Upper vaginectomy for the treatment of vaginal intraepithelial neoplasia.

OBJECTIVE: The purpose of this study was to evaluate the use of upper vaginectomy for the treatment of vaginal intraepithelial neoplasia (VAIN). STUDY DESIGN: We conducted a retrospective review. Between August 1, 1985 and April 30, 2004, 105 patients were identified who had undergone upper vaginectomy for VAIN. RESULTS: Thirty-six patients had previously been treated for VAIN. Mean operative time and estimated blood loss were 55 minutes and 113 mL, respectively. Ten percent had intraoperative complications. Twenty-three (22%) patients had negative findings on final pathologic examination, and invasive cancer was found in 13 (12%) patients. Four patients had postoperative complications. Follow-up was available in 52 patients; 46 (88%) remain without recurrence at a mean follow-up of 25 months. CONCLUSION: In our patients, upper vaginectomy was efficacious for the treatment of VAIN. The procedure led to the diagnosis of occult invasive cancer in 12% of these women

The effect of aquatic and terrestrial habitat characteristics on occurrence and breeding probability in a montane amphibian: insights from a spatially explicit multistate occupancy model

Understanding species distribution and predicting range shifts are major goals of ecology and biogeography. Obtaining reliable predictions of how species distribution might change in response to habitat change requires knowledge of habitat availability, occupancy, use for breeding, and spatial autocorrelation in these parameters. Amphibians in alpine areas provide an excellent model system for disentangling habitat drivers of occupancy from that of breeding while explicitly accounting for spatial autocorrelation. We focused on the widespread common frog (Rana temporaria) inhabiting alpine lakes in the Southern Carpathians, Romania. We used single season multistate occupancy models developed to account for imperfect detection and spatial autocorrelation to estimate the occupancy and breeding probabilities and to evaluate their response to habitat characteristics. We found that frogs do not occur in all water bodies [occupancy probability: 0.697; 95% credible interval (0.614, 0.729)] and do not breed in a substantial proportion of water bodies where they occur [breeding probability conditional on occupancy: 0.707; 95% credible interval (0.670, 0.729)]. Habitat characteristics explain water body occupancy but not breeding probability; and altitude, water body surface area, water body sinuosity and permanency, presence of invertebrates, and grazing along the banks all had positive effects on occupancy. We also detected strong spatial autocorrelation in occupancy and breeding probabilities. Thus, our results indicate that habitat choice by montane amphibians is influenced by both spatial autocorrelation and habitat characteristics. Because spatial autocorrelations matter and because the presence of adults is not the same as the presence of a reproducing population, it will be difficult to predict the effects of habitat change on high altitude amphibian populations