Cystic Cavity Research Articles

A conservative approach for unicystic ameloblastoma: Retrospective clinic-pathologic analysis of 12 cases.

Unicystic ameloblastoma is an encapsulated odontogenic neoplasm with a single cyst cavity. The conservative or aggressive surgical approaches used to treat the tumor directly affect recurrence rates. However, there is a lack of a standard protocol that can guide its management. We retrospectively reviewed the clinicopathological findings and therapeutical procedures of 12 unicystic ameloblastoma cases treated by the same surgeon during the past 20 years. All cases of unicystic ameloblastoma diagnosed by biopsy and treated by the same surgeon between 2002 and 2022 were reviewed. Eligibility criteria were patients with completely filled-out charts containing the follow-up period and confirmation of the diagnoses based on the microscopic findings of the whole excised specimens. Data collected were categorized into clinical, radiographic, histological, surgical, and recurrence aspects. There was a female predilection (2:1), and ages ranged between 18 and 61 years (mean: 27.25, ±12.45). Almost all (92%) affected the posterior mandible. Radiographically, the mean length of the lesions was 46.14 mm ± 14.28 mm which 92% were unilocular and 8.3% multilocular. Root resorption (n = 7, 58%), tooth displacement (n = 9, 75%), and cortical perforation (n = 5, 42%) were also observed. The mural histological subtype corresponded to 9 (75%) of the cases. The same conservative protocol was performed in all cases. The follow-up period ranged between 12 and 240 months (~62 ± 65) and recurrence occurred in only one patient (8%). Our findings suggest a conservative approach should be the first option for unicystic ameloblastoma treatment, even for those with mural proliferation.

Kidney cystosis — hereditary, congenital and acquired

Renal cysts can be both an independent nosological entity, and a clinical manifestation, or a complication of a severe diseases. Understanding the epidemiology, pathogenesis and diversity of causes of cystic kidney disease contributes to the timely diagnosis and selection of reasonable treatment and prevention tactics. The presented literature review describes the most common processes that contribute to the development of this pathology, as well as genetic diseases and rare causes, the clinical manifestation of which is the formation of cystic cavities. The article presents the main diagnostic algorithms and modern classifications of the disease for practical assistance to the doctor. The review contains up-to-date information on the modern staging of cystic kidney disease according to the Bosniak classification, and also presents the risk of malignancy, according to the statistical data presented in the literature.

The role of stem cell secretome on spinal cord injury regeneration: a systematic review and meta-analysis

Background: The treatment of spinal cord injuries (SCIs) is a controversial topic and is not yet effective. Stem cell secretome is an emerging alternative treatment that uses the paracrine effect of stem cells. Although there have been many studies on this subject, there are still differences regarding the origin, dose, route of secretome administration, type of experimental animal, phase of the SCI, and outputs evaluated. The topic needs a systematic review and meta-analysis. Methods: This systematic review and meta-analysis were reported based on criteria from Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The authors searched PubMed, ScienceDirect, Cochrane Library, and Google Scholar with multiple electronic databases until October 2021. Results: Twenty-eight studies that met the inclusion criteria were included in this research. The stem cell secretome was very beneficial as the axonal regeneration agent (n=12); it increases the locomotor recovery (n=28) and growth factors (n=2) and reduces the size of the cystic cavity (n=1) and lesion extension (n=14). We recognized 28 studies that met our inclusion criteria. Stem cell secretome therapies showed improvement in the locomotor score (standard mean difference [SMD]: 0.94; 95% confidence interval [CI]: 0.75–1.13, p<0.000001, I2=90%) and reduction in the lesion size (SMD: 5.06; 95% CI: 3.44–6.67, p<0.00001, I2=94%). Conclusion: The stem cell secretome greatly affects treating SCI rodent models. Future studies should focus on chronic SCIs in the primary research, translational research, and neurological research stage of stem cell secretome.

