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Purpose
This study reviews contemporary management and follow-up of pediatric ovarian torsion.Methods
This is a retrospective series of patients from birth to 19 years undergoing operative management of ovarian torsion from 2012 to 2016.Results
We studied 43 girls who underwent 51 operations for ovarian torsion. The median age was 8.3 years. Ultrasound was utilized for diagnosis in 24/29 patients (83%) evaluated in a children's hospital. In contrast, computed tomography was used initially in 7 cases (50%) in children imaged at non–children's hospitals before transfer. Initial operation for ovarian torsion was completed laparoscopically in 38 (88%). Overall, ovarian preservation was performed in 37 (86%) patients, while 6 (13%) underwent oophorectomy. Indications for oophorectomy included 5 infants with in utero torsion and an 18-year-old with a suspected malignancy. In girls with acute ovarian torsion, the oophorectomy rate was reduced to 2%. Postoperatively, 1 patient developed a small bowel obstruction requiring operation after laparoscopic ovarian detorsion. Recurrent torsion occurred in 3 patients (7%). In total, 34 patients underwent postoperative ovarian imaging. A total of 25 (74%) had follicles visualized in the previously torsed ovary.Conclusion
Ovarian-sparing operations for acute torsion are safe and result in ovarian salvage and preservation of follicular development in more than 70% of children and adolescents. 相似文献67.
The temporal bones from a 55-year-old woman with deafness and dizzy spells caused by a right-sided acoustic neurinoma were examined by the techniques of microdissection, surface preparations, and celloidin sections. Sensorineural degeneration was present in the basal end of the right cochlea but was not severe enough to explain the deafness. The compression of the cochlear nerve by the tumor was postulated to have caused deafness by injury to neurons adjacent and central to the tumor. There was profound degeneration of the vestibular nerve and sensory cells. A gelatinous material occluded the scala vestibuli, and the vestibular fluid spaces contained an amorphous proteinaceous substance. Fewer erythrocytes were seen in the vessels of the right cochlea, but there was no atrophy of capillaries to indicate long-term reduction of circulation. Vasculoneogenesis of venous vessels had occurred in the scala tympani, probably as a result of venous stasis. 相似文献
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This study investigated the hypothesis that overweight college students and normal weight “restrained” students, particularly those susceptible to stress related overeating and binge episodes, have a restricted range of pleasurable activities available for positive reinforcement of behaviors other than eating. The major finding was that overweight students in a behavioral weight control program reported less enjoyment of pleasant activities than did normal weight classroom control subjects. The relationship of the amount and variety of pleasurable activities to subsequent body weight fluctuations, however, was ambiguous. 相似文献
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