Objective: The clearance rate of human papillomavirus (HPV) after conization is generally high, although some HPV infections persist. We investigated the factors that affect the clearance of HPV after conization in patients with negative margins. Methods: We retrospectively analyzed 77 patients (mean age 39.9 years, range 25 to 51 years) with CIN 2/3 who underwent loop electrosurgical excision procedure (LEEP) conization with negative margins. All patients had a Pap smear and high-risk (HR) HPV testing using Hybrid Capture II system and HPV DNA chip before conization. We used≥1 relative light units (RLUs) as the cutoff for persistence of HPV after conization. Results: High-risk HPV was detected in 73 of 77 (94.8%) patients before conization. At the 6-months follow-up, the high-risk HPV was eliminated in 60 of 73 (82.2%) patients. The HPV persistence rate after conization was 17.8% (13/73). Univariate analysis showed that persistent HPV infection after conization with negative margins was more likely to occur when the pretreatment viral load was high (RLU/positive control ＞100 (p=0.027) and the HPV was type 16 (p=0.021). Logistic regression analysis showed that preoperative HPV type 16 infection was the only significant independent factor (p=0.021) for HPV persistence out of age, cytology, punch biopsy histology, HPV viral load, and conization histology. Conclusion: Conization effectively removes HR-HPV infection. HPV type 16 infection before conization was significantly related to HR-HPV persistence after conization with negative margins. Therefore, patients with HPV 16 infection before conization need to be followed closely.

Objective: Absence of dysplasia in the excised specimen following loop electrosurgical excision procedure (LEEP) for treatment of cervical intraepithelial neoplasia (CIN) 2/3 is an occasional finding of uncertain clinical significance. We evaluated several factors including age, liquid-based Pap (LBP) test, human papillomavirus (HPV) load before treatment, and HPV typing as predictors for absence of dysplasia. Absence of dysplasia in LEEP specimens was analyzed in terms of factors for recurrent disease after LEEP conization. Methods: In total, 192 women (mean age, 39.3±8.4 years; range, 24 to 70 years) with biopsy-proven CIN 2/3 were treated by LEEP conization. Age, LBP test, histological grade, HPV load, and HPV DNA typing were evaluated as possible predictors of the absence of residual dysplasia or recurrent disease. Results: Of the LEEP specimens, 34 (17.7%) showed no dysplasia in preoperative biopsies from patients with proven CIN 2/3. Low HPV load (＜100 relative light units [RLU]) was significantly related to the absence of dysplasia in LEEP specimens, using logistic regression. Margin involvement and high HPV load (≥400 RLU) were significant factors for recurrence. Conclusion: Absence of dysplasia in LEEP specimens occurred in 17.7% of our specimens. Prediction of the absence of dysplasia in LEEP specimens was associated with low HPV load. Residual/recurrent disease after LEEP was associated with a positive resection margin and high viral load, and was not associated with absence of dysplasia in LEEP specimens. Even if there is no dysplasia in conization specimens, close follow-up for residual/recurrent disease is needed.

ObjectivesTo evaluate the prevalence of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) of perimenopausal women at a university hospital along with their menstrual characters.MethodsA questionnaire survey regarding premenstrual symptoms was carried out in 100 perimenopausal women (43 to 53, years). The pattern of menstruation and, the intensity of dysmenorrhea were assessed; and further, the symptoms were classified according to their number, intensity, and persistence. The PMS criteria of American College of Obstetrics and Gynecology (ACOG) and PMDD criteria by American Psychiatric Association (APA) were evaluated.ResultsThe approximate prevalence of PMS criteria was 95% and that of PMDD criteria was 23%. The most dominant symptoms were 'breast tenderness', 'abdominal bloating', 'and headache'. PMDD was significantly associated with the severity of dysmenorrhea (P = 0.020). There was no significant relation with age, height, weight, body mass index and the cycle of menstruation.ConclusionMost women experience PMS and PMDD, which and have a significant impact on the activity of perimenopause women. However in most women that do not know well about PMS and PMDD. We should educate and inform women of PMS and PMDD, thus helping them increase their quality of life.

ObjectiveWe wanted to evaluate the prevalence of dysmenorrhea and premenstrual syndrome (PMS) among the career women of Bucheon City and their knowledge of and ability to seek treatment regarding their dysmenorrhea and premenstrual syndrome. MethodsA questionnaire survey regarding premenstrual symptoms was conducted for 289 career women. The cycle of menstruation, the regularity, the amount of menstruation and the intensity of dysmenorrheal were assessed and the symptoms were classified according to their intensity and persistence. Women's awareness of PMS and the physician consultations were also evaluated. ResultsThe approximate prevalence of PMS by the World Health Organization's International Classifi cation of Disease (ICD-10) and the American College of Obstetrics and Gynecology criteria was 74% and 38%, respectively. The predominant symptoms of PMS were abdominal bloating, anger, weight gain, sleep disturbance, attention deficit, drowsiness, nausea and vomiting. PMS was signifi cantly associated with the large amount of menstruation (P = 0.017) and there was no signifi cant relation with the cycle, the severity of dysmenorrhea and the use of analgesics. Most of the women (94.1%) had no knowledge regarding the terminology pertaining to PMS and premenstrual dysphoric disorder. ConclusionPMS occurs frequently and it has a significant impact on the activity of career women. However, career women have little knowledge about PMS and they only infrequently consult their physicians. Physicians should educate and inform career women about PMS and this can help to increase the quality of life of these women.

The detection of CIN 2+, particularly high-grade cytological abnormalities and large lesion size, can be increased by additional random biopsies after satisfactory colposcopy. Loop electrosurgical excision procedure conization can detect lesions not detected by punch biopsy.