Clinical analysis of the treatment of maxillary odontogenic cyst by nasal endoscope fenestration through nasal base

Objective:To investigate the feasibility and clinical effect of the surgical approach and method of transnasal fenestration under nasal endoscope for the treatment of maxillary odontogenic cyst. Methods:The clinical data of 23 cases with maxillary odontogenic cysts treated by nasal endoscopy through nasal fenestration were retrospectively analyzed. All cases underwent nasal endoscopy and CT examination before the operation. The mucosal membrane of the parietal wall of the cyst was excised through fenestration of the nasal base. The cyst fluid was removed by decompression, and the bony opening of the nasal base was trimmed and enlarged to the edge of the cyst. The intraoperative and postoperative effects were observed. Results:All cases were well exposed under the direct vision of nasal endoscope. The top wall of the cyst was removed to maximize the communication between the cyst cavity and the nasal floor. There were no complications such as nasolacrimal duct injury, turbinate atrophy, necrosis, and facial numbness. All patients were followed up for 6-12 months, and the clinical symptoms gradually disappeared after surgery. The inferior turbinate was in good shape, the cyst cavity was smooth, the cyst wall was determined, and no cyst recurrence was observed. Conclusion:The treatment of odontogenic cyst of maxilla under nasal endoscope through nasal fenestration is convenient. It has less trauma, fewer complications and a satisfactory curative effect, which is worthy of clinical promotion.

Successful treatment of a colonic cyst by endoscopic aspiration and sclerotherapy.

A 38-year-old man presented to our department with constipation that had persisted for 2 years. Upon colonoscopy, we discovered a smooth protrusion (about 2 cm × 2 cm) at the hepatic flexure of his colon ([Fig. 1]). Anechoic ultrasonic colonoscopy was suggestive of a cyst. A transparent puncture needle was used to puncture into the cyst cavity and a syringe was used to aspirate the cyst fluid ([Video 1]). After sufficient aspiration, we verified the disappearance of the cyst ([Fig. 2]) and 2 ml of yellow cyst fluid ([Fig. 3]). Subsequently, 2 ml of polidocanol-methylene blue mixture was injected into the cyst cavity through the puncture needle ([Video 1]). A 6-month follow-up colonoscopy revealed no cyst at the hepatic flexure of the patient’s colon ([Fig. 4], [Video 1]).

Management of angle-closure glaucoma with X-linked retinoschisis: a case report

BackgroundX-linked retinoschisis (XLRS), due to mutations in the RS1 gene, is a common genetically determined form of macular degeneration. This report describes an unusual case of angle-closure glaucoma (ACG) with XLRS and discusses the treatment.Case presentationA 39-year-old Chinese man with an X chromosome-recessive inherited c.489G > A variant in the RS1 gene was diagnosed as XLRS and ACG, presenting with cystic macular lesions, shallow anterior chamber depth (ACD), and angle-closure with uncontrolled intraocular pressure (IOP). Malignant glaucoma occurred following trabeculectomy combining phacoemulsification with intraocular lens (IOL) implantation and goniosynechialysis. Subsequent anterior vitrectomy and irido-zonulo-hyaloid-vitrectomy (IZHV) effectively lowered IOP and deepened ACD, but the cystic cavity became larger.ConclusionsThere is a potential risk of malignant glaucoma in ACG patients with XLRS after filtering surgery. Although anterior vitrectomy can effectively resolve aqueous misdirection, the macular retinoschisis may get worse. Awareness of this risk may aid in surgical planning and postoperative management in these patients.

Clinical efficacy of titanium prepared platelet rich fibrin in periodontal regeneration: A systematic review and meta-analysis

Background: Periodontal regeneration therapies frequently involve autologous platelet concentrates (APCs). They can be used in sinus lift surgeries and socket preservation, among other clinical settings. Platelet rich fibrin (PRF) membrane has been used to treat gingival recession in individuals or groups of individuals using a coronally progressed or lateral pedicle flap. In the treatment of mixed periodontic endodontic lesion/furcation defect, PRF functions as a healing and interpositional biomaterial, filling a cystic cavity. PRF is known to help the bone regeneration process. In the last few years, efforts have been made to enhance the PRFs characteristics and quality. One of them is titanium platelet rich fibrin (T-PRF). Third-generation platelet concentrate no longer contains silica, and its preparation in glass vacuum containers, no longer creates any known concerns. The effectiveness PRF's has been evaluated in connective tissue and bone repair. The aim of this study is to compare T-PRF to other platelet concentrates and different treatment modalities for periodontal regenerative procedures. Methods: A protocol of this systematic review have been registered in prospero (CRD42022293545). The online database searched were PUBMED, COCHRANE for published articles up to November 2022 without language restrictions. Studies in trial registers, handsearching, bibliographic references of relevant articles were also checked. Data collection and analysis was done by individual authors. Independent eligibility assessments were conducted by four review authors. Then, using the standard Cochrane methodology, four review authors extracted the data and evaluated the risk of bias for individual studies. We developed "Summary of findings" tables and used GRADE to evaluate the evidence. Results: Three studies were included for meta-analysis. Results of meta-analysis supported that T-PRF is effective for correction of both hard and soft tissue defects. Conclusions: The overall qualitative and quantitative analysis suggest that T-PRF has superior structural properties and thicker fibrin network for periodontal regenerative procedures.

