Sexual risk behavior in women with cervical human papillomavirus infection

In a study of 972 women, sexual characteristics of 66 women with a cervical human papillomavirus infection (CHPI) were compared to the remaining study population. Among a number of sexual variables that were significantly correlated with CHPI were number of lifetime sexual partners, short partnerships, many recent partners, infidelity, casual travel sex, sexual début abroad, oral and anal sex, and sexual abuse. In multifactorial analyses four variables remained significantly correlated with CHPI, i.e., number of lifetime sexual partners, casual travel sex, sexual début abroad, and infidelity. It is concluded that CHPI shows most of the epidemiological characteristics of a sexually transmitted disease.     

Medical follow-up visits in adults 5-25 years after treatment for childhood acute leukaemia, lymphoma or Wilms' tumour

Aim: One aspect of organizing medical follow-up for adult survivors of childhood cancer is to determine to what extent the former patient experiences a need for health services. In the present paper, we studied how the healthcare needs, both subjectively and objectively, were fulfilled for our former patients. Methods: 335 survivors over 18 y of age, with a follow-up time of more than 5 y after completion of therapy, were sent a questionnaire probing their present use of health services. Results: The response rate was 73%. A majority (60%) of the survivors had no regular follow-up visits, and 42% of these reported that they missed not having one. More than one third were thus far dissatisfied with the follow-up programme. Only 3% of those who had regular follow-ups found them “unnecessary”. Complaints subjectively related to their diseases or treatments were reported by 47%. Out of all responders, 34% did not miss having regular follow-up visits. Neither perceived disease-related complaints nor radiation therapy was a predictor for having a scheduled follow-up visit.

Conclusion: In the absence of a long-term follow-up programme, many survivors were not receiving proper medical healthcare, whether from their perspective or from a professional one.     

Single blastocyst transfer after ICSI from ejaculate spermatozoa, percutaneous epididymal sperm aspiration (PESA) or testicular sperm extraction (TESE)

Purpose: To investigate the outcome of IVF following intracytoplasmic sperm injection (ICSI) from ejaculate, percutaneous epididymal sperm aspiration (PESA) and testicular sperm extraction (TESE), with subsequent blastocyst culture and single blastocyst transfer. Methods: Single blastocyst transfer was performed after ejaculate ICSI (oligozoospermia) in 587 patients, TESE/PESA (azoospermia) in 31 patients, and standard IVF in 680 women. Results: There were only minor differences in IVF characteristics between the standard IVF and the PESA-TESE couples. Couples where ejaculate ICSI were performed seemed to represent a slightly poorer prognostic group. A viable fetus after the 12th gestational week, i.e. ongoing pregnancy, was present in 41.4% after ICSI/ET, 51.6% after PESA-TESE/ET and in 40.4% after standard IVF/ET (no significant differences). Conclusion: Single blastocyst transfer after ejaculate ICSI or after PESA/TESE appears to give similar results as conventional IVF blastocyst culture.     

Biological consequences of exposing ileal mucosa to urine

Segments of ileum are often used as conduits in connection with supravesicle diversion or sometimes for bladder augmentation. This implies that ileal mucosa will be deprived of the normal intestinal contents and instead exposed to urine. Reports on the morphological consequences of exposure to urine have been contradictory. Either normal structure or various degrees of atrophy have been reported. For this reason, an investigation was designed for systematic follow-up of effects on the ileal mucosa in patients with continent ileal reservoirs for urinary collection (Kock pouch). These investigations showed that there were significant changes in villous height, crypt depth, and number of goblet cells starting early after construction and leading to complete atrophy in certain areas. Electron microscopy and enzyme histochemistry also showed, in the epithelial cells, that there was a reduction in the number of cell organelles and microvillous units, and also decreased metabolic activity. Reductions were also recorded in studies of net transport of both water and electrolytes across the mucosa of the ileal reservoir used for urinary collection.From the clinical point of view, the adaptive changes recorded in the investigations of ileal mucosa exposed to urine are advantageous, since the risk of metabolic disturbances due to reabsorption of urine is diminished.

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Resumen Segmentos de íleo son frecuentemente utilizados como canal urinario en casos de desviación supravesical o, algunas veces, para agrandamiento de le vejiga. Esto quiere decir que la mucosa ileal, en vez de recibir el contenido intestinal normal, queda expuesta a la orina. Los informes sobre las consecuencias morfológicas de la exposición a la orina han sido contradictorios; se ha informado tanto la presencia de una estructura normal como de atrofia. Por tal razón se diseñó una investigación para el seguimiento sistemático de los efectos sobre la mucosa ileal en pacientes con reservorios urinarios ileales continentes (bolsa de Kock). La investigación demostró que se presentan cambios de significación en cuanto a altura de las vellosidades, profundidad de las criptas, y número de células caliceales, comenzando muy temprano después de la creación de la bolsa y dando lugar a atrofia completa en ciertas áreas. La microscopía electrónica y la histoquímica enzimática también demostraron que en las células epiteliales había reducción en el número de los organelos, las unidades microvellosas, y una reducida actividad metabólica. También se registraron reducciones en los estudios de transporte neto tanto de agua como de electrolitos a través de la mucosa del reservorio ileal utilizado para la recolección de la orina.Desde el punto de vista clínico, los cambios de adaptación registrados en la investigación realizada sobre la mucosa ileal expuesta a orina son ventajosos, puesto que disminuyen el riesgo de alteraciones metabólicas producidas por la reabsorción de la orina.

