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M Fortier

Publications and source records attributed to M Fortier.

At least 37 records · Page 2Linked to original sources

[Cervico-vaginal cytology and condylomata. Reproducibility and predictive value].

Human Papilloma Virus (HPV) is associated with two groups of intra-epithelial lesions of the cervix: the condyloma or the very low grade lesion, and intra-epithelial cervical neoplasia (CIN) or a higher grade of lesion. Cervico-vaginal cytology can be used to screen for these two types of lesion. Further to this research is to evaluate the reproducibility and the predicted value of cervico-vaginal cytology to detect condylomas. The study is based on 610 patients who were referred because of abnormal cytology. 270 (44%) of these patients were referred because the cytology suggested condylomas and 241 (40%) had cytological signs of CIN. The reference cytology and the control cytology did not accord well. Control cytology showed signs of condyloma in only 116 (43%) of the 270 patients referred for this type of lesion. On the other hand in the case of CIN there was better correlation. Of the 241 patients who were referred for cytological signs of CIN 185 (70%) also had these signs on controlled cytology. The positive predictive value of cytology to diagnose condyloma is relatively poor. In only 126 (47%) of the women referred with diagnosis of condyloma could this diagnosis be confirmed histologically, 20% of these 270 patients had CIN. In contrast the positive predictive value of cytology with signs of CIN were better-182 (76%) of 241 patients who were referred with CIN had the diagnosis confirmed histologically.

Adult↗

A colposcopical lesion of the uterine cervix frequently associated with papillomavirus type 16 as detected by in situ and Southern blot hybridization: a cytohistological correlation study.

A convoluted aceto-white lesion was observed by colposcopy on the uterine cervix of 19 patients. A search for specific types of papillomavirus was undertaken in these lesions which proved histologically to be a vertical association of CIN in the lower strata of the squamous epithelium and typical condyloma in the uppermost layers. Previous cell samples correlated with histology in only 11 out of the 19 cases, and were not therefore an accurate predictor of histologic findings. However 16 out of our 19 cases had sufficient cellular changes to warrant colposcopy and biopsy. Papillomavirus capsid antigen was detected by peroxidase-antiperoxidase staining technique in 12 out of the 19 cases (63.1%). In situ hybridization using biotinylated HPV-16 DNA probes was positive in 13 out of 18 cases (72.2%). Southern blot hybridization gave the typical PstI pattern of HPV-DNA in 8 out of 9 cases examined. The detection of HPV-DNA and HPV capsid antigen was particularly high in this "convoluted" cervical lesion, suggesting that the virus remains biologically active. It may therefore be assumed that this lesion represents a particular phase of the disease process in which early gene function and late gene expression of the viral genome are markedly manifested. Furthermore, this lesion may well represent a link between the early manifestation of HPV infection (condyloma) and CIN, which constitute a morphologic continuum initiated by papillomaviruses.

Adolescent↗

Condyloma and intraepithelial neoplasia of the uterine cervix: a case-control study.

Cervical condyloma and cervical intraepithelial neoplasia are related to human papillomavirus infections, some of which may be involved in the etiology of cancer of the uterine cervix. This case-control study was designed to assess the relation of age at first sexual intercourse, number of sexual partners, and cigarette smoking to the risk of cervical condyloma and cervical intraepithelial neoplasia. Cases and controls were premenopausal women under age 50 years who had been referred for examination at the Colposcopy Clinic of Saint-Sacrement Hospital in Quebec from 1982 to 1985. These were 136 cases of histologically confirmed cervical condyloma and 247 cases of cervical intraepithelial neoplasia. The 137 controls were women without anogenital condyloma, dysplasia, or carcinoma. Information on personal characteristics and exposures of subjects was obtained by interview. Associations observed with age at first intercourse were different for condyloma and cervical intraepithelial neoplasia. Relative risk of condyloma varied little with age at first intercourse. In contrast, relative risk of cervical intraepithelial neoplasia increased as age at first intercourse decreased. For the two types of lesions, relative risk was elevated among women with more than one sexual partner and increased steadily with increasing number of cigarettes smoked per day. The association with cigarette smoking was, however, somewhat stronger for cervical intraepithelial neoplasia.

Adult↗

beta-Adrenergic catecholamine-dependent properties of rat myometrium primary cultures.

