[Children's knowledge of sex behavior and contraception]. / Znanja dece iz oblasti seksualnog zivota i kontracepcije.

INTRODUCTION: Adolescent sexuality is not a new phenomenon, but it has been accepted differently at various times and societies. In modern times, adolescents start sexual life early, not well educated and not prepared for possible consequences. The period between the first sexual relationship, marriage and having children is prolonged with a greater possibility of having artificial abortions or sexually transmitted diseases (STD). It is of great importance to work on proper education of children and adolescents on sexual life and contraception. MATERIAL AND METHODS: An inquiry into the knowledge of sex and contraception was performed in an elementary school in Novi Sad, comprising 134 children from VII and VIII grade (aged 13-14, 77 girls and 57 boys) in order to prepare a lecture on these topics. RESULTS: Most of the knowledge on these topics children aged 13 and 14 got watching TV and reading magazines (44.15% girls and 70.17% boys) and from their friends (42.1%). Communication about sex and contraception exists mostly among friends (51.95% girls and 82.46% boys). One third of girls talk with parents and one quarter got knowledge from them. Only four boys (2.98%) had sexual intercourse without complications: artificial abortion or STD. Almost every child (96.95%) knows about AIDS and 89.25% children know about at least one method of contraception (mostly condom). Three quarters claim artificial abortion is harmful. 50% of children want more education about sex and contraception. DISCUSSION AND CONCLUSIONS: Most of the knowledge on sexual life and contraception children get from various forms of mass-media and from one another which is unreliable and incomplete. Unfortunately, parents and teachers play a minor role in sex education of children. In order to prevent spreading of sexually transmitted diseases and to decrease the percentage of adolescent pregnancy and artificial abortions, it is of great importance to investigate knowledge, attitudes and practice of children and adolescents in regard to sexual life and contraception and to prepare acceptable and efficient programs for education on these topics. However, not only education is important, but also acceptance and behavior of children and adolescents resulting from these programs.

[Transvaginal sonography of the postmenopausal endometrium]. / Transvaginalna sonografija postmenopauzalnog endometrijuma.

INTRODUCTION: The most frequent symptom suggesting endometrial pathology is uterine bleeding. Each postmenopausal uterine bleeding requires fraction explorative curettage and histopathologic examination of the material obtained from the cervical canal and uterine cavity. The aim of this study was to estimate the efficacy of ultrasonography as a non-invasive method in detection of endometrial pathology in postmenopausal women, and to find out whether its more frequent use could safely decrease the number of curettages in detection of these conditions. MATERIAL AND METHODS: A prospective investigation has been performed in postmenopausal women not menstruating for more than a year, and who reported to the Department of Obstetrics and Gynaecology in Novi Sad for uterine bleeding during 1996 and 1997. Each woman underwent ultrasonographic examination by vaginal probe of 5 MHz and fraction curettage, whereas the samples from cervical canal (if obtained) and from uterine cavity were sent to histopathologic examination to the Institute of Pathology in Novi Sad. Standard statistical methods have been used for the analysis of the results. Validity of the applied ultrasonographic method in detecting endometrial pathology has been estimated by calculation of its sensitivity and specificity. RESULTS: A satisfactory visualisation of the endometrium has been obtained in all 35 examined cases. The thinnest endometrium was 1 mm wide and the thickest one was--25 mm. The fraction curettage has been used to obtain material from the cervix in 2 cases and from the uterine cavity in 35 cases. In our patients with uterine bleeding, who were in the postmenopause for 13 years on average, endometrial atrophy was recorded in 17.14%, endometrial polyp in 11.43%, endometrial hyperplasia in 22.86%, endometrial adenocarcinoma in 42.86% and uterine sarcoma in 5.71%. There were 2 false negative ultrasonographic findings (2 cases of endometrial hyperplasia) and sonographic thickness less than standard versus 2 false positive cases (endometrium thicker than the limit value, 7 and 14 mm, with no real pathology) which showed that the sensitivity of the investigated method was 93.10% and the specificity was 66.66%, if the limit value for the thickness of endometrium was 3 mm. DISCUSSION: Ultrasonographic thickness of endometrium means maximum double thickness in longitudinal plane, i.e. the distance of the opposite bordering surfaces of endometrium and myometrium. The procedure of measurements of endometrial thickness is simple in most cases. Most authors agree that there is a positive correlation between the thickness of endometrium and its pathological conditions. The most often used limit values are 3 and 4 mm. Higher limit values of endometrial thickness increase the sensitivity of the method even to 100%, but negatively affect its specificity making this method inadequate as a screening method for endometrial carcinoma. Many authors insist on introducing other criteria for evaluation of the endometrium i.e. for taking its thickness as the only criterion. Ultrasonography does not provide a completely safe differentiation between benign hyperplasia and endometrial carcinoma. CONCLUSION: The transvaginal sonography is an efficient and acceptable, noninvasive method for early detection of endometrial pathology in postmenopausal women. The thickened endometrium during menopause is the most significant ultrasonographic criterion implicating its pathology. The vaginosonographically measured thickness of 3 mm and less, gives a relatively safe prediction of endometrial atrophy, whereas the thickness above 3 mm requires explorative curettage and histopathologic examination of the endometrium, no matter if the woman has or has not uterine bleeding. (ABSTRACT TRUNCATED)

