Physical activity for primary and secondary prevention. Position paper of the Working Group on Cardiac Rehabilitation and Exercise Physiology of the European Society of Cardiology

There is now clear scientific evidence linking regular aerobic physical activity to a significant cardiovascular risk reduction, and a sedentary lifestyle is currently considered one of the five major risk factors for cardiovascular disease. In the European Union, available data seem to indicate that less than 50% of the citizens are involved in regular aerobic leisure-time and/or occupational physical activity, and that the observed increasing prevalence of obesity is associated with a sedentary lifestyle. It seems reasonable therefore to provide institutions, health services, and individuals with information able to implement effective strategies for the adoption of a physically active lifestyle and for helping people to effectively incorporate physical activity into their daily life both in the primary and the secondary prevention settings. This paper summarizes the available scientific evidence dealing with the relationship between physical activity and cardiovascular health in primary and secondary prevention, and focuses on the preventive effects of aerobic physical activity, whose health benefits have been extensively documented.

Study of Adsorption from Dilute Aqueous Solutions on to Activated Carbon. Part 1. Novel Representation of Experimental Data

The dependence of the equilibrium concentration of dilute aqueous solutions of 1-propanol and 2-propanol on the mass of adsorbent for two types of activated carbon was investigated at fixed initial concentrations. Two kinds of differential equation were proposed for the characterization of these curves. The solution functions of the given differential equations were fitted to the experimental data. The second model was accepted as providing a good description of the required functional relationship. The similarity and differences in the values of the constants relative to the functions arising from the accepted model were also discussed for the two types of activated carbons.

Mini review on blood-brain barrier penetration of pyridinium aldoximes

This paper reviews the blood-brain barrier (BBB) penetration of newly developed pyridinium aldoximes. Pyridinium aldoximes are highly charged hydrophilic compounds used in the treatment of subjects exposed to organophosphonates because they are effective as acetylcholinesterase reactivators. Pyridinium aldoximes have antidotal effects against poisoning with cholinesterase inhibitors, a frequent problem affecting people working with organophosphate-based insecticides and pesticides. Toxic organophosphonate products such as sarin and tabun can be used by terrorists as chemical warfare agents. This poses a severe challenge to all innocent and peace-loving people worldwide. This review gives a brief summary of BBB transporters and description of the current in vitro and in vivo methods for the characterization of BBB penetration of established and novel pyridinium aldoximes. The authors provide a putative mechanism of penetration, outline some future ways of formulation and discuss the possible advantages and disadvantages of increasing BBB penetration.

Dendrodendritic connections between the cochlear efferent neurons in guinea pig

The outer hair cells of organ of Corti are innervated by the efferent neurons of medial olivocochlear neurons (MOC) of the brainstem which modify the cochlear auditory processing and sensitivity. Most of the MOC neurons are excited by a dominant ear and only a small portion of them is excited by both ears resulting in a binaural facilitation. The functional role of the feedback system between the organ of Corti and the cochlear efferent neurons is the protection of the ear from acoustic injury. The rapid impulse propagation in the bilateral olivocochlear system is suggestive of an electrotonic interaction between the bilateral olivocochlear neurons. The morphological background of the MOC pathway is not yet completely characterized. Therefore, we have labeled the bilateral cochlear nerves with different neuronal tracers in guinea pigs. In the anesthetized animals the cochlear nerves were exposed in the basal part of the modiolus and labeled simultaneously with different retrograde fluorescent tracers. By using confocal laser scanning microscope we could detect close appositions between the dendrites of the neurons of bilateral MOC. The distance between the neighboring profiles suggested close membrane appositions without interposing glial elements. These connections might serve as one of the underlying mechanisms of the binaural facilitation mediated by the olivocochlear system.

Isolation of 11 new polymorphic microsatellites from CA enriched turkey genomic libraries (Short communication)

Abstract. Microsatellite loci from the ancient Hungarian variety of the Broad Breasted Bronze Turkey (Meleagris gallopavo) were isolated. CA-repeat enriched libraries were constructed from DNA of randomly collected samples. Libraries were screened for repeat-containing clones by PIMA (PCR Isolation of Microsatellite Arrays) and the DNA-sequence of 167 positive clones was determined. A total of 136 microsatellite repeat-containing sequences were found, 59 sequences were unique. Comparing these with the genomic databases, we found 7 previously annotated microsatellite sequences. The newly isolated 52 microsatellites were tested on the mapping population of the University of Minnesota, and the map position of 11 microsatellites was determined.

