BACKGROUND Rhabdomyosarcoma(RMS)of the vagina in postmenopausal women is an extre-mely rare malignant tumor that was originally described as a unique group of soft tissue sarcomas originating from primitive mesenchyma...BACKGROUND Rhabdomyosarcoma(RMS)of the vagina in postmenopausal women is an extre-mely rare malignant tumor that was originally described as a unique group of soft tissue sarcomas originating from primitive mesenchymal cells.It was first re-ported in postmenopausal women in 1970,and fewer than 50 postmenopausal patients have been reported to date.CASE SUMMARY A 68-year-old multiparous female was admitted to the hospital on October 11,2023,with the chief complaint of a mass causing vaginal prolapse with incomplete urination that had persisted for 4 months.The vaginal mass was approximately the size of a pigeon egg;after lying down,the vaginal mass retracted.Complete resection was performed,and vaginal pleomorphic RMS was diagnosed based on pathology and immunohistochemical staining features.The patient is currently undergoing chemotherapy.The present study also reviewed the clinical,histolo-gical,and immunohistochemical features and latest treatment recommendations for vaginal RMS.Any abnormal vaginal mass should be promptly investigated through pelvic examination and appropriate imaging.The current initial treat-ment for vaginal RMS is biopsy and primary chemotherapy.CONCLUSION When surgery is planned for vaginal RMS,an organ-preserving approach should be considered.展开更多
AIM: To explore the relationship between metastasis and vagina vasorum in the progress of gastric carcinoma and to find some facts and references for gastric surgeons. METHODS: One hundred and seven specimens of left ...AIM: To explore the relationship between metastasis and vagina vasorum in the progress of gastric carcinoma and to find some facts and references for gastric surgeons. METHODS: One hundred and seven specimens of left or right gastric arteries (55 left and 52 right) were gathered from 59 patients undergoing radical gastrectomy for gastric carcinoma. All the frozen specimens were cut into 3 μm-thick sections and stained with hematoxylin-eosin (HE) and immunohistochemical method separately. Cytokeratin (CK) and mesothelial cells (MC) were stained with immunohistochemical method. Cancer cells inside vagina vasorum were detected and the structure of artery wall was observed under microscope. RESULTS: Metastatic cancer cells or tubercles were found inside vagina vasorum in some stage Ⅲ or Ⅳ specimens, but not in stageⅠor Ⅱ specimens. Tumor cells in vagina vasorum were CK positive in 26 specimens of 14 tumors. Among them, stage Ⅲ was found in 4 specimens of 2 tumors, and stage Ⅳ in 22 specimens of 12 tumors. None of these specimens was positive for MC. The positive rate of CK increased with TNM staging. Compared with the lower part, tumors in the upper and middle parts of stomach were more likely to metastasize into vagina vasorum. CONCLUSION: Vagina vasorum dissection should be performed during D2 lymphadenectomy for TNM stage Ⅲ or Ⅳ gastric carcinoma.展开更多
Gastrointestinal(GI)stromal tumor is the most common mesenchymal neoplasm of the GI tract but also occurs with a lower frequency in extragastrointestinal regions and is called extragastrointestinal stromal tumor(EGIST...Gastrointestinal(GI)stromal tumor is the most common mesenchymal neoplasm of the GI tract but also occurs with a lower frequency in extragastrointestinal regions and is called extragastrointestinal stromal tumor(EGIST).We report an unusual case of EGIST presenting as a vaginal mass.A 41-year-old woman presented with a gradually enlarging vaginal mass for the last2 years.Physical examination revealed an elliptical,non-tender mass about 7.5 cm×7 cm in size in the posterior vaginal wall and was resected completely.Under histological examination,the tumor showed a spindle cell type with coagulation necrosis,hemorrhage and high mitotic count.Immunohistochemical analysis revealed tumor cells were positive for DOG1,CD117,CD34 and p53 protein.Ki-67 labeling was 8%.Genetic analysis showed a deletion of exon 11 of the c-kit gene at codons 557-558.EGISTs should be kept in mind in the differential diagnosis in patients presenting with solid mass of the vaginal wall.展开更多
South African indigenous bucks are raised under extensive conditions and are more likely to reject artificial vagina (AV) due to their limited contact with human beings, as they are less handled. The purpose of the st...South African indigenous bucks are raised under extensive conditions and are more likely to reject artificial vagina (AV) due to their limited contact with human beings, as they are less handled. The purpose of the study was to compare goat semen collection techniques used for goats based on semen traits of South African indigenous bucks during the natural breeding season. A total of eight South African indigenous bucks were used, four bucks per semen collection technique due to their scarcity. Before semen collection with AV group, ten bucks were trained and exposed to AV. Semen was then collected from both groups over a period of six weeks per individual buck. Semen volume, pH and sperm concentration were evaluated immediately. The Computer Aided Sperm