[Sex knowledge and behavior in male high school students]. / Prilog o seksualnom znanju i ponasanju mladica u srednjoj skoli.

INTRODUCTION: Adolescent sexual activity has increased in the last 30 years. Nowadays approximately 73% of male adolescent had sexual intercourse by the age of 18. Practice is not always followed by adequate knowledge and behavior. Therefore, it is of utmost importance to have appropriate education on sexual life and contraception in order to prevent unwanted pregnancies, abortions and spreading of sexually transmitted diseases. MATERIAL AND METHODS: Sexual behavior and knowledge was surveyed in a high school in Novi Sad among 520 male students, aged 15-19, in order to prepare lectures on sexual topics. RESULTS: Most information male teenagers got from different forms of mass-media (63.65%) and through communication with friends (50.58%). The communication with parents (5%) and experts (1%) is poor. According to their opinion, 69% have enough knowledge about sexuality and 62% about contraception, but 75.77% want further education from experts. 90% participated in some kind of sexual activity by the age of 18, and 84.3% had sexual intercourse for the first time at the age of 15.55 years, on average. artificial abortion occurred only in one case of pregnancy. Almost all young men knew about AIDS. The most common known means of contraception was condom (90%) and 70% consider it as the best method. 90% of male students consider abortion harmful, because it can cause infertility (51.38%). DISCUSSION: Most knowledge on sex life and contraception male adolescents gain from magazines, TV and friends, which can not be accepted as appropriate and undoubtedly can be incorrect and inadequate. Communication with parents and teachers is poor. Male adolescents are aware of their need for more education on these subjects and they want it from experts. CONCLUSION: Young men are not educated about sexual life and contraception well enough. Proper sexual education among adolescents is of great importance for psychic and reproductive health of young people.

Induction of labor by endocervical application of prostaglandins and intravenous infusion of oxytocin in postterm pregnancy.

The study compares two contemporary modes of labor induction: intravenous application of Syntocinon and endocervical application of prostaglandins and examines their efficacy and safety. Ninety women were divided according to the degree of cervical maturation (shown by Bishop score) into two groups. In group I there were 60 women with unripe cervix (Bishop score < or = 5) and induction was performed by endocervical application of 0.5 mg Dinoprostone, and in group II there were 30 women with ripe cervix (Bishop score < or = 6) in which the induction was performed by intravenous application of Syntocinon (500 ml of 5% glycose with 10 iu of Syntocinon). After three hours the initially significantly different Bishop score values were equalized and it was possible to correlate the duration of the labor (Group I 545 min, Group II 338 min). The correlation of initial Bishop score values and the total duration of the labor was negative and high in both groups. All the neonates from both groups were in good condition and no serious complication was noted. Both methods of labor induction appear similarly effective and safe both for the fetus and the mother.

[Use of suture materials in gynecologic surgery]. / Primena savnog materijala u ginekoloskoj hirurgiji.

This paper presents evolutionary development of suture materials in surgery from the "period of renaissance" to these days. Ideal suture materials in surgery should fulfil characteristic demands such as the four following: safety of knots, tension force, tissue reactions and wound safety. The table presents absorptive and nonabsorptive suture materials especially taking into consideration the application of the materials in contaminated-inflamed tissues. Recommendations in regard to choice of surgical suture materials are given considering gynecologic surgery.

[Modern approach to classification of precancerous conditions and vulvar dystrophy]. / Savremeni pristup u klasifikaciji prekanceroza i distrofija vulve.

Precancerous conditions of vulva are diseases which can exceed into carcinomas and are called preblastomatoses. These are all sorts of various diseases: intraepithelial vulvar neoplasias, Paget's disease, precancerous circumscript melanosis, malignant melanoma of the first Clark level, verrucous type of leukoplakia, vulvar dystrophy with atypia, giant Buschke-Lowenstein's condyloma and chronic skin damages. Vulvar dystrophy belongs to medical terminology since 1966 and includes a group of diseases known as leukoplakia and kraurosis, primary vulvar atrophy and hyperplastic vulvitis. According to classification from 1987 vulvar dystrophies are divided into: squamocellular hyperplasia, lichen sclerosus and other dermatoses. The term vulvar leukoplakia is not a special disease, but is used for a whole group of different lesions of white color due to leukoderma, vitiligo, chronic infections, benign tumors, dystrophies and even invasive carcinomas.

