Tamás Major

The characteristics of human papillomavirus DNA in head and neck cancers and papillomas.

Aim: To determine the prevalence, type, physical state, and viral load of human papillomavirus (HPV) DNA in cases of head and neck cancer and recurrent respiratory papillomatosis (RRP). Methods: The prevalence and type of HPV DNA was determined in 27 fresh frozen tissue specimens from patients with head and neck cancers and 16 specimens from 10 patients with RRP by MY09/MY11 and GP5+/GP6+ nested polymerase chain reaction (PCR) and subsequent restriction enzyme cleavage. The physical state of HPV DNA was analysed by E1, E2, and E1E2 specific PCRs and Southern blot hybridisation (SBH). Results: HPV DNA was detected in 13 of 27 cancers and 10 of 10 papillomas. Both low risk HPV-6 and HPV-11 and high risk HPV-16 were present in cancers in low copy numbers, whereas papillomas exclusively harboured low risk HPV-6 and HPV-11. E1E2 PCRs failed to determine the physical state of HPV in cancers except one case where HPV-6 DNA was integrated. In contrast to cancers, all papillomas showed the episomal state of HPV DNA and a relatively higher viral load. Conclusions: Based on the prevalence, type, physical state, and copy number of HPV DNA, cancers and papillomas tend to show a different HPV DNA profile. The 100% positivity rate of low risk HPV types confirms the role of HPV-6 and HPV-11 in the aetiology of RRP.

High co-prevalence of genogroup 1 TT virus and human papillomavirus is associated with poor clinical outcome of laryngeal carcinoma

Background: The aetiology and factors leading to the progression of laryngeal cancer are still unclear. Although human papillomavirus (HPV) has been suggested to play a role, reports concerning the effect of HPV infection on tumour development are controversial. Recently, transfusion transmitted virus (TTV) was suggested to play a role in certain infections as a causative or coinfecting agent. Aims: To investigate whether the development and progression of laryngeal squamous cell carcinoma is associated with coinfection with TTV and HPV. Methods: The prevalence of TTV and HPV was investigated using the polymerase chain reaction in tissue samples from 40 healthy individuals, 10 patients with recurrent papillomatosis, five patients with papillomatosis with malignant transformation, and 25 patients with laryngeal carcinoma. The obtained prevalence data were compared and analysed statistically. Results: In the 11 patients with carcinoma who had metastasis or relapse there was a high rate of coinfection with genogroup 1 TTV and HPV (eight of 11), whereas in the 14 without tumour progression no coinfection was found. Coinfection was associated with significantly lower tumour free survival in patients with carcinoma (p < 0.001). Furthermore, four of five patients who had papillomatosis with malignant transformation were coinfected with genogroup 1 TTV and HPV. Conclusions: Although the nature of cooperation between HPV and TTV needs to be investigated further, coinfection with genogroup 1 TTV and HPV appears to be associated with poor clinical outcome in laryngeal cancer.

Evaluating the level of pain during office hysteroscopy according to menopausal status, parity, and size of instrument.

IntroductionThe aim of the study was to evaluate the factors that may affect experienced pain during office hysteroscopy performed without anesthesia in an outpatient setting.Materials and methodsWe enrolled the patients into six groups, differentiated by parity, menopausal status and type of the sheath that was used for the examination. During office hysteroscopy the pain score was recorded using a visual analog scale.ConclusionStatistical analysis of the results revealed no evidence that parity, menopausal status, or the thickness of the instrument influence the level of experienced pain.

Accuracy of Assessment of Tubal Patency With Selective Pertubation at Office Hysteroscopy Compared With Laparoscopy in Infertile Women

STUDY OBJECTIVE To estimate the accuracy of the assessment of tubal patency using selective pertubation with office hysteroscopy compared with laparoscopy in infertile women. METHOD Selective pertubation with office hysteroscopy was also performed in 35 infertile patients prior to their scheduled laparoscopy and chromohydrotubation as part of infertility evaluation. We compared the findings of the two methods. RESULTS Hysteroscopic tubal assessment had a 82.9% accuracy with the laparoscopic dye method taken as reference, with a positive predictive value of 87.5%, and a negative predictive value of 76.7%. No complication or failure occurred. CONCLUSION Selective pertubation with office hysteroscopy is a useful method for the assessment of tubal patency. As a minimal invasive office procedure it can be offered as a first line method for the evaluation of the uterine cavity and the tubes in infertile women.