Medicinal chemistry of drugs used in diabetic cardiomyopathy

Diabetes mellitus is a common disease and contributes to a high degree of morbidity and mortality. Cardiovascular complications, including diabetic cardiomyopathy are major causes of morbidity and mortality in diabetic patients. Diabetic cardiomyopathy is a condition that affects the myocardium, primarily. It is not necessarily associated with ischemic heart disease, high blood pressure, valvular or congenital anomalies. The pathology of diabetic cardiomyopathy includes interstitial fibrosis, apoptosis of cardiomyocytes, abnormal energy utilization, small vessel disease and cardiac neuropathy. These pathologies are induced by hyperglycemia and oxidative stress. Biochemical as well as electrolyte changes, especially reduced calcium availability also occurs in the myocardium of diabetic patients. The abnormal structure and biochemistry of the myocardium result in functional problems such as diastolic and systolic dysfunctions, which may cause symptoms of dyspnea and inability to tolerate exercise. No single specific therapeutic agent can treat diabetic cardiomyopathy because once the disease is overt, the management may require a variety of approaches such as risk factors and lifestyle modification, glucose control (insulin, alpha glucosidase inhibitors, sulfonylureas, biguanides, meglitinides, thiazolidinediones and dipeptidyl peptidase 4 (DPP-4) inhibitors); hormones (IGF-1); ACE inhibitors (captopril, enalapril); angiotensin II receptor antagonists (losartan, olmesartan); beta adrenoreceptor antagonists (acebutolol, carvedilol); peptides (adrenomedullin); endothelin-1 receptor antagonists (bosentan, tezosentan); calcium channel blockers (amlodipine, verapamil); antioxidants (methalothionein, alpha tocopherol, alpha lipoic acid) and antihyperlipidemic drugs (simvastatin, fenofibrate, ezetimibe) to effectively treat patients with diabetic cardiomyopathy.

Sequence and expression analysis of the androgen receptor gene from Compact mouse (Brief Report)

Abstract. The phenotype of hypermuscled Compact mouse is determined by the MstnCmpt-dl1Abc myostatin mutation and also by additional modifier genes, mapped to different chromosome regions (VARGA et al. 1997, SZABÓ et al. 1998, VARGA et al. 2003, VARGA et al. 2005). The androgen receptor gene (Ar) was considered to be a potential candidate gene on the basis of our mapping results and its function, as it is located in that region of the X chromosome, where the strongest modifier effect was detected in the males and because Ar was described earlier as a regulator of TGF-ß (CHIPUK et al. 2002). A similar regulation could thus also be assumed through the androgen response element of myostatin, a member of the TGF-ß superfamily (MA et al. 2001). The sex-influenced nature of the Compact phenotype (VARGA et al. 1997, BÜNGER et al. 2005) appeared to strengthen this hypothesis. In this study we analysed the coding sequence of the Ar locus in Compact mice and the expression of Ar mRNA by quantitative Real-Time PCR.

Survivin promoter polymorphism and cervical carcinogenesis

BACKGROUND

Survivin, a novel member of the inhibitor of apoptosis family, plays an important role in cell cycle regulation. A common polymorphism at the survivin gene promoter (G/C at position 31) was shown to be correlated with survivin gene expression in cancer cell lines.

AIM

To investigate whether this polymorphism could be involved in the development of human papillomavirus (HPV)-associated cervical carcinoma.

METHODS

Survivin promoter polymorphism was detected in patients with cervical cancer, in patients with equivocal cytological atypia and in a control population using polymerase chain reaction (PCR-restriction fragment length polymorphism (RFLP) and PCR-single strand conformation polymorphism analysis. HPV was typed in patients with cervical cancer and cytological atypia using PCR-RFLP.

RESULTS

No statistically significant differences were found in the genotype distributions of the survivin promoter variants among our study groups.

CONCLUSIONS

The survivin promoter polymorphism at position 31 may not represent an increased risk for the development of cervical cancer, at least in the population studied here.

Evaluation of CD detection in an HPLC system for analysis of DHEA and related steroids

The biological importance of dehydroepiandrosterone (DHEA) is reflected by the fact that DHEA is a crucial precursor of the biosynthesis of the steroidal sex hormones. Simultaneous separation of DHEA, dehydroepiandrosterone sulfate (DHEA-S), pregnenolone, androstenedione and testosterone has been accomplished by reversed-phase ion-pair high-performance liquid chromatography (RP-IP-HPLC) based on isocratic elution applying circular dichroism (CD) detection at 295 nm. Addition of tetrabutylammonium hydrogensulfate to the mobile phase increases the retention of DHEA-S on the C8-silica column by an apparent ion-pairing mechanism without affecting the retention of the other (non-ionic) steroids. CD spectroscopy provides highly selective detection of compounds possessing optically active absorption bands and the separation is even more selective in the higher wavelength range applied. The linearity of the steroid concentration (c, mg mL(-1)) versus peak area was tested in the concentration range of 0.5-2 mg mL(-1) (injected quantities were 10-40 microg). The relative standard deviation (RSD) values for DHEA and DHEA-S indicated a good intra-assay and inter-assay precision of the method.

