Radical vulvectomy and lymphadenectomy at Srinagarind Hospital.

Vulvar carcinoma, although rare, is difficult to manage. We conducted a study to describe the management in our hospital. From 1978 to 1991, 69 patients with primary carcinoma of the vulva were treated at Srinagarind Hospital, Faculty of Medicine, Khon Kaen University. Forty-two patients underwent radical vulvectomy and lymphadenectomy. The data presented the techniques, surgical events and outcome of the operations. The 5 and 10-yr survival rates for the operable cses were 88.5 per cent and only 22 per cent for those who were non-operable. Surgery is still the recommended primary treatment for this rare malignancy of the female genital tract.

Post-cesarean section puerperal morbidity. The incidence and risk factors at Srinagarind Hospital.

We found that the incidence of post-cesarean puerperal morbidity at Srinagarind Hospital, Khon Kaen University was 5.5 per cent, which is very low compared to other reports. Statistically significant risk factors for post-cesarean puerperal morbidity included having less than 4 antenatal care visits, duration of labour longer than 12 hours and absence of prophylactic antibiotics.

Febrile and infectious morbidity after abdominal hysterectomy at Srinagarind Hospital.

Two hundred and fifty-seven patients who had undergone total abdominal hysterectomy (TAH) in a rural University Hospital in Thailand between September, 1989 and May, 1990 were found to have an incidence of postoperative febrile and infectious morbidity of 35.4 per cent and 10.1 per cent respectively. The risk factors for febrile morbidity are administration of prophylactic antibiotics, a resident being the surgeon and duration of operation time of more than 120 minutes. The risk factors for infectious morbidity included history of previous surgery, performing TAH alone without adnexectomy and omentectomy and also operation time longer than 120 minutes.

Cass scores as a preoperative prediction for recurrences of cervical cancer after radical hysterectomy and pelvic lymphadenectomy at Srinagarind Hospital.

Risk factors for recurrence after radical hysterectomy and pelvic lymphadenectomy at Srinagarind Hospital was studied from 218 patients operated between 1976 to June 30, 1988. Four preoperative risk factors i.e., cell types, age, stages and size of the lesions were computed and cross-tabulated with the recurrence rate from the data of the whole patients. The correlation was found to be statistical significant. This scoring system should be called from the first letter of the factor as 'CASS' and used for selection of the patients for radical hysterectomy and pelvic lymphadenectomy.

Risk factors for survival in patients performed radical hysterectomy for cervical carcinoma.

Risk factors for survival were analyzed for 208 women diagnosed with invasive cervical cancer at Srinagarind hospital, Faculty of Medicine, Khon Kaen University between January 1, 1976 and December 31, 1987. All underwent radical hysterectomy and pelvic lymphadenectomy. The clinical data, operative data, histology, complications and follow-up profiles were analyzed by cross-tabulation and chi-square test. The main significant factors were analyzed for survival functions by the Cutler-Ederer method with Breslow and Mantel-Cox tests. Recurrences of the disease, FIGO stages, sizes and types of the lesions, histology, lengths of the uterus and modes of removal of left ovaries were all significant risk factors. The first five factors have been mentioned in previous literature but the latter two were not and need further investigation.

A rapid detection of herpes simplex virus by ELISA in asymptomatic pregnant women and neonates.

Herpes simplex virus (HSV) was detected by the enzyme-linked immunosorbent assay (ELISA). The assay system employed rabbit anti-HSV-2-coated microplates to detect HSV in clinical specimens and the same reagent labelled with peroxidase as a conjugate. The HSV type 2 obtained from vero cell culture and normal cell lysate (NCL) were used as positive and negative reference antigens respectively. HSV was detected in 40 (9.93%) of vaginal swabs obtained from 403 pregnant women just before the deliveries and in 39 (9.68%) fluid samples collected immediately after birth from the mouths of 403 newborns. HSV was detected in five pairs of mother-newborn under investigation. There was no correlation between the incidence of HSV in mothers and newborns (p greater than 0.05).