Role of frozen sections in the evaluation of moderate to severe dysplasia during uterine cervix conization.

BACKGROUND: The utility of frozen section examination (FSE) of cone specimens in evaluation of the resection margin status and in ruling out invasion in patients with high grade cervical intraepithelial neoplasia requires evaluation. METHODS: Twenty patients with high grade cervical intraepithelial neoplasia who underwent conization biopsy and frozen section examination were studied in a prospective trial from March 2008 through September 2009. The results with permanent paraffin sections were compared with those of FSE. RESULTS: Among the twenty cases, 15 (75%) had the same results in frozen and permanent sections of cone biopsy specimens. Among the other 5 patients, 2 had high grade cervical intraepithelial neoplasia in frozen sections and 2 showed a lower grade while only one case was found in which the FSE result was CIN3 while the permanent section showed invasive carcinoma which was of clinical importance and considered as significant. Paired sample t-testing showed no significant difference in the results of the two groups of frozen and permanent sections (P=0.716, CI=95%). CONCLUSION: Frozen section evaluation of cervical cone biopsy specimens in patients with a diagnosis of CIN 3 is accurate, efficient and cost-effective. Because of the great importance of missing even one case, further research is highly recommended on this controversial subject.

Bacteriological evaluation of adult dacryocystitis in Iran.

PURPOSE: To examine the microbiology and antibiogram of specimens from patients with dacryocystitis. METHODS: A total of 66 samples from lacrimal sac contents of 61 consecutive patients with acute and chronic dacryocystitis were obtained. These specimens were cultured for bacteria with a routine microbiological technique. Antibiograms were acquired from positive cultures. RESULTS: A total of 61 patients (12 patients with acute and 49 patients with chronic dacryocystitis) were included in this investigation with the average age of 40 (12-85) years (female = 74% and male = 26%). Five patients were culture-negative and five patients had mixed gram-positive cultures (a total of 66 samples were obtained). The total prevalence of gram-positive, gram-negative, and culture-negative samples were 71.2%, 21.2%, and 7.6%, respectively. The prevalence of gram-positive, gram-negative, and culture-negative samples were 77.4%, 18.9%, and 3.8% in the chronic and 46.2%, 30.8%, and 23.1% in the acute groups, respectively. The most prevalent pathogen in both groups was Staphylococcus epidermis. In 38% of patients the culture results were similar to those of the contralateral conjunctival flora. Gram-negative bacteria had a high sensitivity to ciprofloxacin and cephalexin while the gram-positive ones were highly sensitive to ceftriaxone and ampicillin. CONCLUSION: The responsible pathogens in acute and chronic dacryocystitis are significantly different. Because of the high prevalence of gram-negative bacteria and also culture-negative samples and considering the necessity of treatment in acute dacryocystitis, selecting an appropriate antibiotic with a good coverage of gram-negative and gram-positive bacteria seems essential.