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Biomedical subjects

J Paavonen

Publications and source records attributed to J Paavonen.

At least 181 records · Page 10Linked to original sources
PubMed1985

Comparison of endometrial biopsy and peritoneal fluid cytologic testing with laparoscopy in the diagnosis of acute pelvic inflammatory disease.

Twenty-seven women with suspected acute pelvic inflammatory disease were studied by laparoscopy and endometrial biopsy. Overall, 67% (18 of 27) of the women had acute salpingitis at laparoscopy, 70% (19 of 27) had plasma cell endometritis, and 67% (10 of 15) had an inflammatory cytologic pattern of the peritoneal fluid. In comparison to laparoscopically detected salpingitis, endometritis detected with biopsy had a sensitivity of 89%, a specificity of 67%, a positive predictive value of 84%, and a false negative rate of 22% in the diagnosis of pelvic inflammatory disease. The corresponding figures for inflammation of the peritoneal fluid were 75%, 67%, 90%, and 25%. This study demonstrates that nonpuerperal endometritis is an entity associated with pelvic inflammatory disease, most likely representing an intermediate stage between cervicitis and salpingitis. Endometrial biopsy as an office procedure is a good alternative to laparoscopy in the diagnosis of acute pelvic inflammatory disease and may in fact detect early cases not yet visible at laparoscopy.

Acute Disease↗
PubMed1985

Haemophilus influenzae causes purulent salpingitis.

We describe two patients with laparoscopically diagnosed, severe acute salpingitis who had nontypable Haemophilus influenzae isolated directly from the fallopian tubes. Nontypable H. influenzae should be recognized as an important genital pathogen.

Adult↗
PubMed1985

Serum antibodies to the major HSV-2-specified DNA-binding protein in patients with an acute HSV infection or cervical neoplasia.

The major HSV-2-specified DNA-binding protein (ICSP 11/12) was purified from HSV-2-infected cells. ELISA and immunoblotting techniques were used to study its antigenicity in HSV-infected patients and patients with cervical neoplasia and control women. Patients with an acute HSV-2 infection had clearcut antibody responses to the purified ICSP 11/12 preparation. Determination of the ICSP 11/12 antibodies by ELISA revealed considerably higher serum antibody levels in patients with cervical carcinoma than in the controls.

Adolescent↗
PubMed1985

Diagnosis and management of tubal pregnancy: effect on fertility outcome.

We analysed 188 ectopic pregnancies seen during a 2-year period. They represented 2.2% of the live births that occurred during the same time interval. Overall, 53% of the tubal pregnancies had ruptured at the time of examination. Location was ampullary in 51% of the cases, isthmic in 28%, and 10% had aborted. Sixty-nine (38%) patients had an IUD. Diagnostic sensitivity was 58%-93% for pregnancy tests, 79% for culdocentesis, 41% for ultrasound examination, 43% for dilatation and curettage, and 100% for laparoscopy. Salpingectomy was performed in 47% of the cases, salpingotomy in 27%, and tubal resection in 19%. During a follow-up of 116 women (mean 1.5 years, range 0.5-3 years) 49% delivered, 10% had repeat ectopic pregnancy, 10% had abortion, 17% were infertile and 15% practised birth control. Among those who delivered no difference was found between those who underwent salpingectomy and those who underwent conservative surgery.

Adolescent↗
PubMed1985

Factors predicting abnormal hysterosalpingographic findings in patients treated for acute pelvic inflammatory disease.

One hundred forty-six consecutive inpatients with acute pelvic inflammatory disease (PID) were randomly treated either with the combination of doxycycline and metronidazole or with the combination of penicillin G/amoxicillin and metronidazole. Forty-three women underwent hysterosalpingography (HSG) 6 months after the treatment, and a multivariate statistical analysis was used to study the effect of 11 different variables (parity, history of previous abortion, history of previous PID, use of an intrauterine contraceptive device (IUD), use of oral contraceptives, presence of adnexal mass, results of cervical cultures for Neisseria gonorrhoeae, and Chlamydia trachomatis, presence of serum antichlamydial antibodies, penicillin-metronidazole treatment, and doxycyclin-metronidazole treatment) on the hysterosalpingographic findings. Abnormal HSG was most likely to occur in women who had antichlamydial antibodies present in the serum, an adnexal mass detected on the initial bimanual examination, or had an IUD (positive associations) and least likely to occur in women who had been treated with the combination of doxycycline and metronidazole (negative association).