MP76-05 PERI-URETHRAL PROSTATIC CAVITY FORMATION FOLLOWING WATER VAPOR THERMAL THERAPY: AN UNRECOGNIZED COMPLICATION CAUSING PERSISTENT LUTS?

You have accessJournal of UrologyCME1 Apr 2023MP76-05 PERI-URETHRAL PROSTATIC CAVITY FORMATION FOLLOWING WATER VAPOR THERMAL THERAPY: AN UNRECOGNIZED COMPLICATION CAUSING PERSISTENT LUTS? Leo D. Dreyfuss, Kevin Alter, Adithya Balasubramanian, Barry Zisholtz, Kevin C. Zorn, Naeem Bhojani, Dean Elterman, and Bilal Chughtai Leo D. DreyfussLeo D. Dreyfuss More articles by this author , Kevin AlterKevin Alter More articles by this author , Adithya BalasubramanianAdithya Balasubramanian More articles by this author , Barry ZisholtzBarry Zisholtz More articles by this author , Kevin C. ZornKevin C. Zorn More articles by this author , Naeem BhojaniNaeem Bhojani More articles by this author , Dean EltermanDean Elterman More articles by this author , and Bilal ChughtaiBilal Chughtai More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003350.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Water vapor thermal therapy (WVTT) causes tissue necrosis secondary to release of thermal energy within the collagen networks of the prostate transition zone. Some men experience worsening of LUTS following treatment. We report 3 patients with persistent LUTS following WVTT who were found to have anatomic abnormalities in the prostate, ultimately requiring repeat procedures. METHODS: WVTT (Rezum, NxThera, Inc, Maple Grove, MN) was offered to patients with bothersome LUTS and prostate volume less than 80 cc’s. WVTT was performed outpatient at a high-volume academic urology clinic. Patients were treated under local anesthesia with 1-3 sticks in bilateral lateral lobes. Patients underwent trial of void on post-procedure day 1 and were followed at regular intervals with post-operative surveys, post-void residual (PVR), and uroflowmetry. RESULTS: All 3 patients successfully underwent WVTT and passed trial of void with minimal post-void residual. Patient 1 experienced persistent bothersome LUTS despite medical therapy. Urodynamics revealed high pressure with low urinary flow. Cystoscopy revealed urethral cavities filled with debris causing obstruction (Figure 1A). Transurethral unroofing was performed leading to resolution of symptoms. Patient 2 experienced persistent LUTS, slow urinary stream, and elevated PVR’s to 100 mL following procedure. After 5 months of persistent symptoms, they began to experience watery ejaculate. CT Urogram revealed cystic dilation of prostatic urethra with urethral stones requiring cystoscopy and stone removal. Patient 3 experienced LUTS for 2.5 months following WVTT, at which time they developed watery ejaculate. Cystoscopy revealed prostatic urethral diverticulum (Figure 1B) and MRI showed 2.4×2.4×2.5 cm cystic cavity in prostatic transition zone contiguous with prostatic urethra (Figure 1C, D). Photoselective vaporization of the prostate was performed 14 months following index procedure with resolution of symptoms. At last follow up, all patients are voiding well with resolution of LUTS. CONCLUSIONS: WVTT may be associated with atypical tissue necrosis and cavity formation within prostatic transition zone. Patients with worsening or persistent LUTS following WVTT may benefit from further workup to exclude anatomic defects. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1092 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Leo D. Dreyfuss More articles by this author Kevin Alter More articles by this author Adithya Balasubramanian More articles by this author Barry Zisholtz More articles by this author Kevin C. Zorn More articles by this author Naeem Bhojani More articles by this author Dean Elterman More articles by this author Bilal Chughtai More articles by this author Expand All Advertisement PDF downloadLoading ...

MRI of Peliosis Hepatis: A Case Series Presentation With a 2022 Systematic Literature Update.

