• Title/Summary/Keyword: LEEP

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Incidences of Cervical Intraepithelial Neoplasia 2-3 or Cancer Pathologic Diagnoses in Patients with a High Grade Squamous Intraepithelial Lesion Pap Smear Attending a Colposcopy Clinic at Srinagarind Hospital

  • Ingkapairoj, Navakorn;Luanratanakorn, Sanguanchoke;Chumworathayi, Bandit;Kietpeerakool, Chumnan;Supoken, Amornrat
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.12
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    • pp.6203-6206
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    • 2012
  • The aim of this study was to evaluate the outcomes of women with high-grade squamous intraepithelial lesion (HSIL) smears who had undergone the "see and treat" approach compared to those who underwent a conventional approach. The records of women with HSIL smears undergoing colposcopy at Srinagarind Hospital were reviewed. In those undergoing the conventional approach, the final histological diagnosis was made on the most severe histological results obtained after initial colposcopy. In the "see and treat" group, the final histological diagnosis was made on the examination of LEEP specimens obtained after initial colposcopy. Overtreatment in the see and treat group was defined as the LEEP specimens containing cervical intraepithelial neoplasia (CIN) 1 or less. During the study period, 302 women with HSIL underwent colposcopy. Twenty (6.6%) were nulliparous. One hundred and ninety-four (64.2%) underwent conventional management while the remaining 108 (35.8%) received the see and treat management. The prevalence of underlying high-grade lesions in women undergoing the conventional approach was significantly higher than that observed among women undergoing the see and treat approach (89.2% and 47.2%, respectively, P<0.001). The overtreatment rate in the see and treat group was 52.8%. Multivariate analysis revealed that only parity status was a statistically significant factor for predicting the overtreatment after undergoing the see and treat approach. In conclusion, the overtreatment rate among women undergoing see and treat in this study is notably high and therefore this approach should not be routinely practiced.

A Case Study on ERP Adoption in Shipbuilding and Marine Engineering Industry (조선해양 산업에서의 ERP 구축 사례 연구)

  • Jung, Sung Leep;Lee, Jaekwang;Jo, Hyeon
    • Journal of Information Technology Services
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    • v.12 no.1
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    • pp.189-199
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    • 2013
  • As many organizations have adopted and implemented ERP systems, concerns about ERP performance also have increased. Former researches studied the ERP implementation of general large or medium size enterprises but there are not enough studies on ERP systems of a specific industry domain. In this paper, we introduce a case study on ERP adoption methodology of global leading company 'D' in shipbuilding and marine engineering industry. We examined ERP implementation background, method and scope and evaluated ERP performance in perspective of both quantitative and qualitative approaches. Quantitative research usually examines ERP performance based on financial statements and qualitative study typically examines organization change or improvement. As a result, ERP implementation in shipbuilding and marine industry can improve quantitative aspects such as cost, human resource and organization performance. As qualitative analysis, business process and tools can be unified and management transparency can be improved by ERP implementation. The result of this paper will be useful guideline for organizations which are considering ERP systems.

See-and-Treat Approach to Cervical Intraepithelial Lesions in HRH Princess Maha Chakri Sirindhorn Medical Center

  • Srisuwan, Siriwan;Hamontri, Suttha;Kongsomboon, Kittipong;Bhamarapravatana, Kornkarn;Suwannarurk, Komsun
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.8
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    • pp.3483-3486
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    • 2014
  • Background: To evaluate the overtreatment rate with the see and treat approach in the management of women with abnormal cervical cytology. Materials and Methods: A retrospective review of patients with abnormal cervical cytology who underwent S&T at MSMC between January 2008 and December 2012 was conducted. Loop electrosurgical excision procedure (LEEP), histological results, cytology and colposcopic impression were analyzed to evaluate overtreatment rate, cyto-histologic correlation and related factors. Results: Average age of S&T cases was 42 years. Ninety seven percents were referred from affiliated health care providers. The study revealed 83.2% patients had HSIL or higher from cervical cytology. Correlation between HSIL and final histology was relatively low at 75% compared to other studies. Overtreatment rate was 28%. Conclusions: S&T was done in 197 patients in a tertiary care health facility with patient satisfaction. Overtreatment occurred, but the rate can be reduced with appropriate recommendations. HSIL Pap smears should be reexamined before S&T while low grade and lesser colposcopic impression groups should obtain conventional colposcopic approach for patient future reproductive benefit.

