Is enhanced, structured prenatal counseling in third trimester associated with postpartum contraceptive uptake?

INTRODUCTION

Contraception is key for maternal well-being in the postpartum period. This study aims to evaluate the impact of prenatal counseling on postpartum contraception uptake.

METHODS

This cohort study assessed pregnant patients who received their prenatal care at our outpatient obstetrics clinic in 2021-2022. The intervention group received counseling at their 28- and 36-week prenatal visits with a language-congruent paper handout and a review of methods by the provider. The non-intervention group was seen in the outpatient clinic prior to implementation. Intervention patients were surveyed on postpartum days 1-3 to evaluate recollection of counseling and intent to start contraception. Data on uptake and type of contraception chosen was collected for both groups at 6- and 12-weeks postpartum. Our primary outcome was uptake of any type of contraception at the 6-week postpartum visit.

RESULTS

A total of 126 patients over two five-month intervals (64 intervention and 62 non-intervention) were included in analysis. Baseline patient characteristics were similar between the groups, including predominance of public insurance. Groups differed by race/ethnicity, with higher rates of Hispanic patients in the intervention group. Patients in the intervention group had higher contraception uptake within six weeks of delivery (OR 2.61, p = 0.0287). Forty-three patients in the intervention group desired postpartum contraception (including permanent methods, such as tubal ligation), although only 21 (48.8 %) received their desired method. There were no differences in method chosen between the non-intervention and intervention groups (p = 0.15).

CONCLUSIONS

Structured prenatal counseling regarding contraceptive options can improve the timely initiation of contraception.

Thermoelectric properties plus phonon and de Haas-van Alphen frequencies of hole/electron-doped [Formula: see text]

We investigate temperature, pressure, and localization dependence of thermoelectric properties, phonon and de Haas-van Alphen (dHvA) frequencies of the anti-ferromagnetic (AFM) CeIn[Formula: see text] using density functional theory (DFT) and local, hybrid, and band correlated functionals. It is found that the maximum values of thermopower, power factor, and electronic figure of merit of this compound occur at low (high) temperatures provided that the 4f-Ce electrons are (not) localized enough. The maximum values of the thermopower, power factor, electronic figure of merit (conductivity parameters), and their related doping levels (do not) considerably depend on the localization degree and pressure. The effects of pressure on these parameters substantially depend on the degree of localization. The phonon frequencies are calculated to be real which shows that the crystal is dynamically stable. From the phonon band structure, the thermal conductivity is predicted to be homogeneous. This prediction is found consistent with the thermal conductivity components calculated along three Cartesian directions. In analogous to the thermoelectric properties, it is found that the dHvA frequencies also depend on both pressure and localization degree. To ensure that the phase transition at Néel temperature cannot remarkably affect the results, we verify the density of states (DOS) of the compound at the paramagnetic phase constructing a non-collinear magnetic structure where the angles of the spins are determined so that the resultant magnetic moment vanishes. The non-collinear results reveal that the DOS and whence the thermoelectric properties of the compound are not changed considerably by the phase transition. To validate the accuracy of the results, the total and partial DOSs are recalculated using DFT plus dynamical mean-field theory (DFT+DMFT). The DFT+DMFT DOSs, in agreement with the hybrid DOSs, predict the Kondo effect in this compound.

Clean graphene interfaces by selective dry transfer for large area silicon integration

Here we present a very fast, selective mechanical approach for transferring graphene with low levels of copper contamination from seed wafers on which it was grown to target wafers for very large scale integration (VLSI) electronics. We found that graphene/copper or copper/silicon oxide delamination paths could be selected by slow and faster separation rates, respectively. Thus graphene can be transferred to a target wafer, either exposed or protected by the seed copper layer, which can later be removed by etching. Delamination paths were identified by SEM and Raman spectroscopy. The sheet resistance of the graphene produced by the two approaches was slightly higher than graphene transferred by a PMMA wet-transfer process, indicating reduced impurity doping, and the variation in the sheet resistance values was much lower. Copper contamination levels, quantitatively established by TOF-SIMS, were several orders of magnitude lower than the values for PMMA assisted transfer. In addition, we demonstrated that top-gated transistor devices from our mechanical, delamination transferred graphene exhibited superior transistor behavior to PMMA-assisted wet transfer graphene. The adhesion energy, strength and range of the interactions were quantitatively determined by nonlinear fracture analyses, and suggest that the roughness of the interface between graphene and copper plays an important role with implications for improvements in manufacturing processes.

