ABSTRACT
Objective: To evaluate the validity of pathological diagnosis of cervical cone specimens prepared by frozen section compared with paraffin section. Study design: Diagnostic test evaluation. Setting: Pathology division, Department of Obstetrics and Gynecology, faculty of Medicine Siriraj Hospital, Mahidol University. Methods: Cervical cone specimens from 78 patients who underwent cold knife conization at Siriraj Hospital from October 1997 to September 1998 were processed by frozen section technique and the pathological diagnoses were made immediately. The remaining cone tissue from each specimen was processed to produce permanent paraffin sections for a final diagnosis. The frozen and permanent pathological diagnoses were compared. Results: The pathological diagnosis from frozen section was in complete agreement with the permanent section in 60.26% of patients. When the subjects were divided into three groups; normal and CIN I, CIN II-III and MIC and invasive cancer, the Kappa analysis for agreement of the pathological diagnoses between the two methods was 0.46 (fair agreement). For the diagnosis of invasive cancer by frozen section, the sensitivity, specificity, positive and negative predictive value, false negative and false positive were 62.5, 97, 71.4, 95.8, 37.5 and 1.9%, respectively. There were three cases of invasive cancer on permanent paraffin section which were diagnosed by frozen section as MIC in tow cases and CIN III in the other. Conclusion: Frozen section evaluation of a cervical cone specimen carries only a moderate degree of agreement with permanent paraffin section. For the diagnosis of invasive cancer in this study, frozen section has a low sensitivity and a high false negative rate. The diagnosis of microinvasive cancer was subject to significant error. The diagnosis of microinvasive cancer by frozen section needs additional careful review of the permanent section.
ABSTRACT
The retrospective study outcome of the ovarian epithelial cancer stage I-II treated in Obstetrics and Gynaecological Department, Siriraj Hospital during June 1989 – June 1997, received postoperative chemotherapy cyclophosphamide plus cisplatinum (CP) or cyclophosphamide plus carboplatin (C-CP). Stage I disease of unfavourable prognosis 66 cases treated with CP and 25 cases of C-CP, achieved the 5-years disease free survival 82% and 86% respectively (P>0.05). Stage II disease of CP group, 21 cases and C-CP group, 7 cases achieved the 5-years disease-free survival 80% and 82% respectively (P>0.05). The toxicities of chemotreatment were manageble.
ABSTRACT
This retrospective study reports on 52 cases of ovarian tumors in young females (under 20 years) treated at Siriraj Hospital over a five-year period from 1988 to 1992. The incidence was 4.7 percent of all ovarian tumors (1,103 cases). Of the total, 41 cases were benign, 10 were malignant and one was a borderlined tumor. In 31 cases (59.6 percent) germ cell tumors were found, of which 19.4 percent were malignant. The common presenting symptom was either abdominal mass (53.9 percent) or abdominal pain (26.9 percent). The tumors, which developed in more than half of the patients (57.7 percent), were between 6 and 15 cm in greatest diameter. Bilaterality was found in five patients (9.6 percent) and six (11.5 percent) and torsion of the tumor. Surgical treatment was conservative in 86.5 percent and radical in 13.5 percent of the patients.
ABSTRACT
A comparative study of the treatment of non-specific vaginitis was carried out in order to compare the efficacy of the use of tetracycline and thiamphenicol among women attending the sexually tranamitted disease clinic of the Department of Obstetrics and Gynaecology, Siriraj Hospital. The inclusion criteria included women with abnormal vaginal discharge having a pH of 5 or more but in whom the presence of Trichomonas vaginalis, Candina albicans or Neisseria gonorrhoea was not observed. Eighty-one women were enrolled in this study and were randomly categorized into two groups, i.e. the tetracycline treatment group and the thiamphenicol treatment group. Two grams of each drug were given orally for seven consecutive days to the women in the respective groups. In this study, vaginal discharge was cultured for Gardnerella vaginalis, Chlamydia trachomatis and for aerobic bacteria; the growth of G. vaginalis and C. trachomatis was encountered in 71.6 and 12.35 percent of the cultured, respectively. The cure rate achieved with tetracycline was 82.93 percent while that of thiamphenicol was 97.5 percent. In this study equal dosage of thiamphenicol yielded a significantly (P=.028) better result than tetracycline in the treatment of non-specific vaginitis with regard to improvement of signs and symptoms. No adverse side-effect was encountered in either treatment group.