Analysis on the Improvement of Ski Resort Service Quality with the Performance Model (스키리조트 서비스품질 개선 우선순위 도출)

  • Yeo, Hwan-Leep;Kim, Pan-Soo
    • Journal of Korean Society of Industrial and Systems Engineering
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    • v.33 no.1
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    • pp.59-70
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    • 2010
  • This paper reorganized five service qualities dimensions of ski-resorts, then derived the improvement priority order of the service quality through a satisfaction measure considering the importance. There're more competitive situations to guarantee customers using the skies and snowboards is a major sports in winter season. In these competitive environments, this paper's going to propose a predominant-competitive strategies for improving the service quality of ski-resorts. This study measured the satisfaction considering the importance of service quality target on customers has an experience ski resort service quality to improve ski resort service quality. This study using Performance Model decide a priority order about a particular item improvement, then is going to present a guideline that can improve the service quality more exactly. As a result of the study the factors that is important to the customer were prime physical factor, access, assistance physical factor, staff service and assistant service, an improvement priority order were accommodation and eating-drinking facilities, waiting time of a slope and lift/gondola, entertainment/shopping facilities in the resorts, equipment rental and lift fare.

Quality Improvement Methods in Cervico-vaginal Cytology; Cytologic/Histologic Correlation vs. 10% Random Rescreening (자궁경부질 도말 검사 정도 관리과정으로서의 세포 및 조직진단의 비교 분석과 10% 무작위 재선별과의 비교 분석)

  • Yoon, Ghil-Suk;Huh, Joo-Ryung;Son, Kyung-Hee;Kim, On-Ja;Gong, Gyung-Yub
    • The Korean Journal of Cytopathology
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    • v.9 no.2
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    • pp.129-137
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    • 1998
  • Although the success of the Papanicolaou test as a screening tool of cervical cancer is evident, there still exists $2{\sim}5%$ of discrepancy rate by both human and machine. To improve the qualilty of cervico-vaginal cytology, the authors compared cervicovaginal smear with cervical biopsy diagnoses, and analysed the causes of discrepancies. Among 30,922 cervicovaginal smears from June 1996 to April 1997 at our hospital, there were 271 cases of cervicovaginal smear with subsequent cervical punch or LEEP cone biopsies within several months. The biopsies and smears from a total of 98 discordant cases were reviewed. The discrepancy was attributed to sampling errors in 43 cases(43.9%), and to cytologic diagnosis in 49 cases(50.0%). Among these, 43 cases were interpretative errors(categories A;19, B;16 and C;8) whereas six cases were screening errors(categories B:2 and C:4). Among cervical biopsy cases, errors were present in four. As for 10% random rescreening, cytotechnologists reviewed 3,196 of 30,922 smears during the same period, There were 43 cases of screening error(categories A;27, B;16). Cytologic/histologic correlation was superior to 10% random rescreening of negative cases. The most effective method for quality improvement in cervicovaginal cytology was to implement both quality control(rescreening) and qualify assurance(cytologic/histologic correlation) programs.

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Is the Correlation between Papanicolaou Smear and Histopathology Results Affected by Time to Colposcopy?

  • Meevasana, Vorachart;Suwannarurk, Komsun;Chanthasenanont, Athita;Tanprasertkul, Chamnan;Bhamarapravatana, Kornkarn;Pattaraarchachai, Janya
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.4
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    • pp.1527-1530
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    • 2014
  • Background: Time to colposcopy (TC) after abnormal Pap smears was evaluated for influence on cytohistologic correlation (CHC). Materials and Methods: This retrospective study assessed the correlation between TC and CHC of women who had abnormal Pap smears. Colposcopic chart review included participants from 2010-2013 who attended a colposcopic clinic, Thammasat University Hospital, Thailand. Results: Four hundred and sixty cases who had abnormal Pap smears were recruited. Pap reports were atypical smears with low grade squamous intraepithelial lesion (SIL), high grade SIL and cancer at 339, 114 and 7 cases, respectively. One hundred and twenty four patients underwent loop electrosurgical excision procedure (LEEP). A half of the cases were colposcopically examined within 1-2 months after abnormal Pap collection. CHC was 88 percent and not affected at all by TC. Subjects who attended cervical cancer screening from affiliated health providers had shorter TC than those screened in our tertiary hospital. Conclusions: Time to colposcopy with abnormal Pap smears conducted at Thammasat University Hospital had a highest frequency of 42 days, in line with the literature. Length of TC does not affect the correlation between Pap and histopathologic reports. A longer waiting period for colposcopy did not alter progression or regression of the disease.

Reid Colposcopic Index Evaluation: Comparison of General and Oncologic Gynecologists