Analysis (CASA) assessed the sperm motility rates. Sperm morphology was evaluated using a fluorescence microscope with the aid of eosin-nigrosin staining. Analysis of variance was used to test the differences among the semen collection groups following assessment by CASA. Semen collected with EE resulted in higher semen volume (1.1 mL) compared with AV (0.5 mL) technique. However, AV technique resulted in higher total sperm motility and rapid movement (91.9% and 48.7%), live sperm (72%) and sperm concentration (635.6 × 106 sperm/mL) compared with EE (86.3% and 30.4%;69% and 463.7 × 106 sperm/mL, respectively). There were no significant differences observed in pH and sperm morphology characteristics between two semen collection techniques. Moreover, EE had higher sperm moving in a progressive (53.6%) and medium rate compared with AV (41.1% and 21.9%) technique. It was concluded that the AV yielded higher total sperm motility rate, sperm concentration and rapid sperm movement compared with EE. Therefore, AV was more suitable for semen collection of South African indigenous bucks, even though training was problematic to such indigenous bucks.展开更多
With the aid of immunohistochemistry, the present review attempts to demonstrate the composite fibers and nerve topographical anatomy in the vaginal supportive tissues. Along the tendinous arch of the pelvic fasciae, ...With the aid of immunohistochemistry, the present review attempts to demonstrate the composite fibers and nerve topographical anatomy in the vaginal supportive tissues. Along the tendinous arch of the pelvic fasciae, distal parts of the pelvic plexus extend antero-inferiorly and issue nerves to the internal anal sphincter as well as the cavernous tissues. At the attachment of the levator ani muscle to the rectum, smooth muscles in the endopelvic fascia lining the levator ani merge with the longitudinal smooth muscle layer of the rectum to provide the conjoint longitudinal muscle coat or the longitudinal anal muscle (LAM: smooth muscle). However, at the rectovaginal interface, the longitudinal smooth muscle layer of the rectum continues to the LAM without any contribution of the endopelvic fascia. The bilateral masses of the perineal smooth muscles (PSMs) are connected by the perineal body, and the PSMs receive 1) the longitudinal anal muscle, 2) the internal and external anal sphincters and, 3) the perineal membrane lining the vestibular wall. Tensile stress from the levator ani seems to be transferred to the PSMs via the LAM. Because of their irregularly arrayed muscle fibers, instead of a synchronized contraction in response to nerve impulses, the PSMs are likely to act as a barrier, septum or protector against mechanical stress because, even without innervation, such smooth muscle fibers resist (not absorb) pressure, in accordance with Bayliss’ rule. The external anal sphincter, a strong striated muscle, inserts into the PSMs and seems to play a dynamic role in supporting the rectovaginal interface to maintain the antero-posterior length of the urogenital hiatus. However, we do not think that smooth muscles play an active traction role without cooperation from striated muscle. The fibrous skeleton composed of smooth muscle in the female perineum is explained in terms of a “catamaran” model.展开更多
Nine cases of vaginal primary malignant melanoma were diagnosed and treaed in Zhejiang Cancer Hospital from 1964 to 1990. The mean age of patients was 48. 6 years. Abnormal vaginal bleeding was the Incipient symptom i...Nine cases of vaginal primary malignant melanoma were diagnosed and treaed in Zhejiang Cancer Hospital from 1964 to 1990. The mean age of patients was 48. 6 years. Abnormal vaginal bleeding was the Incipient symptom in 6 patients. Five cases of malignant melanoma located in the lower one-third of the vagina. Five patients had the tumor in size larger than or equal to 4 cm In diameter. All of them were of the cauliflower-like, nodular configuration grossly. The surface of the mass demonstrated in a variable degree of black or grey- blackish in 7 patients. The htstological appearances were similar to those in the skin. Sections of 4 cases Indicated only few or no melanin under microscope. The covering epithelial changes of 3 vaginal primary malignant melanoma resembled that of malignant melanoma in situ. All sections of 9 cases showed positive reaction to S-100 protein and negative to CEA immunohistochemically. This article laid emphasis on the origin, diagnosis and treatment of this tumor, and make discussion in conjunction with the literature.展开更多
