Background: The aim of this investigation is to evaluate the histologic results of biopsy in women with ATYPICAL SQUAMOUS CELLS of UNDETERMINED SIGNIFICANCE (ASCUS) cytologic diagnosis.Materials and Methods: We reviewed a series of cases with ASCUS pap smears from March 1999 to Feb 2002 in Imam Khomeini Hospital (n= 104), Who had cervical biopsy indirected colposcopy (103) and in Onec endocervical biopsy obtained without colposcopy. In 60 patients before colposcopy and biopsy repeat pap smear was tabled.Results: Biopsy revealed 28.8% SIL (14 LSIL and 16 HSIL),1 invasive carcinoma and 1 endometrial carcinoma. Pap smear repeated for 60 women before colposcopy examination, which 7 (11.7%) of them were normal. ASCUS persisted in 45 cases (75%) and 8 cases (13.3%) turned out to be SIL (6 LSIL, 2 HSIL) of 7 normal repeat smear, 2 marked as LSIL by biopsy. In colposcopic examination 22 of 103 (21.4%) had normal view which one of them was LSIL histologically.Conclusion: Based on these findings, it seems immediate colposcopy and directed biopsy are appropriate procedures for management of ASCUS and to detect underlying SIL.

Objective: Since colposcopy biopsy test plays a significant role in the evaluation of cervix, especially in patients with an abnormal result of Pap smear test, therefore, this research study was conducted to compare the results of Pap smear and colposcopy directed punch biopsy tests at Firoozgar and Akbarabady hospitals from 2001 to 2003. Materials and Methods: This cross-sectional study was carried out on 80 convenientlysampled women at different ages with an abnormal result of Pap smear test. In this respect, colposcopy directed biopsy was taken from suspicious areas of these patients. Results: A positive predictive value equal to 67.5% was found in patients with an abnormal result of Pap smear and colposcopy directed biopsy tests which confirmed the reliability of the study. Conclusion: These findings strongly suggest the necessity to obtain cervicovaginal smears from all sexually active women and for this purpose colposcopy directed biopsy is the best choice for evaluation of patients with an abnormal result of Pap smear test.

Objective: This study was conducted to obtain histological results in cases with ATYPICAL SQUAMOUS CELLS of UNDETERMINED SIGNIFICANCE (ASCUS) found on Papanicolaou (Pap) smears. Methods: We reviewed cases with ASCUS found in cervical cytology from March 1999 through February 2002 of patients who attended Imam Khomeini or Mehr General Hospitals (n = 104). Except for one patient in whom cervical biopsy was done without colposcopy, the remaining 103 had biopsy under direct colposcopy. Results: Histological examination revealed 28.8% SQUAMOUS intraepithelial lesion (SIL) (14 low-grade SIL [LSIL] and 16 high-grade SIL [HSIL]), 1 invasive carcinoma, and 1 endometrial carcinoma. A Pap smear was repeated in 60 women with ASCUS before colposcopy and was normal in 7 (11.7%) cases, revealed ASCUS in 45 (75%) cases, and SIL in 8 (13.3%) cases including 6 LSIL and 2 HSIL. Among the 7 normal cases after the repeated Pap smear, histological examinations showed 2 cases of LSIL. In colposcopic examinations of 103 cases, 22 (21.4%) were diagnosed as normal, while one case had a histological report of LSIL. Conclusion: Since the cytopathologists’ reports do not differentiate between ASCUS and ATYPICAL SQUAMOUS CELLS seen in HSIL, to detect any underlying SIL, it seems that immediate colposcopy and direct biopsy are more appropriate methods for managing cases with ASCUS.