Assessment of cerebral hemodynamics during roll over test in healthy pregnant women and those with pre-eclampsia.

Objective To compare cerebral autoregulatory responses obtained during roll over tests in healthy pregnant women and those with pre‐eclampsia in order to assess the middle cerebral artery velocity changes in relation to the roll over test in normotensive and pre‐eclamptic women.

Fetal arterial redistribution indicating true umbilical cord knot

True umbilical cord knot often remains undiscovered prenatally due to a lack of characteristic clinical or ultrasound signs. We present a pregnancy with favorable outcome in which a non-stress test (NST) found non-reassuring fetal status. Abnormal Doppler blood flow patterns in the descending aorta and in the middle cerebral artery revealed fetal arterial redistribution with normal circulation in the umbilical artery despite a true cord knot. The benefit of fetal Doppler assessment is discussed. Increased aortic-cerebral ratio may reflect acute hypoxic compromise caused by the transitory constriction of the true umbilical cord knot with unrecognized morphologic and circulatory signs.

Laparoscopic removal of gonads in gonadal dysgenesis

Prophylactic gonadectomy is widely accepted in male pseudohermaphroditism because of the possible malignant conversion of the gonads. Gonadoblastoma or dysgerminoma may occur in the dysgenetic gonads. Laparoscopic gonadectomy has been performed on a patient and is suggested as the optimum mode of management of patients with dysgenetic gonads.

Comparison of Cerebral Blood Flow Velocity as Measured in Preeclamptic, Healthy Pregnant, and Nonpregnant Women by Transcranial Doppler Sonography

Aim: To test the hypothesis that the middle cerebral artery blood flow velocity (MCAV) is altered in preeclamptic pregnant women as compared with healthy pregnant and nonpregnant women. Methods: Preeclamptic (n = 21) and healthy pregnant (n = 17) as well as healthy nonpregnant (n = 29) women underwent transcranial Doppler MCAV measurements. The mean MCAV values were compared between the different groups. Anova combined with Bonferroni correction was used for statistical analysis. Results: The MCAV was significantly higher in nonpregnant women (mean ± SE 73.0 ± 2.12 cm/s) as compared with healthy pregnant women (67.0 ± 1.8 cm/s, p = 0.0356). Preeclamptic women showed significantly higher MCAV values (83.5 ± 2.1 cm/s) as compared with nonpregnant females (73.0 ± 2.12 cm/s, p = 0.0014). Similar to nonpregnant women, healthy pregnant women showed lower MCAV values (67.0 ± 1.8 cm/s) as compared with preeclamptic women (83.5 ± 2.1 cm/s, p = 0.001). After Bonferroni correction the MCAV values in patients suffering from preeclampsia were still statistically significantly higher as compared with the two other groups. Conclusions: We detected increased resting MCAV values in pregnant women with preeclampsia. In our opinion, this finding refers to arteriolar dilation of the resistance vessels of the brain. Further studies are needed to prove altered vasoreactivity responses of the brain resistance arterioles in preeclampsia.

Lymphangioma of the sphenoid sinus

Lymphangiomas are rare benign lymphatic tumours found predominantly in the head and neck region. A case of a cavernous lymphangioma isolated to the sphenoid sinus is described. The authors emphasize the extreme rarity of the isolated sphenoid lymphangioma, as to their knowledge this is the first report in the English literature.

Ovarian malignancies in childhood and adolescence

We retrospectively reviewed all cases of ovarian malignancies during a 10-year period at the Department of Obstetrics and Gynecology, University Medical School of Debrecen, Hungary. The experience with 16 cases: three epithelial tumors, one granulosa cell tumor, 11 germ cell tumors (six dysgerminoma, four teratoma, one endodermal sinus tumor), and one metastatic ovarian cancer is discussed. Malignant ovarian tumors can best be treated with conservative surgery, followed by adjuvant chemotherapy. Survival mainly depends on tumor type and stage at the time of diagnosis.