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J Paavonen

Publications and source records attributed to J Paavonen.

At least 145 records · Page 8Linked to original sources
PubMed1990

C-reactive protein in preterm premature rupture of the membranes.

The usefulness of maternal C-reactive protein (CRP) measurements in the diagnosis of chorioamnionitis and puerperal and neonatal infectious morbidity was studied among 147 patients with preterm rupture of the membranes (PROM). Thirty-three patients developed chorioamnionitis, 10 patients developed puerperal endometritis, and 21 newborn infants developed neonatal infections. There was no difference in the highest antepartum CRP between patients with or without chorioamnionitis. The overall test performance for CRP was poor suggesting that elevated antepartum CRP may be misleading in the diagnosis of chorioamnionitis. However, use of serial CRP measurements increases the test performance. The high negative predictive value suggests that CRP is useful in predicting the absence of chorioamnionitis.

Adult↗
PubMed1990

Deoxyribonucleic acid flow cytometric analysis of cervical adenocarcinoma: prognostic significance of deoxyribonucleic acid ploidy and S-phase fraction.

Paraffin-embedded tumor samples from 125 patients with cervical adenocarcinoma were analyzed by deoxyribonucleic acid flow cytometry. Thirty-one percent of the tumors were aneuploid. Triploid deoxyribonucleic acid content predominated (51.3%) and one third of the deoxyribonucleic acid aneuploid tumors were tetraploid, whereas near-diploid deoxyribonucleic acid aneuploidy was seen infrequently. Deoxyribonucleic acid aneuploidy was associated with tumor size, histologic grade, clinical stage, and high S-phase fraction. Deoxyribonucleic acid ploidy and S-phase fraction value were independent prognostic parameters, together with the presence of lymph node metastases and tumor size. In conclusion, our results indicate that flow cytometric deoxyribonucleic acid analysis helps to predict the prognosis and may thus influence the choice of treatment.

Adenocarcinoma↗
PubMed1990

Use of AffiProbe HPV test kit for detection of human papillomavirus DNA in genital scrapes.

The presence of human papillomavirus (HPV) DNA in cervical and vaginal scrapes was analyzed by the AffiProbe HPV test kit (Orion Corp., Orion Pharmaceutica, Helsinki, Finland), which is a 1-day solution hybridization test for HPV type 6/11, 16, or 18. The AffiProbe test was compared with a commercially available dot blot test (ViraPap and ViraType tests; Life Technologies Inc., Gaithersburg, Md.). The study group consisted of 178 patients seen in a gynecological outpatient clinic. Altogether, 64 specimens (36 cervical and 28 vaginal scrapes) from 49 patients were positive by the AffiProbe test. Concurrently collected cervical scrapes from 174 patients were available for the reference test, which yielded 27 positive results for HPV type 6/11 or 16/18 and 25 positive results for HPV type 31/33/35. Agreement as to the presence of HPV type 6/11, 16, or 18 by the two tests was reached in 85% of the specimens. Eleven cervical specimens were positive by the AffiProbe test only, and nine cervical specimens were positive by the ViraType test only. Independent evidence obtained by the polymerase chain reaction, repeat examination, or the concurrent presence of HPV DNA in vaginal or vulval epithelium supported the AffiProbe and the ViraType test results for 6 of the 11 and 6 of the 9 specimens with discrepant results, respectively. Thus, the DNA tests had similar sensitivities for HPV type 6/11, 16, and 18 DNAs, but the results were obtained within 1 day by the AffiProbe test, whereas results for the ViraPap and ViraType analyses required from 4 days to 2 weeks.

Cervix Uteri↗
PubMed1990

Antigen specific serum antibody response to Chlamydia trachomatis in patients with acute pelvic inflammatory disease.

Sera from 35 patients with acute pelvic inflammatory disease (PID) with and without Chlamydia trachomatis confirmed by culture and sera from 19 control patients with neither evidence of pelvic infection nor C trachomatis infection were studied for the presence of serum IgG, IgA, and IgM antibodies to C trachomatis using enzyme immunoassay (EIA) and immunoblotting techniques. There was no correlation between the antibody concentrations in the EIA and the spread of chlamydial infection, as determined by cervical, endometrial, and laparoscopic sampling for chlamydia. The immunoblot analysis showed antibodies to the major outer membrane protein (MOMP) of C trachomatis elementary bodies in all patients who had had C trachomatis isolated. Reactivity was also frequently observed against the 68, 62, 60, 45, and 31 kilodalton antigens. About 20 antigenic polypeptides were identified. Differences in antibody prevalence to specific chlamydial antigens, however, were not related to the site of chlamydial isolation or serum antibody concentrations observed with the EIA. The results indicate that patients with PID with and without upper genital tract infection with C trachomatis cannot be differentiated by reactivity of sera to specific chlamydial polypeptide antigens. The determination of a specific serum IgA antibody response by EIA was the most effective single test to discriminate between patients with and without acute chlamydial infection.

