Human papillomavirus type 16 expression in cervical keratinocytes: role of progesterone and glucocorticoid hormones

OBJECTIVE

To determine the role of the steroid hormones, progesterone and glucocorticoids, and the viral hormone response elements, in the episomal expression of human papillomavirus (HPV) type 16 in primary human ectocervical cells.

METHODS

In situ hybridization and mutagenesis were used to assess the requirements of these hormones and the HPV 16 glucocorticoid/progesterone response elements in the induction of HPV 16 expression in ectocervical cells.

RESULTS

The assays detected a marked increase in viral messenger RNA only after treatment of the cells with either of the steroid hormones. This response was inhibited by the anti-progestin RU 486 in a concentration-dependent manner. Mutagenesis of the previously identified hormone response element in the regulatory region of the HPV 16 genome had no effect on hormone-induced HPV gene expression. We have now identified two additional hormone response elements. Different combinations of mutations in the three hormone response elements showed that all three were independently sufficient for the hormone-mediated induction of viral transcription.

CONCLUSIONS

Steroid hormones induce HPV 16 gene expression in cervical keratinocytes directly through three hormone response elements in the regulatory region of the viral genome. The anti-progestin RU 486 inhibits this induction. Because the physical state of HPV DNA in this in vitro system and in premalignant cervical lesions is extrachromosomal, steroid hormones may have a critical role in modulating HPV expression in such lesions.

Physical and sexual growth pattern of affluent Indian children from 5 to 18 years of age

The present study was conducted to study growth parameters on 12,899 boys and 9,951 girls of affluent class from 8 States of the country. In pooled data, the 50th centile height approached 30-40th centile till 6 1/2 years in boys and up to 10 years in girls, and ultimately the height growth curves for both fell between the 10-20th centile of NCHS standards. Similarly, for weight, they approached 10-20th centile of NCHS at the age of 17 yr. Comparison with other European countries showed that Indian affluents are shorter and lighter; however, they are similar to their counterparts of Asian origin. The secular trend for height in Delhi showed increase of 2.1 cm for boys, and 2.7 cm for girls per decade at 17 yr and 14 yr, respectively. In Varanasi, the corresponding trend was 1.5 and 2.1 cm at 16 yr for boys and girls, respectively. The mean ages for genital development stages G 2-5 were 11.9, 13.3, 14.6 and 15.9 yr; respectively. In girls, the breast development Stages B 2-5 had mean ages of 10.9, 12.8, 13.9 and 14.8 yr, respectively. The mean age for menarche was 12.6 yr. In 14 yr old boys, the mean height may vary between 150.3, 155.8, 161.2 and 165.2 cm and mean weight between 38.0, 42.5, 46.8 and 52.9 kg for genital stages G 2-5, respectively. Similarly, girls of 12.5 yr (close to menarcheal age of 12.6 yr) had mean height 145.3, 150.3, 152.1 and 153.8 cm and mean weight 34.7, 41.2, 45.4 and 54.4 kg for breast stages B 2-5, respectively. It is recommended that for growth assessment during adolescence these charts in relation to sexual development and age be used for comparison.

Enhanced siderophore production and mouse kidney pathogenicity in Escherichia coli grown in urine

Fifteen siderophore producing urinary isolates of Escherichia coli were compared for aerobactin and enterochelin production in trypticase soy broth and pooled normal human urine. Significant increase in siderophore production (both phenolate and hydroxamate) was observed when organisms were grown in urine. Mouse kidney pathogenic potential of the strains grown in urine was compared with that of bacteria grown in trypticase soy broth in an ascending model of pyelonephritis in female Swiss Webster mice. Organisms grown in urine and instilled into a mouse bladder demonstrated markedly enhanced renal pathogenicity (p less than 0.01). Further information about the influence of urinary constituents on siderophore production could help in understanding the pathogenesis of pyelonephritis.

Altered hemolysin production in urine-grown uroisolates of Escherichia coli

Fifteen uroisolates of E. coli were studied for both cell-free and cell-bound hemolysin production. Estimations were done in Trypticase soy broth (TSB, providing iron-replete medium) TSB + 2,2'-bipyridine (providing experimentally created iron-depleted conditions) and pooled normal human urine (providing natural iron-depleted growth medium). In TSB 40% of strains showed no detectable cell-free hemolysin, they were able to produce it in the presence of 2,2'-bipyridine and more so when grown in urine. The cell-bound hemolysin was produced by all the strains in TSB, but in the presence of 2,2'-bipyridine and urine an insignificant increase was observed. All the strains when given 2nd and 3rd passage in urine, were found to elaborate significantly more cell-free as well as cell-bound hemolysin.

Small cell lung cancer presenting as Cushing's syndrome

A rare case of small cell carcinoma of the lung who presented with Cushing's syndrome and superior vena cava syndrome is described. The relevant literature is reviewed.

