PubMed Health⌕ Search

Biomedical subjects

R Soeters

Publications and source records attributed to R Soeters.

At least 19 recordsLinked to original sources
PubMed2001

Oral antibodies to human papillomavirus type 16 in women with cervical neoplasia.

This study investigated the relationship between human papillomavirus type 16 (HPV-16) antibodies detected in oral fluid from women with cervical neoplasia, their HPV-16 antibody seroprevalence, and their cervical HPV-16 DNA presence. Cervical HPV-16 DNA was detected by polymerase chain reaction in 43.2% (35/81) of these women. The prevalence of IgG and IgA antibodies to HPV-16 virus-like particles (VLP-16) in oral fluid and was investigated by enzyme-linked immunosorbent assay. Anti-VLP-16 IgA antibodies were detected in oral fluid from 54.3% (44/81) of women with cervical neoplasia, compared with 8% (3/36) in controls (P = 0.000002). Anti-VLP-16 IgG was detected in oral fluid from 43.2.9% (25/72) and 13.3% (4/30; P = 0.029), respectively. Women who were HPV-16 DNA positive at their cervical lesion, displayed an oral fluid anti-VLP-16 IgA prevalence of 60.7% (17/28) and HPV-16 DNA negative women an oral fluid anti-VLP-16 IgA prevalence of 50% (20/40; P = 0.38). Oral fluid anti-VLP-16 IgG prevalence in HPV-16 DNA positive women was 28.6% (8/28) compared with 40% (16/40) in oral fluid from HPV-16 DNA negative women (P = 0.3). Amongst HPV-16 DNA positive women, the anti-VLP-16 IgG seroprevalence was 75% (21/28) and IgA seroprevalence 35.7% (10/28) and for the HPV-16 DNA negative women these values were 60% (24/40) and 32.5% (13/40), respectively. Oral IgA antibody testing proved no more sensitive than serum antibody detection for the determination of HPV infection but could be useful as a non-invasive screening method for women with cervical neoplasia and for estimating the mucosal antibody response to HPV vaccines.

Adolescent↗
PubMed2000

Seroresponses to human papillomavirus types 16, 18, 31, 33, and 45 virus-like particles in South African women with cervical cancer and cervical intraepithelial neoplasia.

The aim of the study was to determine the prevalence of antibodies to human papillomavirus (HPV) types 16, 18, 31, 33, and 45 in woman in Cape Town with cervical intraepithelial neoplasia (CIN) (n = 95), cervical cancer (n = 40), female blood donors (n = 95) and children (n = 110). The enzyme-linked immunosorbent assay (ELISA) made use of baculovirus synthesised HPV virus like particles (VLPs) as antigen. Antibodies to at least one HPV type were detected in sera from 75% of cancer patients, 71.6% of CIN patients, 44.2% of blood donors and 27.3% of children. Sera from 95 women with CIN were compared with age-matched female blood donors. There was a significant association of seropositivity to VLP-16 (P = 0.006) and VLP-45 (P = 0.008) with CIN compared with the blood donors. There was also a significant difference in the seropositivity of women with CIN to any of the five virus-like particle (VLP) types compared to the blood donors (P = 0.0002: OR = 3.2). Thirty-nine of sixty-nine (56.5%) women with CIN were found to be HPV-16 DNA positive. The average age of women in this group that were VLP-16 seropositive was 34 years and those found to be VLP-16 seronegative was 52 years of age. Antibodies to all five VLP types were detected in these populations, thus an ideal vaccine should induce protection from infection by a wide range of HPV types.

Adult↗
PubMed1998

Is there an effect of perioperative blood transfusion on the outcome of radical hysterectomy with lymphadenectomy for cervical cancer in South Africa?

The aim of this study was to investigate whether there is an effect of perioperative blood transfusion on the outcome of radical hysterectomy with lymphadenectomy for cervical cancer. One hundred and thirty-one patients with cervical cancer were treated by Wertheim radical hysterectomy in the period from 1984-1991. Eighty-six patients received blood transfusions during surgery or within two weeks, whereas 45 patients did not receive any blood transfusion. Transfused and non-transfused patients did not differ with respect to mean age, race, weight, FIGO-stage, cell-type, grade, size, depth of invasion and nodal involvement. Transfused patients had more blood loss, longer surgical time and lower haemoglobin levels. Using log rank analysis, the calculated five-year survival was 81% for the transfused group and 84% for the non-transfused group, a non-significant difference. The five-year disease-free survival rate was 87% for the transfused group and 88% for the non-transfused group. This study suggests that perioperative blood transfusion does not adversely influence survival after the Wertheim operation for cervical cancer.