P boutons in lamina IX of the rodent spinal cord express high levels of glutamic acid decarboxylase-65 and originate from cells in deep medial dorsal horn

Presynaptic inhibition of primary muscle spindle (group Ia) afferent terminals in motor nuclei of the spinal cord plays an important role in regulating motor output and is produced by a population of GABAergic axon terminals known as P boutons. Despite extensive investigation, the cells that mediate this control have not yet been identified. In this work, we use immunocytochemistry with confocal microscopy and EM to demonstrate that P boutons can be distinguished from other GABAergic terminals in the ventral horn of rat and mouse spinal cord by their high level of the glutamic acid decarboxylase (GAD) 65 isoform of GAD. By carrying out retrograde labeling from lamina IX in mice that express green fluorescent protein under the control of the GAD65 promoter, we provide evidence that the cells of origin of the P boutons are located in the medial part of laminae V and VI. Our results suggest that P boutons represent the major output of these cells within the ventral horn and are consistent with the view that presynaptic inhibition of proprioceptive afferents is mediated by specific populations of interneurons. They also provide a means of identifying P boutons that will be important in studies of the organization of presynaptic control of Ia afferents.

Effect of human papillomavirus type 16 E6 and E7 oncogenes on the activity of the transforming growth factor-?2 (TGF-?2) promoter

The effect of the human papillomavirus type 16 (HPV 16) E6 and E7 proteins was studied on the transcriptional activity of the human transforming growth factor beta2 (TGF-beta) promoter in different cell lines. Luciferase tests were performed after co-transfection of cells with TGF-beta2 reporter constructs and HPV 16 E6 or E7 expression vectors. HPV 16 E7, but not E6 significantly repressed TGF-beta2 promoter activity in NIH/3T3 cells, which have wild-type p53 and pRb proteins. The repressive effect of HPV 16 E7 on the transcriptional activity of the TGF-beta2 promoter could be localized to the promoter region -528 to -251 relative to the transcriptional start site. Ability of E7 to bind pRb was necessary to inhibit the TGF-beta2 promoter. Over-expression of the transcription factor E2F-1 had an effect on the TGF-beta2 promoter similar to that of E7, which may indicate that HPV 16 E7 represses the TGF-beta2 promoter by releasing E2F from pRb.

Secondary prevention through cardiac rehabilitation: position paper of the Working Group on Cardiac Rehabilitation and Exercise Physiology of the European Society of Cardiology

The purpose of this statement is to provide specific recommendations in regard to evaluation and intervention in each of the core components of cardiac rehabilitation (CR) to assist CR staff in the design and development of their programmes; the statement should also assist health care providers, insurers, policy makers and consumers in the recognition of the comprehensive nature of such programmes. Those charged with responsibility for secondary prevention of cardiovascular disease, whether at European, at national or at individual centre level, need to consider where and how structured programmes of CR can be delivered to the large constituency of patients now considered eligible for CR.

Persisting TT virus (TTV) genogroup 1 variants in renal transplant recipients

TT virus (TTV) genogroup 1 infection has an increased prevalence in solid organ transplant recipients. In this study, the presence of TTV in renal transplant recipients was examined by two PCR methods, one capable of detecting most TTV genotypes (UTR-PCR), the other specific to genogroup 1 (N22-PCR). The N22-PCR detected TTV in 57% (53/92) of the renal transplant patients and in 20% (13/66) of the healthy individuals, while the prevalence of TTV with the UTR-PCR was above 90% in both the control and the patient groups. The N22-PCR was used in longitudinal studies of 31 renal transplant recipients, these PCR products were sequenced and aligned. TTV status was not associated with the patients' age at transplantation, male to female ratio and the time lag between kidney transplantation and the TTV test. During the follow-up consistent TTV status was found in 26 patients, while two initially TTV positive patients converted to negative and three initially negative patients converted to positive. The TTV variants varied among the tested patients, but were the same in the consecutive samples of each patient, indicating that TTV infection was persistent in renal transplant recipients and novel infection occurred rarely in the post-transplant period.