Pre-harvest application of polyamines enhances antioxidants and table grape (Vitis vinifera L.) quality during postharvest period

Pre-harvest foliar spraying of grapevines with putrescine (Put) and spermidine (Spd) (0, 1, 2mM) was evaluated for determining the fruit quality at harvest and improving postharvest characteristics of table grapes during cold storage. Fruit parameters in terms of firmness, fungal infection, weight loss, total phenol concentration, antioxidant activity, skin color, total anthocyanin concentration, total soluble solids (TSS) and titratable acidity (TA) were evaluated after 0, 25 and 55 days of storage at 1.5 ± 1 °C and 90 ± 5% R.H. Softening, fungal infection and weight loss increased during cold storage but the rate of changes significantly was delayed in Put- and Spd-treated fruits. Besides these, the application of Put and Spd maintained higher values of phenolics content, antioxidant activity and anthocyanins at the end of storage in compare to control. Furthermore, after 55 days of storage all treated fruits with Put and Spd showed lower changes in L(∗), TSS and TA and also higher value of chroma in berries.

Exposure to Radiofrequency Radiation Emitted from Common Mobile Phone Jammers Alters the Pattern of Muscle Contractions: an Animal Model Study

INTRODUCTION

The rapid growth of wireless communication technologies has caused public concerns regarding the biological effects of electromagnetic radiations on human health. Some early reports indicated a wide variety of non-thermal effects of electromagnetic radiation on amphibians such as the alterations of the pattern of muscle extractions. This study is aimed at investigating the effects of exposure to radiofrequency (RF) radiation emitted from mobile phone jammers on the pulse height of contractions, the time interval between two subsequent contractions and the latency period of frog's isolated gastrocnemius muscle after stimulation with single square pulses of 1V (1 Hz).

MATERIALS AND METHODS

Frogs were kept in plastic containers in a room. Animals in the jammer group were exposed to radiofrequency (RF) radiation emitted from a common Jammer at a distance of 1m from the jammer's antenna for 2 hours while the control frogs were only sham exposed. Then animals were sacrificed and isolated gastrocnemius muscles were exposed to on/off jammer radiation for 3 subsequent 10 minute intervals. Isolated gastrocnemius muscles were attached to the force transducer with a string. Using a PowerLab device (26-T), the pattern of muscular contractions was monitored after applying single square pulses of 1V (1 Hz) as stimuli.

RESULTS

The findings of this study showed that the pulse height of muscle contractions could not be affected by the exposure to electromagnetic fields. However, the latency period was effectively altered in RF-exposed samples. However, none of the experiments could show an alteration in the time interval between two subsequent contractions after exposure to electromagnetic fields.

CONCLUSION

These findings support early reports which indicated a wide variety of non-thermal effects of electromagnetic radiation on amphibians including the effects on the pattern of muscle extractions.

Survey of the Effects of Exposure to 900 MHz Radiofrequency Radiation Emitted by a GSM Mobile Phone on the Pattern of Muscle Contractions in an Animal Model

BACKGROUND

The rapid development of wireless telecommunication technologies over the past decades, has led to significant changes in the exposure of the general public to electromagnetic fields. Nowadays, people are continuously exposed to different sources of electromagnetic fields such as mobile phones, mobile base stations, cordless phones, Wi-Fi routers, and power lines. Therefore, the last decade witnessed a rapidly growing concern about the possible health effects of exposure to electromagnetic fields emitted by these sources.