BACKGROUND Myeloid sarcoma(MS),including isolated and leukaemic MS,is an extramedullary myeloid tumour.MS can involve any anatomical site,but MS of the female genital tract is rare,with the ovaries and uterine body an...BACKGROUND Myeloid sarcoma(MS),including isolated and leukaemic MS,is an extramedullary myeloid tumour.MS can involve any anatomical site,but MS of the female genital tract is rare,with the ovaries and uterine body and cervix being the most commonly seen sites.Involvement of the vagina and vulva is extremely rare.CASE SUMMARY We report a rare case of MS with involvement of the vulva and vagina and massive infiltration of the pelvic floor.A 26-year-old woman presented with a vulvar mass,irregular vaginal bleeding and night sweats.Magnetic resonance imaging demonstrated an ill-defined,irregular vulvovaginal mass with massive involvement of the paravaginal tissue,urethra,posterior wall of the bladder,and pelvic floor.The signal and enhancement of the huge mass was homogeneous without haemorrhage or necrosis.Positron emission tomography/computed tomography showed high fluorodeoxyglucose uptake by the mass.Peripheral blood count detected blast cells.Vulvovaginal mass and bone marrow biopsies were performed,and immunohistochemistry confirmed the diagnosis of acute myeloid leukaemia(M-2 type,FAB classification)and vulvovaginal MS.The patient was treated with induction chemotherapy followed by allogeneic haematopoietic stem cell transplantation,and achieved complete remission.A systemic review of the literature on vulvovaginal MS was conducted to explore this rare entity’s clinical and radiological features.CONCLUSION Vulvovaginal MS is extremely rare.Diagnosis of vulvovaginal MS can only be confirmed histopathologically.Even though its clinical and imaging presentations are nonspecific,MS should be considered in the differential diagnosis of a newly developed T2-hyperintense,homogeneously enhanced vulvovaginal mass,especially in a patient with suspected haematological malignancy.展开更多
Objective: To investigate whether administration of genistein can improve hormonal changes [estradiol and follicle stimulating hormone (FSH)] , heat shock protein 70 (Hsp70) expression, and thickness of vaginal epithe...Objective: To investigate whether administration of genistein can improve hormonal changes [estradiol and follicle stimulating hormone (FSH)] , heat shock protein 70 (Hsp70) expression, and thickness of vaginal epithelial cells in a rat model of vaginal atrophy. Methods: Twenty-five multiparous female rats were divided into five groups, namely the control group (without ovariectomy), the ovariectomy only group, and the ovariectomy groups 1, 2 and 3 receiving genistein at the doses of 0.045, 0.090 and 0.180 mg/kg body weight/day, respectively. Estradiol, FSH, and Hsp70 expression were analyzed by using the immunoassay technique. Analysis of the thickness of the vaginal epithelium was performed by histology. Results: Ovariectomy significantly decreased estradiol levels compared to the control group (P<0.05). All doses of genistein significantly increased levels of estradiol in rats with vaginal atrophy compared to the ovariectomy only group (P<0.05). Ovariectomy significantly increased FSH levels compared to the control group (P<0.05). All three doses of genistein restored FSH levels comparable to those in the control group (P>0.05). Ovariectomy significantly increased parabasal cell Hsp70 expression compared to the control group (P<0.05). Of all the genistein doses, only the dose at 0.045 mg/kg body weight/day restored the expression of Hsp70 to levels in the control group (P>0.05). Conclusions: Genistein is able to increase the thickness of the vaginal epithelium through hormone modulation and cellular stress suppression. Genistein is beneficial in the form of a herbal or alternative food for improvement of vaginal atrophy due to menopause.展开更多
Language plays a central role in how gender and sexuality are described. In Bangla or Bengali, physicians, when educating and counseling women patients, do not have a socially acceptable word for “vagina”. If langua...Language plays a central role in how gender and sexuality are described. In Bangla or Bengali, physicians, when educating and counseling women patients, do not have a socially acceptable word for “vagina”. If language is missing for female genitalia or important female sexual functions, could this absence reflect on the position of women in society, reproductive rights, and access to healthcare? Is there a relationship between language and the high rates of the gender-based cervical and breast cancers in some low and middle-income countries? This commentary examines scholarship on the topic of language, the female body, gender-based violence, disparities of healthcare for women, and the consequences of language on sexual attitudes and health.展开更多
Introduction: Malignant melanoma (MM) represents 1% of all cancers and has an incidence of 3% - 7% in the female genital tract, the majority of cases being reported in the vulva. The cervico-vaginal region is an unsua...Introduction: Malignant melanoma (MM) represents 1% of all cancers and has an incidence of 3% - 7% in the female genital tract, the majority of cases being reported in the vulva. The cervico-vaginal region is an unsual primary location of the malignant mela-noma. Case report: The clinical and morphologic findings of 3 MM patients with cervico-vaginal tumours mimicking cervical polyp in third case. Histologically, the neoplasia was formed by nodules of broad cytoplasmic cells with poorly defined borders with pleomorphic nuclei with prominent nucleolae. Tumor cells were positive for S-100 protein, Melan A, HMB 45 and CD117. The authors discuss three cases of cervico-vaginal melanoma and analyze clinical and prognostic aspects of this disease. Conclusion: Primary MM of the cervix should be considered in the differential diagnosis of cervical malignancies. Early diagnosis is essential in order to warrant a better prognosis, although there are no cases of cure described.展开更多
