Congenital vulvar teratoma: a case report

Introduction: Teratoma is an embryonal neoplasm consisted of 3 germinal layers. Teratoma usually arises along the line of embryonic cleft and sinus closure formed by the fusion of skin during the embryonic development. In this case report, we present a case of fetal Teratoma on the vulval region, a very rare variant of the disease. Case: A 28-year-old woman came for a routine check-up for her first pregnancy at her 26th weeks of gestational age. On ultrasound examination, a mass was found around the fetal vulva. There was no mass or malformations on other body parts. Placenta and the amount of amniotic fluid were normal. History of congenital anomaly in the family was denied. The patient then gave birth to a female baby at 38 weeks of gestational age without any complication. The baby was healthy, 2650 gram in weight, 50 cm in length, with good APGAR Score (8-10). On the baby left labia, there was a mass measured 5 cm x 4 cm x 3 cm, with slight discoloration. We recommend an early tumor excision to prevent unnecessary complication such as malignant transformation. Although at the time of writing, the patient still waiting for the schedule to remove the tumor due to a non-medical factor. Conclusion: Congenital Teratoma in the vulvar region was a very rare event. First-line therapy is early tumor excision and usually carries an excellent prognosis.

Representing concurrent document structures using Trojan Horse markup

The need for markup to handle multiple concurrent document structures has been clear at least since SGML introduced the CONCUR feature to support such markup. Few SGML users found the use of CONCUR necessary, few products ever supported it, and the designers of XML dropped it as an unnecessary complication. But those who need concurrent markup really need it. Fortunately, the functionality of CONCUR can be recreated more or less successfully in XML: one document structure can use conventional XML, while others use Trojan-Horse markup (DeRose 2004). Rabbit/duck grammars can be used to validate the document and to guide the creation of conventional schemas for use in editing tools.

The crystallographic chameleon: when space groups change skin

VolumeAofInternational Tables for Crystallographyis the reference for space-group information. However, the content is not exhaustive because for many space groups a variety of settings may be chosen but not all of them are described in detail or even fully listed. The use of alternative settings may seem an unnecessary complication when the purpose is just to describe a crystal structure; however, these are of the utmost importance for a number of tasks, such as the investigation of structure relations between polymorphs or derivative structures, the study of pseudo-symmetry and its potential consequences, and the analysis of the common substructure of twins. The aim of the article is twofold: (i) to present a guide to expressing the symmetry operations, the Hermann–Mauguin symbols and the Wyckoff positions of a space group in an alternative setting, and (ii) to point to alternative settings of space groups of possible practical applications and not listed in VolumeAofInternational Tables for Crystallography.

About science by the language of science, or How not to write scientific papers (an open letter to the authors of the journal «Vegetation of Russia»)

An attempt has been made to draw the attention of the authors of the journal “Vegetation of Russia” on the style of scientifi c papers, which suffers from numerous inaccuracies (frequent recurrence of words; unreasoned use of refl exive verbs, passive forms, anthropomorphisms, words-parasites; unnecessary complication of the text; uncertainty of argumentation; cumbersome constructions to express simple ideas; and many others). The author expresses her deep assurance that it is necessary and possible to write the scientifi c papers by using both the scientifi c and good literary languages. Numerous examples of bad writing style (in Russian) are given.

Impella Induced Massive Hemolysis: Reemphasizing Echocardiographic Guidance for Correct Placement

The Impella LP 2.5 (Abiomed, Danvers, MA) has been a tool of use for high risk coronary procedures and for cardiogenic shock. As with any invasive or intracardiac device, improper placement can result in disastrous complications. Hemolytic anemia secondary to Impella implantation is one of the documented complications. However, cases of severe hemolytic anemia are rare in the literature. Proven imaging modalities like ultrasound need to be used to guide proper placement. We present a case of device induced severe hemolysis due to Impella insertion and the need to use ultrasound guidance to avoid such an unnecessary complication.

Anaesthetic complications in plastic surgery

ABSTRACTAnaesthesia related complications in plastic surgeries are fortunately rare, but potentially catastrophic. Maintaining patient safety in the operating room is a major concern of anaesthesiologists, surgeons, hospitals and surgical facilities. Circumventing preventable complications is essential and pressure to avoid these complications in cosmetic surgery is increasing. Key aspects of patient safety in the operating room are outlined, including patient positioning, airway management and issues related to some specific conditions, essential for minimizing post-operative morbidity. Risks associated with extremes of age in the plastic surgery population, may be minimised by a better understanding of the physiologic changes as well as the pre-operative and post-operative considerations in caring for this special group of patients. An understanding of the anaesthesiologist′s concerns during paediatric plastic surgical procedures can facilitate the coordination of efforts between the multiple services involved in the care of these children. Finally, the reader will have a better understanding of the perioperative care of unique populations including the morbidly obese and the elderly. Attention to detail in these aspects of patient safety can help avoid unnecessary complication and significantly improve the patients′ experience and surgical outcome.