The effect of delivery on regression of abnormal cervical cytologic findings.

The purpose of this study was to determine whether abnormal antepartum cervical cytologic findings result in differing postpartum regression rates. Between 1993 and 2000, 107 pregnant women with antepartum abnormal cervical cytologic findings were identified. Papanicolaou smear data were separated into three groups by use of the CIN classification system. Postpartum regression rates of antepartum Papanicolaou smears were analyzed six months after delivery. Normalization of Papanicolaou smears in the postpartum period were observed in 50 of 107 women (46.7%). Regression of cervical cytologic findings was noted in 61 of 107 women (57%). Respectively, persistence of Papanicolaou smear was noted in 43 of 107 patients (40%). Only 3 of 107 (3%) antepartum findings progressed after delivery. Desquamation of the cervical epithelium or enhancement of a localized reparative immunologic response after vaginal delivery could play an important role in the spontaneous regression of cervical dysplasia in the postpartum period.

Circulating platelet aggregates and progression of visual field loss in glaucoma.

The aim of the study was to assess a relationship between circulating platelet aggregates (CPA) and progression of visual field loss in primary open-angle glaucoma patients. CPA was determined in 27 patients with open-angle glaucoma with nonprogressive visual field loss and 15 patients with open-angle glaucoma and progression of visual field loss. Intraocular pressure (IOP) under topical therapy was < 18 mmHg in all patients. CPA in glaucoma patients with progression of visual field loss was not significantly higher than those without visual field progression (p = 0.59). In conclusion, our study shows that increased platelet aggregability is not solely responsible for progression of visual field loss in glaucoma patients, and indicates the role of IOP in the pathogenesis of visual field loss.

Pulmonary ventilatory function in premenopausal women with and without genital descensus.

A hypothesis on the existence of link between the changes in connective tissue in patients with genital descensus and impairments of their pulmonary function was made. In the sample of 40 patients, admitted to hospital for surgical correction of their genital descensus, their pulmonary ventilatory function was examined and compared with 40 matched female examinees without genital descensus. All the examinees were in premenopausis, nonsmokers and without history or clinical signs of the diseases that could affect their pulmonary function. Patients exhibited highly significant decrements in all expiratory flows, especially in the peak expiratory flow (-26%) and other flows at large lung volumes. The forced vital capacity and forced expired volume at 1 second were also decreased (-9% and -16%, respectively). The findings were typical for reduced strength of the expiratory muscles, suggesting the possible link between the lack of collagen and the impairments of pulmonary function in women with genital descensus.

Socio-demographic characteristics of postmenopausal estrogen users.

The purpose of the paper was to describe general health, socio-economic and demographic characteristics of postmenopausal estrogen users in comparison to nonusers. During years 1994-2000, 717 postmenopausal estrogen users and 235 postmenopausal nonusers were gynecological examined, interweaved with a questionnaire including information on their health, socio-economic and demographic status and compared. Women who had prescription on a hormone replacement minimally 6 months before interview were deemed to be current users, but the controls had not use hormone replacement ever. Hormone replacement users were statistically significant more often smokers, they had better physical activity and better general health than nonusers. Women with surgical menopause were more often hormone replacement users than nonusers. Women with better socio-economic status, higher education and urban population were more likely to use hormone replacement. Single, divorced and widowed women were more likely, but married women were less likely to use hormone replacement. However, more healthy profiles among hormone replacement users may inflate the apparent benefit of treatment. The gynaecologists play a major role in hormone replacement therapy decision-making because of a substantial public health impact.

Influence of war circumstances on tumor morphological characteristics in patients with breast cancer.

The influence of war circumstances on tumor morphological characteristics in patients with breast cancer has not been studied up to now. The aim of this study is to investigate if war circumstances have influenced breast cancer incidence. The study covered both the patients in which during a period of observation a breast cancer was diagnosed as well as those who died of the same disease in the same period. Three sources of data were used: 1) The archives of the Oncology and Radiotherapy Center of the University Hospital "Split" (UHS): hospital data of 768 patients were reviewed. The war sample consisted of 380 patients aged 59.4+/-12.1 (31 to 86) (including 5 males), whereas the pre-war sample was made up of 388 patients aged 58.4+/-12.7 (19 to 88) (including 3 males); 2) Register of death of the Pathology Department of UHS with 162 analyzed persons whose death was caused by breast cancer in the six-year period between 1988 and 1993. The list of 162 dead patients included 79 people who died from breast cancer diagnosed in that period (1988-1993) and another 83 people that had been diagnosed before that period; 3) The biopsy register of the Pathology Department of UHS with 851 breast biopsies performed between 1988 and 1993. Breast cancer is predominantly a female illness (99.1%). The war circumstances influenced the of T, N and M rate. The rate of N2, N3, Ml were conspicuously higher in the war period. There were significantly more malignant histological diagnoses found in new patients and also significantly more patients died due to breast cancer. Stress and other war circumstances undoubtedly have a negative impact on the numerous markers of breast cancer which we have proved in this study.

[Disorders of pulmonary ventilation function in patients with genital prolapse in postmenopause]. / Poremecaji plucne ventilacijske funkcije u bolesnica sa spustenim genitalnim organima u postmenopauzi.

