Background/Aim: Sperm cells are competent to integrate exogenous DNA into their genome. We sought to clarify Human Pappiloma Virus (HPV) internalization in spermatozoa and early preimplantation embryos. Materials and Methods: Sperm was incubated with plasmid vectors containing the complete genome of human HPV 16 and HPV 18 tagged with the green fluorescent protein (GFP) gene, to investigate HPV 16 and HPV 18 integration in mouse spermatozoa. Oocytes were in vitro fertilized with preincubated spermatozoa to investigate HPV 16 and HPV 18 potential transfer to mouse embryos. Results: Spermatozoa were able to internalize constructs of cloned high-risk HPV either as integrated or as episomal DNA. Constructs of cloned HPV can also be transferred to mouse embryos, through in vitro fertilization of the oocytes by mouse spermatozoa. Conclusion: Viral DNA transmission to the early mouse embryo via sperm, highlights the effect of HPV in reproductive cells and preimplantation development.Human Pappiloma Virus (HPV) is a non-enveloped, circular, double stranded DNA virus (1). The viral genome consists of a regulatory non-coding long control region, an early region encoding for E6, E7, E1, E2, E4 and E5 genes and a late region encoding for L1 and L2 genes (2). HPVs are generally classified as low and high risk, according to their potential to cause genital cancer. The different types of papilloma viruses exhibit characteristic tropism and distinct life cycle features (3).HPV 16 and HPV 18, as oncogenic types, are responsible for cervical cancer, the second most common cause of cancer-related death worldwide (4, 5). HPV 16 is considered to be the most frequently identified high-risk HPV genotype, followed by HPV 18. Approximately 70% of cervical cancer cases are linked with these two genotypes (6, 7).Cancer of the uterine cervix is associated with high-risk HPV presence and increased HPV E6/E7 oncogene expression (8-11). Persistent infection with oncogenic HPV genotypes triggers HPV DNA integration into the host genome, eventually leading to chromosomal damage accumulation and genome destabilization in infected cells (12)(13)(14)(15)(16)(17). The exogenous DNA insertion into the oocyte by sperm (18-20), as well as the mechanisms involved (21-28), have been extensively studied. In fact, living spermatozoa of almost all species are able to take up spontaneously exogenous DNA and internalize a part of it into their nucleus (24). The exogenous DNA fragments are localized at the postacrosomal and equatorial regions of the sperm head (22,23) with 15-22% internalized into the sperm nuclei (24). A proportion of the internalized DNA is integrated at specific sites in sperm genome, probably at a nucleosomal subfraction of chromatin, suggesting a common site for exogenous DNA insertion (29,30). Sperm has the capacity to actively take up exogenous DNA derived from HPV. In addition to HPV L1 gene, sperm probably take up DNA from HPV types 16 and 18 (31, 32).Taking into account the capability of sperm cells to integrate exogenous DNA into th...
Background/Aim: Acute pulmonary embolism during cesarean section is extremely rare and only a limited number of cases have been reported in literature. The aim of this study was to report a case of acute high risk pulmonary embolism during elective cesarean section treated with systemic thrombolysis and discuss the multidisciplinary management in both early recognition and prompt treatment. Case Report: A 39-year-old, G5P2, ASA II parturient presented for repeat cesarean section under general anesthesia. A sudden drop in end-tidal CO 2 after placenta delivery combined with significant hemodynamic instability after an uneventful intraoperative course was strongly indicative of pulmonary embolism. Urgent transthoracic ultrasound revealed a sizable thrombus in the inferior vena cava and the right atrium. Thrombolysis was carried out intraoperatively using recombinant tissue plasminogen activator, which was administered under continuous US monitoring until thrombus resolution. This resulted in significant bleeding that was treated in a stepwise manner beginning with implementation of massive transfusion protocol, Bakri balloon placement, and rescue hysterectomy several hours after the event. Follow-up was uneventful and she was discharged on the 12 th postoperative day. Conclusion: Though pregnancy is one of the major risk factors of the development of venous thromboembolism, acute intraoperative pulmonary embolism is extremely rare. Specific guidelines for the management of such cases are difficult to issue due to the paucity of relevant data. Thus, an individualized approach by a multidisciplinary team for diagnosis and intervention is mandated.Hemostatic alterations in normal pregnancy, characterized by marked increase in the procoagulant activity (FVII, FVIII, fibrinogen, FX, vWF), together with venous outflow obstruction due to uterus enlargement, predispose to a hypercoagulable state (1). These changes are maximal around term. The co-existence of other risk factors, such as prolonged immobilization, obesity, and cesarean section (CS) increase the risk for venous thromboembolism (VTE) in the obstetric population (2). Moreover, known inherited coagulation disorders complicate further the matter and require a multidisciplinary approach.Since pregnancy represents a hypercoagulable state, it is not surprising that VTE remains one of the leading causes of 498
Knowledge of epidemiological data of psoriasis among elderly people is limited. Herein the prevalence of psoriasis among non-permanently hospitalized, elderly (70-89 year old) individuals was assessed by a face-to-face interview using a structured questionnaire adapted from an earlier telephone survey elsewhere. 450 individuals 70-89 years old consented to contribute. Psoriasis was found in 15/450 individuals [life-long prevalence: 3.33%; (95% confidence intervals: 1.99-5.47%)]; 1/450 individuals have ever required systemic treatment (0.2% [0.01-1.4%]). This prevalence is about ten times higher than corresponding results of the aforementioned telephone survey with the same questionnaire. In conclusion this study: i) Provides the first estimation of psoriasis prevalence in Greece, albeit focused in a particular age group and demonstrates a relatively high life-long prevalence, however with minimal morbidity among older people; ii) Underscores the need for studies to evaluate the impact of proxy effects (e.g. telephone information) in assessing skin morbidity of older probands.
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