Human cytomegalovirus load in the peripheral blood determined by quantitative competitive polymerase chain reaction

Primary human cytomegalovirus infection and the viral reactivation from latency are major complications in organ transplant recipients. In the peripheral blood the replicating virus can be detected either by nucleic acid based tests or by demonstrating the HCMV structural proteins in antigenemia test. We developed a quantitative competitive PCR method to assess the HCMV load in the peripheral blood. The viral load in nine healthy blood donors and in four renal transplant recipients with negative antigenemia test was in the same range: 5-124 (median: 18) HCMV copies/10(6) beta-globin copies for healthy blood donors and 16-48 (median: 37) HCMV copies/10(6) beta-globin copies for the transplant recipients. Three antigenemia positive renal transplant recipients had a HCMV load of 2.2 x 10(5)/10(6) beta-globin, 1.5 x 10(4)/10(6) beta-globin and 6.5 x 10(3)/10(6) beta-globin, respectively. In conclusion, the quantitative measurement of HCMV load in the peripheral blood correlated well with the routine HCMV antigenemia test. The DNA-based test, however can detect earlier the reactivation of the HCMV infection.

Hypoglycemia activates compensatory mechanism of glucose metabolism of brain

The effect of plasma glucose concentration on the cerebral uptake of [18F]-fluorodeoxy-D-glucose (FDG) was studied in a broad concentration range in a rabbit brain model using dynamic FDG PET measurements. Hypoglycemic and hyperglycemic conditions were maintained by manipulating plasma glucose applying i.v. glucose or insulin load. FDG utilization (K) and cerebral glucose metabolic rate (CGMR) were evaluated in a plasma glucose concentration range between 0.5 mM and 26 mM from the kinetic constant k1, k2, k3 obtained by the Sokoloff model of FDG accumulation. A decreasing set of standard FDG uptake values found with increasing blood glucose concentration was explained by competition between the plasma glucose and the radiopharmacon FDG. A similar trend was observed for the forward kinetic constants k1, and k3 in the entire concentration range studied. The same decreasing tendency of k2 was of a smaller magnitude and was reverted at the lowest glucose concentrations where a pronounced decrease of this backward transport rate constant was detected. Our kinetic data indicate a modulation of the kinetics of carbohydrate metabolism by the blood glucose concentration and report on a special mechanism compensating for the low glucose supply under conditions of extremely low blood glucose level.

[Myocarditis simulating myocardial infarction]

Acute myocarditis caused by infectious mononucleosis simulated myocardial infarction, initially the quantitative and qualitative blood picture was normal. Repeated blood and serological studies confirmed the diagnosis, which was altered by acute porphyria caused by infection. In each case of young patients with myocardial infarction and in older patient with coexisting infectious symptoms, myocarditis must be considered. Since the cardiac manifestation may precede the infectious disease symptoms, repeating the necessary examinations may be mandatory.

Transcriptional activity of human papillomavirus type 16 variants having deletions in the long control region

Transcription of the E6 and E7 viral oncogenes of human papillomavirus (HPV) type 16 is regulated by the P97 major early promoter, and enhancer and silencer elements found in the long control region (LCR). In this study, we tested the transcriptional activity of natural HPV 16 variants having long deletions in the LCR. The HPV 16 LCR regions were amplified from invasive cervical cancer specimens, and cloned into the reporter vector pALuc. Transcriptional activity of the different clones was measured by luciferase test after transient transfection into HeLa cells. The deletions found in the LCR encompassed parts of the enhancer and either the YY1-specific silencer alone or together with the CDP-specific silencer. The transcriptional activity of these deletion variants were usually reduced compared with that of the corresponding full-length clones. However, a deletion variant lacking the whole enhancer and both silencer regions retained substantial enhancer activity on the P97 promoter. These results point to the existence of a novel context-dependent enhancer element in the 5' LCR of HPV 16.

Prevalence and age distribution of human herpesvirus-8 specific antibodies in Hungarian blood donors

Sera of blood donors were investigated by a peptide ELISA and indirect immunofluorescence assay to assess the prevalence of HHV-8 infection in the Hungarian population. A 14 amino acid long synthetic oligopeptide from the carboxyterminus of orf65/small virus capsid antigen was used as antigen in the ELISA. ELISA results were confirmed by recombinant orf65 antigen Western blot. Antibodies to the latent nuclear antigen were detected by the immunofluorescence assay. Nine of 12 sera obtained from patients with classical Kaposi sarcoma were reactive by ELISA whereas all were positive by immunofluorescence. Four of 482 (0.83%) healthy blood donors had anti-orf65 peptide antibodies and 17/1089 (1.56%) had antibodies to the latent nuclear antigen. In a group of children ages 1-14 years, antibodies to the latent nuclear antigen (0/29) were not detected. The prevalence of antibodies to the latent nuclear antigen showed a moderate but significant increase in correlation with senescence. In the Kaposi sarcoma patients, the titre of antibodies to the latent nuclear antigen was significantly higher than in the healthy seropositive donors. The overall HHV-8 seroprevalence by the two assays was 2.28% (11/482) in the Hungarian blood donor group.

