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M Menton

Publications and source records attributed to M Menton.

At least 19 recordsLinked to original sources
PubMed2004

Detection and typing of human papillomavirus by e6 nested multiplex PCR.

A nested multiplex PCR (NMPCR) assay that combines degenerate E6/E7 consensus primers and type-specific primers was evaluated for the detection and typing of human papillomavirus (HPV) genotypes 6/11, 16, 18, 31, 33, 35, 39, 42, 43, 44, 45, 51, 52, 56, 58, 59, 66, and 68 using HPV DNA-containing plasmids and cervical scrapes (n = 1,525). The performance of the NMPCR assay relative to that of conventional PCR with MY09-MY11 and GP5+-GP6+ primers, and nested PCR with these two primer sets (MY/GP) was evaluated in 495 cervical scrapes with corresponding histologic and cytologic findings. HPV prevalence rates determined with the NMPCR assay were 34.7% (102 of 294) in the absence of cervical intraepithelial neoplasia (CIN 0), 94.2% (113 of 120) in the presence of mild or moderate dysplasia (CIN I/II), and 97.8% (44 of 45) in the presence of severe dysplasia (CIN III). The combination of all four HPV detection methods applied in the study was taken as "gold standard": in all three morphological subgroups the NMPCR assay had significantly (P < 0.0001) higher sensitivities than the MY09-MY11 and GP5+-GP6+ assays and sensitivities comparable or equal to those of the MY/GP assay. All 18 HPV genotypes investigated were detected among the clinical samples. The ratio of high- to low-risk HPV genotypes increased from 4:1 (80 of 103) in CIN 0 to 19:1 (149 of 157) in CIN I to III. Multiple infections were detected in 47.9% (124 of 259) of the patients. In conclusion, the novel NMPCR method is a sensitive and useful tool for HPV DNA detection, especially when exact HPV genotyping and the identification of multiple HPV infections are required.

DNA Primers↗
PubMed2003

Inclusion of HPV testing in routine cervical cancer screening for women above 29 years in Germany: results for 8466 patients.

In a prospective cohort study 8466 women attending routine cervical cancer screening were recruited. Colposcopy was performed on women with any degree of atypia on cytology and/or a positive high-risk human papillomavirus (HPV)-DNA test (HC2; Hybrid Capture 2((c))), and for a randomly selected sample of 3.4% women with negative findings on both. Quality control included reviews of cytology, histology, colposcopy images and retesting of samples with polymerase chain reaction. Test diagnostic performances were based on 7908 women who had complete baseline and follow-up results. Routine histology identified 86 women with high-grade cervical intraepithelial neoplasia (CIN2+), which was confirmed by review histology in only 46 cases. Sensitivity of routine cytology for the detection of CIN2+ was 43.5%, with a specificity, positive predictive value (PPV), negative predictive value (NPV) of 98.0, 11.4 and 99.7%, respectively. Sensitivity of the HC2 test for the detection of CIN2+ was 97.8%, with a specificity, PPV and NPV, of 95.3, 10.9 and 100%, respectively. No high-grade neoplasia was detected in the randomly selected control group. A negative HPV-test result, even in combination with a positive Papanicolaou (Pap) result, virtually excluded any risk of underlying high-grade disease, but this was not the case for a negative Pap result. These data show that HPV testing is of value for the detection or exclusion of prevalent CIN in a routine cervical cancer-screening setting and could be used for further risk classification of women for follow-up management.

Adult↗
PubMed1998

Detection of human papillomavirus type 16 E6/E7 oncogene transcripts in dysplastic and nondysplastic cervical scrapes by nested RT-PCR.