MATERIALS AND METHODS

In this study that was aimed at investigating the effects of exposure to radiofrequency (RF) radiation emitted by a GSM mobile phone on the pattern of contraction in frog's isolated gastrocnemius muscle after stimulation with single square pulses of 1V (1 Hz), pulse height of contractions, the time interval between two subsequent contractions and the latency period were measured.

RESULTS

Our findings showed that the pulse height of contractions muscle could be affected by the exposure to electromagnetic fields. Especially, the latency period was effectively altered in RF-exposed samples. However, none of the experiments could show an alteration in the time interval between two subsequent contractions after exposure to electromagnetic fields.

CONCLUSION

These findings support early reports which indicated a wide variety of non-thermal effects of electromagnetic radiation on amphibians including the effects on the pattern of muscle extractions.

Apical microleakage of AH Plus and MTA Fillapex® sealers in association with immediate and delayed post space preparation: a bacterial leakage study

AIM

The aim of the present study was to compare the apical microleakage of root canals obturated with AH Plus and MTA Fillapex® sealers.

METHODS

A total of 76 anterior teeth were randomly divided into 4 groups (N.=15) and in each group 2 positive and 2 negative control teeth. All the teeth were cleaned, shaped and obturated using lateral compaction technique with gutta-percha and AH Plus® sealer in groups 1 and 2 and MTA Fillapex® sealer in groups 3 and 4. In groups 1 and 3 post spaces were prepared immediately and groups 2 and 4 were stored for 1 week at 100% relative humidity and then post spaces were prepared. The teeth were connected to a bacterial microleakage evaluation system. Each 72 hours, E. faecalis bacteria were inoculated into the coronal thirds of the root canals. The study period was 90 days and the samples were evaluated on a daily basis, Meier-Kaplan technique was used for estimation of the mean time of microleakage to occur. Log-rank test was used for comparison of microleakage.

RESULTS

Contamination occurred in positive control groups on the first day of bacterial inoculation; however, the negative control groups did not exhibit any contamination up to the end of 90-day study period. the difference was not statistically significant between two materials (P>0.05).

CONCLUSION

There were no significant differences between AH Plus® and MTA Fillapex® sealers with the two immediate and delayed postspace preparation techniques.

A Comparative Study on the Life-Saving Radioprotective Effects of Vitamins A, E, C and Over-the-Counter Multivitamins

INTRODUCTION

Oral intake of vitamins which present antioxidant characteristics can protect living organisms against oxidative damage caused by exposure to ionizing radiation. It was previously reported that administration of high levels of vitamin C can lead to increased DNA damage through production of hydroxyl radicals from hydrogen peroxide by the Fenton reaction. However, our early experiments did not confirm this hypothesis. The main goal of this study was to determine if high doses of Vit C can show life-saving radioprotective effects.

MATERIALS AND METHODS

Phase I: Seventy two male Balb/c mice weighing 20-25g were randomly divided into six groups of 12 animals each. Group I; Vit E for five days, Groups II and III; Vit C and Vit A. Group 4; all three vitamins. Group V; an over-the-counter multivitamin. Group VI; none of the above. Phase II: 120 male BALB/c mice weighing 20-25g were randomly divided into 12 groups of 10 each. Group I; Vit A for five days. Groups II-IV; Vit C 200 mg/kg, 400 mg/kg, 800 mg/kg, respectively. Group V-VII; Vit E at daily doses of 200 iu/kg, 400 iu/kg, 800 iu/kg, respectively. Group VIII and IX; all three vitamins at low and high doses, respectively. Group X; an over-the-counter multivitamin. Group XI; controls group and Group XII; received pure olive oil. All animals (Phases I and II) were exposed to a lethal dose of gamma rays and the survival rates of the animals were monitored and recorded continuously for 16 days after exposure.