Degrees of cooperativity between triiodothyronine and hydrocortisone in their regulation of the expression of myelin basic protein and proteolipid protein during brain development

Cultures of cells dissociated from embryonic mouse cerebra were used to demonstrate: (1) that the developmental expression of the mRNA of proteolipid protein is dependent on thyroid hormone; (2) that the expression of the mRNA of proteolipid protein is stimulated not only by triiodothyronine but also by hydrocortisone, which achieve their respective stimulations by an additive and uncompetitive mechanism; (3) the stimulation of the net accumulation of the mRNA of myelin basic protein by hydrocortisone and triiodothyronine is also cooperative, additive, and uncompetitive, and (4) the stimulation of the net accumulation of myelin basic protein, during development by hydrocortisone, is completely dependent on the presence of thyroid hormone. These results suggest that the regulation of the synthesis of myelin basic protein by hydrocortisone requires the presence of triiodothyronine at a posttranscriptional event, but not for transcription itself.

Generalized muscular pseudohypertrophy in cysticercosis

A 32 year old male Hindu, presenting with generalized muscular hypertrophy (Veritable Hercules), together with subcutaneous nodules and epilepsy, due to cysticercosis is described.

Patterns of gastrointestinal hemorrhage in hemophilia

Peptic ulcer has been reported to be the cause of bleeding in 53%-85% of hemophiliacs with gastrointestinal hemorrhage (GIH). The management of GIH in hemophiliacs during the past decade has been affected by the availability of plasma concentrates, an increasing occurrence of chronic liver disease, and widespread use of endoscopic procedures. To determine the present patterns of GIH, we reviewed our experience at the Hemophilia Center of Western Pennsylvania during the last 10 yr. Twenty-five (10.3%) of 243 hemophiliacs experienced 41 episodes of GIH. The severity of hemophilia and a history of retroperitoneal hemorrhage were significant risk factors for GIH. Duodenal ulcer (22%), unknown site (22%), and gastritis (14%) were the three most common diagnoses. The use of fiberoptic endoscopy resulted in the recognition of diagnoses such as gastritis, esophagitis, Mallory--Weiss syndrome, and esophageal varices. Red cell transfusion requirements of hemophiliacs with GIH were no different than those of nonhemophiliacs with GIH (p greater than 0.05). The amount of factor VIII replacement used by hemophiliacs with GIH correlated with the severity of gastrointestinal bleeding (p less than 0.01), but not with the cause of gastrointestinal bleeding (p greater than 0.05). In conclusion, hemophiliacs develop GIH secondary to a variety of causes as do nonhemophiliacs. Fiberoptic endoscopy, after correction of factor VIII level to 0.40 U/ml, is a safe and valuable diagnostic procedure in hemophiliacs. The specific etiology of GIH in hemophiliacs should be aggressively sought and appropriate specific therapy provided.

Accuracy of computerized tomography in determining hepatic tumor size in patients receiving liver transplantation or resection

Computerized tomography (CT) of liver is used in oncologic practice for staging tumors, evaluating response to treatment, and screening patients for hepatic resection. Because of the impact of CT liver scan on major treatment decisions, it is important to assess its accuracy. Patients undergoing liver transplantation or resection provide a unique opportunity to test the accuracy of hepatic-imaging techniques by comparison of findings of preoperative CT scan with those at gross pathologic examination of resected specimens. Forty-one patients who had partial hepatic resection (34 patients) or liver transplantation (eight patients) for malignant (30 patients) or benign (11 patients) tumors were evaluable. Eight (47%) of 17 patients with primary malignant liver tumors, four (31%) of 13 patients with metastatic liver tumors, and two (20%) of 10 patients with benign liver tumors had tumor nodules in resected specimens that were not apparent on preoperative CT studies. These nodules varied in size from 0.1 to 1.6 cm. While 11 of 14 of these nodules were less than 1.0 cm, three of 14 were greater than 1.0 cm. These results suggest that conventional CT alone may be insufficient to accurately determine the presence or absence of liver metastases, extent of liver involvement, or response of hepatic metastases to treatment.

Polyarthritis with atypical keratotic nodular dermatosis or polyarthritis with multiple keratoacanthoma. A case report

We report an interesting case of generalized papular and nodular lesions with central keratinous plugs and severe hyperkeratotic-acanthotic histopathology with arthritis in a 19-year-old male patient who had suffered from a similar disease 2 years earlier. Papules and nodules erupted a few days after the arthritis and this was noticed during both episodes. On healing, nodules fell spontaneously leaving behind insignificant hyperpigmented scars.

Incontinentia pigmenti et achromians

A case is reported, apparently the first of its kind in the literature, of a female child in which there were not only pigmented lesions of incontinentia pigmenti but also hypopigmented lesions of incontinentia pigmenti achromians. The title incontinentia pigmenti et achromians is suggested for this combined disorder. The child also had associated lesions in the form of nail dystrophy, delayed dentition and epilepsy.