Infections with high-risk human papillomaviruses (e.g., HPV-16) play an important role in the development of cervical intraepithelial neoplasia (CIN) and invasive cervical cancer (IC). Continued expression of the viral E6 and E7 genes is believed to be a key factor for oncogenic transformation of infected cells. Two spliced transcripts of the E6/E7 oncogenes, termed E6*I and E6*II, can be detected by reverse transcriptase polymerase chain reaction (RT-PCR). To increase the sensitivity of detecting E6/E7 transcripts in cervical scrapes we took advantage of a nested RT-PCR (nRT-PCR) protocol. In a series of 30 HPV-16-positive patients with histologic diagnoses ranging from nondysplastic epithelium to IC, the application of nRT-PCR significantly improved the detection of E6/E7 transcripts compared to conventional RT-PCR. The prevalence of E6/E7 spliced transcripts correlated with lesion severity and the nRT-PCR protocol allowed detection of these transcripts even in nondysplastic epithelium and CIN I lesions. Therefore, in epidemiologic follow-up studies, detection of E6/E7 transcripts by nRT-PCR should prove to be a useful diagnostic tool for risk evaluations regarding the development of CIN and its progression to cervical cancer, especially in high-risk HPV-type-infected patients with CIN 0 and CIN I.

Blotting, Southern↗
PubMed1996

The colposcopic screening.

The objective of this paper is a valuation of colposcopy as a screening tool. As database, 392 patients with histologically confirmed intraepithelial neoplasia were used. Colposcopic and cytologic findings were compared with the final histologic diagnosis. The following results were obtained: (1)The colposcopic findings correlated with the histologic diagnosis to a significantly higher degree than the cytologic findings. Depending upon the rate of dysplasia, the colposcopic findings predicted the diagnosis in 84-97%. (2) The false-negative rate of cytology in condylomatous lesions and mild dysplasia was high (39 and 26%, respectively), in particular in comparison with the false-negative rate of colposcopy of 5% for both lesions. Thus, a negative smear does not exclude consistently a dysplasia of the cervix. (3) The false-negative rate of cytology for the high grade lesions (CIN II and CIN III) was 13 and 1% respectively and, thus, lower than in the low grade lesions. There were, however, considerable discrepancies in comparison with the histologic rating of the lesion. In CIN III cytology correlated with histology in only 61%, colposcopy, however, 85% (P < 0.001). Our results demonstrate that colposcopy is an excellent tool for detecting HPV caused lesions especially subclinical lesions and CIN I. Colposcopy is also a corrective for the false-negative cyto-smear rate (about 20-40%). Thus, colposcopy may be used as an effective quality assurance method and an excellent screening method in that colposcopy is superior in grading dysplastic lesions of the cervix. The application of the European terminology was advantageous.

Colposcopy↗
PubMed1995

[Bacteriological findings in patients with cervical intra-epithelial neoplasia].

In order to evaluate the cervical flora in patients with histologically confirmed cervical intraepithelial neoplasia (grades I to III) the microbiologic results of 216 patients with CIN were compared with those of 100 symptom free controls. Gardnerella vaginalis combined with Mykoplasma spp. and Bacteroides spp. were found in 22% of the patients with dysplasia and in 5% of the control group. The difference was significant (p < 0.004). Microorganisms causing sexually transmitted diseases like Neisseria gonoroheae and Trichomonas vaginalis were not found. Chlamydia trachomatis was detected in 5% of all CIN groups. Comparing patients with CIN I, CIN II and CIN III, we did not notice any difference in their bacterial flora, wet smear or smell test. However the results of this study indicate that women with cervical dysplasia may have a higher prevalence of an altered cervical flora in comparison to controls.

Bacteria↗
PubMed1994

[The value of colposcopy and portio biopsy in preventive examination].

133 patients attending the colposcopy-laser outpatient consultations were examined simultaneously by cytology, colposcopy and punch biopsy. A cone biopsy was taken 25 patients and one patient was hysterectomised later. A comparison between cytology and histology revealed 17.1% false negative smear results. Cytology and histology showed the same result in 84.6%. The highest percentage of high-grade dysplasia was found in colposcopy with signs of punctation and/or mosaicism. A similar diagnosis was achieved in 92.3% of cases comparing punch with cone biopsy. Simultaneous use of cytology, colposcopy and punch biopsy enables reliable diagnosis and follow-up of dysplastic lesions of the cervix. Besides, one can use punch biopsy as basic histology for local destructive manoeuvres such as laser vaporisation.