Adenocarcinoma↗
PubMed1996

Acetic acid visualization of the cervix: an alternative to cytologic screening.

OBJECTIVE: To investigate the value of acetic acid visualization of the cervix as an alternative to cytologic screening. METHODS: A prospective study was conducted in a squatter area in Cape Town, South Africa, on 2426 women who underwent speculum examination, naked-eye inspection of the cervix after application of acetic acid, and cytologic smear. The smears were stained and processed at the screening site. Patients with a positive reading after acetic acid or a smear indicating a high-grade squamous intraepithelial lesion (SIL) were referred for immediate colposcopy, biopsy, and when indicated, treatment by large loop excision of the transformation zone. Therefore, histology was obtained on all patients with a positive acetic acid test or a positive cytology. RESULTS: Seventy-six women with positive reactions to acetic acid. Among the 2350 women with negative reactions, 254 had positive cervical smears; only 11 of these had histologic high-grade SIL. In contrast, 20 of the 61 women with positive cytology and positive acetic acid test had high-grade SIL on histology. Therefore, the acetic acid reaction enabled the observer to detect 20 of the 31 women (64%) who exhibited a high-grade SIL both on cytology and histology. CONCLUSION: In locations where access to cytopathology is limited, naked-eye visualization of the cervix after application of diluted acetic acid warrants consideration as an alternative in the detection of cervical premalignant lesions.

Acetates↗
PubMed1996

The influence of hormonal status on excision margins after large loop excision of the transformation zone (LLETZ).

To evaluate the influence of the type of contraception used and post-menopausal status on the involvement of excision margins with CIN after Large Loop Excision of the Transformation Zone (LLETZ), the authors reviewed a computerised database and the clinical files of 451 sequential women treated by LLETZ, for CIN diagnosed on cytology and colposcopy. There was a statistically significant association between both the use of Long Acting Injectable Progesterone (LAIP) and post menopausal status with histological report of incomplete excision of CIN on the endocervical excision margin. Therefore, the authors conclude that both progesterone-only containing contraception and menopause induced atrophy of the endocervical epithelium significantly increase the risk of involvement of the endocervical excision margin with CIN in the treatment by LLETZ. This parameter is of particular importance, as it is one of the known factors for recurrence.

Contraception↗
PubMed1996

Human papillomavirus in normal cervical smears from Cape Town.

OBJECTIVE: To determine the prevalence of human papillomavirus (HPV) types in South African women with normal cervical cytology and to determine whether our results are comparable to what has been found elsewhere in the world. DESIGN: Cervical smears were collected from 262 women. SETTING: The Cape Town metropolitan area. PARTICIPANTS: A total of 262 women, aged 19-85 years. Eighty-five women attended the family planning clinic of the Gynaecology Department at Groote Schuur Hospital and 177 women consulted private gynaecological practices. MAIN OUTCOME MEASURES: The prevalence and types of HPV in 192 women with normal cervical cytology. RESULTS: The incidence of HPV DNA in cervical smears from Cape Town women with normal cytology was found to be 13% (25/192) using Southern blot hybridisation. The types of HPV found in normal cervical tissue from Cape Town did not differ significantly from those found elsewhere in the world. Nine per cent (17/192) were positive for "high-risk' HPV types which are associated with premalignant and malignant cervical lesions. In the age group 20-39 years, 15 of 92 (16%) were positive for HPV DNA, while in the age group above 39 years, 3 of 53 (6%) women were positive for HPV DNA. CONCLUSIONS: In this study, 25 of 192 (13%) women with normal cytology were positive for HPV.

Blotting, Southern↗
PubMed1995

Placental site trophoblastic tumor: three case reports and literature review.

The clinical features of three patients with placental site trophoblastic tumour (PSTT) are presented. Two patients had probable nephrotic syndrome, which was unrecognized at the time. The nephrotic syndrome disappeared after hysterectomy in one patient and the other demised after one cycle of chemotherapy. The use of hysteroscopy in one patient and the management of a pulmonary metastasis in another are described.

Adult↗
PubMed1995

Cervical carcinoma associated with pregnancy.

Because of the uncommon synchronous occurrence of pregnancy and invasive cervical carcinoma, this disease entity remains poorly understood. In addition inconsistent reporting has precluded meaningful meta-analysis. About 1 in 2000 pregnancies are associated with cervical cancer and pregnancy is a complication in approximately 3 percent of patients with cervical cancer. There is little evidence to suggest that the pregnancy has an influence on prognosis. Although not firmly established, vaginal delivery may have an adverse effect on outcome. Timing of delivery must be individualized inasmuch as there is a role for delaying treatment in order to achieve fetal lung maturity. Surgery and radiotherapy should be utilized in the same stage-dependent manner as in nonpregnant patients but management should be individualized and undertaken by a multidisciplinary team. These and other issues are discussed more fully in this review.

