Histopathogenesis of Early-stage Mitral Annular Calcification

Mitral annular calcification (MAC) is a commoncondition in elderly subjects that sometimescauses degenerative mitral valvular diseases. Toinvestigate the early histopathogenesis of MAC, weexamined 180 consecutive autopsies of elderlysubjects. After a macroscopic and radiologicalexamination, 5-mm-thick serial tissue blocksobtained from the mitral annulus were examined inall MAC cases. Five cases without MAC were alsostudied using histology, immunostaining, electronmicroscopy, analytical electron microscopy andthe TUNEL method. The incidence of MAC infemales (23%) was higher than that in males(15%). Most MAC was located at the posteriorcusp (91%). The mitral annulus showed signs ofmicroscopic calcification and lipid-deposition insome degenerated areas in all of the cases withoutMAC. The interstitial cells were positive forvimentin and partially positive for smooth muscleactin, indicating the myofibroblastic differentiation.Ultrastructural studies showed an abundanceof cellular degradation products and foci ofcalcium- and phosphorus-deposition on theseproducts in the interstitium. Several interstitialcells tested positive for both single-stranded DNAimmunostaining and the TUNEL reaction. In conclusion,the microscopic calcification of mitralannulus is an early stage of MAC and caused bycalcium-deposition on cellular degradation products,probably released from apoptotic or necroticinterstitial cells

Knowledge and attitude toward cervical cancer and its prevention among female workers in the Vientiane Capital, Lao PDR

Purpose: This study aimed to provide the data to establish the national cervical cancer prevention program by studying the knowledge and attitude regarding cervical cancer and its prevention among Lao female workers in Vientiane, capital city of Laos. Methods: This cross-sectional study was conducted among 356 female workers in Vientiane, the capital of Laos. They were interviewed by means of a structured questionnaire. The data were analyzed and compared between the medical worker (MW) group, office worker (OW) group, and factory worker and cleaner (FWC) group. Results: Participants who had heard of cervical cancer, human papillomavirus (HPV), and HPV vaccine comprised 89.9%, 34.0%, and 27.8%, respectively. The average knowledge score of FWC was lower than that of the MW or OW group. Only 3.4% of the participants knew that HPV infection was the cause of cervical cancer. Among the 175 women who felt at a risk of cervical cancer, 84 had never undergone a Pap smear. The main reasons for not undergoing a Pap smear were the absence of symptoms (28.8%) and the feeling of shame or embarrassment (24.6%). Conclusions: Female workers, especially in the FWC group, had little knowledge regarding cervical cancer and its prevention. Thus, cervical cancer education for female workers and the cultivation of health professionals are most efficient steps to overcome this situation

Efficacy of careHPV ™ human papillomavirus screening versus conventional cytology tests for the detection of precancerous and cancerous cervical lesions among women living with HIV‐1 in Lao People's Democratic Republic

International audienc