RESULTS

Phase I: 14 days after irradiation the survival rate for control group was 33.33%, while the survival rates for the 1st to 5th groups were 45.45%, 81.81%, 50%, 57.14%, and 9.09% , respectively. Phase II: The survival rates in the control group and the group that only received pure olive oil, were 50% and 60%, respectively. Survival rate in the animals received Vit C at daily doses of 200 mg/kg, 400 mg/kg, 800 mg/kg, were 90%, 90% and 90%, respectively. Log rank (Mantel-Cox) test showed statistically significant differences between the survival rates in control irradiated mice (no vitamins) and mice received Vit C at daily doses of 200 mg/kg (P=0.042), 400 mg/kg (P=0.042) and 800 mg/kg (P=0.042).

CONCLUSION

Altogether, findings of this study showed that even high doses of Vit C can show life-saving radioprotective effects. The significant radioprotective effect of Vit C at doses used in this study, opens new horizons in developing non-toxic, cost effective, easily available radioprotectors in life-threatening situations such as exposure to lethal doses of ionizing radiation.  The radioprotective effect of Vit A and Vit E seem to be less efficient compared to that of Vit C.

Urogynecologic conditions: chronic pelvic pain

Immigration has brought millions of individuals into the United States over the past decade. The Centers for Disease Control and Prevention and the US Public Health Service are charged with ensuring that immigrants who enter do not pose a public health risk. Health examinations and immunization regimens are required for individuals wishing to live in the United States. Many immigrants and refugees are exposed to communicable diseases not routinely encountered in the United States These include helminthic infections, tuberculosis, malaria, and other infections. Zoonotic infections, such as influenza A, and novel coronavirus infections also are of increasing concern because of population mobility.

Impact of robotic technology on hysterectomy route and associated implications for resident education

OBJECTIVE

We sought to compare the proportion of benign hysterectomies performed vaginally and the mean number of hysterectomies with resident involvement by route before and after robot implementation.

STUDY DESIGN

This multicenter, retrospective cohort study using nonsynchronous controls was conducted through the Society of Gynecologic Surgeons Fellows' Pelvic Research Network. The route of hysterectomy for benign disease was compared for 1-year periods before (prerobot) and after (postrobot) robotic introduction at 4 academic institutions. We reviewed medical records and recorded patient demographics, hysterectomy approach, preoperative and postoperative diagnosis, and resident involvement.

RESULTS

In all, 1440 hysterectomies were included: 732 in the prerobot group and 708 in the postrobot group. Median age was 46 years and mean body mass index was 29.5 (standard deviation, 6.9). The proportion of hysterectomies performed via the vaginal route decreased from 42.5% prerobot to 30.5% postrobot (P < .0001) and via the abdominal route from 22.1% prerobot to 16.5% postrobot (P = .001). The proportion of hysterectomies performed laparoscopically increased from 1.6% prerobot to 11.9% postrobot (P < .0001). At a mean of 2.3 years after introduction of the robot into an institution, hysterectomies performed using robotic assistance accounted for 23.3% of hysterectomies for benign disease. Mean uterine weight was similar in the prerobot and postrobot groups. Resident involvement in all hysterectomies done via all routes other than robotic increased from 81.0% prerobot to 88.6% postrobot; however, residents were involved in only 58.9% of robotic hysterectomies.

CONCLUSION

The proportion of hysterectomies performed vaginally has significantly decreased since the adoption of robotic technology at institutions included in this study. The proportion of hysterectomies with resident involvement is lower with a robotic approach than any other route.

Effects of dangling bonds and diameter on the electronic and optical properties of InAs nanowires

In this article we explore the effects of dangling bonds and diameter on the electronic properties of the wurtzite InAs nanowires (NWs) using the density functional theory.