Low collagen contents in urogenital organs and skin were found in women with genital descensus, pointing to genetic abnormalities in connective tissue as the underlying cause. Since lungs have abundant connective tissue and depend on its integrity we hypothesized that postmenopausal women with genital descensus may have pulmonary function disorders. Therefore, in the sample of 66 inpatients that were planned for surgical correction of genital descensus, the pulmonary ventilatory function was evaluated and compared to 67 matched volunteers without genital descensus. All examinees were in postmenopausis, nonsmokers and without history or clinical signs of the diseases that are known to affect the pulmonary function. All subjects were interviewed, gynecologically examined and performed the dynamic spirometry (MASTERLAB, Jaeger). Statistically significant reductions in vital capacity and forced expiratory volume at 1st second were observed. However, the initial expiratory flows were greatly reduced, mostly the peak expiratory flow (for 40%) and the forced expiratory flow at 75% and 50% of forced vital capacity (for 39% and 35%). These findings are consistent with reduced strength of expiratory muscles and point towards possible association of the lack of collagen and the impairment in pulmonary function in postmenopausal women with genital descensus.

[Development of obstetrics at Knin Hospital after liberation in 1995]. / Razvoj porodnistva u kninskoj bolnici nakon oslobodenja 1995. Godine.

The objective of this study is to present the development of obstetrics in the Knin General Hospital after military action "Storm" and consecutive liberation in 1995. Delivery register was used as the source of data in the period from liberation, i.e. from August 1995 to December 31, 1998. The number of medical visits during pregnancy, number and methods of deliveries and perinatal outcome are presented. Along with the improved organization of the Obstetrics and Gynecology Department of the Knin General Hospital the number of visits during pregnancy increased from average 2.4 (0-4) in 1995 to 6.7 (2-13) in 1998. With return of the population, the number of deliveries increased from 18 in 1995 to 275 in 1998. Also, the number of Cesarean sections increased from 1 (5.6%) in 1995 to 18 (6.5%) in 1998, but the frequency is the same. Perinatal mortality was low, only one child died from twin pregnancy, as a fetal death because of cord prolapse. The results of the Department of Obstetrics and Gynecology from the Knin General Hospital are comparable with other modern centers which were not under war occupation, thanks to the great effort of the Ministry of Health and help of medical staff from Zagreb, Sisak, Sibenik, Bjelovar, Cakovec and the Knin General Hospital.

Blood gases and sex hormones in women with and without genital descensus.

BACKGROUND: Abnormalities in connective tissue and spirometric disorders have previously been found in women with genital descensus. OBJECTIVE: To evaluate the association of descensus and respiratory function. METHODS: The blood gases and sex hormones were measured in 130 women scheduled for surgical correction of descensus and 60 matched women without descensus. All subjects were nonsmokers and without past or present cardiorespiratory disease. RESULTS: Women with descensus had a lower pH (7.39+/-0.04 vs. 7.41+/-0.04, p = 0.01), lower arterial tensions of oxygen (12.7+/-12. vs. 14.1+/-0.9 kPa, p = 0.003) and carbon dioxide (5.1+/-0.4 vs. 5.3+/-0.3 kPa) but a higher hemoglobin concentration (141+/-11 vs. 132+/-9 g/l) and a higher serum progesterone in the follicular phase of the cycle (3.1+/-4 vs. 1.5+/-1 ng/ml, p = 0.03). In 39 (30%) women with descensus, the arterial carbon dioxide tension was below 4.9 kPa. All subjects ventilated more in the luteal compared to the follicular phase of the cycle. In women with descensus, the hemoglobin concentration increased with decreasing arterial oxygen tension (p = 10(-4)) and with decreasing pH (p<10(-3)). CONCLUSION: Women with descensus frequently hyperventilate and, compared with women without descensus, have a lower arterial oxygen tension, increased hemoglobin concentration and slightly lower pH.

Leiomyomatosis peritonealis disseminata in a postmenopausal woman.

Leiomyomatosis peritonealis disseminata (LPD), a multifocal proliferation of smooth muscle like cells, has so far been described in 48 cases. Most of them were pregnant women or women taking the oral contraceptives, which supported the hypothesis that LPD is associated with hyperestrogenism. We report a 65-year-old women, without history of taking exogenous estrogens, which suggests that factors other than hormonal influences may contribute to pathogenesis of LPD.

Spirometric disorders in women with genital descensus.

BACKGROUND: We hypothesized that abnormalities in connective tissue, found in women with genital descensus, could impact their pulmonary function. METHOD: Therefore we compared lung flows and volumes between women with (n = 100) and without (n = 100) descensus. RESULTS: Patients exhibited highly significant decrements in all expiratory flows, especially in the peak expiratory flow (-35%) and other flows at large lung volumes. The forced vital capacity and forced expired volume at 1 second, but not their ratio, were also decreased (-16% and -17%, respectively). These differences were exaggerated in postmenopausal subjects and in patients with third degree of descensus, but did not depend on the presence of stress incontinence. Lung flows and volumes did not change between follicular and luteal phase of the cycle, either in patients or in controls. The forced vital capacity decreased with increasing years past the menopauses in patients (65 +/- 10 ml per year), but not in controls. CONCLUSION: In women with genital descensus deteriorations in lung ventilatory function were observed in association with the presence and duration of postmenopauses.

A cure from the small cell neuroendocrine carcinoma of the uterine cervix following conventional surgery.

The small cell neuroendocrine carcinoma of the uterine cervix is a rare, but very aggressive neoplasm. Previous reports suggested that it had dismall prognosis if treated with conventional surgery and radiotherapy, even in early stage disease. We present the case of neuroendocrine cervical carcinoma that was cured from the disease following conventional surgery only.