Acute Disease↗
PubMed1990

Human papillomavirus DNA in unselected pregnant and non-pregnant women.

Human papillomavirus (HPV) DNA is associated with genital squamous cell neoplasia, especially types 16, 18, and 31. Several studies, using histopathology and DNA hybridization, have shown an increased prevalence of cervical HPV DNA in pregnant women. We determined the prevalence of HPV DNA and the distribution of specific HPV DNA types in exfoliated cervical cells from 748 randomly selected pregnant and 503 non-pregnant women, using a dot blot DNA hybridization technique. The prevalence of HPV DNA was 9.6% in pregnant women and 8.9% in non-pregnant women. Thus, we found no evidence of higher prevalence of HPV DNA in pregnant women. HPV DNA types 16/18 and 31/33/35 were more common than types 6/11. The prevalence of HPV DNA was highest (15%) in the youngest age groups suggesting an association between young age and the prevalence of HPV DNA.

Adolescent↗
PubMed1990

Pelvic inflammatory disease.

Pelvic inflammatory disease (PID) and PID-related sequelae have risen to alarming proportions and are a major public health problem. During the last two decades, an epidemic of sexually transmitted diseases has led to an epidemic of PID that has now led to a secondary epidemic of tubal infertility and ectopic pregnancies. The direct and indirect economic consequences caused by PID to the community are enormous. The spectrum of clinical manifestations of PID is extremely broad, leading to major diagnostic problems in clinical practice. Although PID is the most preventable cause of tubal damage, PID and PID-related sequelae remain one of the most neglected areas in modern medicine. Prevention of PID should be the main goal of the appropriate diagnosis and treatment of lower genital tract infections. Only better understanding of the risk factors, microbial etiology, pathophysiology, immunopathology, and manifestation of PID can ultimately lead to improved therapeutic results and decrease in the current epidemic of acute, chronic, and late complications of PID.

Female↗
PubMed1990

Observer variability in the scoring of colpophotographs.

Colposcopy and cervicography are accepted tools for assessing the cervix for an atypical transformation zone. We studied the validity of the colpophotograph as a measurement tool by determining the agreement of experienced colposcopists using colpophotographs of 50 women. Interobserver agreement was generally fair to good (kappa greater than or equal to 0.40) for the presence of the squamocolumnar junction and the area of ectopia but it was poor (kappa less than 0.40) for the area, border, and color characteristics of an atypical transformation zone. Intra-observer agreement was fair to good for the color characteristics of an atypical transformation zone, but it was poor for the area and border characteristics. We conclude that observer agreement studies should play a role in the validation of methods used in the visual diagnosis of cervical intraepithelial neoplasia. Considerable lack of agreement in reporting cytologic findings is a well-known problem, and lack of agreement might be an even bigger problem in reporting colposcopic findings.

Cell Transformation, Neoplastic↗
PubMed1989

Lack of serum antibodies to the major HSV-2 specified DNA-binding protein before diagnosis of cervical neoplasia.

We report results based on a prospective case-control study within a cohort obtained by linking the Finnish Social Insurance Institutions Mobile Clinic Survey Registry and the Finnish Cancer Registry. The overall prevalence of herpes virus early antigen (ICSP 11/12) antibodies was similar in controls and in cervical neoplasia cases (consisting of invasive cervical carcinoma, ICC, and cervical intraepithelial neoplasia group III, CIN III cases). However, those CIN III cases, who after a long lag period (average 7 years after the blood sample was drawn) developed cervical neoplasia, had significantly lower antibody levels than did matched controls. Their ICSP 11/12 antibody levels became higher the shorter the lag period. The negative correlation between the ICSP 11/12 antibody levels and the lag period was most pronounced in the HSV-2 seropositive CIN III cases. In an analysis of cross-sectional case-control material from the Clinic of Obstetrics and Gynaecology, Tampere University Central Hospital, the patients with ICC had the highest ICSP 11/12 antibody levels. Statistically significant differences between cases and controls were not found. We conclude that in cervical neoplasia the kinetics of ICSP 11/12 antibody levels are determined by the malignant process itself. The cervical disease may selectively induce early viral antigens, thus giving rise to the antibody response described in this paper.

Antibodies, Viral↗
PubMed1989

Analysis of DNA synthesis in herpes simplex virus infected cells by dual parameter flow cytometry.

