Background: Early oral cancer is asymptomatic and highly curable, but unfortunately most cancers are advanced by the time when they are discovered, so the mortality is relatively high. The aim of this study was to refer the advantages as well as the difficulties of brush cytology in the identification of early oral cancer. Methods: Cytological smears obtained from of the oral mucosa of 36 patients were evaluated. The materials were taken with a cytobrush by scraping the surface of the suspected lesions, fixed with cytospray fixative and stained with the Papanicolaou method, whereas the residual was prepared by the liquid-based technique Thin-Prep 2000. Results: There were 29 inflammatory and mild dysplastic lesions, three cases with mild dysplasia only and two cases with severe dysplasia possible carcinoma. Another two showed squamous cell carcinoma. Histological examination of possible malignant and malignant cases showed well differentiated squamous cell carcinomas, so wide excisions were performed. Conclusion: Oral cytology is well accepted by the patient and attractive option for the early diagnosis of the oral cancer. It is useful when the lesion is large or multiple or the patients refuse biopsy. However there are factors that contribute to a false negative diagnosis such as the selection of the site of biopsy, necrosis, blood crusting, lack of adequate training, and the fact that malignant features of squamous cell carcinoma can be subtle resembling dysplasia
Aim: This study examined the effect of pelvic floor muscle exercises after 12 months of successful treatment for stress urinary incontinence based on subjective (incontinence episodes and pad test) and objective outcome variables (urethral closure pressure, UCP, functional profile length and pressure transmission ratio, PTR). Methods: Fifty women aged 24–58 years old with genuine stress urine incontinence who successfully underwent pelvic floor muscle exercises, as measured by incontinence episodes and pad test, were included in the study. All women underwent a comprehensive standardized evaluation of urethral pressure profilometry at baseline assessment and at the end of 12 months of pelvic floor exercise program. Maximal UCP, mean UCP, functional profile length or PTR were recorded in all patients. Results: At baseline, the study population had a mean maximal UCP of 33 ± 20 cm H2O, a mean UCP of 18 ± 10 cm H2O, a mean functional urethral length of 22 ± 5 mm and a mean PTR of 81 ± 12%. At the end of 12 months of successful and continuous pelvic floor exercises and a significant improvement of incontinence episodes, no difference could be recorded concerning urethroprofilometry parameters studied apart from mean PTR, which was significantly increased. Conclusions: The results of this study indicate that apart from the mean PTR no other urodynamic parameter reflected the continence improvement of pelvic floor exercise program.
Aims: To present a study on severe Asherman's syndrome after open myomectomy and investigate the possible reasons for this outcome. Methods: This study involves a rare case of a 38-year-old nulliparous woman who underwent a relatively minor and straightforward open myomectomy in a university hospital setting, during which the uterine cavity was not entered and there were no post-operative complications. Post-operatively the patient had oligomenorrhoea for over a year. The patient was investigated with three-dimensional power Doppler angiography of the uterus and underwent diagnostic/operative hysteroscopy. Main outcome measures were to sonographically assess the blood flow and vascularisation throughout the uterus and to hysteroscopically confirm diagnosis of Asherman's syndrome and treat the patient at the same time. Results: Sonographically there was reduced perfusion in the outer part of the uterus and the scarred areas of the endometrium. Upon hysteroscopic confirmation of diagnosis, the division of adhesions led to a normal sized uterine cavity. Conclusions: Among the predisposing and causal factors that have been implicated in post-operative adhesion formation, endometrial trauma, infection and tissue hypoxia are considered the most important. This case supports a role for tissue hypoxia in the development of Asherman's syndrome after open myomectomy.
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