常规开腹手术治疗卵巢囊肿的临床应用

目的探讨卵巢囊肿患者采取常规开腹手术治疗的临床效果。方法选取48例卵巢囊肿患者,均接受常规开腹手术治疗,统计分析患者的临床治疗效果、不良反应发生情况、治疗前后卵巢功能指标(雌二醇、促黄体生成激素、血清卵巢雌激素)。结果治疗后,患者中显效20例(41.67%),有效28例(58.33%),无效0例(0),临床治疗总有效率为100.00%。术后患者发生疼痛1例,发热2例,出血1例,未发生感染,不良反应发生例数为4例,不良反应发生率为8.33%。患者治疗前的雌二醇为(68.21±4.10)pg/ml,治疗后3个月为(55.25±3.84)pg/ml,患者治疗后3个月的雌二醇低于治疗前,差异具有统计学意义(t=15.984,P=0.000<0.05)。患者治疗前促黄体生成激素为(8.68±2.84)U/L,治疗后3个月为(10.18±3.10)U/L,患者治疗后3个月的促黄体生成激素高于治疗前,差异具有统计学意义(t=2.472,P=0.015<0.05)。患者治疗前血清卵巢雌激素为(6.54±1.26)U/L,治疗后3个月为(7.98±1.30)U/L,患者治疗后3个月的血清卵巢雌激素高于治疗前,差异具有统计学意义(t=5.511,P=0.000<0.05)。结论卵巢囊肿患者采取常规开腹手术治疗能有效改善卵巢功能,临床疗效较高,同时产生不良反应较少,安全性较高,具有一定临床推广和应用价值。     

Cognitive Function and Language of a Child with an Arachnoid Cyst in the Left Frontai Fossa

Summary: The authors inspected the cognitive function of a boy with a congenital arachnoid cyst in the left frontal fossa. Neuropsychological tests described his cognition, including language, memory, and frontal functions, as mildly retarded overall. The boy's verbal ability was delayed, but his frontal function was intact. We supposed that the cyst would not affect his cognitive function. SPECT images showed low perfusion in the left temporal lobe. Dysfunction of the left temporal lobe should cause delayed language leading to learning difficulty. Neuropsychological evaluation of cognitive function concurrent with rCBF imaging was necessary not only for describing the influence of the cyst but also in discriminating its psychological aspects     

A pure fluid-filled intradural cyst associated with intradural disc herniation and possible pathogenesis: a case report

Background contextLumbar intradural disc herniation (IDH) is rare, and intradural cyst associated with IDH is quite rare. Only seven cases of an intradural cyst associated with lumbar disc herniation have been reported, and all were gas-filled cysts. We report the first case, to our knowledge, of a fluid-filled intradural cyst associated with IDH.PurposeTo report an extremely rare case of a fluid-filled intradural cyst associated with lumbar IDH and suggests the possible pathogenesis.Study designCase report.MethodsAn 82-year-old woman presented with right leg pain and motor weakness. Computed tomography and magnetic resonance imaging (MRI) scans showed calcified lumbar disc herniation and an intradural cystic mass at the L1–L2 level. An MRI, which was performed 2 years before admission, showed an IDH without a cyst at the same level.ResultsSurgical resection of the intradural cyst was performed. Intraoperative finding showed a fluid-filled intradural cyst with 1-cm diameter of displacing nerve rootlets. The cyst was connected with extradural cystic components through a ventral dural hole, but the tract was blocked by fibrous septum. Histopathologic examination showed a pseudocyst that consisted of degenerative cartilaginous and fibrous tissues, including degenerative disc materials. We concluded that the cyst was an intradural cyst transformed from the intradural disc fragment.ConclusionsThe current case is the first report to our knowlege of a fluid-filled intradural cyst associated with IDH. The possible mechanism may be focal degeneration and spontaneous absorption of the intradural disc with fluid production. Unlike the gas-filled intradural cysts, the cause of the pure fluid-filled cyst may be disconnection from the intervertebral vacuum because of a calcified disc and septation of the cyst.     

Hepatic cystic echinococcosis:Percutaneous treatment as an outpatient procedure

Objective:To demonstrate utility and safety of the puncture aspiration injection and reospiration(PAIR)technique for outpatients.Methods:Percutaneous treatment with US guidance was applied to 33 patients for 44 cysts.Patients treated with the PAIR technique,were outpatients.PAIR and catheterization technique were evaluated for efficacy and safety of procedure and complication rates.Results:Thirty-five of 44 cysts were treated with the PAIR and 9 of 44 were treated with the catheterization technique.The success rate of the cysts Gharbi type 1(CEI)and type 2(Ct3a)treated with the PAIR technique was 1009.hi the follow up of 9 cysts treated with the catheterization technique,2 of them(22%)developed cyst infection and 1(11%)developed a biliary fistula.Conclusions:The PAIR technique was found to be an effective and safe approach in order to treat Gharbi type 1 and type 2 cysts percutaneously for outpatients.It has a very low complication rate in comparison with the catheterization technique.So every effort should be mode to finish the treatment with PAIR technique.     