Biopsy↗
PubMed1993

[Condylomata acuminata in pregnancy. Is there an indication for Cesarean section?].

Condylomata acuminata are very rare in children, although the prevalence of clinically or cytologically visible human papilloma virus infections is high. We report on a 28-year old G IV, P II with genital warts at the time of delivery, who had a baby boy without any signs of HPV-infection. The condylomata of the mother persisted, and subsequently laser vaporisation was performed one year after delivery. One year after laser therapy, a recurrent HPV-infection in the mother was detected. At this time, her two year old son had condylomata on his scrotum. The same serotypes, HPV 6 and 11, could be identified in the mother and child. With this case report, we discuss the possible ways of transmission and consequent clinical management of HPV infections in pregnancy.

Adult↗
PubMed1993

Probe-guided chorionic villus sampling. Report of a new technique.

This paper reports a new technique of chorionic villus sampling. A new probe has been developed to allow easier passage and manipulation of the catheter and improve visualization by ultrasound. Our initial experience with this new probe-guided sampling device indicates that it simplifies the operation, and this could improve the success rate.

Catheterization↗
PubMed1993

[Attitude of patients to chorionic villi biopsy: motivation for the decision and perception].

56 patients with CVS were asked with a standardized questionnaire why they decided to undergo that surgical procedure and how they felt about it. 52 patients said, that their main motivation for CVS was the early diagnosis of a healthy baby. The low health risk of an early performed abruption in case of fetal abnormalities played a secondary role. Concerning the severity of that surgical procedure 44 patients thought, that it was harmless or tolerable and no woman had the feeling that CVS is a fearful intervention. 76% said, that CVS was not painful or only a little bit, 2 patients had the feeling of a painful surgical procedure. The most disagreeable moment during CVS was the hooking of the cervix. There were different opinions comparing CVS stress to amniocentesis stress in patients with a preceding amniocentesis.

Abortion, Eugenic↗
PubMed1993

[Laser therapy of the vulva, perineal area and uterine cervix].

Within a period of two years 205 patients of our colposcopy-laser-outpatient department have been treated with a 40 Watt CO2-laser. 97 patients had dysplastic or condylomatous lesions of the portio, 85 ones condylomas in the vulvar, vaginal or perianal regions. 70 per cent of laser vaporisations had been done ambulatoryly. Complication rate following laser conisation was 12 per cent, following laser vaporisation 0 per cent. The rate of recurrent or persistent dysplasias was 12 per cent, of condylomas 18 per cent on an average observation time of 16 months.

Cervix Uteri↗
PubMed1993

Diagnosis and follow-up of atypical hyperplasia of corpus endometrium--a critical methodological investigation.

Within 5 years 181 patients were diagnosed with grade I and grade II atypical hyperplasia (AH) in the curettage material of 4193 specimens at the University Department of Gynecology and Obstetrics in Tübingen. In 62.6% of grade I and in 38.8% of grade II AH, concomitant endometrial polyps were observed, rarely cystic alterations as well. Especially with AH grade II, most polyps exhibited epithelial proliferation. Plurifocality and in situ residuals of AH were seen (grade I 38.5%, grade II 77.3%). In the same time period 345 endometrial carcinomas were found. Due to embedding techniques and the observation that only approximately 60% of the cavum uteri surface is reached via curettage, diagnostic security is quite limited. It has been published that women with AH have a higher risk of developing endometrial carcinoma. A control curettage after 6 months or a wide indication for hysterectomy is recommended after atypical endometrial hyperplasia has been demonstrated.

