The Clinical Significance and The Optimal Management of Atypical Squamous Cells of Undetermined Significance in Cervical Smears / 대한산부인과학회잡지

OBJECTIVE: To evaluate the clinical significance and the optimal management of atypical squamous cells of undetermined significance (ASCUS) in Papanicolaou cervical smears. METHOD: This study included 25380 cases of cervical Pap smears received from January 1995 to June 2000 by the Department of Obstetrics & Gynecology, Inha Hospital, Medical College, the Inha University. Retrospective review was done on 384 cases of ASCUS. RESULT: ASCUS and squamous intraepithelial lesions (SIL) were diagnosed in 384 cases (1.5%), and 311 cases (1.1%), respectively. The ratio of ASCUS to SIL was 1.2. Colposcopic directed biopsies revealed 14 cases (14.1%) of low grade SIL (LSIL), 21 cases (21.2%) of high grade SIL (HSIL), and 2 cases (2.0%) of squamous cell carcinoma. CONCLUSION: The immediate colposcopy with biopsy in women with ASCUS may decrease follow-up visits for Pap testing, reduce patient anxiety, minimize the loss of high risk cases during follow-up and lower medicolegal litigation. The early colposcopy may be the method of choice for follow-up in women with ASCUS in Korea.

The Distribution of CA-125 Level Among the Patients Who Underwent Hysterectomy / 대한부인종양콜포스코피학회잡지

OBJECTIVES: To understand the importance of the serum level of Ca-125 among pelvic mass, we performed a study. METHOD: From January to December 1998, we performed the study. Before hysterectomy, we performed a blood sampling to know the serum level of Ca-125, After hysterectomy, we weighed the uterus and measured the thickness of endometrium and other histologic characteristics. RESULTS: We performed my research to 80 peoples. The relation between uterine weight and the serum level of Ca-125 is little, if ever(R2=0.0007), and the relation between the thickness of endometrium and the serum level of Ca-125 is also little, if ever(R2=0.0353). The relation between leiomyoma, the cycle of endometrium and the serum level of Ca-125 were also little, but there was a close relationship between adenomyosis and the serum level of Ca-125. CONCLUSION: There was little relationship between uterine weight and the serum level of Ca-125.

The relationship of maturation value of vaginal epithelium and bone mineral density in postmenopausal women / 대한산부인과학회잡지

OBJECTIVE: To assess the relationship between vaginal cytology and bone mineral density in postmenopausal women. METHODS: In 93 postmenopausal women, vaginal cytology smears were taken for maturation index, serum estradiol level and bone mineral density were also taken. the percentage of each cell type found By vaginal cytology was multiplied to its specific value:superficial cells, 1.0; intermediate cell, 0.6; parabasal cell, 0.2 and modified to maturation value. Bone mineral density was measured at lumbar spine using DEXA. RESULTS: The mean bone mineral density was 0.88+/-0.14g/cm2. Mean maturation value was 50.53+/-20.74 and it was related with age and bone mineral density. CONCLUSION: Maturation value of vaginal epithelial cell represents the influence of estrogen on bone mineral density.

The change of bone mineral density according to the duration of hormone replacement therapy and the characteristics of the patients in postmenopausal women / 대한산부인과학회잡지

OBJECTIVES: A retrospective study was performed to clarify the change of lumbar bone mineral density(BMD) according to the duration of hormone replacement therapy(HRT) and the other factors such as age, years since menopause(YSM) and initial BMD in postmenopausal women. METHODS: From January, 1995 to December, 1998 we measured lumbar bone mineral density in 100 postmenopausal women in the department of obstetrics and gynecology, Inha University Hospital. These women had been followed for 2 years after taking HRT. We investigated whether there were any relation between the duration of HRT, age, YSM, initial BMD and change of BMD. RESULTS: Lumbar BMD was increased 2.06% after one year of HRT(p=0.0001) but there was no change of BMD at the 2nd year of HRT(p=0.847). The response to HRT was greatest in those who were oldest(r=0.209 ; p=0.039) and furthest YSM(r=0.209; p=0.039), and consequently among those who had the lowest BMD(r=0.590 ; p=0.0001). CONCLUSION: The bone mass was increased upto 2.06% at the 1st year of HRT but no more progressive increase was occurred. It suggest that intensive HRT is needed at 1st year of therapy. The risk of fracture is not decreased to that of the healthy population inspite of HRT, so the earlier therapy is necessary to prevent osteoporotic fracture despite of intervention.