Melanoma of the vagina is a rare lesion. It results from the malignant transformation of ectopic melanocytes occurring in post-menopause. The CKIT is expressed in 36% of cases in addition to melanoma markers. Prognosi...Melanoma of the vagina is a rare lesion. It results from the malignant transformation of ectopic melanocytes occurring in post-menopause. The CKIT is expressed in 36% of cases in addition to melanoma markers. Prognosis is poor especially for inoperable and disseminated forms despite systemic therapy. Treatment with Imatinib is an option in cases of metastatic mucosal melanoma with CKIT mutation or amplification. We report the case of post-menopausal women, treated at Hassan II University Hospital, diagnosed with metastatic melanoma of the vagina, that didn’t respond to first line of chemotherapy, and received Imatinib as second line of treatment, with good clinical response and durable stability at radiological assessment.展开更多
Introduction: We aim to report outcomes and predictors of outcome of transvaginal mesh (TVM) for pelvic organ prolapse (POP). We also report frequency, severity, risk factors, and management of mesh-related complicati...Introduction: We aim to report outcomes and predictors of outcome of transvaginal mesh (TVM) for pelvic organ prolapse (POP). We also report frequency, severity, risk factors, and management of mesh-related complications after TVM. Materials and methods: We performed retrospective chart review of TVM performed from 2005 to 2010. There were 67 patients followed for a mean duration of eighteen months. Complications were reported using the International Continence Society and International Urogynecological Association classification system for prosthesis/graft complication. Results: Success rate was 88% (97% for anterior repair, 100% for posterior repair and 71% for combined repair) and complications occurred in 13 patients (19%), including vaginal hematoma, pelvic pain, urinary retention, dyspareunia and vaginal mesh exposure (in 9 patients). On multivariable logistic regression, recurrence was significantly higher with combined repair (P = 0.021), overall complication was significantly associated with younger age (P = 0.019), and mesh exposure was significantly associated with age and combined repair. All mesh-related complications were vaginal exposures occurring at median of 6 months postoperatively. Two patients were managed conservatively with vaginal estrogen cream, while seven patients elected surgical excision of exposed mesh with primary re-approximation of the vaginal epithelium. There were no excision-related complications, and in no case was the defect large enough to require closure with graft or secondary material. Conclusion: Combined anterior and posterior repair using TVM is associated with failure, younger age is associated with higher rate of complication, and combined repair and younger age are associated with mesh-related complication specifically.展开更多
In the present study, eight strains were isolated from 20 cow vagina samples and identified using phenotype, biochemical analysis, sugar fermentation tests, and 16S rRNA sequence analysis. Among eight strains, only SQ...In the present study, eight strains were isolated from 20 cow vagina samples and identified using phenotype, biochemical analysis, sugar fermentation tests, and 16S rRNA sequence analysis. Among eight strains, only SQ0048 was identified as Lactobacillus johnsonii based on a series of biochemical testing (including the adhesion test, catalase test, bacteriocin production test, antibacterial test, and pH value), suggesting that its biological activity was superior to the other seven strains. Furthermore, SQ0048 had the lowest pH value (4.32) and the shortest fermentation time (8 h) compared with the other strains. The adhesion rate of SQ0048 was significantly higher than that of Lactobacillus delbrueckii, with an average adhesion number of 304 ± 2.67. The hydrogen peroxide production testing in SQ0048 was positive;in addition, bacteriocin gene of SQ0048, encoding an approximately 10-kDa product, was successfully cloned, expressed, and detected using the SDS-PAGE method. Meanwhile, SQ0048 had a weak inhibitory effect on Staphylococcus aureus and Escherichia coli. However, the expression products of the bacteriocin gene of SQ0048 had a very strong inhibitory effect on S. aureus and E. coli, with inhibition zone sizes of 18 ± 0.45 mm and 15 ± 0.60 mm, respectively. These data showed that SQ0048 has excellent antibacterial properties compared with other isolated strains and is a potential probiotic candidate to improve the health of the vaginas of cows by inhibiting pathogenic microorganisms.展开更多
This is a case report of a woman with a vaginal aggressive angiomyxoma（AAM） which is a rare benign tumor. The woman was 51-years old who had a previous cesarean section. On July 3 2006, she was admitted because of a...This is a case report of a woman with a vaginal aggressive angiomyxoma（AAM） which is a rare benign tumor. The woman was 51-years old who had a previous cesarean section. On July 3 2006, she was admitted because of an increase in vaginal excretions accompanying micturition over a period of 1 month. She had limitated activity of her left lower extremity from childhood because of inappropriate medication,展开更多
