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The anencephaly is a congenital malformation, characterized by the absence of the cerebral structures and of the skull. In this study we have considered 5 cases of anencephaly, occurred in the decade 1985-1994. All the pregnant women have been interviewed and underwent ultrasonographic evaluation. Four out of 5 pregnant women have voluntarily interrupted pregnancy. In only 1 case, having achieved woman the 40th week of pregnancy, the delivery has been spontaneous: the fetus has died after few hours. The results of this study suggest that, being the anencephaly the most commonly indications for the abortion, would be important to help the women bearers of anencephalic fetuses to consent taking the organs, using them for transplantations on children that necessitate them.

All phases of HPV infection are under the control of the immunitary system which is probably inhibited by the virus itself. We studied 65 patients (range 22-55 year). They presented an HPV vulvovaginal infection not healed after common therapy. The aim of our study was to verify the changes occurring in the immune system during HPV vulvo-vaginal infection. Using the immunohistochemical method we evaluated the number of T4,T8 and NK lymphocytes inside the lesion. Moreover we measured the immunitary cells of the hematic compartment. Inside the lesion we noted a reduction of the immune system in 69.23% of cases, while in the hematic compartment it was reduced only in 6.15% of cases. These data strongly suggested that the evaluation of the immunitary state, before starting therapy, is important in deciding when it would be useful to associate immunostimulating substances at the common treatment of vulvo-vaginal infection.

At present the therapy of cervical condylomatosis is based on the use of interferon because the HPV types responsable for condyloma inhibit the immunitary system. But many A. studying the effects of IFN have found that at high concentration it has an immunosuppressive action. The aim of the present study was to evaluate if interleukin-2 associated with IFN is useful in avoiding this negative effect by improving the efficacy of cervical condylomatosis therapy. We treated 25 women suffering from cervical condyloma with increasing doses of IL-2 injected intralesionally and associated with natural alpha-IFN injected intramuscularly. The duration of the whole therapy was six weeks. We evaluated the percentage of inflammatory cells in peripheral blood before and after treatment. The per-cent number of lymphocytes, eosinophils and lymphoblasts was increased by 27%, 88% and 40%, respectively. The clinical response to the therapy was total in 14 cases, partial in 9 cases and unsuccessful in 2 cases. These data suggested that combination therapy with interleukin-2 and alpha-IFN for the treatment of patients with cervix condylomatous is successful.

Cervical intraepithelial lesions associated with genital human papilloma virus (HPV) infection occur with increased frequency and severity among women with immunodeficiency. In this study, we considered 24 HIV-seropositive and 12 HIV-seronegative women. Each woman was interviewed and underwent a cytologic and colposcopic evaluation. Then colposcopic and cytologic findings were correlated with histologic and differences between HIV-seropositives and seronegatives were analyzed. Ten (41%) of 24 HIV-seropositive and one (9%) of 12 HIV-seronegative women had human papilloma virus infection. Among seropositives, eight (34%) had cervical intraepithelial (CIN): of those eight, 5 had CIN I, 2 CIN II and 1 CIN III. There (24%) of the 12 HIV-seronegative had CIN: two had CIN I and one CIN II. Six of the HIV-seropositive women were found to have multicentric disease (two or more sites). The objective of this study is to determine the relationship between human immunodeficiency virus (HIV) and human papilloma virus infection, sexual habits, reproducive history, and risk of cervical intraepithelial neoplasia (CIN). The results of this study suggest that cervical intraepithelial neoplasia is a common finding in HIV-infected women. Papanicolaou tests should be effective for detecting cervical disease in this population.

This is an experience about the utility of CA125 in diagnosis, staging, prognosis, and therapeutic response of ovarian cancer. The patients were 21 (the ages range was 38-66). They had an epithelial cancer (10 serous, 3 mucinous, 2 endometrioid, 6 non specific). The quantitative test of CA125 was performed with purified monoclonal antibody OC125 pre and post antineoplastic treatment. The reduction of CA125 was in connection with the neoplastic regression. Perservering or increasing values were related to neoplastic stasis or to non-responsive neoplasia, respectively. Even if the method we used was specific its sensibility is lower in patients with smallest residue disease.

