[Papilloma virus--occurrence and correlation with cancer].
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Biomedical subjects
Publications and source records attributed to E Rylander.
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The incidence of genital wart virus infection was estimated in 160 women with cervical cytologic atypia detected at routine screening. More than 70% of the women younger than 25 years had condylomata, as judged from colposcopy, histologic study and test for human papilloma virus antigen. Rational management of this sexually transmitted disease should include the male partner(s). Subclinical infection is common, and colposcopy is an important aid for its identification. 'Condylomatous vaginitis' may be a new entity which should be considered in women with cytologic atypia and/or diffuse vaginal symptoms.
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Fifty-six cervical smears originally classified as Pap. I, from women in whom cervical cancer of stage I to IV was detected within 4 to 5 years after the cytological check, were re-examined in order to estimate the screening error and sampling failure. At the review, 35 smears were classified as Pap. II to V. The incidence of changed classification of the smears obtained from population screening was 70% and that of the smears taken at private specialists or at hospitals was about 50%. The influence of sampling failure on the evaluation of the smears classified as Pap. II should be considered. On 14 slides, correctly interpreted as negative, there were no columnar cells present, a fact that may indicate inefficient sampling of cells from the squamo-columnar junction.
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Women belonging to the cytologically screened population of Stockholm in 1968 to 1974 and developing cervical cancer of stage I to IV were studied. The purpose was to find out the number of women, in whom the cancer or its preclinical stage was not detected at routine screening, and the reasons for this fact. It was found that 34 out of 177 women had never been cytologically screened. The remaining 143 women had been checked at mass screening and/or at private specialists or hospitals. In 51 screened women the cancer was not detected until the women themselves attended a doctor because of symptoms. Thus in 85 women, or 48% of the series, the cancer escaped detection at an asymptomatic stage. Errors causing a delay or interruption of the follow-up of patients with suspicious smears or colposcopic atypia were observed in 25 cases. Sixty-four patients, or 45% of all screened women, had had at least one negative smear within 4.5 years prior to discovery of the malignancy. Out of these, 53 patients had got a negative smear within 3 years. Whatever might be the true evaluation of these negative smears, their influence on the continued management of the women was important. In view of the results of this study the 4 years interval of rescreening practiced in Stockholm seems to be too long. Moreover the statement is supported, that the value of health screenings is counteracted by the fact that the people most at risk are the least likely to attend.
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An investigation of the mechanisms of norepinephrine action and heat production in brown adipose tissue from newborn rabbits has been carried out. Data obtained with the use of biochemical techniques has been correlated with morphological data from electron microscopy. Norepinephrine was found to stimulate the respiration of brown fat in vitro. Inhibitors of glycolysis abolish this effect, whereas inhibitors of oxidative phosphorylation do not, at least not to the same extent. Brown fat is readily permeable to added Krebs cycle intermediates. Substrate level phosphorylation, but no electron transport-coupled phosphorylation, could be demonstrated in isolated mitochondria. It is suggested that the rate of fatty acid oxidation is limited by the availability of phosphate acceptor systems which break down ATP formed at the substrate level and thus provide ADP for further substrate level phosphorylation. The theory of respiratory control by the action of reesterification of fatty acids is discussed in the light of these findings. Under the electron microscope, brown fat mitochondria are characterized by their large size, tightly packed cristae, and by the different types of granules in the matrix. No elementary particles are seen when the mitochondria are examined by the negative-staining technique. The absence of electron transport-coupled phosphorylation together with the apparent absence of elementary particles seems to be of particular significance.