[Diagnostic significance of preoperative determination of CA-125 serum levels in the differentiation of malignant and benign pelvic masses]. / Dijagnosticki znacaj preoperativnog odredivanja koncentracije CA-125 u serumu u diferencijaciji malignhin i benignih karlicnih tumefakcija.

Preoperative estimation of serum C-125 tumour marker was performed in 45 patients with adnexal malignancies, 50 patients with benign pelvic masses and in 30 healthy women who underwent plastic surgery for disturbed statics of genital organs. Elevated serum CA-125 values (above 65 U/ml) were observed in 38 (84.5%) patients with ovarian malignancies (chi = 355.93, SD +/- 251.86) and in 7 (14%) patients with palpable benign pelvic masses (chi = 48.09, SD +/- 77.08). Preoperatively evaluated serum CA-125 values were not evident in the control group (chi = 7.20, SD +/- 6.98). There were statistically significant differences (T = 8.13, p < 0.05) between preoperative mean serum CA-125 values in the patients with malignant and benign pelvic masses. Also, there was statistically significant difference between the control group, the group with malignancies (T = 7.48, p < 0.05) and the group with benign pelvic masses (T = 2.86, p < 0.05). Preoperative assessment of the serum CA-125 values proved to be significant but not absolutely reliable laboratory-diagnostic parameter in differentiation of malignant and benign pelvic masses in the female.

[Conditions and indications for urodynamic examinations]. / Uslovi i indikacije za urodinamska ispitivanja.

Urodynamic investigations (UDI) present a new diagnostic method for the research of the physiology, pathophysiology, biomechanics and hydrodynamics of the urine flow. The purpose of UDI is to establish the function of the lower part of the urinary tract, most frequently in the presence of urinary incontinence. They are used in gynecology, urology, neurology, pediatrics, rehabilitation, geriatrics and general surgery. There are absolute and relative indications for UDI. Adequate preparations of the patient are necessary prior to UDI. Exact diagnostics of the impaired function of the lower part of the urinary tract can be maintained only by a complete performance of the UDI objectivity tests. A correct diagnosis will enable adequate therapy.

[Use of lasers in medicine with special emphasis on their use in gynecology]. / Upotreba lasera u medicini sa posebnim osvrtom na primenu u ginekologiji.

Laser invention is one of the most important scientific inventions which has found its application in medicine. Biologic effects of laser radiation are biostimulating and destructive. For various purposes carbon dioxide, argon and Nd: YAG lasers have been applied in medicine. The use of laser in gynecology is particularly suitable for the treatment of condyloma, vaginal and cervical intraepithelial neoplasias as well as for the surgical treatment of sterility.

[Tumor markers and their use in gynecologic oncology]. / Tumor-markeri i njihova primena u ginekoloskoj onkologiji.

The following specific tumour markers used in female patients affected by neoplasm of the genital system are described, such as: CA-125, pheritin, beta--HCG, UGF, CEA and AFP. A continuous postoperative follow-up of all cited tumour markers has been made at the Clinic of Gynecology and Obstetrics at the Faculty of Medicine in Novi Sad from January 1989. Each of the cited tumour markers has been individually described and the explanation pertaining to the validity of individual onco-markers for the specific kind of tumour has been given.

[Personal experience with ovarian dysgerminoma]. / Nase iskustvo s dizgerminomom jajnika.

The authors present 11 patients with ovarian dysgerminoma treated at the Institute of Oncology and the University Hospital Department of Gynecology and Obstetrics in Novi Sad. The average age of the patients was 33.90 years (the mean value 27). In most of them the disease was in an advanced stage, with considerable local findings at the beginning of the treatment. In only three 3 patients was the disease relatively limited. The results of the treatment were unsatisfactory: three patients have been alive for 8, 11, and 12 years after the beginning of the treatment, three patients after 6 and 26 months and are still under treatment but with suspect clinical or laboratory findings, whereas the remaining five died in the period between 3 and 4 months following the beginning of the treatment. All these patients were treated surgically in the first place, but radiotherapy proved of great help, because this tumour is markedly radiosensitive, and also chemotherapy was useful in some of the women treated. In general, therapy should be strictly adjusted to individual cases, primarily because the disease appears more frequently in younger women.