Objective
This study aimed to investigate the clinicopathologic risk factors for type-specific persistence of high-risk human papillomavirus (hrHPV) and residual/recurrent cervical intraepithelial neoplasia (CIN) after surgical treatment.
Methods
Patients with CIN-2/3 who underwent conization or loop electrosurgical excision procedure (LEEP) at Korea University Hospital were enrolled. All patients underwent hrHPV testing and genotyping before conization or LEEP followed by both hrHPV genotyping and cytology. The significance of associations between patient characteristics and persistence of infection were assessed by multivariate logistic regression analyses.
Results
Among 398 women with pathologically confirmed CIN-2/3, 154 (38.7%) patients showed hrHPV persistence after surgical treatment. In multivariate analysis, high preoperative hrHPV load (
P
<0.05; odds ratio [OR], 2.063), presence of CIN-2 at treatment (
P
<0.01; OR, 2.732), and multiple hrHPV infections (
P
<0.001; OR, 4.752) were associated with hrHPV persistence. HPV 53 was the most likely to persist after treatment (24/43, 55.8%). The risk of residual/recurrent CIN-2/3 was higher in persistent infection with HPV 16 than other types (
P
<0.05). Menopause (
P
<0.001; OR, 3.969), preoperative and postoperative hrHPV load (
P
<0.05; OR, 2.430;
P
<0.05; OR, 5.351), and infection with multiple hrHPV types (
P
<0.05; OR, 2.345) were significantly related to residual/recurrent CIN following surgical treatment.
Conclusion
HPV load before treatment and infection with multiple hrHPV types were predictors of postoperative hrHPV persistence. HPV 53 was the type most likely to persist, but HPV 16 was the type that was most closely associated with residual/recurrent CIN-2/3.
This paper presents experimental investigations on the mechanical properties of no-slump high-strength concrete (NSHSC), such as the compressive and flexural strength. First, to determine the proper NSHSC mixtures, the compressive and flexural strength of three different water-to-binder ratios (w/b) of specimens with and without polyethylene (PE) fiber was tested at test ages. Then, the effect of hybrid combinations of PE fiber and steel fiber (SF) on the compressive strength, flexural strength, flexural toughness, and flexural energy dissipation capacity was experimentally investigated. Furthermore, the various hybrid fiber-reinforced NSHSCs were evaluated, and their synergy was calculated, after deriving the benefits from each of the individual fibers to exhibit a synergetic response. The test results indicate that a w/b of 16.8% with or without fibers had lower strength and flexural strength (toughness) than those of other mixtures (w/b of 16.4% and 17.2%). Specimens with a hybrid of SF and short PE fibers exhibited a higher compressive and flexural strength, flexural toughness, energy dissipation capacity, and fiber synergy in all considered instances.
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