Peliosis hepatis (PH) is a rare benign condition, characterized by hepatic sinusoidal dilatation and blood-filled cystic cavities, often found incidentally, with still challenging diagnosis by imaging due to polymorphic appearance. Based on a retrospective analysis of our series (12 patients) and systematic literature review (1990-2022), to organize data about PH and identify features to improve characterization. Retrospective case series and systematic review. Twelve patients (mean age 48 years, 55% female) with pathology-proven PH and 49 patients (mean age 52 years, 67% female) identified in 33 studies from the literature (1990-2022). 1,5-T; T1-weighted (T1W), T2-weighted (T2W), diffusion-weighted (DW), contrast-enhanced (CE) T1W imaging. We compared our series and literature data in terms of demographic (gender/age/ethnicity), clinical characteristics (symptoms/physical examination/liver test), associated conditions (malignancies/infectious/hematologic/genetic or chronic disorders/drugs or toxic exposure) percentage. On magnetic resonance imaging lesion numbers/shape/mean maximum diameter/location/mass effect/signal intensity were compared. PH pathological type/proposed imaging diagnosis/patient follow-up were also considered. Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Case Reports/Series quality assessment. Intraclass correlation and Cohen's kappa coefficients for levels of inter/intrareader agreement in our experience. Patients were mainly asymptomatic (92% vs. 70% in our study and literature) with associated conditions (83% vs. 80%). Lesions showed homogeneous T1W-hypointensity (58% vs. 65%) and T2W-hyperintensity (58% vs. 66%). Heterogeneous nonspecific (25% vs. 51%), centrifugal (34% vs. 8%), or rim-like centripetal (25% vs. 23%) patterns of enhancement were most frequent, with hypointensity on the hepatobiliary phase (HBP), without restricted diffusivity. Good inter- and intrareader agreement was observed in our experience. Concerning JBI Checklist, 19 out of 31 case reports met at least 7 out of 8 criteria, whereas 2 case series fulfilled 5 and 6 out of 10 items respectively. A homogeneous, not well-demarcated T1W-hypointense and T2W-hyperintense mass, with heterogeneous nonspecific or rim-like centripetal or centrifugal pattern of enhancement, and hypointensity on HBP, may be helpful for PH diagnosis. Among associated conditions, malignancies and drug exposures were the most frequent. 4 TECHNICAL EFFICACY: Stage 2.

Влияние нутрицевтика на комплексную терапию неоваскулярной возрастной макулярной дегенерации на фоне применения анти-VEGF препарата афлиберцепт

Purpose. Evaluation of efficacy of aflibercept (Eylea®, Bayer, Germany) in combination with nutraceutical Ophtholique® (Sentiss Pharma, India) in treatment of neovascular agerelated macular degeneration (nAMD). Material and methods. 32 patients (32 eyes) with nAMD aged 54 to 75 years, controls – 12 healthy people of same age and gender. Initially, best-corrected visual acuity (BCVA) averaged 0.32±0.05. Clinical and morphological features of nAMD was macular neovascularization (MNV): in 18 patients – type 1; 14 people – type 2. All patients underwent 3 intravitreal injections of aflibercept. Two groups were formed, comparable in terms of BCVA and central retinal thickness (CRT), duration and severity of macular changes, gender, age: the main group (17 patients) – treatment was supplemented with Ophtholique®; comparison group (15 patients) – Ophtholique® was not prescribed. Results. After 1 month after 3 intravitreal injections of aflibercept, all 32 patients had no signs of disease activity. The interval between injections was increased according to the protocol by 2 weeks. After 6 months in the main group, the BCVA increased to 0.61 ± 0.02 due to regression of MNV, a decrease of CRT to control values was noted. In the comparison group, BCVA increased to 0.47 ± 0.03, CRT decreased to control values in 8 out of 15 patients. In 7 patients, BCVA, on the contrary, decreased to 0.30 ± 0.01, while the CRT increased to 421.5 ± 5.2 µm. By 12 months all patients of the main group showed none resumption of MNV activity, complete reattachment of neurosensory retina and pigment epithelium, resorption of intraretinal cystic cavities was noted. In the comparison group MNV activity was noted in 5 eyes with decrease in functional parameters of the retina. Conclusion. Combination of aflibercept in Tread-and-Extend treatment regimen with oral administration of nutraceutical Ophtholique® take it possible to increase efficacy of treatment of nAMD. Keywords: neovascular AMD, anti-VEGF therapy