Objective To review our eoperience of vaginal reconstruction using pudendal- thigh flap.Methods In the past 4 years, 9 patients suffering from the congenital vaginal agenesis underwent vaginalreconstruction using the ...Objective To review our eoperience of vaginal reconstruction using pudendal- thigh flap.Methods In the past 4 years, 9 patients suffering from the congenital vaginal agenesis underwent vaginalreconstruction using the pudendal- thigh flaps. The modilications of the surgical technique were de-tailed. Results All patients recovered satisfactorily from surgery and have been lollowed - up for a mean of 1.5years. There were no instances of flap loss, penetration of rectum and urethra. On final examination, all patientswere recorded as having a satislactory result, complete flap take, adequate dimensions and depth of neovagina andthe external appearance of the perineum and vagina was satisfactory. All married patients reported a satisfactoryintercourse. Conclusion The result proves that neurovascular pudendal- thigh flaps provide excellent tissue forvaginal reconstruction with low complication rate and good results. This operation does not cause an ugly donorsite scar and can be completed in single stage, without need of loparotomy and postoperative daily dilation. It isbelieved that this method can serve as a reliable alternative in vaginal reconstruction, which is one of the mostchallenging subjects of plastic surgery.展开更多
文摘BACKGROUND Rhabdomyosarcoma(RMS)of the vagina in postmenopausal women is an extre-mely rare malignant tumor that was originally described as a unique group of soft tissue sarcomas originating from primitive mesenchymal cells.It was first re-ported in postmenopausal women in 1970,and fewer than 50 postmenopausal patients have been reported to date.CASE SUMMARY A 68-year-old multiparous female was admitted to the hospital on October 11,2023,with the chief complaint of a mass causing vaginal prolapse with incomplete urination that had persisted for 4 months.The vaginal mass was approximately the size of a pigeon egg;after lying down,the vaginal mass retracted.Complete resection was performed,and vaginal pleomorphic RMS was diagnosed based on pathology and immunohistochemical staining features.The patient is currently undergoing chemotherapy.The present study also reviewed the clinical,histolo-gical,and immunohistochemical features and latest treatment recommendations for vaginal RMS.Any abnormal vaginal mass should be promptly investigated through pelvic examination and appropriate imaging.The current initial treat-ment for vaginal RMS is biopsy and primary chemotherapy.CONCLUSION When surgery is planned for vaginal RMS,an organ-preserving approach should be considered.
文摘AIM: To explore the relationship between metastasis and vagina vasorum in the progress of gastric carcinoma and to find some facts and references for gastric surgeons. METHODS: One hundred and seven specimens of left or right gastric arteries (55 left and 52 right) were gathered from 59 patients undergoing radical gastrectomy for gastric carcinoma. All the frozen specimens were cut into 3 μm-thick sections and stained with hematoxylin-eosin (HE) and immunohistochemical method separately. Cytokeratin (CK) and mesothelial cells (MC) were stained with immunohistochemical method. Cancer cells inside vagina vasorum were detected and the structure of artery wall was observed under microscope. RESULTS: Metastatic cancer cells or tubercles were found inside vagina vasorum in some stage Ⅲ or Ⅳ specimens, but not in stageⅠor Ⅱ specimens. Tumor cells in vagina vasorum were CK positive in 26 specimens of 14 tumors. Among them, stage Ⅲ was found in 4 specimens of 2 tumors, and stage Ⅳ in 22 specimens of 12 tumors. None of these specimens was positive for MC. The positive rate of CK increased with TNM staging. Compared with the lower part, tumors in the upper and middle parts of stomach were more likely to metastasize into vagina vasorum. CONCLUSION: Vagina vasorum dissection should be performed during D2 lymphadenectomy for TNM stage Ⅲ or Ⅳ gastric carcinoma.
文摘Gastrointestinal(GI)stromal tumor is the most common mesenchymal neoplasm of the GI tract but also occurs with a lower frequency in extragastrointestinal regions and is called extragastrointestinal stromal tumor(EGIST).We report an unusual case of EGIST presenting as a vaginal mass.A 41-year-old woman presented with a gradually enlarging vaginal mass for the last2 years.Physical examination revealed an elliptical,non-tender mass about 7.5 cm×7 cm in size in the posterior vaginal wall and was resected completely.Under histological examination,the tumor showed a spindle cell type with coagulation necrosis,hemorrhage and high mitotic count.Immunohistochemical analysis revealed tumor cells were positive for DOG1,CD117,CD34 and p53 protein.Ki-67 labeling was 8%.Genetic analysis showed a deletion of exon 11 of the c-kit gene at codons 557-558.EGISTs should be kept in mind in the differential diagnosis in patients presenting with solid mass of the vaginal wall.