Acute Disease↗
PubMed1985

Chlamydial endometritis.

Endometrial biopsies were obtained from 32 women with suspected pelvic inflammatory disease, of whom 23 (72%) had histopathological evidence of endometritis. Chlamydia trachomatis was isolated from the endometria of nine (39%) women (chlamydia group) but not from the other 14 (non-chlamydia group). Severe plasma cell endometritis and lymphoid follicles with transformed lymphocytes were significantly more common in the chlamydia group than in the non-chlamydia group. This suggests that C trachomatis is an invasive endometrial pathogen which often causes severe inflammation. The association was independent of predisposing factors such as use of intrauterine contraceptive devices.

Adult↗
PubMed1985

Immunoblotting and enzyme-linked immunosorbent assay analysis of serological responses in patients infected with herpes simplex virus types 1 and 2.

Serological responses to soluble membrane and cytoplasmic antigens specified by herpes simplex type 1 (HSV1) and 2 (HSV2) were studied by immunoblotting and by enzyme-linked immunosorbent assay (ELISA). In the immunoblotting test, polypeptides migrating like the HSV1-specified glycoprotein C showed type-specific reactivity but could not always be detected. The immunoblotting and ELISA results were in agreement when antibody responses to HSV1- and HSV2-specified antigens were compared, and they allowed the identification of patients with HSV2 and/or HSV1 antibodies.

Antibodies, Viral↗
PubMed1985

Endometritis and acute salpingitis associated with Chlamydia trachomatis and herpes simplex virus type two.

A patient who had endometritis confirmed by endometrial biopsy and acute salpingitis confirmed by laparoscopy is reported. Chlamydia trachomatis and herpes simplex virus type two were isolated from the endometrial cavity and the fallopian tube. The histopathologic findings of the endometritis were similar to those frequently seen in chronic chlamydial eye disease or chlamydial cervicitis.

Acute Disease↗
PubMed1985

Anatomic sites of upper genital tract infection.

The microbiologic correlates of upper genital tract infection were studied among 36 women with suspected upper genital tract infection and 11 control women undergoing tubal ligation. Laparoscopic evidence of confirmed salpingitis was seen in 25 (69%) of the 36 women. Pathologic evidence of endometritis was present in 26 women (72%), and 22 (85%) of them had salpingitis as well. Thus, four women had endometritis but no salpingitis, three women had salpingitis but no endometritis, and seven women had neither. Among the 25 women with salpingitis, one or more organisms were isolated from the fallopian tubes of nine women (36%) and from the cul-de-sac of six women (24%), versus none and one (9%), respectively, among the 11 cases without salpingitis, and one (9%) and none among the 11 control women. Among the 26 cases with endometritis, one or more organisms were isolated from the endometrium of 19 women (73%) versus 12 (67%) among the 18 women without endometritis. Chlamydia trachomatis was isolated from the uterine cavity of nine women and from the fallopian tubes of three women with upper genital tract infection. The corresponding figures for Neisseria gonorrhoeae were three and two. Other nongonococcal nonchlamydial organisms were commonly isolated from the fallopian tubes and/or culde-sac of women with salpingitis. Bacteria frequently were isolated from the endometrium of both study cases and control subjects, but the latter were more likely to have nonpathogens of low virulence.

Adolescent↗
PubMed1984

Mucopurulent cervicitis--the ignored counterpart in women of urethritis in men.

