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Recently, cervical adenocarcinoma has been increasing especially among young women and account for 10-20% of cervical cancer. However, the detection rate of HPV-DNA was 35-85% and lower than that of squamous cell carcinoma. Furthermore, the relationship with HPV in cervical adenocarcinoma was not much investigated in Japan, so we studied HPV status in cervical adenocarcinoma by in situ PCR method using biotin-labeled DNA probes, because in situ PCR method possesses the advantages of both PCR and in situ hybridization in being highly sensitive and enabling visualization of the cellular localization of the DNA. HPV infection was analyzed in 60 cervical adenocarcinomas, including 1 adenocarcinoma in situ and 15 adenosquamous carcinomas. HPV-DNA was detected in 47 of all 60 cases(78%): 35 of 45(78%) in adenocarcinomas and 12 of 15(80%) in adenosquamous carcinomas. No significant correlation was found between the HPV-DNA detection rate and histological subtypes of adenocarcinoma. In conclusion, cervical adenocarcinoma demonstrates a high prevalence of HPV-DNA as well as other previous studies. Therefore, HPV infection plays a very important role in not only squamous cell carcinoma but also adenocarcinoma in uterine cervix.

We report a case of CA19-9 producing urothelial carcinoma of the right ureter. A 61-year-old male patient who had an extremely high value of serum CA19-9 (1,185 U/ml) with right hydronephrosis was referred to us. Magnetic resonance urography and retrograde ureterography revealed a long irregular filling defect in the right distal ureter. Under the diagnosis of right ureteral tumor, we performed right total nephroureterectomy and pelvic lymphadenectomy. The tumor was histologically diagnosed as grade 1 transitional cell carcinoma and pelvic lymphnodes were positive (pT1N2M0). The tumor cells showed positive immunostaining for CA19-9. The serum CA19-9 level was normalized after the operation and successive adjuvant chemotherapy (M-VAC 2 course). No recurrence was found for 15 months after operation. In this case, the serum CA19-9 level was useful as a tumor marker.

To elucidate the characteristics of group B streptococcus (GBS)-positive vaginal flora in pregnant women, vaginal cultures were conducted in 4025 women at 22 to 36 weeks of gestation. The results were analyzed by Fisher's exact test. Among 4025 women, 408 were found to be GBS positive and 3617 were GBS negative (GBS-negative group). A total of 1151 bacterial strains were recovered in the GBS-positive group and 6746 strains in the GBS-negative group. The percentages of Gram-positive cocci other than GBS, anaerobes, fungi, and Lactobacillus were 18.8%, 1.4%, 6.0%, and 34.4%, respectively, in the GBS-positive group, and 30.4%, 4.1%, 8.8%, and 53.5% in the GBS-negative group. The percentages were significantly lower in the GBS-positive group ( P < 0.0001, P < 0.0001, P= 0.0012, P < 0.0001, respectively). Judging from the reduction in Lactobacillus, the GBS-positive vaginal flora is not considered a normal flora. However, it is not regarded as a pathogenic flora either, because the isolation rates of anaerobes (strongly associated with bacterial vaginosis) and fungi (occasionally causing vulvovaginal candidiasis) were lower than in the GBS-negative flora. These results suggest that the GBS-positive flora is associated with a lower risk of abnormality during pregnancy and abnormal pregnancy outcome compared with the GBS-negative flora, although this group is one of the most important pathogens in neonatal infections.

A polyp of about 1.0 cm diameter was incidentally found at the center of the posterior wall of the urinary bladder in a 73-year-old man on cystoscopic examination. A polyp was resected through a transurethral route without recurrence for 22 months. A polyp consisted of a tumor covered with mucosa of the bladder. Tumor cells have round or oval nuclei with fine chromatin and one or two nucleoli per nucleus, and finely granular eosinophilic cytoplasm, being arranged in a trabecular or tubular pattern. Furthermore, they showed positive staining for chromogranin-A and with Grimelius stain, indicating that the tumor is a carcinoid tumor. Since there was no evidence of carcinoid tumors in organs other than the urinary bladder, the present case is a primary carcinoid tumor (well differentiated endocrine tumor) of the urinary bladder which is extremely rare.