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PubMed1975

Cryosurgery.

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Cervix Uteri↗
PubMed1976

[Use of cryocoagulation in gynecology].

Cryocoagulation was performed in 101 cases, mainly when the lesions were on the surface of the vaginal portion or when endocervicitis resistant to conservative therapy was present. Healing was achieved in 95%, in 65% of the cases in 4 weeks, in 32% in 8 weeks. Cryocoagulation is painless and can be applied without anaesthesia even in out-patients. It is advisable to apply treatment a few days after the end of menstruation. No complications were observed. Pathologic lesions or extensive ruptures of the cervix are not suited for cryocoagulation and should be treated as before by surgical intervention.

Adult↗
PubMed1999

Pemphigus vulgaris localized to the vagina presenting as chronic vaginal discharge.

Involvement in pemphigus vulgaris of the female genital tract including the vulva, vagina and cervix has previously been described. In all these cases other cutaneous and mucosal sites have also been affected at some time. We describe a case of pemphigus vulgaris which only involved the vaginal mucosa. The patient presented with a persistent vaginal discharge and examination showed extensive vaginal erosions. Histology of vaginal biopsies was non-diagnostic. The recognition that the vaginal changes may represent an immunobullous disease led to further vaginal biopsies on which direct immunofluorescence studies were performed. These biopsies showed IgG and C3 in the intercellular epidermis, suggesting a diagnosis of pemphigus vulgaris. During the 3-year period that the patient has been under review there have never been any other cutaneous or mucosal lesions. To our knowledge, this is the first case of pemphigus vulgaris localized exclusively to the vaginal mucosa. There was considerable delay in diagnosis and this case highlights how important it is to recognize that chronic mucosal lesions at genital sites may be caused by immunobullous diseases such as cicatricial pemphigoid and pemphigus, and to institute appropriate investigations.

Anti-Inflammatory Agents↗
PubMed2003

A comparison of the erosive susceptibility of cuspal and cervical enamel using an ultrasonic technique.

The aim of this study was to compare the erosive susceptibility of cuspal and cervical enamel from human premolar and molar teeth. Small blocks of cervical and cuspal enamel were immersed in either orange juice or Coca-Cola at 37 degrees C and the surface enamel loss was measured by surfometry at 1, 2, 3 and 4 h. Additionally, once-hourly enamel loss was measured, specimens were placed in an ultrasonic bath containing water and ultrasonicated for 5 s to determine the degree of surface demineralization. A further set of enamel specimens were prepared that had 100 microm of the enamel surface removed. This was done to remove the hypermineralized surface enamel layer. Surface enamel loss in orange juice at 4 h, following ultrasonication, ranged from 13.2 to 16.9 microm. The surface enamel loss in Coca-Cola at 4 h, following ultrasonication, ranged from 21.7 to 27.5 microm. Subsurface enamel loss in orange juice at 4 h, following ultrasonication, ranged from 10.7 to 16.1 microm. The subsurface enamel loss in Coca-Cola for 4 h, following ultrasonication, ranged from 36.8 to 37.2 microm. Overall, little difference was found in the erosive susceptibility of cervical and cuspal enamel to the effects of orange juice or Coca-Cola.

Bicuspid↗
PubMed1975

Effect of local infection and oral contraception on immunoglobulin levels in cervical mucus.

The concentrations of immunoglobulin A (IgA) and immunoglobulin G (IgG) were estimated in cervical mucus from 115 patients attending a clinic for sexually transmitted diseases. The patients were divided into two groups; those using combined estrogen/progestogen oral contraceptives, and those with presumed normal ovulatory cycles. Gonorrhea, trichomoniasis, candidosis, and herpes genitalis were diagnosed by conventional smear and culture techniques, and the two groups were subdivided according to these diagnoses. Gonorrhea, trichomoniasis, herpetic, and nonspecific cervicitis all caused marked increases in the mean concentrations when compared with a control group of uninfected patients with natural cycles (P = less than 0.01). Patients with candidosis and contacts of men with nonspecific urethritis showed a lesser rise. IgG/IgA ratios lower than that of serum suggested a considerable locally produced contribution of IgA. Oral contraception with the combined pill also caused a significant increase in mean IgA and IgG levels even in the absence of local infection (P = less than 0.01). an increase in the IgG/IgA ratio of this group may indicate that the hormonal effect was manifest through increased serum transudation. IgM was also detected more commonly in patients taking the pill. The marked effect of local disease on immunoglobulin levels in cervical mucus which occurs even in asymptomatic patients emphasizes the importance of screening for infection when studying these secretions.

Candidiasis↗
PubMed1980

Chlamydial infection of the cervix in contacts of men with nongonococcal urethritis.

An investigation of chlamydial infection in sexual contacts of patients with nongonococcal urethritis (NGU) was carried out to determine the clinical signs of infection in the cervix, and their response to chemotherapy, and the incidence of cervical infection in the presence of ectopy and oral contraception. In 202 consecutive female contacts of NGU the isolation rate of Chlamydia trachomatis was 35%. Hypertrophic ectopy and endocervical mucopus were present in 19% and 37% of chlamydia-positive patients respectively and, in all but one, resolved after treatment. Only 14% of those followed up after treatment developed yeast infections. The chlamydial isolation rate was significantly higher in patients with hypertrophic ectopy and endocervical mucopus. Cervical ectopy and oral contraceptives acted additively, each producing a significant effect on the chlamydial isolation rate in the presence of the other but not when present alone.