The DNA incorporation of a thymidine analogue bromodeoxyuridine (BrdUrd) in herpes simplex virus type 2 (HSV-2) infected cervical cancer cell lines (CaSki and C-33 A) was studied by dual parameter flow cytometry. HSV-2 infection resulted in an exponential increase in DNA synthesis in the CaSki cells. In the less permissive C-33 A cells the proportion of DNA-synthesizing cells cycled during HSV-2 infection. The inhibition of viral DNA synthesis by phosphonoformate (PFA) was able to inhibit the virus induced changes in the CaSki but not in the C-33 A cells. In the C-33 A cells a part of the virus induced cellular DNA synthesis represents repair replication of cellular DNA.

Bromodeoxyuridine↗
PubMed1989

The relation between serum sex steroid levels and plasma cell infiltrates in endometritis.

We measured serum levels of progesterone and estradiol among 35 patients with endometritis confirmed by endometrial biopsy. The onset of symptoms took place predominantly in the proliferative phase of the cycle. A negative correlation was found between the serum progesterone levels and the histopathologic severity of plasma cell endometritis. Our results suggest that the hormonal status contributes to the immune response and susceptibility to endometrial infection.

Cell Count↗
PubMed1989

Randomized treatment of mucopurulent cervicitis with doxycycline or amoxicillin.

A randomized trial of doxycycline versus amoxicillin was performed to treat mucopurulent cervicitis. Chlamydia trachomatis, the most common single agent associated with mucopurulent cervicitis, was isolated from 30 (47%) and Neisseria gonorrhoeae from five (8%) of 64 patients. Patients were followed up for 3 months, and the effect of treatment was assessed by clinical (presence of endocervical mucopus, cervicitis severity score, and number of polymorphonuclear leukocytes on Gram-stained smears of endocervical secretions) and microbiologic criteria. Doxycycline and amoxicillin were equally effective for treating chlamydial and nonchlamydial cervicitis. However, endocervical mucopus was still present in 18% of the patients in both treatment groups after 2 months and in 23% of the doxycycline group and 33% of the amoxicillin group after 3 months of therapy. The cause of persistent/recurrent mucopus after antimicrobial treatment was not explained by relapse or reinfection with Chlamydia trachomatis, Neisseria gonorrhoeae, genital mycoplasmas, or Gardnerella vaginalis, but persistence was associated with the degree of cervical ectopy.

Amoxicillin↗
PubMed1989

Serum CA 125 in acute pelvic inflammatory disease.

Serum levels of CA 125 and other selected tumour markers were measured in 31 patients with proven pelvic inflammatory disease (PID). Ten (32%) of the patients had elevated CA 125, one (4%) had elevated CEA, and none had elevated CA 15-3, AFP or beta 2-microglobulin. Compared to patients with normal CA 125, patients with elevated CA 125 were older, more often users of intrauterine contraceptive devices, had longer duration of symptoms, higher erythrocyte sedimentation rates, and more often had an adnexal mass on pelvic examination. There was a correlation between CA 125 levels and the severity of adnexal inflammation as defined by laparoscopy. Isolation of specific micro-organisms from the upper genital tract was not associated with elevated CA 125. In most women serum levels of CA 125 decreased during treatment. PID should be considered as a major cause of positive CA 125 findings among young women.

Adult↗
PubMed1989

Concentrations of tumor-associated trypsin inhibitor and C-reactive protein in serum in acute pelvic inflammatory disease.

We measured tumor-associated trypsin inhibitor (TATI) and C-reactive protein (CRP) in serum of 29 patients with proven pelvic inflammatory disease (PID). TATI values were increased in seven (24%), paralleling increases in CRP. TATI was increased by about 3.5-fold in seven of eight patients with CRP concentrations greater than 90 mg/L, but in none of 21 patients with CRP concentrations less than 90 mg/L. TATI concentration and severity of PID as determined by laparoscopy or endometrial biopsy were not correlated. These results suggest that, in severe infections, regulation of TATI synthesis resembles that of acute-phase proteins.

Acute-Phase Proteins↗
PubMed1989

Immunoblotting analysis of class-specific antibody response in patients with primary HSV infection.

Class-specific immune response in acute herpes simplex virus (HSV) infections to individual virus specified polypeptide antigens was analysed by immunoblotting. The HSV specified glycoproteins B (gB), C (gC), and D (gD) were detected. IgG-antibody response was shown to develop to various other virus specific polypeptides as well. The IgM- and IgA-antibody responses remained restricted to only a few HSV specific proteins, namely VP 13 (80 kD), VP 20 (52 kD), and VP 23 (40 kD) and to the low molecular weight polypeptides.

Adult↗