We have used cultured trypsin-collagenase-dispersed cells from uteri of 21-day-old rats to investigate the mechanism of control of uterine motility by the beta-adrenergic receptor. After 5 to 7 days in RPMI 1640 the cells started to assume some of the morphological characteristics of smooth muscle cells. When cultures were incubated with 45Ca2+ for 3 h then washed free of isotope and incubated in medium with unlabeled Ca2+, efflux from the prelabeled intracellular pools was linear for up to 60 min. The potent beta-adrenergic agonist isoproterenol had a rapid effect on the rate of efflux and increased it almost sevenfold. Isoproterenol's effect was blocked by propranolol and could be duplicated by the addition of 8-bromo-adenosine 3',5'-cyclic monophosphate or cholera toxin. The cultured myometrial cells had adenylate cyclase properties similar to those of intact muscle strips when these were determined by the conversion of radioactive substrate (alpha-32P-ATP) to 32P-cAMP using a broken-cell preparation. Adenylate cyclase was sensitive to stimulation by GTP and by isoproterenol in the presence but not in the absence of GTP. Adenylate cyclase was also sensitive to stimulation by Ca2+ in the absence of GTP. We conclude that the primary cultures had the properties expected of smooth muscle cells including beta-adrenergic receptors that were coupled to a physiologically important function, Ca2+ flux. The beta-adrenergic receptor's effect on Ca2+ flux was cAMP mediated, and the divalent cation may also regulate its rate of flux by an effect on Ca2+-sensitive cAMP production.

8-Bromo Cyclic Adenosine Monophosphate↗

Endometrial hyperplasia and neoplasia. Cytologic screening with the Endopap endometrial sampler.

A new endometrial sampling device, the Endopap, was tested in a series of 851 patients. This sampler is of simple design, without moving parts, inexpensive and easy to use. Cellular samples proved adequate in 90% of the cases, usually with very abundant material. Endometrial cancer shed atypical cells in all 20 cases studied. However, only about half the patients with adenomatous hyperplasia were correctly identified by the endometrial sample. This fact seems to reflect the lack of adequate morphologic criteria for the recognition of endometrial hyperplasia; this situation prevails with all types of endometrial cell samplers.

Adenocarcinoma↗

Vaginal condylomata: a human papillomavirus infection.

In our clinic, as a rule, we do not treat vaginal condylomata. They are usually subclinical and asymptomatic. When atypia is present on biopsy, they should be treated in the same manner as vaginal intraepithelial neoplasia. When vaginal discharge and pruritus are present, infection should be searched for and treated. When condylomata are seen with the naked eye, colposcopy has shown that there were many more, too small to be seen, so that local therapy seems a waste of time. If on colposcopic examination only a few condyloma acuminata are located, then therapy is defendable. CO2 laser therapy should be preferred to other modalities until a systemic treatment is available and safe.

Animals↗

Confirmation of the papillomavirus etiology of condylomatous cervix lesions by the peroxidase-antiperoxidase technique.

The peroxidase-antiperoxidase technique with the use of paraffin sections of 67 cervical biopsy specimens and an antiserum cross-reactive with all papillomaviruses provided immunologic confirmation for the observation that papillomavirus infection of the cervix is not uncommon and that it most often presents as a flat, colposcopically unremarkable lesion. Papillomavirus antigen was detected in 21 or 35 condylomata of the cervix. Antigen-positive nuclei were found in the upper layers of the epithelium. Electron-microscopic examination of five reprocessed antigen-positive sections revealed, in each instance, papillomavirus particles in the nuclei of the most superficial layers of the condylomatous epithelium. The viral antigen was not detected in dysplasia, carcinoma in situ, or invasive carcinoma.

Animals↗

Treatment of Hemophilus vaginalis vaginitis.

Four antimicrobial agents (triple sulfa cream, doxycycline, ampicillin, and metronidazole) were studied by double-blind techniques to determine their effectiveness in the treatment of Hemophilus vaginalis vaginitis, documented by vaginal culture in 96 patients. Cure was confirmed by negative vaginal cultures 7 weeks after the start of therapy. Metronidazole proved to be effective in 20 of 22 couples (90.9%) treated. Sulfa cream, doxycycline, and ampicillin were effective in 47.8 to 63.6% of patients treated.

Adolescent↗

Conservative management of intraepithelial cervical neoplasia.

In a prospective trial cryotherapy was performed in 164 patients with preinvasive cervical neoplasia, most of whom desired future childbearing. Their disease had been evaluated by repeat cytology, colposcopy and colposcopically directed punch biopsies, with endocervical curettage when necessary. This conservative treatment eradicated the disease in 147 (89.6%) of the patients. The remaining 17 underwent complete reinvestigation. The focal residual disease in 12 was successfully treated by conservative means--repeat cryotherapy, focal electrocautery or punch biopsy. The other five required either cone biopsy or hysterectomy because of more extensive lesions.

Adolescent↗