Adolescent↗
PubMed1989

[Development of a cancer of the large bowel following radiotherapy for cancer of the uterine cervix].

Eight patients with a colorectal cancer, following radiotherapy for a cervical cancer have been analyzed. A total of 9 lesions in the large bowel were found. Four were located in the rectum. The average interval between radiation and the diagnosis of a second tumor was 9 years and 6 months. Four patients had had a post-irradiation interval of more than 10 years. In 7 resected specimens, histologic alterations were seen, such as atrophy or the erosion of the mucosal layer around the tumor. Radiotherapy may have contributed to the development of the colorectal cancer in some of these patients. Thus, attention should be paid to monitoring patients who have received radiotherapy for a cervical cancer, since the development of a colorectal cancer after pelvic radiotherapy may occur.

Aged↗
PubMed2001

Utility of trichrome and reticulin stains in the diagnosis of superficial endometriosis of the uterine cervix.

Superficial endometriosis of the uterine cervix is a not uncommon lesion and the cells on the cervicovaginal smear shed from it can be easily mistaken for cervical glandular intraepithelial neoplasia (CGIN). The correct diagnosis can not always be easily made on H&E stained tissue sections unless it is suspected. The endometriotic stroma is often misinterpreted as stromal hypercellularity or postinflammatory fibrosis following erosion or ulceration of the cervical mucosa. Moreover, the endometriotic glands may resemble tubo-endometrioid metaplasia of the endocervical glands. This article describes the utility of trichrome and reticulin stains in the diagnosis of superficial cervical endometriosis. The absence of abundant thick collagen bundles and the investment of individual stromal cells by a fine reticulin network within the endometriotic foci are characteristic histologic features. These findings are not observed in the surrounding normal cervical stroma nor in the usual conditions in the differential diagnosis.

Adult↗
PubMed1975

Morbidity of the lower genital tract during pregnancy.

The lower genital tract of 280 pregnant women was studied in detail, and symptoms relevant to its morbidity were elicited and recorded. The study was contemporaneous with a study of microbial flora in the genital tract of these women (de Louvois et al, 1975). Complaint was made frequently of discharge (42%), irritation (15%), or both (11%). Apart from these symptoms, 14% admitted a past history of vulvovaginitis, emphasizing the importance of this condition in obstetric and gynaecological practice. The notorious discrepancy between the complaint, and the objective demonstration of discharge, was confirmed, but a significant difference in observations, varying with the clinical observer (P less than 0-001), was also demonstrated. This illustrates the necessity of even more accurate grading of signs when clinicopathological correlations are to be attempted. Only 30% of women had no evidence of vulvovaginitis or cervicitis. Morbidity did not relate to age, gestation or parity, but there was a significant correlation between clinical acumen, as evidenced by a request for a microbiological report with a view to treatment, and morbidity (P less than 0-001), between past vulvovaginitis and present morbidity (P less than 0-01), and between cervicitis and the presence of pus cells in the smear (P less than 0-001). The results indicate that microbiological investigations should be requested when there is past history of vulvovaginitis, and that lesions of the cervix, if not already noted, should be suspected if pus cells are demonstrable in stained smears.

Adolescent↗
PubMed1977

[Clinical evaluation of the dysplasias and the early forms of cervical cancer].

One hundred and forty patients, admitted to the Center of Oncology Research of the USSR Academy of Medical Sciences with a suspicion to cervical cancer, were examined by the complex method comprising in addition to routine gynecological examination also extended colposcopy, cytological investigation of smears from pathological foci surface as well as histological studies, "aimed biopsy and cervical canal curetting. It was found that the cytological picture of moderate dysplasia of cervical epithelium is more frequently recognized in patients with pseuderosions developed with unchanged in size and form uterine cervix in the background, in the presence of benign colposcopic picture. The cytological picture of marked epithelial dysplasia and dysplasia with clear-cut cell atypism is observed in patients with bleeding pseuderosions against the background of hypertrophic and deformed cervix. Histological assay in these patients revealed early cervical cancer in 67% of observations. Marked extensive leucoplakia of the cervix found in clinical examination is manifested by different forms of epithelial dysplasia, while histological assay revealed early cervical cancer in 29.4% of observations.

Colposcopy↗
PubMed1997

[An artificial urinary bladder sphincter for men].

Urinary incontinence is a condition with involuntary escape of urine and causes not only medical but also social and hygienic problems. One of the causes of incontinence is insufficiency of the urethral closure mechanism which in men is usually caused by previous prostatectomy or neurogenic dysfunction of the lower urinary pathways. The method of choice is the application of an artificial sphincter (model AMS 800) to the bulbar urethra or cervix. The authors applied an artificial sphincter in 1993-1996 to one boy and 14 men aged 11-72 years. The basic components of the artificial sphincter of the urethra-AMS 800 is a cuff, balloon and pump. The whole system is filled with isotonic solution Omnipaque 300, the cuff which is 45-80 mm long is placed either round the bulbar urethra from a perineal approach or round the cervix by a retropubic approach. The pump is placed beneath the skin of the scrotum and the balloon is in a perivesical position. All parts of the AMS are connected by tubes. Because of infectious complications the authors had to explant the sphincter in two patients. In one patient it was necessary to add another cuff. The perineal approach is simpler, but is associated with a higher risk of erosion of the urethra. Patients with a neurogenic bladder had more complications than those after prostatectomy. Despite the fact that the method and aid is expensive, the treatment is very effective and makes the patients independent on other aids for incontinent patients.

Adolescent↗