  • Aue-Aungkul, Apiwat;Suprasert, Prapaporn
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.12
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    • pp.5001-5004
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    • 2015
  • The Reid colposcopic index (RCI) helps physicians for interpret the results of colposcopic examination. To compare the accuracy of RCI in colposcopic evaluation between general and oncologic gynecologists, this prospective trial was conducted by invited women over 20 years of age who were scheduled for a colposcopy at Chiang Mai University Hospital between August, 2008 and May, 2014 to participate. Pregnant patients or those having a history of hysterectomy or conization were excluded. During the colposcopy, all patients were simultaneously evaluated by general and oncologic gynecologists utilizing the RCI. Further management with either a biopsy or LEEP in each patient was dependent on the decision of the attending oncologic gynecologist. The accuracy of the RCI in diagnosing HSIL or more was calculated by the comparison with the final histology. Finally, 135 patients were recruited into this study. The sensitivity, specificity, PPV, NPV, and accuracy of RCI in diagnosing HSIL or more in general gynecologists were 45.2%, 80.7%, 41.1%, 83.2% and 72.6% while in the oncologic gynecologists were 51.6%, 85.6%, 51.6%, 85.6% and 77.8%, respectively. The difference in accuracy between evaluator groups was not significant (p-value=0.28). Of 3 patients with invasive cervical cancer, all were undetected by the general gynecologists using RCI while only 1 invasive cervical cancer was missed via RCI by the oncologic gynecologists. We conclude that RCI could be used by general gynecologists in provincial hospitals with major concerns about missing invasive cervical cancer. A short training period regarding colposcopy might help to resolve this problem.

A Case Report of Recurrent Cervical Intraepithelial Neoplasia Treated by Korean Traditional Medicine and Mistletoe Extract Inject (미슬토 추출물 투여와 병행한 한방치료를 통해 호전된 재발성 자궁경부상피내종양 증례보고)

  • Ko, Eun-Bin;Park, Nam-Gyeong;Choi, Min-Young;Lee, Jin-Moo;Lee, Chang-Hoon;Jang, Jun-Bock;Hwang, Deok-Sang
    • The Journal of Korean Obstetrics and Gynecology
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    • v.35 no.4
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    • pp.174-185
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    • 2022
  • Objectives: The purpose of this study is to report the improvement of recurrent cervical intraepithelial neoplasia (CIN) and chief complaint including dysmenorrhea, premenstrual syndrome after Korean medicine treatment. Methods: The patient who diagnosed CIN even after undergoing two times of loop electrosurgical excision procedure (LEEP) and complained dysmenorrhea with premenstrual syndrome was treated by acupuncture, moxibustion and herbal medicine as Ojeok-san-gami-bang along with mistletoe extract injection (Abnobaviscum®). The effect of treatment was evaluated by the results of liquid based cytology and HPV genotyping. Other symptoms were evaluated according to the patient's subjective complaint. Results: Before the treatment, the result of cytology was low grade squamous intraepithelial lesion and a low-risk group for HPV was detected. At the first examination after treatment, cytology showed negative for intraepithelial lesion or malignancy and the HPV genotyping was negative. The result showed negative findings in 3 consecutive follow-up tests. In addition, the chief complaint and general conditions were improved. Conclusion: This study shows that the recurrent cervical intraepithelial neoplasia (CIN) was improved after the Korean traditional treatment and it can be effective medical alternatives or options for patients receiving mistletoe injection during follow-up.

Role of the HPV DNA Test in Follow-up of Treated Cervical Intraepithelial Neoplasia in Bangladesh

  • Nessa, Ashrafun;Rashid, Mohammad Harun Ur;Jahan, Munira;Ferdous, Noor-E;Nahar, Pervin Akhter Shamsun;Chowdhury, Afroza
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.19
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    • pp.8063-8067
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    • 2014
  • Background: Cervical cancer is a major public health problem in Bangladesh. Persistence of high risk human papillomavirus (HRHPV) influences the progression of the disease, with an important role in followup for cervical intraepithelial neoplasia (CIN). Objective: To establish application of high risk HPV DNA test in the follow-up of women after treatment of CIN. Materials and Methods: This cross-sectional and hospital based study was carried out among 145 CIN treated women during the previous six months to three years at the colposcopy clinic of Bangabandhu Sheikh Mujib Medical University, Dhaka, between January 2011 and June 2012. Pap smear and HPV samples were collected and colposcopy was performed to find out the persistence of the disease. Cervical samples obtained were tested for HPV DNA using the Hybrid Capture II (HC-II) test. A cervical biopsy was collected whenever necessary. The results were compared to assess the efficacy of different methods during follow up such as Pap smear, HPV test and colposcopy. Results: Mean age of the recruited women (n=145) was 33.6 (${\pm}7.6$), mean age of marriage was 16.8 (${\pm}2.9$) and mean age of 1st delivery was 18.8 (${\pm}3.5$) years. More than half had high grade CIN before treatment and 115 (79.3%) women were managed by LEEP and 20.7% were managed by cold coagulation. Among the 145 treated women, 139 were negative for HPV DNA and six of them (4.1%) were HPV positive. Sensitivity of Pap smear (40.0) and HPV DNA test (40.0) was poor, but specificity was quite satisfactory (>93.0) for all the tests. Conclusions: The high risk HPV DNA test can be an effective method of identifying residual disease. It can be added to colposcopy and this should be applied to all treated women attending for their first or second post-treatment follow-up visit at 6 months to one year, irrespective of the grade of treated CIN.