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Résumé Des segments de l'iléon sont souvent employés pour augmenter la capacité de la vessie ou pour la remplacer. Ce fait implique que la muqueuse iléale exempte du contenu intestinal normal est exposée à l'action de l'urine. Des études sur les conséquences morphologiques dues à ce facteur ont abouti à des résultats contradictoires. Tantôt la structure a été considérée comme normale, tantôt des degrés divers d'atrophie ont été constatés. Pour cette raison une étude a été entreprise pour établir les effets secondaires de l'urine sur la muqueuse de l'iléon, en particulier après la constitution d'une néo-vessie selon la technique de Kock. Cette étude a montré des modifications significatives de la hauteur des villosités, de la profondeur des cryptes, du nombre des cellules à gobelet, modifications débutant rapidement après la confection du réservoir iléal et aboutissent à une atrophie complète en certaines zones. La microscopie électronique et l'histochimie enzymatique ont montré qu'au niveau des cellules épithéliales se manifestent aussi une réduction du nombre des organelles cellulaires, des unités microvilleuses, et de l'activité métabolique. Une réduction du transport à la fois de l'eau et des électrolytes au travers de la muqueuse iléale du réservoir a été également constatée.D'un point de vue clinique, les phénomènes d'adaptation constatées au niveau de la muqueuse iléale soumise au contact de l'urine ont pour avantage de réduire les risques d'altérations métaboliques dues à la réabsorption de l'urine.

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Supported by grants from the Swedish Medical Research Council (no. 00577).     

The combined use of immunohistochemistry and intracellular staining with horseradish peroxidase for light and electron microscopic studies of transmitter-identified inputs to functionally characterized neurons

Physiologically identified triceps surae alpha motoneurons in the cat were stained intracellularly with horseradish peroxidase (HRP). After fixation with 2% glutaraldehyde and treatment with sodium borohydride, spinal cord sections were incubated with rabbit antiserum against thyrotropin-releasing hormone (TRH) and rabbit peroxidase-antiperoxidase complex. Light microscopically detected close contacts between immunoreactive nerve terminals and intracellularly HRP-stained profiles were studied under the electron microscope. In this way, synaptic contacts between TRH-immunoreactive boutons and functionally characterized alpha motoneurons could be demonstrated.     

Adolescents' experiences of being food-hypersensitive: a qualitative study

Background  

Experiencing or being at risk of adverse reactions to certain food items is a common health issue, especially among children and adolescents. Research has shown that living with the risk of food reactions and always having to take measures to avoid certain food in one's diet has a negative impact on quality of life. The aim of this study was to illuminate adolescents' experiences of being food hypersensitive.     

The expression profile of p14, p53 and p21 in tumour cells is associated with disease-specific survival and the outcome of postoperative chemotherapy treatment in muscle-invasive bladder cancer

Purpose: We investigated the effects of alterations in the biological markers p14, p53, p21, and p16 in relation to tumour cell proliferation, T-category, N- category, lymphovascular invasion, and the ability to predict prognosis in patients with muscle-invasive bladder cancer (MIBC) treated with cystectomy and, if applicable, chemotherapy.Materials and methods: We prospectively studied patients with urinary bladder cancer pathological stage pT1 to pT4 treated with cystectomy, pelvic lymph node dissection and postoperative chemotherapy. Tissue microarrays from paraffin-embedded cystectomy tumour samples were examined for expression of immunostaining of p14, p53, p21, p16 and Ki-67 in relation to other clinical and pathological factors as well as cancer-specific survival.Results: The median age of the 110 patients was 70 years (range 51-87 years), and 85 (77%) were male. Pathological staging was pT1 to pT2 (organ-confined) in 28 (25%) patients and pT3 to pT4 (non-organ-confined) in 82 (75%) patients. Lymph node metastases were found in 47 patients (43%). P14 expression was more common in tumours with higher T-stages (P?=?0.05). The expression of p14 in p53 negative tumours was associated with a significantly shorter survival time (P=0.003). Independently of p53 expression, p14 expression was associated with an impaired response to chemotherapy (P=0.001). The expression of p21 in p53 negative tumours was associated with significantly decrease levels of tumour cell proliferation detected as Ki-67 expression (P=0.03).Conclusions: The simultaneous expression of the senescence markers involved in the p53-pathway shows a more relevant correlation to the pathological outcome of MIBC than each protein separately. P14 expression in tumours with non-altered (p53-) tumours is associated with poor prognosis. P14 expression is associated with impaired response to chemotherapy. P21 expression is related to decreased tumour cell proliferation.     

A novel ECEL1 mutation expands the phenotype of distal arthrogryposis multiplex congenita type 5D to include pretibial vertical skin creases

Arthrogryposis multiplex congenita (AMC) is a heterogeneous disorder characterized by multiple joint contractures often in association with other congenital abnormalities. Pretibial linear vertical creases are a rare finding associated with arthrogryposis, and the etiology of the specific condition is unknown. We aimed to genetically and clinically characterize a boy from a consanguineous family, presenting with AMC and pretibial vertical linear creases on the shins. Whole exome sequencing and variant analysis revealed homozygous novel missense variants of ECEL1 (c.1163T > C, p.Leu388Pro, NM_004826) and MUSK (c.2572C > T, p.Arg858Cys, NM_005592). Both variants are predicted to have deleterious effects on the protein function, with amino acid positions highly conserved among species. The variants segregated in the family, with healthy mother, father, and sister being heterozygous carriers and the index patient being homozygous for both mutations. We report on a unique patient with a novel ECEL1 homozygous mutation, expanding the phenotypic spectrum of Distal AMC Type 5D to include vertical linear skin creases. The homozygous mutation in MUSK is of unknown clinical significance. MUSK mutations have previously shown to cause congenital myasthenic syndrome, a neuromuscular disorder with defects in the neuromuscular junction.