Adenocarcinoma↗
PubMed1992

[Clinical and immune hematologic problems in prenatal prevention of Rhesus sensitization].

Various studies have provided impressive evidence of the efficacy of antenatally administered anti-D in the prevention of rhesus (D) alloimmunisation in rhesus-negative women. However, possible clinical and immunohaematological problems associated with this prophylactic therapy have received little attention. We describe perinatal and immunohaematological problems, which occurred in four cases after antenatal rhesus prophylaxis. Classical immunohaematological techniques were employed, to detect and specify irregular red cell antibodies. It was found, that the antenatal administration of anti-D could mask sensitization to other red cell antigens or the production of maternal immune anti-D antibodies later in pregnancy. A further problem encountered was that of neonates with a positive direct Coombs' test (the uncertainty in the individual case being, whether this is a result of the antenatal administration of anti-D) and marked hyperbilirubinaemia. Antenatal immunoprophylaxis for rhesus disease can give rise to immunohaematological and clinical findings, of which the interpretation is extremely difficult and requires intensive cooperation between the obstetrician, neonatologist, and haematologist/clinical biochemist.

Adult↗
PubMed1992

[Colposcopy, histology, cytology and HPV findings in patients with condylomata of the vulva].

The presence of vulvar condylomata acuminata shows evidence HPV infection of the vulva. 49 patients with such lesions came to our hospital for laser treatment. At that time, none of the patients were aware of their cervical disease. Colposcopy and biopsy of the cervix revealed in eight (16%) of the 49 patients CIN I and CIN II in one patient (2%). Condylomata or other HPV-associated lesions were found in seven patients (14%) and cervicitis in two (4%). HPV were detected in the cervix in 23 patients (46%). HPV types 16 and 18 were found in seven patients (14%) and HPV types 31, 33 and 35 in four patients (8%). It is concluded, that patients with condylomata acuminata of the vulva have a high risk of developing CIN and should undergo colposcopy.

Biopsy↗
PubMed1990

[Seroma formation and drainage technic following mastectomy].

Although seromas represent the most frequent postoperative complication of mastectomy, little attention has been paid in the literature to etiologic factors or therapy. In the present paper, a modified drainage technique is described which reduced the incidence of seroma formation after total mastectomy with removal of the axillary lymph nodes from 50% to 20.2%. Seroma formation was associated with drainage of significantly higher amounts of fluid. Seroma formation generally began on the 7th day after operation, reached a peak rate of growth on the 8th day, and subsequently slowed continuously up to the 16th day after operations. Age was revealed to be a very important etiologic factor: the frequency of seroma formation increasing with age.

Adult↗
PubMed1990

[Fertility following tubal pregnancy: comparison of tube-saving surgery and salpingectomy].

391 patients were operated during 1980 to 1987 at the Department of Gynaecology of the University of Tübingen for extrauterine pregnancy. A questionnaire was circulated to inquire, how many of these women wanted to become pregnant again. 176 answered positively, the return quota being 82%. After surgery, performed to preserve the Fallopian tubes, 64% of these patients had an intrauterine pregnancy, compared with only 41% after salpingectomy or segmental resection without anastomosis. In women without the characteristic factors which reduce fertility, such as primary sterility, surgery concerning sterility or refertilization, or other kinds of abdominal surgery, a greater proportion of intrauterine pregnancies was seen after surgery preserving the Fallopian tubes (79%), than in women with the above mentioned risk factors (53%). The incidence of repeat extrauterine pregnancies was approximately equal after Fallopian tube-preserving surgery and after salpingectomy (20% and 18%, respectively).

Adult↗
PubMed1990

[Gaucher disease and pregnancy].

Up to date, initial or recurrent pregnancy has been reported in 46 patients suffering from Gaucher's disease. In the present review of the literature, potential complications and therapeutic concepts are outlined and a case report of a 22-year-old primipara is presented.

Adult↗