J. Zvolensky, & J. M. Chaney, 1998) and the Multigroup Ethnic Identity Measure (J. S. Phinney, 1992) were administered to 160 Navajo college students to explore the relation between ethnic identity and culturally related anxiety, compare level of ethnic identity in reference to standardized samples, and test for gender differences. Correlations indicated a notable lack of relation between ethnic identity and cultural anxiety. This particular Navajo sample evidenced significantly higher levels of ethnic identity in comparison to students of Caucasian, Asian, Hispanic, or mixed ethnicity. There were no significant gender differences in culturally related anxiety. Results are discussed in relation to culturally related anxiety and ethnic identity in the Navajo, with implications for better understanding the nature of cultural anxiety in other American Indians and Alaska Natives.

Poisoning by amatoxin-containing mushrooms in suburban New York--report of four cases.

We report four cases of poisoning with amatoxin-producing mushrooms in suburban Long Island. All occurred when amateur mushroom hunters picked mushrooms from neighboring lawns. Two patients presented 30 hours post ingestion with evidence of acute hepatic dysfunction. One survived, after treatment with charcoal and penicillin; the other, a 90-year-old woman with prior cardiac disease soon developed shock and subsequently died. The other two patients were admitted 18 hours after ingestion of Lepiota chlorophyllum and received prompt charcoal hemoperfusion. Both did well, although one had a mild elevation of transaminases. Although most reports of amatoxin poisoning originate in Europe, these cases confirm that amatoxin-producing mushrooms, including Lepiota chlorophyllum, may be found in northeastern American suburbs. Such patients who present prior to 24 hours after ingestion should receive charcoal hemoperfusion if a lethal dose (> 50 g of mushroom) has been eaten.

Post-traumatic stress disorder and civil violence in Northern Ireland.

The case records of 499 victims of civil and terrorist violence were examined, and the presence or absence of post-traumatic stress disorder (PTSD) and associated features recorded. The results support the face, and predictive, validities of PTSD. 'Acting as if the event were reoccurring' and 'survivor guilt' seemed not to be characteristic symptoms, and the homogeneity of the emotional state in PTSD was questionable. Only marital disharmony and suicidal behaviour were associated complications. PTSD seemed to be found in a wide range of stressors, but the danger in over-reliance on results from combat veterans is emphasised.

Post-traumatic stress in Northern Ireland.

The sample studied was a group of 643 adults each seeking compensation for "Nervous Shock" and seen by a single Belfast psychiatrist for medico-legal assessment. Demographic information, risk factors, diagnosis, type of incident, symptoms and outcome were recorded for each patient. From the symptoms recorded, a subgroup of 23% were identified as suffering from Post-Traumatic Stress Disorder (PTSD) as defined in DSM III. This subgroup tended to be older, included more females, had more depressive symptoms and had more severe, prolonged disturbance. The findings document our experience of PTSD in the special context of Northern Ireland and suggest it may be a more useful term in describing psychological reaction to violence than the nebulous concept of "Nervous Shock" used at present by our courts.