Yuko Okajima

Vertical Transmission of Hepatitis C Virus: Risk Factors and Infantile Prognosis*

Objectives: To clarify the incidence and risk factors of the vertical transmission of hepatitis C virus (HCV) and to determine the prognosis of the carrier infants.

Cytokeratin fragment 21-1 in gynecologic malignancy : comparison with cancer antigen 125 and squamous cell carcinoma-related antigen

We measured serum cytokeratin fragment 21-1 (CYFRA 21-1) levels by a solid-phase immunoradiometric assay in 102 healthy Japanese women, and set the reference value at 1.9 ng/ml (mean +2 SD of the serum levels based on a linear distribution). Pretreatment serum CYFRA 21-1 levels were also analyzed in 235 women with benign (n = 94) or malignant (n = 141) gynecologic disease, and were compared with the serum levels of CA 125 and SCC. The respective positivity rates for CYFRA 21-1 and CA 125 were 64.0 and 77.2% in ovarian malignancy, while they were 4.2 and 30.8% in benign ovarian masses. CYFRA 21-1 had an accuracy of 61.3% in diagnosing ovarian malignancy, which was higher than that of CA 125 (53.4%). The positive predictive value of CYFRA 21-1 for ovarian malignancy reached 94.1%, which was significantly (p < 0.005) higher than that of CA 125 (68.8%). These findings indicate the potential usefulness of CYFRA 21-1 as a tumor marker for ovarian malignancy. In addition, the positivity rates fo CYFRA 21-1 in cervical cancer (51.2%) and endometrial cancer (52.2%) were also similar to the respective rates for SCC and CA 125, which suggests that CYFRA 21-1 seems to be a general tumor marker for gynecologic malignancy.

A case of T1N0M0 vulvar apocrine gland carcinoma with a positive outcome

BACKGROUND Apocrine carcinoma of the vulva is extremely rare; only two cases have been reported worldwide. Here we report a case of apocrine carcinoma of the vulva. CASE A 58-year-old woman complaining of a small, asymptomatic genital tumor visited the gynecology clinic of Chiba Social Insurance Hospital. The biopsy specimen suggested that it was an adenocarcinoma derived from the apocrine gland. The diagnosis was confirmed by periodic acid-Schiff staining and immunohistochemical staining for gross cystic disease fluid protein 15. She underwent simple vulvectomy with hemilateral groin dissection. She has been followed as an outpatient for the past 7 years with no signs of recurrence or metastasis. CONCLUSION Despite the positive outcome of this case, small, asymptomatic genital lesions should be regarded with caution.

Hepatitis G virus infection in Japanese pregnant women

Hepatitis G virus (HGV), which was discovered in the plasma of a patient with chronic hepatitis in 1995 [l], is a Flavivirus and homologous with GB virus-C (GBV-C) and caused by vertical transmission [2]. We investigated the incidence of HGV infection among Japanese pregnant women. Six hundred and sixty-six hepatitis C virus antibody (HCV-Ab) negative pregnant women [CAb( >] who visited our clinic during a 1Zmonth period were examined for HGV-RNA as well as 66 HCV-Ab positive pregnant women [C-Ab( + )I. HGV-RNA was screened by using an RT-PCR kit (Boehringer Mannheim). HCV-Ab was screened with an EL4 kit (Imucheck . F-HCV-Ab Kokusai) or an RIA kit (Ortho HCV-Ab IRMA Test III). HCV-RNA was screened with an RTPCR kit (amplicore@ HCV).

HGV vertical transmission with special reference to its risk factors

pare&ml. Our aim of this study was to evaluate the possibility of materno-infantile transmission of lTV. Methods: Serum samples which were collected from 36 healthy and 8.5 hepatitis C virus (HCV) / hepatitis B virus (HBV) carrier pregnant women were screened for ‘lTV DNA. ‘lTV DNA was detected by seminested PCR using the primers detecting genotype .Pa. Twenty one infants who were born from ‘lTV carrier mothers were followed for 1 to 37months. Results: The detection rates of ‘lTV were 27% (10/36) and 26% (22/85) in non-pathological and HCV/HBV carrier pregnant women, respectively. The vertical transmission frequency of TTV was 43% (9/21) and the positive seroconversion occurred after the age of 5 months without an exception. In addition, breast feeding periods correlated positively with the frequency of TTV materno-infantile transmission, which suggests the significance of breast milk as one of infectious routes. Conclusion: ‘lTV is transmitted very highly from carrier mothers to their respective offsprings. Based on the infantile age of TTV-positive seroconversion, intrauterine or birth canal infection takes places less frequently. Breast feeding seems, so far, to be one of the most possible infectious routes.

HCV vertical transmission — Its clinical significance

HBSAg in 600 pregnant women and the rate of vertical transmission. (2) Retrospective statistical analysis done to assess HBSAg positivity in 72 women admitted from 1996-1999 with jaundice complicating pregnancy. (3) The sero positivity rate of HBSAg in 8084 voluntary donors from Govt. RSRM Hospital from 1993-1999 was studied. (4) The VDRL reactivity in 2809 pregnant women attending ANOP from October 1998 December 1999 was studied. Results: Out of 600 healthy pregnant women 20 (3.3%) were found to be HBSAg carriers. Out of 20 HBSAg positive mothers 8 babies were found to be HBSAg positive with 40% vertical transmission rate. The carrier rate of HBSAg was found to be increasing with age groups, 3.2%, 3%, 5.9% in ~20 years, 21-25 years, 26-30 years, respectively. The sero positivity was 3.3% in primipara and 11.7% in para IV and above. Analysis of 72 icteric pregnant women revealed 29.4% (21) sero positive for HBSAg. The HBSAg sero positivity in icteric women increased with age and parity, 66.7% in >30 years age group and 40% in para IV and above. Among 8084 blood donors 1.6% were found to be HBSAg positive. Among 2809 pregnant women 1.8% were found to be VDRL reactive. Conclusion: Hepatitis B is a problem in developing countries. The high carrier rate (3.3%), vertical transmission rate (40%) in the prospective study and 29.4% HBSAg positivity in icteric women stresses the importance of routine screening for HBSAg.