Although the diagnostic category of ATYPICAL SQUAMOUS CELLS of UNDETERMINED SIGNIFICANCE (ASCUS) has been known since 1988, its use and appropriate clinical follow up and management still remains controversial. This study was carried out to evaluate the diagnostic value of ASCUS, using cytohistologic correlation. A retrospective review of archival materials in our cytology laboratory files was performed for cervicovaginal smears diagnosed as ASCUS from March 1999 to February 2002. In 8551 cervicovaginal smears examined, ASCUS was reported in 236 (2.76%) cases, with histologic follow up in 98 (41.2%). During the follow up period of patients with ASCUS, 51 patients (52%) had benign/reactive lesions, 43 patients (43.9%) were diagnosed as having a SQUAMOUS intraepithelial lesion (SIL), 2 (2.1%) specimen were insufficient and finally two cases (2%) proved to be invasive cervical carcinoma on histology. Of cases diagnosed as SIL, 22 (22.4%) were interpreted as flat condyloma, 9(9.1%) cervical intraepithelial neoplasia (CIN) 1, 2 (2.1%) CIN 1-2, 3 (3.1%) high grade SIL, 6 (6.1%)basal cell abnormality of UNDETERMINED SIGNIFICANCE, and 1 (1%) had features of CIN 1 in presence of severe inflammation. Patients whose smears fall into the category of ASCUS may exhibit a spectrum of findings, ranging from benign/reactive lesions to frequent SIL and rarely to invasive carcinoma. Therefore, patients with a diagnosis of ASCUS justify careful follow-up and investigation.

Background: In recent years, human papillomavirus (HPV) test has been approved in triage of women with ATYPICAL SQUAMOUS CELLS of UNDETERMINED SIGNIFICANCE (ASCUS). However, due to the low prevalence of cervical cancer, high costs and limited access to test, the effectiveness of this test in our country is ambiguous. Methods: In a diagnostic accuracy study, 245 women who were diagnosed as ASCUS in cervical cytology based on Bethesda 2001 criteria, were then assessed with colposcopy. Cervical biopsy was taken when needed. They were classified according to the results to high risk [Cervical Intraepithelial Neoplasia (CIN) > 2] or normal. Cobas® HPV Test was conducted for participants. Considering the colposcopy-biopsy as the golden standard, the performance of the HPV test was determined for detecting precancerous lesions. Findings: 24 patients had CIN1, 10 patients CIN ≥ 2, and 4 patients had CIN ≥ 3. The sensitivity and specificity of the HPV test was 80% and 77%, respectively. Positive predictive value (PPV) and negative predictive value (NPV) was 12. 9% and 98. 9%, respectively. Conclusion: Considering the low prevalence of high-risk lesions in this series of women with ASCUS cytology, and the high NPV of the HPV test, it seems that its application can be helpful in the initial triage of patients with this pathology. In other words, the negative result of this test provides sufficient assurance that there are no precancerous or cancerous lesions.

Background and Objective: Microscopic evaluation of cervicovaginal smears (Pap smear) plays an essential role in detection of preneoplastic and neoplastic lesions of uterine cervix. A wide spectrum of changes is seen in Pap smears. Interpretation of intermediate changes which resulting in observation of so- called ASCUS is difficult. ASCUS is defined as a cellular change that is more marked than typical reactive change but lack features diagnostic of intraepithelial neoplasia. The aim of this study was determination of reliable cytological parameters to identifying real nature of ASCUS.Patients and Methods: In this descriptive, cross sectional study, all Pap smears with presence of ASCUS, which followed by biopsy samples in Urmia, Shahid Matahari hospital during March 1999 to December 2002 were reviewed. In this regard, 17 parameters of cytoplasm, nuclei and smear background were considered and data were analyzed by SPSS and Chi Square test.Results: Four parameters of irregular nuclear contour, increased nucleo- cytoplasmic ratio, cytoplasmic vacuolization and dirty background are highly suggestive of dysplasia.Conclusion: It is important to consider that to find out the real nature of ASCUS a group of parameters are more helpful than a single one. In addition, a single Pap smear is not enough for this purpose and further investigation is required.