Squamous cell carcinoma of skin: a brief review

Cutaneous squamous cell carcinoma (SCC) is the second most common skin cancer in Caucasians, most frequently occurring on sun-exposed areas of the body. Most SCCs are treated surgically, either by excision or Mohs micrographic surgery. Despite the large amount of English literature with regard to cutaneous SCC in many instances the surgical treatment is not appropriate resulting in recurrences and/ or metastasis. The following brief review highlights the histology, molecular biology and surgical treatment of skin SCC.

Electrochemical corrosion assessment of RaCe and Mtwo rotary nickle-titanium instruments after clinical use and sterilization

Aim: The aim of the present study was to electrochemically evaluate corrosion resistance of RaCe and Mtwo files after repeated sterilization and preparation procedures. Study Design: A total of 450 rotary files were used. In the working groups, 72 files from each file type were distributed into 4 groups. RaCe and Mtwo files were used to prepare one root canal of the mesial root of extracted human mandibular first molars. The procedure was repeated to prepare 2 to 8 canals. The following irrigation solutions were used: group 1, RaCe files with 2.5% NaOCl; group 2, RaCe files with normal saline; group 3, Mtwo files with 2.5% NaOCl; and group 4, Mtwo files with normal saline in the manner described. In autoclave groups, 72 files from each file type were evenly distributed into 2 groups. Files were used for a cycle of sterilization without the use of files for root canal preparation. Nine new unused files from each file type were used as controls. Then the instruments were sent for corrosion assessment. Mann-Whitney U and Wilcoxon tests were used for independent and dependent groups, respectively. Results: Statistical analysis indicated that there were significant differences in corrosion resistance of files associated with working and autoclave groups between RaCe and Mtwo file types (p<0.001). Conclusions: Corrosion resistance of #25, #30, and #35 Mtwo files is significantly higher than that in RaCe files with similar sizes.

Key words:Corrosion, NiTi instruments, autoclave, RaCe, Mtwo.

Endoscopic balloon dilation in the management of ureteral stricture after urogynecologic surgery: a case report

BACKGROUND

Ureteral injuries are known complications of urogynecologic surgery. Until now, ureteral reimplantation with laparotomy has been used in cases in which ureteral stenting of distal obstruction was unsuccessful.

CASE

We report a case of a 74-year-old woman with a recognized right ureteral injury after vaginal reconstructive surgery that failed ureteral stenting to relieve the obstruction and who presented with ureteral stricture and mild hydronephrosis 6 weeks postoperatively. Ureteroscopy with endoscopic balloon dilation reduced the stricture successfully. The patient remains asymptomatic, with normal renal sonogram, 6 months after the procedure.

CONCLUSION

Endoscopic balloon dilation is an effective technique that can be used for the management of ureteral strictures after urogynecologic surgery and avoids further surgical intervention.

Ultracompact and fabrication-tolerant integrated polarization splitter

Design and fabrication of a 2×2 two-mode interference (TMI) coupler based on-chip polarization splitter is presented. By changing the angle between the access waveguides, one can tune the effective TMI length for the mode with less optical confinement (transverse magnetic, TM) to coincide with the target TMI length for a desired transmission of the mode with higher optical confinement (transverse electric, TE). The fabricated 0.94 μm long 2×2 TMI splits the input power into TM (bar) and TE (cross) outputs with splitting ratio over 15 dB over 50 nm bandwidth. Fabrication tolerance analysis shows that the device is tolerant to fabrication errors as large as 60 nm.

Temporary eyelash loss following dental treatment

The isolated absence or loss of eyelashes (madarosis) is associated with many processes including systemic and local diseases. Madarosis of dental origin has not been reported. This paper is a report of the successful treatment of unilateral eyelash loss following root canal therapy of an upper posterior tooth.