HHV-8 ELISA based on a one-step affinity capture of biotinylated K8.1 antigen

The immunogenic envelope antigen gp35-37 of human herpesvirus-8 (HHV-8) is encoded by orfK8.1. An ELISA is described using streptavidin capture of bacterially expressed and biotinylated recombinant K8.1 antigen. The antigen capture strategy provides a simple and reliable method, which does not require high yield production and purification of the recombinant antigen before the serological assay. The specificity and sensitivity of the K8.1 ELISA were validated by gp35-37 envelope antigen Western blot and anti-lytic membrane immunofluorescence assay using lytically induced HHV-8 infected BCBL-1 cells. Under the established ELISA conditions, eight of the 10 Kaposi's sarcoma patients and five of the 180 healthy blood donors had IgG antibodies to K8.1 envelope antigen.

Cardiac rehabilitation: applying exercise physiology in clinical practice

In this paper new insights into the beneficial effects of physical training for patients with coronary artery disease are reviewed. Endurance training as part of a comprehensive cardiac rehabilitation programme in combination with strength training, smoking cessation and lipid management may slow down and in some cases reverse the progress of coronary atherosclerosis. Thus, exercise training remains an invaluable tool in the hands of the clinical cardiologist dealing with chronic coronary care.

Integration status of virus DNA and p53 codon 72 polymorphism in human papillomavirus type 16 positive cervical cancers

BACKGROUND

The aim of this study was to determine the physical state of HPV16 DNA and to reveal any association between the physical state of virus DNA and pathologic or prognostic factors in HPV16 positive cervical cancers. The other aim was to estimate the role of p53 codon 72 polymorphism in disease progression.

MATERIALS AND METHODS

The presence and physical state of HPV16 DNA was analysed by Southern blot hybridisation and E1-E2 specific PCRs in the primary tumours and pelvic lymph nodes of 85 cervical carcinoma patients. Results Integrated HPV16 DNA was found in 32 out of 41 (78%) primary tumours and 2 out of 22 (95%) lymph nodes carrying HPV16 DNA. No significant association was found between integration of virus DNA and course of the disease. There was a trend towards an association between disease recurrence and the presence of the p53 codon 72 arginine homozygous genotype (OR = 3.41, p = 0.23).

CONCLUSION

The physical state of HPV16 DNA does not seem to play a major role as a prognostic indicator in Hungarian cervical cancer patients, while the p53 codon 72 genotype may have an impact on the clinical outcome of the disease.

Additional human papillomavirus types detected by the hybrid capture tube test among samples from women with cytological and colposcopical atypia

The type specificity of the human papillomavirus (HPV) Hybrid Capture Tube (HCT) test was evaluated by using typing with PCR (MY09-MY11)-restriction fragment length polymorphism (RFLP) and sequencing. All samples HCT test positive for only low-risk HPV (n = 15) or only high-risk HPV (n = 102) were confirmed, whereas 9 of 12 HCT test double-positive samples contained only high-risk HPV types as determined by PCR-RFLP. Several high-risk HPV types (HPV-53, -58, -62, -66, -CP8304, and -MM4) not included in the HCT test were indeed detected, indicating a broader detection range with retained distinction between low-risk and high-risk HPV types.

Frequency of p53 codon 72 genotypes in human papillomavirus associated squamous intraepithelial lesions and cervical cancer

BACKGROUND

A recent study suggested that the p53Arg (at residue 72) homozygous genotype could be a potential genetic risk factor for cervical cancer among white women. To confirm this result we examined the proportion of p53 genotypes in a larger number of patients with cervical cancer and in patients with squamous intraepithelial lesions (SIL) compared to a control population.

MATERIALS AND METHODS

We used allele-specific primers to amplify the p53Arg and p53Pro sequences and we examined the proportion of genotypes in the study populations using chi 2-test.

RESULTS

The distributions of p53Arg homozygous, heterozygous and p53Pro homozygous genotypes were 63%, 27% and 10% in cervical cancer patients, 53%, 36% and 8% in individuals with SIL, and 60%, 36% and 4% in control population. Using chi-square test, no significant difference was found between genotype frequencies in the study groups.