Among 100 randomly selected nonmenstruating women attending a clinic for sexually transmitted diseases, we assessed objective criteria for the clinical diagnosis of mucopurulent cervicitis. Visualization of yellow mucopurulent endocervical secretions on a white swab and the presence of 10 or more polymorphonuclear leukocytes per microscopical field (at a magnification of 1000) in satisfactory gram-stained endocervical smears were independently correlated with cervical Chlamydia trachomatis infection. Neither finding correlated with gonorrhea or genital herpes, although herpes caused characteristic cervical ulcerations. C. trachomatis was isolated from the cervix of 20 of 40 women with mucopurulent cervicitis but of only 2 of 60 without it. The overall prevalence of mucopurulent cervicitis among women attending the clinic (40 per cent) exceeded that of nongonococcal urethritis among men in the same clinic, and the prevalence of C. trachomatis infection was higher in mucopurulent cervicitis than in nongonococcal urethritis, a condition that is conventionally treated with tetracyclines. These findings support recommendations for the treatment of mucopurulent cervicitis and should guide the selective use of confirmatory diagnostic tests for C. trachomatis infection.

Adolescent↗
PubMed1984

Detection of Mycoplasma hominis antigen in clinical specimens by using a four-layer modification of enzyme immunoassay (EIA).

A 4-layer modification of enzyme immunoassay (EIA) was developed for the detection of Mycoplasma hominis antigen in clinical specimens. Microtiter plates were sensitized with rabbit anti-mycoplasma immunoglobulin, guinea pig anti-mycoplasma immunoglobulin was used as the secondary antibody, and horseradish peroxidase-conjugated anti-guinea pig immunoglobulin was used as the indicator antibody. The specificity of the assay was confirmed by using guinea pig immunoglobulins from preimmunization sera. The sensitivity of the assay is down to 10 ng/ml of antigen protein. Marked cross-reactivity was demonstrated for different strains within the species M. hominis, whereas the other genital mycoplasma species tested showed no reactivity in the assay. A comparison was made of EIA and conventional culture of vaginal specimens from 24 women. All 6 specimens positive by culture were also positive for M. hominis antigen by EIA. Antigen detection by EIA is a sensitive, rapid and simple method for the detection of M. hominis in clinical specimens.

Adult↗
PubMed1984

Velamentous insertion of the umbilical cord and vasa previa.

We report 31 cases with velamentous insertion of the umbilical cord of whom two had coexistent vasa previa. The prevalence of the former was 0.22% and of the latter 0.014%. Perinatal mortality was low, 3.2%, but there was a high rate of complications during pregnancy, such as threatened abortion, antepartum and intrapartum bleeding, premature delivery and fetal distress. Fifteen patients underwent caesarean section. Four of the term infants were small for gestational age. One infant had congenital malformations. The two cases with vasa previa are described in detail. We conclude that velamentous insertion of the umbilical cord should be kept in mind in the differential diagnosis of fetal distress accompanied with antepartum or intrapartum vaginal bleeding.

Abortion, Threatened↗
PubMed1984

Uterine perforation by copper intrauterine device.

Sixteen cases with uterine perforation by a copper intrauterine device (IUD) are presented. In 13 cases the IUD had been inserted within 5 months following delivery, and in 6 cases the insertion had been painful. Missing string was the first sign in most cases. Laparatomy was performed in all cases to remove the IUD. The IUD was adherent to omentum or sigmoid in 10 cases. There is an increased risk of uterine perforation if the IUD is inserted postpartum during lactation and involution of the uterus. Therefore a painful IUD insertion and a missing string demand investigation of a partial or complete perforation.

Adult↗
PubMed1984

Purification of herpes simplex virus-specified major DNA-binding proteins and detection of antibodies to them in human and rabbit sera.

We purified herpes simplex virus type 1 and 2-specified nonstructural DNA-binding proteins (ICP8 and ICSP 11/12, respectively) from infected Vero cells and applied them in ELISA test to analyse human and rabbit sera. Only a weak immune response to the ICP8 and ICSP 11/12 could be demonstrated following experimental HSV-1 or HSV-2 infections of rabbits. Low levels of ICSP8 antibodies were found also in acute HSV infections of man.

Animals↗