文摘South African indigenous bucks are raised under extensive conditions and are more likely to reject artificial vagina (AV) due to their limited contact with human beings, as they are less handled. The purpose of the study was to compare goat semen collection techniques used for goats based on semen traits of South African indigenous bucks during the natural breeding season. A total of eight South African indigenous bucks were used, four bucks per semen collection technique due to their scarcity. Before semen collection with AV group, ten bucks were trained and exposed to AV. Semen was then collected from both groups over a period of six weeks per individual buck. Semen volume, pH and sperm concentration were evaluated immediately. The Computer Aided Sperm Analysis (CASA) assessed the sperm motility rates. Sperm morphology was evaluated using a fluorescence microscope with the aid of eosin-nigrosin staining. Analysis of variance was used to test the differences among the semen collection groups following assessment by CASA. Semen collected with EE resulted in higher semen volume (1.1 mL) compared with AV (0.5 mL) technique. However, AV technique resulted in higher total sperm motility and rapid movement (91.9% and 48.7%), live sperm (72%) and sperm concentration (635.6 × 106 sperm/mL) compared with EE (86.3% and 30.4%;69% and 463.7 × 106 sperm/mL, respectively). There were no significant differences observed in pH and sperm morphology characteristics between two semen collection techniques. Moreover, EE had higher sperm moving in a progressive (53.6%) and medium rate compared with AV (41.1% and 21.9%) technique. It was concluded that the AV yielded higher total sperm motility rate, sperm concentration and rapid sperm movement compared with EE. Therefore, AV was more suitable for semen collection of South African indigenous bucks, even though training was problematic to such indigenous bucks.
文摘With the aid of immunohistochemistry, the present review attempts to demonstrate the composite fibers and nerve topographical anatomy in the vaginal supportive tissues. Along the tendinous arch of the pelvic fasciae, distal parts of the pelvic plexus extend antero-inferiorly and issue nerves to the internal anal sphincter as well as the cavernous tissues. At the attachment of the levator ani muscle to the rectum, smooth muscles in the endopelvic fascia lining the levator ani merge with the longitudinal smooth muscle layer of the rectum to provide the conjoint longitudinal muscle coat or the longitudinal anal muscle (LAM: smooth muscle). However, at the rectovaginal interface, the longitudinal smooth muscle layer of the rectum continues to the LAM without any contribution of the endopelvic fascia. The bilateral masses of the perineal smooth muscles (PSMs) are connected by the perineal body, and the PSMs receive 1) the longitudinal anal muscle, 2) the internal and external anal sphincters and, 3) the perineal membrane lining the vestibular wall. Tensile stress from the levator ani seems to be transferred to the PSMs via the LAM. Because of their irregularly arrayed muscle fibers, instead of a synchronized contraction in response to nerve impulses, the PSMs are likely to act as a barrier, septum or protector against mechanical stress because, even without innervation, such smooth muscle fibers resist (not absorb) pressure, in accordance with Bayliss’ rule. The external anal sphincter, a strong striated muscle, inserts into the PSMs and seems to play a dynamic role in supporting the rectovaginal interface to maintain the antero-posterior length of the urogenital hiatus. However, we do not think that smooth muscles play an active traction role without cooperation from striated muscle. The fibrous skeleton composed of smooth muscle in the female perineum is explained in terms of a “catamaran” model.
文摘Nine cases of vaginal primary malignant melanoma were diagnosed and treaed in Zhejiang Cancer Hospital from 1964 to 1990. The mean age of patients was 48. 6 years. Abnormal vaginal bleeding was the Incipient symptom in 6 patients. Five cases of malignant melanoma located in the lower one-third of the vagina. Five patients had the tumor in size larger than or equal to 4 cm In diameter. All of them were of the cauliflower-like, nodular configuration grossly. The surface of the mass demonstrated in a variable degree of black or grey- blackish in 7 patients. The htstological appearances were similar to those in the skin. Sections of 4 cases Indicated only few or no melanin under microscope. The covering epithelial changes of 3 vaginal primary malignant melanoma resembled that of malignant melanoma in situ. All sections of 9 cases showed positive reaction to S-100 protein and negative to CEA immunohistochemically. This article laid emphasis on the origin, diagnosis and treatment of this tumor, and make discussion in conjunction with the literature.
