SUMMARYVaginal candidosis represents a significant health problem to women of childbearing age worldwide. It has been postulated that localized T cells play a role in protection against vaginal candidosis. In an attempt to evaluate the role of vaginal T cells in protection against vaginal candidosis, T cell population kinetics was evaluated using an oestrogen-dependent vaginal candidosis murine model. Vaginal T lymphocytes were isolated at different time points post C. albicans inoculation, viable cells were enumerated, phenotypically analysed for the expression of CD3, CD4 and CD8 T cell markers and absolute numbers of T cell subsets were calculated. Oestrogen-induced persistence of vaginal candidosis resulted in a significant increase in the total number of vaginal lymphocytes within 24-48 h post infection; increased vaginal lymphocyte numbers persisted throughout the infection period. The number of CD3 + T cells dramatically increased following C. albicans administration and was maintained at high levels throughout the infection period. The majority of CD3 + T cells were of the CD8 + type; however, considerable numbers of both CD4+ T cells and CD4 + CD8 + T cells were also observed throughout the infection period. The considerable and persistent increase in vaginal T cell numbers in general and that of CD8 + T cells in particular are evidence of the possible role played by localized T cells in protection against vaginal candidosis.

The capacity of estrogen to induce vaginal candidosis (VC) in the absence of previous or concurrent Candida albicans infections was examined. Adult female Balb/c mice were evaluated for vaginal C. albicans burden, C. albicans-specific delayed type hypersensitivity (DTH) responses and vaginal lymphocyte population kinetics at several time-points while receiving weekly injections of 0.5 mg estrogen. Estrogen treatment resulted in the appearance of significant levels of C. albicans vaginal colonization, which persisted for a period of 4 weeks. A marked suppression of DTH responses mounted against subsequent C. albicans challenge was observed. Absolute number of vaginal T lymphocytes gradually increased by several folds especially at weeks 5-6 following the start of estrogen treatment. These results clearly indicate that estrogen, independent of other predisposing factors, is capable of perturbing the commensal relationship between the host and the fungus, which results in the induction of persistent VC.

Arteriovenous malformations (AVM) of the uterus can cause life-threatening hemorrhage. Unexplained, heavy vaginal bleeding in a reproductive age woman should raise suspicion for an AVM. Here a 37-year-old woman had increasingly severe vaginal bleeding for 15 days. Serum β-hCG was elevated. Two-dimensional transvaginal ultrasound suggested retained products of conception. Before dilation and curettage (D&C), color Doppler and three-dimensional (3D) power Doppler demonstrated findings indicative of uterine AVM. A bilateral uterine artery embolization was performed without complications. Three months after uterine artery embolization, 3D power Doppler ultrasonography found complete resolution of the AVM. This case illustrates the importance of assessing both gray-scale and 3D power Doppler, and the ability of postprocedure Doppler to assess resolution.

HighlightsOur study shows transarterial embolization had a decreased in blood loss.TAE allowed high stage tumors of greater average size to be removed.Time to surgery post embolization varied from several hours to one day.