OBJECTIVE: To compare the clinical results between laparoscopically assisted vaginal hysterectomy (LAVH) and total laparoscopic hysterectomy (TLH), and to realize the merits and demerits of both operations, so we know which pelviscopic hysterectomy operation is better method at the present time. METHODS: 30 of LAVH cases and 30 of TLH cases were performed from 12 December 2002 to 25 February 2004 at department of OB and GY, Dankook University Hospital. We analyzed the results with regard to patient's characteristics, indication of hysterectomy, size of uterus, operation time, blood loss, duration of hospitalization and complications. RESULTS: LAVH operations, and TLH operations were performed by same operator respectively. There were no significant differences in patient's characteristics (age, height, weight) between the two groups. The main preoperative indication was myoma uteri in both groups, followed by CINIII in LAVH groups and adenomyosis in TLH groups. The majority of uterine size on operation field was adult fist size in both groups. The mean operation time was 86.3 +/- 19.5 min for LAVH group and 153.3 +/- 44.4 min for TLH group, the operation time is significantly longer in TLH group (P-value<0.05). The blood loss was not significantly different between the two groups (265 +/- 92.9 mL for LAVH, 268 +/- 119.2 mL for TLH, P-value>0.05). The duration of hospitalization was not significantly different between the two groups (6.1 +/- 0.4 days for LAVH, 6.2 +/- 0.8 days for TLH, P-value>0.05). There is no complication in LAVH group, 3 complications in TLH group. CONCLUSION: LAVH has no significant differences in patient's characteristics, indication of operation, size of uterus, blood loss and duration of hospitalization, compared with TLH, but it has the merits of short operation time and less complication. In this study we consider that LAVH operation method stands at advantage over TLH.
Adenomyosis ; Adult ; Female ; Hospitalization ; Humans ; Hysterectomy* ; Hysterectomy, Vaginal* ; Myoma ; Uterus

Uterus didelphys with unilateral obstructed hemivagina is indeed a very rare congenital anomaly due to M llerian duct malformation. The most common clinical presentation is pelvic pain and dysmenorrhea shortly after menarche, in associated with the finding of a vaginal or pelvic mass. An accurate and prompt diagnosis is of importance to permit treatment and to assure the future fertility of the patient. The simple and adequate treatment of the condition is incision of the obstructed vaginal septum providing adequate drainage of the retained blood. We report a case of uterus didelphys with obstructed hemivagina with brief review of the literature.
Diagnosis ; Drainage ; Dysmenorrhea ; Female ; Fertility ; Humans ; Menarche ; Pelvic Pain ; Uterus*

Cornual pregnancy, which is a rare form of ectopic pregnancy, is an implantation of embryo in the intramural portion of a fallopian tubes. The incidence of cornual pregnancy is reported to be between 2-4% of all tubal pregnancy, about 1% of ectopic pregnancy, and occurs once for every 2,500 to 5,000 live births. Because the greater distensibility and vascularlity of this site lead to rupture at a latter gestational age and rapid intraperitoneal hemorrhage, cornual pregnancy causes serious maternal mortality and morbidity. Intraligamentary pregnancy, also a form of ectopic pregnancy, is one of the most unusual accident so that the diagnosis of intraligamentary pregnancy is hardly ever made prior to laparotomy. The incidence of intraligamentary pregnancy is reported to be about once for every 245 all ectopic pregnancy, and about once for every 49,000 to 184,000 all pregnancy. We have experienced an extremely rare case of right cornual pregnancy complicated with right intraligamentary pregnancy which was proven by histopathologic diagnoses in a 34-year-old woman and report it with review of literatures.
Adult ; Diagnosis ; Embryonic Structures ; Fallopian Tubes ; Female ; Gestational Age ; Hemorrhage ; Humans ; Incidence ; Laparotomy ; Live Birth ; Maternal Mortality ; Pregnancy* ; Pregnancy, Ectopic ; Pregnancy, Tubal ; Rupture

Heterotopic pregnancy, simultaneous intrauterine and extrauterine gestations, is a relatively rare condition with an estimated incidence of 1 in 30,000 pregnancies. The incidence of heterotopic pregnancies have increased in recent years because of rising incidence of pelvic inflammatory disease, pelvic surgery, expanding use of assisted reproductive technology. Common sites of extrauterine gestation are salpinx, cornus and cervix of uterus, ovary, and abdomen in order of incidence. Early detection of heterotopic pregnancy is very difficult and is often more difficult in the case of abdominal pregnancy. However, to avoid high maternal morbidity, mortality, and loss of pregnancy, one should always take this into consideration and should conduct careful and thorough gynecologic evaluations. We have experienced a case of abdominal pregnancy following termination of intrauterine pregnancy in a 23-year-old unmarried woman and report it with brief review of literatures.
Abdomen ; Cervix Uteri ; Cornus ; Fallopian Tubes ; Female ; Humans ; Incidence ; Mortality ; Ovary ; Pelvic Inflammatory Disease ; Pregnancy ; Pregnancy, Abdominal ; Pregnancy, Heterotopic* ; Reproductive Techniques, Assisted ; Single Person ; Uterus ; Young Adult

Background: and Purpose: In this study we aimed to find the association between neuropsychological performance and body mass index (BMI) in patients with mild cognitive impairment (MCI). In addition, we investigated the effects of the apolipoprotein E (APOE) genotype in the relationship between the BMI and cognition in MCI. Methods: We enrolled a cohort of 3,038 subjects with MCI aged 65–90 from the Clinical Research Center for Dementia of South Korea and a dementia cohort of the Ewha Womans University Mokdong Hospital. MCI patients were classified into three subgroups according to the Asian standard of BMI. We compared cognitive performances between groups by one-way analysis of variance. To investigate the effects of the APOE genotype, we used multivariate linear regression models after adjusting for possible confounders. Results: Even though normal BMI groups were younger, had more females, and had less comorbidities, the higher BMI groups had better cognitive functions. Among subjects with APOE ε4 carriers, there was a positive relationship between the BMI and the memory task alone. Conclusions Our findings suggested that higher BMI in patients with MCI were associated with better cognitive performance. The effects of the APOE ε4 genotype in the associations between BMI and cognition were distinguishing. Therefore, according to physical status, APOE ε4 genotype-specific strategies in the assessments and treatments may be necessary in elderly patients with MCI.