Colpocytologic study by ink staining technique for assessing ovulation.

Vaginal smears were taken from women who came for artificial insemination using donor’s semen, to assess the time of ovulation. The smears were obtained from the upper 1/3 of the lateral vaginal wall, and immediately placed in a staining bottle containing sheaffer ink sulution. The slides were examined under light microscope, and the eosinophillic index (E.I.) were recorded. The result of the study of 78 cycles demonstrated that 59 in 65 cycles (90.8%) which were evaluated between 3 days before and 2 days following ovulation showed the E.I. over 50. Vaginal smears from 2 normal menstruating women were also examined daily, and the peak of E. I. Was clearly over 50 at the time of ovulation. The E.I. values of this technique were compared to the maturation index which stained by Papanicolaou method, and good correlation was recognized. We concluded that the colpocytologic study ink staining technique is simple, rapid, and inexpensive. It can be used reliably with other methods to assess the time of ovulation.

Cis-platinum and mitomycin-C in treatment of recurrent, metastatic, or residual uterine cervical cancer post radiation.

Fifteen patients with recurrent, metastatic, or residual cervical cancer post radiotherapy were treated by combined cis-platinum 40 mg/m2 IV and mitomycin-C 30 mg/m2 IV in day 1, repeated every 4 weeks for 3-5 cycles. The maintained therapy was performed by mitomycin-C 2 mg/day orally for 7 days, every 4 weeks for 6 cycles. Six of 15 patients (40%) showed complete remission and are alive without disease after a follow-up period of 5-41 months; 3 patients (20%) with partial remission are alive with disease after a follow-up period of 8-12.5 months; 6 patients (40%) with no remission expired with a survival time of 3-6 months. Severe anemia and leukopenia (grade 3-4) were seen in 26.66 per cent. Thrombocytopenia grade 4 was seen in 13.33 per cent of cases. Nausea and vomiting occurred in almost all patients. There were no problems with hepatotoxicity, nephrotoxicity, or ototoxicity.

Use of ofloxacin in treatment of acute cystitis in non-pregnant women.

Fifty non-pregnant women, who were diagnosed as acute cystitis were given ofloxacin (Tarividฎ, 100 mg.), tablets orally twice daily for 7 days. The ages of the patients ranged from 17 to 64 years. After 3 days of treatment, the symptoms and fregvenay of dysuria were almost resolved, pyuria improved, and bacteriuria disappeared. Bacteriological study revealed that the most common organism found was E. coli (34.2 per cent). The other isolated organisms were Staph. epidermidis (21.1 per cent), polymicrobial (18.4 per cent), and Staph. Coagulase (-) (10.6 per cent). No symptoms nor alternations in haematological, renal and hepatic function were observed in the patients during and after completion of medication. Utilizing ofloxacin for the treatment of acute cystitis in non-pregnant women is efficient even with 3 days regimen. It also has no been shown to produce any side-effect.

Diagnostic dilatation and curettage at Siriraj Hospital.

Dilatation and curettage (D & C) was carried out in 914 patients, with abnormal uterine bleeding, who visited GYN-section, Siriraj Hospital between April 1985 and March 1986. The histological results showed that proliferative endometrium was most common (47.5 percent). Endometrial hyperplasia (16.1 percent), secretory endometrium (13.1 percent), atrophic endometrium (9.8 percent) were next in order. Endometrial carcinoma was found in 22 cases (2.4 percent), with 0.39 percent of the women younger than 40 years of age, and 4.94 percent of the women 40 years of age or order. There were 154 patients with previous history of oral or injectable contraceptive use, proliferative endometrium was found in 88 cases (57.1 percent) and no malignancy was found. This study showed that the common cause of abnormal uterine bleeding was anovulatory bleeding. Women who are younger than 40 years of age without risk factors of endometrial cancer, would have an alternative treatment of ateriod hormone, followed by D & C when he uterine bleeding could not be controlled. All woman with previous history contraceptive pills use or DMPA who show no abnormalities finding on pelvic examination.

Measurement of urinary oestrogen level for monitoring of ovulation.

A new micrometering kit using latex agglutination inhibition reaction for determination of urinary oestrogen of 15 infertile women undergoing induction with the injections of HMG – HCG (human menopausal gonadotropin and human chorionic gonadotropin), was studied. The value of urinary oestrogen measured by this method related closedly to the value of serum oestradiol measured by radioimmunoassay. The micrometering kit was sensitive enough to monitor follicular maturation. It was found that when the level of urinary oestrogen was 75 ng/ml, the chance of ovulation was 75 percent; once the level exceeded 100 ng/ml, all patients had ovulation; when the level was 50 ng/ml or less, there was no ovulation. This method of urinary oestrogen measurement is shown to be useful in clinical practice, because the technique is simple, the results can be obtainted in 2 minutes, and it is sensitive for measuring oestrogen from the level of 2 ng/ml.