The effect of repetitive spreading depression on neuronal damage in juvenile rat brain

Spreading depression (SD) is pronounced depolarization of neurons and glia that travels slowly across brain tissue followed by massive redistribution of ions between intra- and extracellular compartments. There is a relationship between SD and some neurological disorders. In the present study the effects of repetitive SD on neuronal damage in cortical and subcortical regions of juvenile rat brain were investigated. The animals were anesthetized and the electrodes as well as cannula were implanted over the brain. SD-like event was induced by KCl injection. The brains were removed after 2 or 4 weeks after induction of 2 or 4 SD-like waves (with interval of 1 week), respectively. Normal saline was injected instead of KCl in sham group. For stereological study, paraffin-embedded brains were cut in 5 microm sections. The sections were stained with Toluidine Blue to measure the volume-weighted mean volume of normal neurons and the numerical density of dark neurons. The volume-weighted mean volume of normal neurons in the granular layer of the dentate gyrus and layer V of the temporal cortex in SD group were significantly decreased after four repetitive SD. Furthermore, densities of dark neurons in the granular layer of the dentate gyrus (after 2 weeks), the caudate-putamen, and layer V of the temporal cortex (after 4 weeks) were significantly increased in SD group. Repetitive cortical SD in juvenile rats may cause neuronal damage in cortical and subcortical areas of the brain. This may important in pathophysiology of SD-related neurological disorders.

Incidental finding of double nodular microscopic hyperplasia versus adenoma of the retinal pigment epithelium in an eye eviscerated for phthisis bulbi

Neoplasms of the retinal pigment epithelium (RPE) are very rare and can clinically simulate choroidal melanoma. The clinical, histopathological and immunohistochemical features of incidental double pseudo-neoplastic proliferation of the RPE in an eviscerated eye for phthisis bulbi are reported. The differential diagnosis of RPE neoplasms and the utility of histopatological examination of eviscerated/enucleated eyes are discussed.

The post-cesarean section symptomatic bladder flap hematoma: A modern reappraisal

The bladder-flap hematoma (BFH) is an unusual complication of the cesarean section (CS) performed by Misgaw Ladach method or Stark CS (performed without peritoneal closure) and it is an usual event after the visceral peritoneal closure performed during the traditional method. A BFH is generally thought of as a blood collection located in a space placed between the bladder and lower uterine segment (LUS), called vescico-uterine space. If, during a Stark CS, pathological fluid collections arise in this space by uterine suture bleeding, these decant into the large peritoneal cavity causing a hemoperitoneum. This last complication can be easily and accurately detectable by ultrasonography, which can be utilised by non-invasive monitoring as a guide for the clinical follow-up. In the authors' experience, the CS by Stark method is associated with a lower febrile and infective morbidity and it is possible also to perform a successful conservative laparoscopy for the BFH management. Laparoscopical treatment of BFH offers to patients the potential clinical benefits of the minimally invasive endoscopical treatments, but it should be reserved for surgeons trained in extensive laparoscopic procedures.

Effects of a direct-fed microbial (primalac) on turkey poult performance and susceptibility to oral Salmonella challenge

A study was conducted to determine 1) the effect of a dietary direct-fed microbial (DFM) on turkey poult performance, 2) the effect of a DFM on a Salmonella challenge, and 3) the effect of feed processing on the efficacy of the dietary DFM. Day-of-hatch Large White female poults were placed in 2 rooms in 2 Petersime batteries per room. Twelve pens of 7 birds each were used in each battery (24 pens per room, 336 birds total). One of 4 dietary feed treatments was assigned to each pen (6 pens per room for each diet). One room housed non-Salmonella-challenged poults, and the other room housed poults challenged with a 1-mL oral gavage of Salmonella (10(10) cfu/mL). A single batch of starter ration was split into 4 parts and used to provide 4 dietary treatments: 1) mash feed with no DFM (M), 2) mash feed with DFM (Primalac; 0.9 kg/tonne of feed, MD), 3) pelleted (20-s steam conditioning at 80 degrees C) and crumbled feed with no DFM (C), and 4) pelleted and crumbled feed with DFM (CD). Feed and deionized, distilled water were provided ad libitum. Data were collected and analyzed separately for each room. Mortality was recorded for each pen on a daily basis and totaled by week and for the 3-wk period. Individual BW and feed consumption, by pen, were measured weekly. Weekly and cumulative BW gains and feed to gain ratios (F:G) were calculated. Liver, spleen, total and lower intestinal tract weights, intestinal length, and most-probable-number Salmonella populations were determined for one randomly selected bird per pen. Feeding processed feed resulted in improved BW and F:G. Feeding the DFM improved 3-wk cumulative F:G in birds not gavaged and reduced relative intestinal weight in birds gavaged. Salmonella populations were reduced 1 log by feeding DFM. Dietary DFM improved bird performance, reduced Salmonella populations, and was not affected by feed processing.