Total thoracoscopic combined lingulectomy and pericardial cystectomy

Thoracoscopic anatomic segmentectomy is usually more complex than lobectomy. This video shows a 58-year-old female who suffered from limited bronchiectasis of the lingular segment of the left upper lung and a pericardial cyst on the same side. Both of these benign thoracic diseases can cause pleural adhesions. Repeated chronic inflammation contributes to hypervascularity and lymph node enlargement, making surgery more difficult. We used single-direction thoracoscopic segmentectomy via a three-port approach and successfully removed the lingula and pericardial cyst.     

Hairy polyp can be lethal even when small in size

A case of sudden cardiopulmonary arrest in a 3‐month‐old girl is presented. The patient had barely recovered from hypoxic encephalopathy when she presented with repeated respiratory distress. Computed tomography and endoscopic analysis revealed a shiny polyp in the lateral wall of the nasopharynx, and this polyp was suspected to be the main cause of respiratory distress. After referral to our hospital, surgical removal was performed, and the histopathological diagnosis was hairy polyp. Hairy polyp is a rare congenital benign tumor that sometimes induces respiratory distress. This polyp can potentially induce a life‐threatening event. In a systematic review of 40 reported cases, polyps of ≤3.0 cm in diameter have a higher risk of respiratory distress than do those >3.0 cm in diameter (P = 0.01). Small hairy polyps may be lethal because of delayed diagnosis. To locate small hairy polyps, physicians should not hesitate to perform further examination because there is the possibility of oversight with only physical examination.     

Non-neoplastic jaw cysts: a 30-year epidemiological study of 2150 cases in the Italian population

Non-neoplastic jaw cyst (NJC) is one of the most common lesions in oral cavity, but there are only few detailed and extended epidemiological data based on the 2017 WHO classification. The aim of this study was to perform an epidemiological analysis of all NJCs treated from 1990 to 2019 at the Marche Polytechnic University, and to compare these data with those published in the literature. This retrospective study considered 2060 patients treated from 1990 to 2019. The NJCs were classified according to the 2017 WHO classification, and the main clinicopathological variables were analysed (sex, age, diagnosis, site of onset, size, and recurrences). Of 2150 total lesions, there were 2095 primary cysts and 55 recurrences; men are more frequently affected than women (M/F ratio of 1.73:1). The mean age of occurrence was 46.6 years, with a peak of frequency in the fifth decade. The mandible was more frequently involved than the maxilla, with a mean size of 1.9 cm. Radicular cyst was the most frequently diagnosed cyst (56.6%), followed by dentigerous cyst (23.4%) and odontogenic keratocyst (12.9%). This is the first epidemiological study on NJCs in the Italian population according to 2017 WHO classification.     

Intraoperative Discography for Detecting Concealed Lumbar Discal Cysts

Lumbar discal cyst is a rare cause of radiculopathy. Their exact pathogenesis and the optimal treatment modality remain unidentified. Depending on their location, discal cysts cannot always be easily identified intraoperatively. We describe 2 patients with discal cysts and introduce an intraoperative discography technique for discal cyst location. Both patients were treated with surgical excision; with intraoperative discography, the cystic lesions could easily be detected and removed.     

Intracardiac Eustachian Valve Cyst in an Adult Detected with Other Cardiac Anomalies: Usefulness of Multidetector CT in Diagnosis

We present an unusual case of an intracardiac Eustachian valve cyst observed concurrently with atresia of the coronary sinus ostium, a persistent left superior vena cava (LSVC) and a bicuspid aortic valve. There have been several echocardiographic reports of Eustachian valve cysts; however, there is no report of multidetector computed tomography (MDCT) findings related to a Eustachian valve cyst. Recently, we observed a Eustachian valve cyst diagnosed on MDCT showing a hypodense cyst at the characteristic location of the Eustachian valve (the junction of the right atrium and inferior vena cava). MDCT also demonstrated additional cardiovascular anomalies including atresia of the coronary sinus ostium and a persistent LSVC and bicuspid aortic valve.     

Retroperitoneal Spinal Extradural Arachnoid Cyst Combined with Congenital Hemivertebrae

Spinal extradural arachnoid cysts usually cause symptoms related to spinal cord or nerve root compression. Here, we report an atypical presentation of a spinal extradural arachnoid cyst combined with congenital hemivertebra which was presented as a retroperitoneal mass that exerted mass effects to the abdominal organs. On image studies, the communication between the cystic pedicle and the spinal arachnoid space was indistinct. Based on our experience and the literature of the pathogenesis, we planned anterior approach for removal of the arachnoid cyst in order to focus on mass removal rather than ligation of the fistulous channel. In our estimation this was feasible considering radiologic findings and also essential for the symptom relief. The cyst was totally removed with the clogged ''thecal sac-side'' end of the cystic pedicle. The patient was free of abdominal discomfort by one month after the surgery.