Adult↗
PubMed1995

Does colposcopically directed punch biopsy reduce the incidence of negative LLETZ?

OBJECTIVE: To evaluate the role of punch biopsy in reducing the occurrence of negative histology provided by large loop excision of the transformation zone in the management of cervical intraepithelial neoplasia. DESIGN: Retrospective review of computerised data base and clinic files. SETTING: Colposcopy Clinic, Groote Schuur Hospital, Cape Town, South Africa. SUBJECTS: Two hundred and ninety-eight women considered suitable for the local outpatient management of cervical intraepithelial neoplasia. METHODS: Two groups of patients were identified: group A consisted of women who had cervical intraepithelial neoplasia confirmed colposcopically and who underwent directed punch biopsy; group B consisted of women who had cervical intraepithelial neoplasia confirmed colposcopically and were referred for large loop excision of the transformation zone without confirmatory punch biopsy. RESULTS: In Group A (n = 184) 123 women had cervical intraepithelial neoplasia diagnosed on punch biopsy. Large loop excision of the transformation zone was performed on 116 women and 7 were lost to follow up. The procedure confirmed cervical intraepithelial neoplasia in 95 cases (82%), but there was no cervical intraepithelial neoplasia in 21 cases (18%). Sixty-one women had negative punch biopsies. Of these, 13 underwent large loop excision of the transformation zone, 31 had persistently negative follow up cytology, and 9 had positive cervical smears of which 7 were treated with large loop excision of the transformation zone, and 8 were lost to follow up. Overall, 25% of all negative punch biopsies were falsely negative. In group B 114 were treated with large loop excision of the transformation zone and cervical intraepithelial neoplasia was confirmed in 97 cases (85%); one woman had unsuspected microinvasion (1%) and 16 women (14%) had no cervical intraepithelial neoplasia. Negative histology after large loop excision of the transformation zone was not statistically different in groups A and B. CONCLUSION: Punch biopsy does not reduce the occurrence of negative histology after large loop excision of the transformation zone.

Adult↗
PubMed1995

Primary chemotherapy with bleomycin, ifosfamide and cisplatinum (BIP) followed by radiotherapy in the treatment of advanced cervical cancer. A pilot study.

Bleomycin, Ifosfamide and Cisplatinum were combined in a 3 cycle regime of neoadjuvant chemotherapy given prior to radiotherapy in the treatment of 26 patients with late Stage (FIGO IIB-IIIB) cervical cancer. Seven patients were withdrawn for reasons of compliance and 1 patient due to toxicity. The response rate to chemotherapy in the remainder (18 patients) was 44.4%. Sixtyfour per cent of 17 patients who completed chemoradiotherapy responded completely. This regime was generally well tolerated and neurotoxicity was less problematic than in other reports, although fatal pneumotoxicity occurred in one patient. It is too early to comment on survival; this is an interim report of responses and toxicities. The results are less impressive than in other reported studies and cast doubt on the role of neoadjuvant chemotherapy in the management of advanced cervical cancer in developing countries.

Adult↗
PubMed1994

Typing of human papillomaviruses in cervical carcinoma biopsies from Cape Town.

Sixty-eight cervical carcinoma biopsies from women at Groote Schuur hospital in Cape Town were screened for human papillomavirus (HPV) DNA by polymerase chain reaction (PCR) amplification with subsequent typing by hybridisation with specific oligonucleotides. Amplified DNAs which hybridised with the HPV group-specific oligonucleotide probes, but with none of the type-specific probes, were categorized as unclassified HPV types. Eighty-one percent of samples were HPV positive and the following distribution and types were detected: 46% HPV 16, 1.5% HPV 18, 6% HPV 31, 6% HPV 33, 1.5% HPV 45, and 25% unclassified HPVs. Four of the tumours had detectable dual infections with the following combinations of HPVs: HPV31/HPV33; HPV16/HPV33; HPV18/HPV16; HPV45/HPV33. Tumour DNA from the 17 PCR unclassified HPVs was analysed by Southern blotting and gave the following results: 11 were negative, 4 were positive on hybridisation but could not be typed (unclassified HPV), 1 was HPV 16, and 1 resembled the HPV 16 "variant" described previously [Williamson et al. (1989): Journal of Medical Virology 28:146-149]. Only 2 of 13 samples that were negative for HPV by PCR were positive for unclassified HPVs by Southern blot analysis. Sequencing of a PCR product revealed that one of the unclassified HPVs was HPV 52. This is the first record of HPV 52 and HPV 45 in Africa.

Adult↗