A leg ulcer as manifestation of metastatic squamous cell vaginal carcinoma

Cutaneous metastasis of vaginal carcinoma is extremely rare. So far, the total number of reported skin metastasis of vaginal carcinoma is only one. We present another case with an unusual manifestation of vagina carcinoma metastasis: skin metastasis presenting as a leg ulcer on the lower leg.     

Epidemiology, the humanities, and public health.

Epidemiologists may benefit from the disciplines of history, philosophy of science, ethics, literature, and art. Within these disciplines lie answers to the questions of who we are, what is right, how to think, and when to act. Studying and participating in the humanities may also help epidemiologists focus their professional concerns on the humanity their methods serve. A parallel phenomenon in the clinical sciences--medical humanities--provides support for the approach (and some lessons).     

Localization of a gene for otosclerosis to chromosome 15q25-q26

Among white adults otosclerosis is the single most common cause of hearing impairment. Although the genetics of this disease are controversial, the majority of studies indicate autosomal dominant inheritance with reduced penetrance. We studied a large multi- generational family in which otosclerosis has been inherited in an autosomal dominant pattern. Five of16 affected persons have surgically confirmed otosclerosis; the remaining nine have a conductive hearing loss but have not undergone corrective surgery. To locate the disease- causing gene we completed genetic linkage analysis using short tandem repeat polymorphisms (STRPs) distributed over the entire genome. Multipoint linkage analysis showed that only one genomic region, on chromosome 15q, generated a lod score >2.0. Additional STRPs were typed in this area, resulting in a lod score of 3.4. STRPs FES (centromeric) and D15S657 (telomeric) flank the 14. 5 cM region that contains an otosclerosis gene.      

Peritoneal fluid concentrations of interleukin-8 in women with endometriosis: relationship to stage of disease

There is increasing evidence that immunological mechanisms play a role in the pathogenesis and pathophysiology of endometriosis. It was therefore of interest to study interleukin-8 (IL-8), a chemokine, in the peritoneal fluid and peripheral blood of women undergoing laparoscopic procedures. The presence and concentrations of IL-8 in relation to endometriosis, infertility and abdominal pain were evaluated. Samples of peritoneal fluid (n = 49) and peripheral blood (n = 50) were obtained from 50 consecutive patients undergoing laparoscopic surgery for various gynaecological indications (abdominal pain, infertility, sterilization). IL-8 was present in the peritoneal fluid of most women (87%). The concentration of IL-8 in the peritoneal fluid was higher in women with endometriosis compared to women without (P = 0.02). This difference was more pronounced in early (stage 1) endometriosis (P = 0.001). IL-8 concentrations in the peritoneal fluid were also higher in women with early endometriosis compared to women with later stages of the disease (P = 0.003). Peripheral blood concentrations did not correlate with peritoneal fluid concentrations of IL-8 and/or the presence of endometriosis. We conclude that IL-8 is an important factor that may contribute to the pathogenesis of endometriosis possibly by promoting neovascularization. This information can be a guide in the development of new therapeutic approaches for the treatment of endometriosis.      

Evaluation of calcium alginate-tipped aluminum swabs transported in Culturettes containing ampules of 2-sucrose phosphate medium for recovery of Chlamydia trachomatis

Two calcium alginate-tipped wire swab specimens were obtained from 94 men and 106 women attending a sexually transmitted disease clinic. One swab was extracted thoroughly in 2-sucrose phosphate (2SP) immediately after obtaining the specimen. The second swab was returned to the Culturette cylinder (Marion Scientific, Kansas City, MO), and the ampule containing 2SP was crushed to moisten the swab during transport to the laboratory. After receipt in the laboratory, the swab was removed from the Culturette and extracted into 2 mL of 2SP. Both specimens then were cultured for the presence of Chlamydia trachomatis in McCoy's cells. C. trachomatis was recovered from 22 of 94 men (23.4%); 16 isolates came from both the Culturette swabs and vials. Six isolates were recovered exclusively from vials. Of 106 women, 13 (12.3%) were positive for C. trachomatis. In five instances, both vials and swabs yielded C. trachomatis; the organism was recovered eight times from vials but not swabs. The 2SP transport system for the 200 specimens was superior to the Culturettes for the recovery of C. trachomatis (P less than 0.01). Based on our results, swab specimens taken for laboratory diagnosis of C. trachomatis should be extracted immediately after collection in a vial containing 2SP. In addition, experiments comparing swab fibers indicated that there was a trend indicating higher inclusion counts with rayon-tipped swabs, compared with those containing calcium alginate. Because of possible toxicity of substances in calcium alginate fibers for several organisms causing sexually transmitted disease, rayon-tipped swabs or swabs of other composition should be used.