Douching with Water Works device for perceived vaginal odor with or without complaints of discharge in women with no infectious cause of vaginitis: a pilot study

OBJECTIVE

To determine if douching with Water Works device for 1 month can (1) lower or eliminate perceived vaginal odor by subject; (2) have any effects on vaginal ecosystem.

METHODS

Ten women with perceived vaginal odor with or without discharge, douched every day for 4 weeks in an open-label, nonrandomized pilot study. Primary outcome measures included perceived vaginal odor by subject, lactobacilli score from Nugent slide, and acceptance of the Water Works douching system. Secondary outcome included the safety of using this douching device.

RESULTS

At week 4, there was improvement in vaginal odor (P=.0006) and there was no significant change in lactobacilli score.

CONCLUSION

Douching with Water Works device is associated with reduction or elimination of vaginal odor without adversely affecting the vaginal ecosystem.

DNA mismatch repair protein expression and microsatellite instability in primary mucosal melanomas of the head and neck

AIMS

To examine the expression of DNA mismatch repair (MMR) proteins and the presence of microsatellite instability (MSI) in seven primary mucosal melanomas of the head and neck (MMHN).

METHODS AND RESULTS

Haematoxylin and eosin staining and immunohistochemical analysis for routine diagnostic markers and for MMR proteins were performed. Six cases were examined for MSI. Four cases were monomorphous and three cases were pleomorphic type MMHN. Melanocytic markers were positive in all cases. Immunoreactivity for MMR proteins was weak in normal epithelium. The neoplastic tissue in six cases showed positivity for all MMR proteins with different percentages. One case showed weak positivity for hMSH2 and hMSH6 and no immunoreactivity for hMLH1 or hPMS2. Staining intensity was higher in tumour cells than in matched normal mucosa in three cases for hMSH2 and hMLH1 and in two cases for hPMS2. None of the examined cases showed MSI.

CONCLUSIONS

Expression of hMSH2 and hMLH1 proteins was up-regulated in three cases, whereas in two cases that of hPMS2 was increased. hMSH6 expression was comparable to that of normal cells in all cases. The percentage of positive neoplastic cells and the intensity of staining seemed to be greater in pleomorphic melanomas. Six cases were MMR-proficient and microsatellite stable.

Rapid testing for vaginal yeast detection: a prospective study

OBJECTIVE

The purpose of this study was to determine the accuracy of rapid vaginal yeast detection assay compared with yeast cultures for the diagnosis of vulvovaginal candidiasis.

STUDY DESIGN

This was a prospective study that involved 104 subjects, 34 asymptomatic women and 70 symptomatic women with vaginitis. Vaginal swabs were obtained from all subjects for wet mount, yeast culture, and the rapid yeast detection test. Overall, the prevalence rate was 39.4%, based on positive yeast cultures. The rapid yeast test performed by the physician was positive in 30 of 41 subjects with positive cultures and 13 of 63 subjects with negative cultures.