文摘BACKGROUND Myeloid sarcoma(MS),including isolated and leukaemic MS,is an extramedullary myeloid tumour.MS can involve any anatomical site,but MS of the female genital tract is rare,with the ovaries and uterine body and cervix being the most commonly seen sites.Involvement of the vagina and vulva is extremely rare.CASE SUMMARY We report a rare case of MS with involvement of the vulva and vagina and massive infiltration of the pelvic floor.A 26-year-old woman presented with a vulvar mass,irregular vaginal bleeding and night sweats.Magnetic resonance imaging demonstrated an ill-defined,irregular vulvovaginal mass with massive involvement of the paravaginal tissue,urethra,posterior wall of the bladder,and pelvic floor.The signal and enhancement of the huge mass was homogeneous without haemorrhage or necrosis.Positron emission tomography/computed tomography showed high fluorodeoxyglucose uptake by the mass.Peripheral blood count detected blast cells.Vulvovaginal mass and bone marrow biopsies were performed,and immunohistochemistry confirmed the diagnosis of acute myeloid leukaemia(M-2 type,FAB classification)and vulvovaginal MS.The patient was treated with induction chemotherapy followed by allogeneic haematopoietic stem cell transplantation,and achieved complete remission.A systemic review of the literature on vulvovaginal MS was conducted to explore this rare entity’s clinical and radiological features.CONCLUSION Vulvovaginal MS is extremely rare.Diagnosis of vulvovaginal MS can only be confirmed histopathologically.Even though its clinical and imaging presentations are nonspecific,MS should be considered in the differential diagnosis of a newly developed T2-hyperintense,homogeneously enhanced vulvovaginal mass,especially in a patient with suspected haematological malignancy.
文摘Objective: To investigate whether administration of genistein can improve hormonal changes [estradiol and follicle stimulating hormone (FSH)] , heat shock protein 70 (Hsp70) expression, and thickness of vaginal epithelial cells in a rat model of vaginal atrophy. Methods: Twenty-five multiparous female rats were divided into five groups, namely the control group (without ovariectomy), the ovariectomy only group, and the ovariectomy groups 1, 2 and 3 receiving genistein at the doses of 0.045, 0.090 and 0.180 mg/kg body weight/day, respectively. Estradiol, FSH, and Hsp70 expression were analyzed by using the immunoassay technique. Analysis of the thickness of the vaginal epithelium was performed by histology. Results: Ovariectomy significantly decreased estradiol levels compared to the control group (P<0.05). All doses of genistein significantly increased levels of estradiol in rats with vaginal atrophy compared to the ovariectomy only group (P<0.05). Ovariectomy significantly increased FSH levels compared to the control group (P<0.05). All three doses of genistein restored FSH levels comparable to those in the control group (P>0.05). Ovariectomy significantly increased parabasal cell Hsp70 expression compared to the control group (P<0.05). Of all the genistein doses, only the dose at 0.045 mg/kg body weight/day restored the expression of Hsp70 to levels in the control group (P>0.05). Conclusions: Genistein is able to increase the thickness of the vaginal epithelium through hormone modulation and cellular stress suppression. Genistein is beneficial in the form of a herbal or alternative food for improvement of vaginal atrophy due to menopause.
文摘Language plays a central role in how gender and sexuality are described. In Bangla or Bengali, physicians, when educating and counseling women patients, do not have a socially acceptable word for “vagina”. If language is missing for female genitalia or important female sexual functions, could this absence reflect on the position of women in society, reproductive rights, and access to healthcare? Is there a relationship between language and the high rates of the gender-based cervical and breast cancers in some low and middle-income countries? This commentary examines scholarship on the topic of language, the female body, gender-based violence, disparities of healthcare for women, and the consequences of language on sexual attitudes and health.
文摘Introduction: Malignant melanoma (MM) represents 1% of all cancers and has an incidence of 3% - 7% in the female genital tract, the majority of cases being reported in the vulva. The cervico-vaginal region is an unsual primary location of the malignant mela-noma. Case report: The clinical and morphologic findings of 3 MM patients with cervico-vaginal tumours mimicking cervical polyp in third case. Histologically, the neoplasia was formed by nodules of broad cytoplasmic cells with poorly defined borders with pleomorphic nuclei with prominent nucleolae. Tumor cells were positive for S-100 protein, Melan A, HMB 45 and CD117. The authors discuss three cases of cervico-vaginal melanoma and analyze clinical and prognostic aspects of this disease. Conclusion: Primary MM of the cervix should be considered in the differential diagnosis of cervical malignancies. Early diagnosis is essential in order to warrant a better prognosis, although there are no cases of cure described.
