However cervical cancer can arise without going through alongpreinvasive phase that is amenable todetection and treatment. Colposcopy wasfirst introduced in ...
SINGAPORE JOURNAL OF OBSTETRICS & GYNAECOLOGY Volume
27 No. 3, November
1996
CONTENTS
EDITORIAL
PAGE
IUGR - An endocrine
and molecular
perspective
A Loganath S Arulkumaran
REVIEW ARTICLES p53, The Gene
M Pandey,
of the decade
R Jha, M Singh
4
K F Thorn. K Razvi, S S Ratnam
9
A A Lardhi, S S AI-Najashi
19
AE Omu, N AI-Qattan
23
S Taneepanichskul
29
C T Yeong, K H Tan, I WLee
33
Cytological assessment of human papilloma and herpes simplex virus infection in routine cervical smears and carcinoma cervix in India
Usha, B R Narang, R M Gupta, P Tiwari, A K Asthana
42
Evaluation of a continuous combined low-dose progestin for hormone replacement therapy
AB Sener, N C Seckin, 0 Gokmen D Aribas, U Buyukkagnici
45
S Skrablin, I Kuvocic. I Fuduric
49
Recent trends in the management
of cervical
intraepithelial
neoplasia
ORIGINAL ARTICLES Erb-Duchenne
Palsy: An analysis of risk factors
Premature menopause: replacement therapy Prevalence
Implications
and need for hormone
of HIV-1 positive mothers in Thailand
Werthiem's hysterectomy: gynaecological practice
A review of 64 consecutive in Singapore
The effect of magnesium sulphate severe preterm preeciampsia GH co-treatment
1990-1993
regimen
on the outcome
for low responders
of oestrogen-
of pregnancy
in
G Milkovic,
H Mden-Vrtovec
in an IVF-ETprogramme
The influence of latent hyperprolactinaemia E2 and T in midffollicular phase "Butterfly" - The new tailess intrauterine
cases in current
on the levels of LH, FSH,
M Kosf61, J
55
Iosner 61
contraceptine
device
In vitro metabolism of (1,2,6,7_3H) - dehydroepiandrosterone testosterone by human spermatozoa
to eH)-
Vaginal Breech Delivery
A R Kamal Bahrin, Nafisah Adeeb, Illina, H Salasawati
65
K L Peh, R Gunasegaram A Loganath.PCT Chew S S Ratnam, S Arulkumaran
70
Mdrjan
Pajntar, Ivan Verdenik
75
R Joshl. R F Chinoy H B Tongaonkar, J N Kulkarni
80
G Allahbadia, S Tibrewala, P Mangeshikar, P B PaiDhungat S Desai
83
S T Beh, Chern S M
87
CASE REPORTS An unusal case of primary
leiomyosarcoma
cervix with pregnancy
Prolonged intrauterine retention of fetal bones after abortion Vaginosonographic diagnosis & hysteroscopic removal
The wandering torsion
spleen: A rare disorder mimicking
Normal pregnancy after successful multiagent choriocarcinoma with cerebral metastases
adnaexal
chemotherapy
-
mass
for
M Joln. S Khanna,
S Gupta
89
8
9 Singapore Journal of Obstetrics and Gynaecology November 1996; 27(3): 9-18
REVIEW genic . gene BO J
r, Tlsty itential
Recent Trends in the Management of Cervical Intraepithelial Neoplasia
·935 Wild gene Cell
KFTham KRazvi ss Ratnam
~y JD, malian 3.lsand
ABSTRACT
203.
The rational management of cervical intraepithelial neoplasia (CIN) is based hchi A, [Iyeloid Nature
on the recognition that there is a continuum
of changes, from mild to severe
dysplasia and eventually invasive disease. However cervical cancer can arise without going through a long preinvasive phase that is amenable to detection and treatment.
osta J. n colon ~i USA
Colposcopy was first introduced in 1925 by Hinselmann in Germany, and initially was not popular because the erminology was entirely in German and the equipment cumbersome. There was a renaissance in the use of colposcopy in the 1950s, and since then it has played a central role in the treatment of CIN with local ablative or excisional therapy. Loop diathermy excision of the transformation
zone was
,
first described in 1989,. and has gained rapid and widespread acceptance as a reliable means of treatment for CIN. It has the important advantage of providing a specimen for histology, compared to the various forms of local ablative therapy. Microinvasive and invasive lesions may be missed even on expert colposcopy, having a specimen for histology removes the uncertainty from local therapy. Key words: Colposcopy; Dysplasia; Cervical; Diathermy; Laser
INTRODUCTION In 1886 Sir John Williams gave the William Harvey Lecture in London, and was the first to report what is now known as carcinoma in situ of the cervix. He observed a cervical lesion which he described as the "... earliest condition which is recognisable as cancer. It presented no symptoms, and was discovered accidentally". This was one of the first reported instances of a
Department of Obstetrics and Gynaecology National University of Singapore National University Hospital Lower Kent Ridge Road Singapore 0511 Correspondence: DI: K. F. Tham, Department of Obstetrics of Gynaecology, National University Hospital, Lower Kent Ridge Road, Singapore
precancerous lesion, and was significant because it implied that cancer might be preempted if the lesion was adequately treated. In 1910 Rubin described in microscopic detail a lesion which today would be termed carcinoma in situ. In the early part of the 20th century clinicians and pathologists agreed that a cervical preinvasive lesion exists, though it was often a chance finding on histological examination of a hysterectomy specimen. There was however no reliable means at that time to reliably diagnose a cervical preinvasive lesion. It was not until 1925 that the use of a microscope for examination of a clinically inapparent lesion was described by Hinselmann in Germany. However when it was first introduced colposcopy was not widely accepted, and was practiced in only a few centres in Europe. This was partly because the terminology used was in German, and the equipment at that time was quite imprecise and cumbersome. In the same year Schiller made