RESULTS

The rapid yeast test had 73.1% sensitivity and 82.0% negative predictive value compared with the wet mount, which had 43.9% sensitivity and 70.9% negative predictive value. In symptomatic patients, the test had 77.4% sensitivity and 81% negative predictive value compared with wet mount, which had 51.6% sensitivity. Patient-performed test results were identical to the tests that were performed by the physicians. The cost of the rapid yeast test kit is estimated to be <$10, compared with a mean of $65 for the yeast culture.

CONCLUSION

Rapid yeast detection assay is accurate and affordable compared with the gold standard yeast culture in the diagnosis of vulvovaginal candidiasis. Relative to the wet mount, it is more sensitive, cheaper, and accurate for the rapid diagnosis of vaginal yeast infection.

Endometrial lymphoepitheliomalike carcinoma: absence of Epstein–Barr virus genomes

The aim of this study was to report a case of primary lymphoepitheliomalike endometrial carcinoma (FIGO stage IB). A 57-year-old woman presented with an endometrial tumor showing the classic clinical and hysteroscopic aspects of endometrial carcinoma. Morphologically, the neoplasm was similar to undifferentiated nasopharyngeal carcinoma (lymphoepithelioma). Immunohistochemistry showed that the tumor cells were cyokeratins and epithelial membrane antigen positive. Leucocyte common antigen, estrogen and progesterone receptors, neuron specific enolase, cromogranin, synaptophysin, and p53 were negative. We did not find evidence of Epstein–Barr virus (EBV) infection using immunohistochemistry and polymerase chain reaction (PCR). We report the third case of an endometrial lymphoepitheliomalike carcinoma (LELC). The patient did not receive chemotherapy and is alive and free of disease 24 month after diagnosis. LELC can occur in the endometrium and in this location may not be associated with EBV infection

Impact of MHC class II incompatibility on localization of mononuclear cell infiltrates to the bronchiolar compartment of orthotopic lung allografts

Chronic pathological changes in transplanted lungs are unique because they center on the airways. We examined the relative role of MHC class I and II antigens in causing bronchial pathology in orthotopic lung transplants to rats maintained on cyclosporin A (CsA). Transplants mismatched for MHC class II antigens had significantly more peri-bronchiolar infiltrates than MHC class I incompatible transplants. No significant increase in infiltrates was found in lung transplants incompatible for MHC class I plus II antigens compared to MHC class II antigens alone. Immunohistochemistry demonstrated that MHC class II antigen expression was confined to macrophages in MHC class I incompatible transplants, but was upregulated on bronchial epithelium in transplants with MHC class II incompatibilities. Vascular endothelium was notably devoid of MHC class II antigen expression in all transplants. However, both peri-bronchial and peri-vascular infiltrates were frequently cuffed by alveolar macrophages and type II pneumocytes that expressed MHC class II antigens. PCR analysis demonstrated that IFN-gamma and regulated on activation, normal T cells expressed and secreted (RANTES) were upregulated in MHC class II incompatible transplants. Thus, MHC class II incompatible orthotopic lung transplants in rats maintained on CsA immunosuppression undergo a bronchiolcentric upregulation of alloantigens.

Presence of HPV in head and neck tumours: high prevalence in tonsillar localization

Human papillomavirus (HPV) seems to be involved in head and neck carcinogenesis. To investigate this association, viral presence and expression were analysed by polymerase chain reaction (PCR)-based methods and correlated to tumour localization, clinical-pathological aspects, and alcohol and tobacco exposure in 65 patients. HPV DNA was found in 16 cases (24.6%); the HPV types detected were: HPV16 (10 cases), HPV 6 (3 cases) HPV 33, 35, and 58 (one case each). The tonsil was the location with the highest HPV positivity (6/8, 75%). This percentage was significantly higher than that found in tumours from any other site (P<0.01). Viral transcripts of early regions were detected in all HPV16 positive tumours. HPV status was not related to age, gender, tumour stage or grade, and use of alcohol and/or tobacco. The results suggest that HPV16 is actively involved in the genesis of a subset of head and neck cancers and that the tonsillar localization may be considered a hot spot for viral transformation.