文摘Melanoma of the vagina is a rare lesion. It results from the malignant transformation of ectopic melanocytes occurring in post-menopause. The CKIT is expressed in 36% of cases in addition to melanoma markers. Prognosis is poor especially for inoperable and disseminated forms despite systemic therapy. Treatment with Imatinib is an option in cases of metastatic mucosal melanoma with CKIT mutation or amplification. We report the case of post-menopausal women, treated at Hassan II University Hospital, diagnosed with metastatic melanoma of the vagina, that didn’t respond to first line of chemotherapy, and received Imatinib as second line of treatment, with good clinical response and durable stability at radiological assessment.
文摘Introduction: We aim to report outcomes and predictors of outcome of transvaginal mesh (TVM) for pelvic organ prolapse (POP). We also report frequency, severity, risk factors, and management of mesh-related complications after TVM. Materials and methods: We performed retrospective chart review of TVM performed from 2005 to 2010. There were 67 patients followed for a mean duration of eighteen months. Complications were reported using the International Continence Society and International Urogynecological Association classification system for prosthesis/graft complication. Results: Success rate was 88% (97% for anterior repair, 100% for posterior repair and 71% for combined repair) and complications occurred in 13 patients (19%), including vaginal hematoma, pelvic pain, urinary retention, dyspareunia and vaginal mesh exposure (in 9 patients). On multivariable logistic regression, recurrence was significantly higher with combined repair (P = 0.021), overall complication was significantly associated with younger age (P = 0.019), and mesh exposure was significantly associated with age and combined repair. All mesh-related complications were vaginal exposures occurring at median of 6 months postoperatively. Two patients were managed conservatively with vaginal estrogen cream, while seven patients elected surgical excision of exposed mesh with primary re-approximation of the vaginal epithelium. There were no excision-related complications, and in no case was the defect large enough to require closure with graft or secondary material. Conclusion: Combined anterior and posterior repair using TVM is associated with failure, younger age is associated with higher rate of complication, and combined repair and younger age are associated with mesh-related complication specifically.
文摘In the present study, eight strains were isolated from 20 cow vagina samples and identified using phenotype, biochemical analysis, sugar fermentation tests, and 16S rRNA sequence analysis. Among eight strains, only SQ0048 was identified as Lactobacillus johnsonii based on a series of biochemical testing (including the adhesion test, catalase test, bacteriocin production test, antibacterial test, and pH value), suggesting that its biological activity was superior to the other seven strains. Furthermore, SQ0048 had the lowest pH value (4.32) and the shortest fermentation time (8 h) compared with the other strains. The adhesion rate of SQ0048 was significantly higher than that of Lactobacillus delbrueckii, with an average adhesion number of 304 ± 2.67. The hydrogen peroxide production testing in SQ0048 was positive;in addition, bacteriocin gene of SQ0048, encoding an approximately 10-kDa product, was successfully cloned, expressed, and detected using the SDS-PAGE method. Meanwhile, SQ0048 had a weak inhibitory effect on Staphylococcus aureus and Escherichia coli. However, the expression products of the bacteriocin gene of SQ0048 had a very strong inhibitory effect on S. aureus and E. coli, with inhibition zone sizes of 18 ± 0.45 mm and 15 ± 0.60 mm, respectively. These data showed that SQ0048 has excellent antibacterial properties compared with other isolated strains and is a potential probiotic candidate to improve the health of the vaginas of cows by inhibiting pathogenic microorganisms.
文摘This is a case report of a woman with a vaginal aggressive angiomyxoma（AAM） which is a rare benign tumor. The woman was 51-years old who had a previous cesarean section. On July 3 2006, she was admitted because of an increase in vaginal excretions accompanying micturition over a period of 1 month. She had limitated activity of her left lower extremity from childhood because of inappropriate medication,
文摘Objective To review our eoperience of vaginal reconstruction using pudendal- thigh flap.Methods In the past 4 years, 9 patients suffering from the congenital vaginal agenesis underwent vaginalreconstruction using the pudendal- thigh flaps. The modilications of the surgical technique were de-tailed. Results All patients recovered satisfactorily from surgery and have been lollowed - up for a mean of 1.5years. There were no instances of flap loss, penetration of rectum and urethra. On final examination, all patientswere recorded as having a satislactory result, complete flap take, adequate dimensions and depth of neovagina andthe external appearance of the perineum and vagina was satisfactory. All married patients reported a satisfactoryintercourse. Conclusion The result proves that neurovascular pudendal- thigh flaps provide excellent tissue forvaginal reconstruction with low complication rate and good results. This operation does not cause an ugly donorsite scar and can be completed in single stage, without need of loparotomy and postoperative daily dilation. It isbelieved that this method can serve as a reliable alternative in vaginal reconstruction, which is one of the mostchallenging subjects of plastic surgery.