CONCLUSION

Thus, the p53Arg homozygous genotype does not seem to increase the risk of cervical cancer in Hungarian women.

Functional significance of sequence variation in the E2 gene and the long control region of human papillomavirus type 16

The long control region (LCR) and the E2 protein of human papillomaviruses (HPV) are the most important viral factors regulating transcription of the viral oncogenes E6 and E7. Sequence variation within these genomic regions may have an impact on the oncogenic potential of the virus. Sequence variation in the LCR and in the E2 gene of human papillomavirus type 16 (HPV-16) isolates originating from cervical cancer patients from East Hungary was studied. In 30 samples, sequencing and/or single-strand conformation polymorphism analysis revealed variants belonging to the European variant lineage of HPV-16. These variants differed from the reference European clone only slightly in their E2 and LCR sequences. Three samples represented variants belonging to the Asian-American group. These differed from the published reference sequence at several positions in the LCR and E2 regions. Compared to the reference clone, the LCR clones of the European isolates showed very similar transcriptional activities, while that of an Asian-American isolate had approximately 1.7-fold increased activity. Most of the increased activity of the Asian-American isolate could be ascribed to nucleotide changes found at the 3' end of the LCR (nt 7660-7890). The transcriptional transactivation potentials of the HPV-16 E2 isolates differed only slightly from each other, and the differences seemed to be independent of the taxonomic position of the isolates.

Consistent polymerase chain reaction-single-strand conformation polymorphism pattern of human herpesvirus-8 in the course of classical Kaposi's sarcoma assumes its clonal origin

There is emerging evidence that Kaposi's sarcoma-associated herpesvirus (KSHV or HHV-8) has a central role in the pathogenesis of Kaposi's sarcoma (KS). The occurrence of HHV-8 in classical KS biopsies is reported irrespective of its clinical stage (patch, plaque, nodular). HHV-8 was detected in 25 of 28 formalin-fixed paraffin-embedded classical KS samples by nested polymerase chain reaction. In addition, in six patients multiple tumors were available (n = 21). Single-strand conformation polymorphism (SSCP) analysis of the amplicons showed uniform SSCP pattern of samples belonging to the same patient regardless of whether the KS was multiplex or developed again years after the first excision. Most of the SSCP patterns were confirmed by further sequence analysis. The presence of the same sequence variant of HHV-8 in various samples of the same patient supports the clonal origin of classical Kaposi's sarcoma.

[Follow-up of high risk, human papillomavirus (HPV)-positive patients with cancer of the uterine cervix]

The study population consisted of 30 cervical cancer patients stage I.a-II.b. (FIGO) stages operated on according to the Wertheim technique. A parallel histological evaluation and HPV status determination were carried out on biopsies from the primary tumors and on the regional lymph nodes. A general primer mediated polymerase chain reaction (PCR) was performed at first and the samples not amplified were examined by type-specific primers. All except one primary tumors contained DNA-sequences characteristic for high risk HPV-types. The lymph nodes of these HPV-positive patients proved to be also HPV-positive with a frequency of 25/30 (83%). The frequency of the HPV-positivity was higher (100%) in the group of patients with HPV-18 positive status, than in the HPV-16 positive group. Two thirds of the evaluated regional lymph nodes were HPV-positive in the HPV-16 group of patients. The same HPV-types were harboured by the primary tumors and by the regional lymph nodes both in the HPV-16 positive and HPV-18 positive groups of patients. In the HPV-16-positive group of patients metastatic lymph nodes occurred with a frequency of 3/16, while the frequency of HPV-16 positivity in the same nodes was 11/15. In the group of patients with HPV-18 positivity the difference was even greater, 1/12 v. 12/12. Early recurrences were detected in a relation of 3 to 1 in the group of patients with histologically tumor-free and metastatic-positive lymph node status. At the same time all of the lymph nodes in this group with early recurrency (4/4) contained DNA-sequences characteristic for the HPV-18 type. These findings raise the hypothesis that the HPV-specific nucleic acids detected in the lymph nodes can be taken as sensitive indicators of metastases. The follow-up results support these hypothesis as patients with HPV-18 positive lymph node status showed early recurrencies and short survival that is poor prognosis not corresponding to the early stage of cervical cancer with histologically negative lymph node status.