Introduction: Microscopic evaluation of cervicovaginal smears (Pap smear) plays an essential role in detection of the preneoplastic and neoplastic lesions of uterine cervix. A wide spectrum of changes are seen in Pap smears. Interpretation of intermediate changes which resulting in observation of so-called ASCUS is difficult. ASCUS is defined as a cellular change that is more marked than typical reactive change but lack features diagnostic of intraepithelial neoplasia. Different studies revealed that in 30%-40% of cases with ASCUS in Pap smear, dysplasia was seen in biopsy sample.The aim of this study was determination of reliable cytologic parameters to identifying real nature of ASCUS.Methods: In this near 4 years investigation, all Pap smears with presence of ASCUS which followed by biopsy samples were reviewed. In this regard 17 parameters of cytoplasm, nuclei and smear background were considered and the datas analysed by SPSS and Chi Square test.Results: After statistical evaluation, we found that 4 parameters of irregular nuclear contour, increased nucleo-cytoplasmic ratio, cytoplasmic vacuolization and dirty background are highly suggestive of dysplasia.Discussion: It is important to consider that to find out the real nature of ASCUS a group of parameters are more helpful than a single one. Also, a single Pap smear is not enough for this purpose and further investigation is required.

Introduction. Detection of ASCUS (ATYPICAL SQUAMOUS cell of UNDETERMINED SIGNIFICANCE) in smears is difficult and can reported as a false result. Sometimes ASCUS changes equivalented with dysplasia. In our oponion in women with cytologic diagnosis of ASCUS, infectious pathogens are related with changes. The purpose of this study is comparison of infectious pathogens in women with cytologic diagnosis of ASCUS and reactive changes.Methods. This descriptive-analytical study carried out in Alzahra Hospital of Isfahan during the period 1996-2001. This was performed on 1095 cervicovaginal smears.58 smears with ASCUS and 580 with reactive changes were selected. The data were analyzed with chi square and t-test.Results. Frequency of cervical pathogens in smears with ASCUS and Reactive changes were 280 (48.3%) and 170 (29.3%) respectively. The difference between them is significant (P<0.005). Frequency of Trichomonas vaginalis in smears with ASCUS and reactive changes were 27.5% and 1.03% respectively. The difference between them was significant (P=0.001). Frequency of Herpes simplex virus in smear with ASCUS and reactive changes were 1.7% and 0% respectively. The difference between them was significant (P=0.002). There is no significant differences with other pathogens. Discussion. The prevalence of organism in smears with ASCUS is more than reactive. The prevalence of Herpes and Trichomonas pathogens in smears with ASCUS are higher than reactive. Considering the significant difference between frequency of cervical pathogens in ASCUS and reactive changes were determined necessity pay attention to infectious pathogens in ASCUS changes.

Lactation length is different in individual cows, which is generally converted to a 305-day standard using curve fitting models for genetic and management practices. Individual curves do not have a standard shape in all cases, and can deviate from the standard pattern according to factors such as individual differences, and type of fitted models. These non-standard curves, called ATYPICAL, resulted from incorrect estimated parameters of the curves; which consist of: continuously increasing or decreasing and reversed standards. This study was conducted to investigate the importance of ATYPICAL curves in estimation of 305-day milk production, by fitting two nonlinear models? Wood (empirical) and Pollott (biological), on 7659 and 6692 test-day milk yield of 977 and 776 first calving Iranian Simmental and Jersey cows, during 2007-2020, using R software. Different patterns obtained based on the combination of increasing (b) and decreasing (c) phase parameters of curves. The number of standard curves from the Pollott and Wood models were 85.5% and 62.2% for Simmental, and 83.1% and 70.6% for Jersey cows, respectively. Only continuously increasing curves were observed in both breeds in Pollott model (14.8% and 16.9%, Simmental and Jersey cows, respectively); Whereas in Wood model, all 3 groups of ATYPICAL curves were observed, which the reversed standard was the most (22.3% and 16.5%, Simmental and Jersey cows, respectively). Based on the findings, at the time of standardizing the production of dairy cows (national evaluations), not only differences between breeds, but also special attention to the production of ATYPICAL curves, should be paid (to correct or discard them).