ABSTRACT
OBJECTIVE: To evaluate the association of level of CA-125 and severity of dysmenorrhea with lesion depth in adenomyosis. METHODS: Sixty-eight women who had undergone hysterectomy and were found to have pure adenomyosis on histopathologic examination were reviewed retrospectively. Specimens were stratified according to the degree of adenomyosis penetration into 4 groups: group A consisted of specimens with adenomyosis penetration into myometrium of up to 25%; group B, 26-50%; group C, 51-75%, and group D, >75%. All women were submitted to serum determination of CA-125. Severity of dysmenorrhea was assessed by means of a modification of 10-point verbal rating scale. RESULTS: Each group was not correlated with severity of dysmenorrhea (p=0.7394 Fisher's exact test). The means of serum CA-125 levels was increased corresponding to depth of adenomyosis (p=0.0441 ANOVA test). CONCLUSION: In this study, serum CA-125 level is associated with the depth lesion and severity of dysmenorrhea is not. Therefore, the level of serum CA-125 might be useful indicator in management of adenomyosis before surgery.
Subject(s)
Animals , Female , Humans , Mice , Adenomyosis , Dysmenorrhea , Hysterectomy , Myometrium , Retrospective StudiesABSTRACT
OBJECTIVE: It has been recognized that cold knife conization has higher incidence of postoperative hemorrhage and many techniques have been developed in an attempt to control hemorrhage. The aim of this study was to evaluate complications of Sturmdorf's suture in cold knife conization and to investigate various measures employed to reduce blood loss. METHODS: The results of 85 patients who had cold knife conization for diagnosis or treatment of cervical intraepithelial neoplasia (CIN) from August, 1997 to July, 2003 were reviewed. RESULTS: Among 85 patients, 83 patients (97.7%) had negative cut margins on conization specimen while 2 patients (2.3%) positive cut margins. 54 patients received no further treatment after cold knife conization and complications occurred in 9 patients (16.7%). Postoperative hemorrhage requiring additional hemostatic procedures occurred in 7 patients (13%), of which 6 patients were rehospitalized and 1 patient was managed at outpatient clinic with gauze packing only. Among 6 rehospitalized patients, hysterectomy was done in 2 patients and electrocoagulation in 1 patient. Packed red cell was transfused in 1 patient and 2 patients were managed with gauze packing only. Postoperative infection was found in 2 patients (3.7%). No other significant complications were noted. CONCLUSION: Cold knife conization using Sturmdorf's suture could be done to get much more accurate results of biopsy with relatively mild complication in magement of CIN, although several days? admission is needed and the other alternative methods seem to be more convenient.
Subject(s)
Humans , Ambulatory Care Facilities , Biopsy , Uterine Cervical Dysplasia , Conization , Diagnosis , Electrocoagulation , Hemorrhage , Hysterectomy , Incidence , Postoperative Hemorrhage , SuturesABSTRACT
OBJECTIVE: To investigate the efficacy of PAP smear as a screening tool for cervical cancer by evaluating the result of a review of 34,970 cases of PAP smear at Pohang St. Mary's Hospital. METHODS: From January, 1992 to December, 2001 cytologic examination of 34,970 women were analysed and the results were reviewed. RESULTS: 1. The average of annual screening rate was 14.8%. 2. Abnormal cytology rate was 2.02% including 1.02% of ASCUS, 0.99% of class III, 0.20% of class IV and 0.30% of class V. 3. 8.28% of the women screened were aged less than 30 years, 31.8% or=70 years respectively. 4. Of the 188 patients who had a cytologic diagnosis of atypical squamous cells of undetermined significance (ASCUS), 127 (68%) were followed up, 99 (78%) were normal and 28 (22%) had squamous intraepithelial lesion. 5. The prevalence rate of cervical neoplasia confirmed by histopathology for the past 10 years was 1.53%. Of those the rate of invasive cervical cancer was 0.65%. 6. The false negative rate was 17.3% and false positive rate was 4.5%. 7. The sensitivity and specificity and positive predictive value of PAP smear were 82.7%, 95.5% and 90.2%. CONCLUSION: For PAP smear to be early detecting tool for cervical cancer, continuous effort is required to raise annual screening rate, to lower the false negative rate, and to raise the sensitivity of PAP smear.
Subject(s)
Female , Humans , Diagnosis , Mass Screening , Prevalence , Sensitivity and Specificity , Uterine Cervical NeoplasmsABSTRACT
Although arteriovenous malformation (AVM) of the uterus is a very rare cause of menometrorrhagia or postmenopausal vaginal bleeding, it is notable to think in the assessment of a woman with abnormal uterine bleeding because correct diagnosis can yield proper therapy to be designed and avoid hysterectomy in women who want to continue their reproductive capacity. AVM may be congenital or acquired. In times past, the diagnosis is usually made after hysterectomy, but currently it may be made before treatment by ultrasound, pelvic angiography, or magnetic resonance imaging. We have experienced one case of AVM of uterus, which is diagnosed after hysterectomy.
Subject(s)
Female , Humans , Angiography , Arteriovenous Malformations , Diagnosis , Hysterectomy , Magnetic Resonance Imaging , Ultrasonography , Uterine Hemorrhage , UterusABSTRACT
OBJECTIVE: The purpose of this study is to evaluate the role of cold knife conization in the diagnosis and treatment of cervical neoplasia. METHODS: Sixty patients were divided into diagnostic and therapeutic conization group and then indication of conization, PAP smear, colposcopy directed biopsy, cone margin and residual lesion of each group were compared respectively. RESULTS: If the difference of PAP and colposcopy directed biopsy was 2 grades or more, upper limit of the lesion was invisible, squamocolumnar junction was not seen, PAP V or invasive cancer was suspected, diagnostic conization was performed in 22 patients. Six cases of follow-up group had cone margin (-) and no recurrence. Sixteen cases of immediate TAH (total abdominal hysterectomy) group had 2 cases of cone margin (+) with residual disease. There were 4 cases of cone margin (-) with residual lesion. If the difference of PAP and colposcopy directed biopsy was 1 grade or less, upper limit of the lesion was visible, squamocolumnar junction was seen and invasive cancer was ruled out, therapeutic conization was performed in 38 cases. All of therapeutic conization group had cone margin (-). Thirty two cases were follow up group and six cases were immediate TAH group. Three of follow up group had recurrences and delayed TAH was performed. There was no residual lesion in the specimen of immediate TAH group. CONCLUSION: The precise dignosis and treatment of cervical neoplasia was capable with cold knife conization. The more aggressive lesion or the more cases of cone margin (+) was diagnosed, the more residual lesion was found. Thorough follow up should be done after treatment of cervical neoplasia because of the possibility of residual disease even after documentation of cone margin (-).
Subject(s)
Humans , Biopsy , Colposcopy , Conization , Diagnosis , Follow-Up Studies , RecurrenceABSTRACT
No abstract available.
ABSTRACT
Peripartum cardiomyopathy is defined as a syndrome of cardiac failure occurring in tbe latter part of pregnancy or in the puerperium, without obvious cause and without prior evidence of heart disease. Despite its infrequency, this clinical problem may have devastating consequences upon maternal and fetal outcome. It is important to recognize the association of cardiac failure and pregnancy as a separate syndrome so that, once identified, peripartum cardiomyopathy can be treated promptly and aggressively. We experienced two cases of peripartum cardiomyopathy, and report these cases with a brief review of the literatures.