Follow-up of human papillomavirus (HPV) DNA and local anti-HPV antibodies in cytologically normal pregnant women

The high level of progesterone during pregnancy may enhance the transcription and replication of genital human papillomaviruses (HPV) through the glucocorticoid/progesterone response element found in the long control region of the viral genome. In this study, cytologically and colposcopically healthy pregnant women were subjected to a follow-up examination. Samples from the uterine cervix were collected during early pregnancy (n = 39), in the third trimester (n = 31), and a few weeks after birth (n = 30). The presence of HPV DNA was detected by polymerase chain reaction (PCR), while local secretory anti-viral IgA antibodies were demonstrated by enzyme-linked immunosorbent assay using synthetic peptide antigens. Follow-up examination by PCR revealed HPV DNA persistence in 5 women. In 5 other cases, HPV positivity changed from negative to positive during the follow-up. There was 1 case which changed from positive to negative and 1 in which the HPV type changed during the study. Altogether, 12 of 39 women (31%) were shown to harbor HPV DNA at some time during follow-up. HPV DNA positivity increased from 18% during early pregnancy to 27% after birth (difference not significant). On the other hand, there was a significant rise in the level of local antibodies against HPV antigens (E2, E7, and L2) between samples collected in early pregnancy and those collected after birth (P < 0.0001). This may indicate the reactivation of genital HPV infections during late pregnancy.

Study of Adsorption from Dilute Aqueous Solutions on to Activated Carbon. Part 2. Some Exotic Adsorption Isotherms

Adsorption isotherms for the adsorption of 1-propanol and 2-propanol from dilute aqueous solution on to two types of activated carbon were presented at fixed different initial concentrations. The confidence limits for the specific excess relative to these fixed initial concentrations were also given. The high precision calculation of these error terms was based on the model description of the equilibrium concentration versus sorbent concentration curves discussed previously. The Dubinin–Radushkevich representation of the adsorption data was presented and tested for the same adsorption data. It appears that in some cases the adsorbed amount as expressed by the specific excess depends not only on the equilibrium concentration of the supernatant solution but also on the initial concentration and sorbent concentration. The so-called characteristic isotherms were also calculated in order to compare the various adsorption systems.

Correlation of human papillomavirus 16 and 18 with prognostic factors in invasive cervical neoplasias

Forty-seven patients with cervical carcinoma were examined in order to correlate human papillomavirus (HPV) types with prognostic factors in invasive cervical neoplasias. Age, clinical stage, histological type, and grade and parity were analysed with respect to HPV status as determined by a general primer mediated polymerase chain reaction (PCR) or a type specific PCR. All but one sample (98%) harboured HPV sequences: HPV 16 was found in 26 cases (55%), HPV 18 in 19 cases (40%), and HPV 31 in 1 case. The presence of HPV 18 DNA was significantly associated with cancers developed below 40 years of age (P = 0.029). HPV 18 detection was associated with poor differentiation malignancy (P = 0.045) and histological types of poor prognosis (adenocarcinoma or nondifferentiated carcinoma; P = 0.006). HPV 18 positivity was also correlated with advanced clinical stages (FIGO II and III; P = 0.032). Parity and HPV status proved to be independent of each other (P approximately 0.99). Eighty-seven percent (27/31) of pelvic lymph nodes from HPV positive patients contained HPV DNA. The virus types found in lymph nodes were identical with those of the primary tumours in all cases. Virological results were compared to those obtained by routine histological examination. Only 6 of 27 patients with HPV positive lymph nodes had any histological evidence of metastasis. Nevertheless, the lack of metastasis as detected by histology does not exclude the possibility of relapses. Follow-up of the clinical prognostic significance of PCR detection of HPV in the possible sites of early metastases.

[Blocked atrial extrasystole simulating impaired anterograde conduction during atrial stimulation]

In a 72-years-old patient with intermittent bradycardia definitive atrial pacing was considered. Surface ECG was misleading because of demonstrating 2:1 anterograde block during atrial stimulation at a rate of 100 beats per minute. Intracardiac recordings disclosed the bigeminal occurrence of premature atrial contractions. Every second stimuli fall within the premature atrial contraction's refractory period simulating impaired AV-conduction. Our report emphasizes the importance of intracardiac recordings during atrial stimulation in order to evaluate the anterograde conduction before pacemaker implantation.

