The Dimension of Trichomonas vaginalis as Measured by Scanning Electron Microscopy

It is known that physicochemical conditions (e.g., pH, temperature, and ionic strength) affect the size of trichomonads. In this study, the sizes of 4 isolates of Trichomonas vaginalis cultured for more than a year (called "old T") and 3 isolates freshly isolated from vaginitis cases (called "fresh T") were compared by scanning electron microscopy. Although the fresh T had shorter body length, body width, and flagellar length than old T, total length (about 26 microm), including body length, flagella length, and axostyle length was almost the same in the 2 groups. A striking difference was observed between the axostyles of the 2 groups; the axostyle length of the fresh T (8.2 microm) was more than twice as long as that of the old T (4.0 microm). However, in several parasitology textbooks, the length of T. vaginalis is said to vary widely from 7 to 32 microm, and its undulating membrane is said to extend about half way (53.5%) to the posterior end of the body. On the other hand, in our study, the undulating membrane was observed to extend more than 3/4 of the body length (72.1%) in old T, whereas in fresh T it could not be measured. Taken together, we suggest that T. vaginalis averages 26 (21-32) microm in total length, with 9.5 (7.4-11.4) microm of body length and 6.8 (5.3-7.7) microm of width, and its undulating membrane extending 3/4 of its body length. Therefore, these findings may provide useful information for morphological characteristics of T. vaginalis.

Study for the clinical efficacy of laparoscopic myomectomy / 대한산부인과학회지

OBJECTIVE: The objective of this study is to evaluate the safety and the clinical efficacy of the laparoscopic myomectomy through analyzing several operation factors. METHODS: There were 185 cases of laparoscopic myomectomy between January 2004 and December 2008 at the department of obstetrics and gynecology in Hanyang University Guri Hospital. Retrospectively many factors of the operation were analyzed. The factors include the size, number and type of the myoma, BMI (body mass index), operation method, operation time, and complication and the prognosis of the operation. RESULTS: For the type of myomas, 115 (62.2%) cases were intramural myomas, 38 (20.5%) cases were subserosal types and 32 (17.3%) cases were mixed types. The average diameter of the biggest myoma was 6.67+/-0.16 cm (range, 2.5~15 cm) and the average number of the myoma was 2.07+/-0.15 (range, 1~15). Previous operation history and pelvic adhesion did not show correlation with the operation time. The size, type and number of myoma and the operation methods showed correlation with the operation time. According to myoma size and number, we divided the cases into two groups, low risk group (122 cases) and high risk group (63 cases). The analysis showed that post-operation hemoglobin drop (2.89+/-0.10 g/dL vs. 4.03+/-0.23 g/dL) and blood transfusion amount (2.89+/-0.10 pints vs. 4.03+/-0.23 pints) as well as the operation time (137.58+/-4.37 min vs. 193.73+/-9.88 min) showed noticeable increase in the high risk group. CONCLUSION: This statistics show that laparoscopic myomectomy is now being applied to patients with larger and more myomas. Factors affecting operation time were the weight of myomas, number of myomas, type of myomas, number of trocars and methods of resected myomas removal. Also, operation time and post-operative hemoglobin drop increased in the high risk group.

Management of Post-lobectomy Bronchopleural: Cutaneous Fistula with a Rectus Abdominis Free Flap

PURPOSE: The repair of complex chest wall defects presents a challenging problem for the reconstructive surgeon. In particular, a free flap is often required when the defect is large, in which case suitable recipient vessels must be found to insure revascularization. The authors report a case of persistent bronchopleural-cutaneous fistula developed after undergoing lobectomy for lung cancer. METHODS: The defect area was repaired using a free vertical rectus abdominis muscle flap revascularized by microvascular anastomosis to the 6th intercostal pedicle. The flap obliterated the right chest cavity, closed the site of empyema drainage, and aided healing of a bronchopleuralcutaneous fistula. RESULTS: The patient has remained healed for 14 months without any postoperative complications or recurrent infection or fistula. CONCLUSION: We suggest that a rectus abdominis musculocutaneus free flap and intercostal pedicle as a recipient could be a useful method for repair of chest defects.

A case of one fetal demise of twin pregnancy by umbilical artery stricture / 대한주산의학회잡지

A death of one fetus in twin pregnancy is a rare obstetric complication. And the stenosis of umbilical cord artery is a very rare complication of cord abnormalities. The umbilical cord showed a false knot due to accentuation of a vascular spiral with a dilated vein and two arteries with incomplete patency of the lumen. This is the first report of single demise of twin pregnancy due to umbilical artery stenosis and umbilical vein varix.

Vesicovaginal fistula repaired by laparoscopic surgery: A case report / 대한산부인과학회지

Vesicovaginal fistula may be a complication of gynecologic and obstetric procedures, of which abdominal hysterectomy remains as the most common cause. Although there are a number of transvaginal or transabdominal surgical techniques for the correction of this condition, we performed a laparoscopic repair to reduce the morbidity of the transabdominal approach. A 44-year-old woman presented with urinary incontinence after undergoing Cesarean hysterectomy for uterine atony eight years ago. After confirming her vesicovaginal fistula, laparoscopic repair was performed. The bladder and vaginal walls were mobilized by meticulous dissection and repaired by intracorporeal stitches in 2 layers followed by omental interposition. Total operative time was 3 and half hours and estimated blood loss was about 400 ml. Foley catheter was removed at 23rd day after operation. Patient was discharged at 26th day after confirming the complete correction of the fistula by cystogram. Laparoscopic repair of a vesicovaginal fistula appears to be a safe and effective procedure. We report this case with a brief review of literature.

A case of huge Gastrointestinal stromal tumor masquerading as an ovarian malignancy / 대한산부인과학회지

Gastrointestinal stromal tumors are common mesenchymal tumors of the gastrointestinal tract. But represent only less than 3% of gastrointestinal malignant neoplasm. Stomach is most common site of localization, followed by the small intestine, other parts of the GI tract, and the omentum. These tumors occasionally misdiagnosed as gynecological tumors. We report a case of gastrointestinal stromal tumor (CD117 positive and CD34 negative) giving an impression of ovarian malignancy with a brief review of the literatures.