5 years (1989-1993) experience of cervical conization including 57 cases, has been reviewed. The mean follow-up was 33 (6-60) months. Mean age was 34.6 (range 21-57) years. Mean height and diameter of the cones were 2.5 +/- 0.3 cm and 1.5 +/- 0.4 cm, respectively. In 55 cases there were free margins of the cones. Cytological diagnosis was CIN I for 8 patients, CIN II for 21 patients, CIN III for 22 patients, CIN+HPV for 6 patients. In 40 of the 57 patients suspected of having a cervical intraepithelial neoplasia on cytology and on colposcopy, the histology was confirmative. Bleeding (the most common pre and postoperative complication) was observed in 6 cases (11.7%). In three patients a new conization was necessary and in the other two patients hysterectomy was necessary. No significant differences were noted in the pregnancy outcome following either treatment in five patients.

The Authors examined 8 cases of endocervical adenocarcinoma: 2 women with positive Pap-smear were colposcopically, micro-colpo-hysteroscopically (MCH) and histologically investigated and 6 with atypical bleeding were evaluated by endocervical curettage. They emphasized the role played by cytology, pointed out the necessity to find endocervical cells in the Pap-smear for catching the lesion in early stage and to save the patients a demolishing surgery.

The principal action of IFN is anti-viral, rather than antiproliferative and immunomodulatory. All three actions are required to resolve pre-neoplastic uterine cervix pathologies, above all if they are at an early stage or associated with viral cytopathic effects.

Kodak Surecell Kit, a new immunoenzymatic test for Chlamydia detection, was evaluated. The Authors compared the sensitivity, specificity and cost between the tissue culture and the immunoenzymatic test. They conclude that the immunoenzymatic test, Kodak Surecell, is sufficiently faithful. It is a rapid and cheap method.

The paper discusses the genesis of vestibular papillomatosis: some researchers affirm that it is epithelio-paraphysiological whereas others maintain that it is a subclinical stage of HPV infection. In some cases "true" symptomatic papillomatosis may be remedied by human leucocyte alpha-IFN treatment.

The Authors point out the importance of histiocytes in Papanicolaou smears. Histiocytes are associated with endometrial carcinoma on tissue sections and may be seen on cervicovaginal smears as well. Smears obtained from 120 women, with clinical signs of endometrial diseases, were evaluated to determine the correlation between the presence of histiocytes in the cervicovaginal smears and endometrial adenocarcinoma. Histiocytes were quantified as minimal [less than 5 per high-power field (hpf)], moderate (5-10 hpf) or heavy (greater than 10/hpf). The histiocytes were found in smears from 80 women. Five adenocarcinomas, 9 hyperplasias were detected in 20 patients with moderate or heavy smears. The Authors conclude that the presence of histiocytes among postmenopausal women who have cervicovaginal smears should not be ignored. The data indicate that, in the absence of endometrial cells, histiocytes on cervicovaginal smears of postmenopausal women are associated with more elevated relative risk for endometrial carcinoma.

The ISSVD has attempted to separate dystrophic lesions from VIN in order to draw up a standard nomenclature based on histopathological characteristics so as to obtain comparable data. But the definition of the dysplastic evolutive possibilities of hyperplastic lesions is still an open problem. In this study 40% of VIN I, 100% of VIN II and 16.6% of VIN III were associated with hyperplastic lesions. 16.6% of VIN III were associated with sclerosing lichen. In this case, a hyperplastic phase could have been followed by a distrophic one since the patient was 73 years old. The overall frequency of cellular atypia in vulvar dystrophy was therefore 14.66%; it increased to 41.66% during the hyperplastic phase. The age of patients increased in parallel to the severity of lesions. No decrease in the mean age of incidence was noted except in those cases associated with HPV. The potential uncontrolled increase of hyperplastic alterations could have been produced by the absence of an inhibitory incidence stimulus, as has been noted in the resistance to topical steroid therapy in some cases of squamous hyperplasia. The localisation of cellular atypia, however, indicates surgical treatment.