Human papillomavirus DNA and anti-HPV secretory IgA antibodies in cytologically normal cervical specimens

Cervical specimens collected from 163 cytologically healthy women were screened for the presence of human papillomavirus (HPV) DNA and anti-HPV secretory IgA antibodies. HPV DNA was detected by a general primer mediated polymerase chain reaction (PCR), which amplifies a conserved region from the L1 ORF of genital HPVs. The PCR products were typed by restriction enzyme digestion. A total of 35 samples (21.5%) were positive for HPV DNA (13 samples for HPV 6, 6 for HPV 16, 3 for HPV 18, and 13 for untypeable HPV X). HPV DNA positivity was significantly higher among women under 25 years of age (34.8%) than among the older patients (12.4%) (P < 0.001). An enzyme-linked immunosorbent assay (ELISA) using synthetic peptide antigens was carried out to detect local secretory IgA antibodies against the following HPV specific antigens: HPV 16 E2, HPV 16 E7, HPV 16 L1, HPV 16 L2, and HPV 11 L2. Thirty-four secretions (20.9%) were found to react with at least one of the oligopeptides. Anti-HPV IgA positivity was the highest among women aged 25-32 years, and it was significantly lower in both the younger and the older age groups (P < 0.05). Correlation between HPV DNA and anti-HPV IgA detection was rather weak: anti-peptide IgA positivity was 34.3% (12 of 35) among HPV DNA positive patients compared to 17.2% (22 of 128) among HPV DNA negative women (P < 0.05). The fluctuating course of latent HPV infections should be considered in evaluating the low level of correlation between HPV DNA and anti-HPV IgA positivity.

[AV reciprocating tachycardia with intermittent bundle branch block in latent Wolff-Parkinson-White syndrome]

This report deals with a patient with concealed Wolff-Parkinson-White syndrome in whom both narrow and wide QRS tachycardias were observed. The simultaneous occurrence of various QRS morphology during supraventricular tachycardia results in a challenging diagnostic ECG problem. The cycle length during tachycardia with left bundle branch block was longer than the cycle length during narrow QRS supraventricular tachycardia and with functional right bundle-branch block. Electrophysiologic studies revealed fixed V-A conduction time and increased V-A conduction during tachycardia with left bundle branch block. These studies suggested the presence of a concealed left-sided anomalous pathway. Differentiation between intra- and extranodal re-entry and therapeutic modalities are also discussed.

Infra-His blocked premature atrial contractions simulating 2:1 sinoatrial block in a patient with an atrio-His bypass tract

Blocked atrial premature contractions simulated 2:1 sinoatrial block because those were superimposed on the T wave of the preceding sinus beats and were not visible on the surface electrocardiogram of our patient. Additionally, His bundle recordings and premature atrial stimulation demonstrated the presence of an atrio-His anomalous pathway. The premature atrial contractions traveled anterograde via the anomalous pathway and were blocked distally to the His bundle. The term, pseudosinoatrial block, is used to describe the arrhythmia because there was no evidence of an intrinsic abnormality of sinus node function and sinoatrial conduction.

Oral contraceptive use and human papillomavirus infection in women without abnormal cytological results

Both experimental and epidemiological data support the idea that oral contraceptive (OC) use may have a stimulating effect to a certain point on cervical carcinogenesis. The current investigation tries to answer the question whether OC use might have an influence on early human papillomavirus (HPV) infections. A total of 425 women without abnormal cytological results were examined colposcopically, and filter in situ hybridisation (FISH) was used to determine the presence of human papillomavirus (HPV) types 6, 11, 16 and 18. Eighty-one cervical specimens (19.1%) were found to be positive for one or more of the HPV types in FISH. HPV positivity was found to correlate with age and parity, being the highest among women under 25 and with less than two births. The use of OCs was inversely correlated with the presence of ectopy or dysplasia in this group of women. On the other hand, HPV positivity was not significantly higher among OC users than among non-users in any colposcopic group. Neither the type of pill used, nor the duration of use had any significant effect on HPV positivity. Further investigations are needed to evaluate the effects of OC use on more severe HPV-induced cervical lesions.

Amplification of human papillomavirus type 16 transforming genes from cervical cancer biopsies and lymph nodes of Hungarian patients

We have used a polymerase chain reaction (PCR) to examine cervical cancer biopsy specimens and pelvic lymph nodes for the presence of human papillomavirus type 16 (HPV 16) DNA. Of the 75 cervical specimens tested, 36 (48%) were positive for HPV 16 in the PCR. A total of 65 pelvic lymph nodes removed during radical surgery on 35 women were also analyzed. Lymph nodes originating from 19 patients whose cervical biopsy specimens were negative for HPV 16 seemed to lack HPV 16 sequences. For 16 women with positive PCR results for cervical biopsy specimens, 9 of 10 lymph node metastases were positive in the PCR, while 11 of their 36 histologically negative lymph nodes were also shown to contain HPV 16 DNA.