Use of Oxidized Regenerated Cellulose (ORC) in treatment of ovarian endometriomas to prevent recurrence and preserve ovarian reserve

Background: Oxidized Regenerated Cellulose (ORC) is used in the treatment of Endometriosis to eliminate or postpone endometriomas’ recurrence and to preserve ovarian reserve subsequently increasing pregnancy rate. The aim of this research was to evaluate the benefit of ORC in surgical management of ovarian endometriomas to reduce the rate of recurrence while preserving ovarian reserve. Methods: This prospective randomized controlled research was carried out on 60 cases, divided into two groups: Group A (drainage and ablation): 30 cases had laparoscopic drainage of ovarian endometrioma with electrocautery of the endometriomal cyst wall. Group B (drainage and ORC): 30 cases had laparoscopic drainage of ovarian endometrioma with insertion of ORC inside the cyst cavity. Results: There was a statistically significant difference according to 3 and 6 months in anti-mullerian hormone (AMH) (ng/ml) and Antral Follicular Count (AFC) being higher in ORC group compared to ablation group while the reduction in AMH (change) was significantly lower in ORC group (P values< 0.001). The recurrence rate of ovarian endometrioma was comparable between both groups. AMH and AFC was significantly associated with the recurrence of ovarian endometrioma 3 and 6 months. Conclusions: ORC reduces effectively the recurrence risk of endometriomas following laparoscopic drainage.

Feasibility of Percutaneous Image-Guided Combined Treatment of Symptomatic Bone Cyst Using Cryoablation and Bone Graft Substitute.

To describe the feasibility and technique of percutaneous image-guided combined treatment of bone cyst (BC) using cryoablation and bone graft substitute injection. Between July 2019 and January 2022, six consecutive patients (ages between 16 and 33years) with symptomatic BC in pelvic and lower extremity bones underwent percutaneous image-guided combined treatment using cryoablation and bone graft substitute. To induce bone mineralization as early as possible, the cyst cavity was filled with bone graft substitute. Technical success of the procedure was evaluated, and clinical success was defined as satisfactory clinical symptom relief using visual analogue scale (VAS). Radiologic success was defined as early BC remineralization on radiographic studies. Detailed demographic data with lesion location, size, time to and degree of BC mineralization, complications, clinical outcomes, and radiological follow-up were retrospectively assessed. Technical success was 100% achieved in all patients. BC mineralization was observed in all patients, with a median time to reach 80% mineralization at 6months, with one patient reaching 80% at 5months and another reaching 100% at 3months. A significant drop in VAS was observed in all patients, reflecting significant pain relief. There were no major complications. The median follow-up period was 31.5months, with a minimum follow-up of 5months and a maximum follow-up of 3years. Percutaneous image-guided combined treatment with cryoablation and bone graft substitute for symptomatic BC is technically feasible and was safe in this limited series.

An unusual giant coronary artery aneurysm mimicking mediastinal mass.

A 55-year-old woman was admitted with complaints of recurrent chest pain for eight days. She had a history of intermittent chest tightness and pain for 5 years. Laboratory test showed increased hypersensitive cardiac troponin I of 0.14 μg/L. The ECG showed ST segment depression in leads V1, V2, V3, and V4. Acute non-ST segment elevation myocardial infarction was diagnosed. Echocardiography revealed a hypoechoic mass (8.9 × 7.0 cm) (asterisk, Panel A, see Supplementary material online, Video S1) in front of the right side of the heart. The right atrium (RA) and right ventricle (RV) were compressed and deformed. A cystic cavity (13 mm wide) can be observed in the mass (arrowhead, Panel B, see Supplementary material online, Video S2), which was connected to the dilated right coronary artery (RCA). Enhanced chest CT showed the obviously enhanced RCA entered into the mass (asterisk, Panels C and D), the distal of which was occlusive and dilated like ‘gallbladder’ (arrowhead, Panel C, D and E). Coronary artery aneurysm (CAA) was suspected. Coronary angiography showed abnormal neoplastic dilatation in the proximal segment of the RCA and complete occlusion in the middle segment (arrowhead, panel F, see Supplementary material online, Video S3). The left coronary artery provided collateral circulation to the RCA (see Supplementary material online, Video S4). The patient underwent resection of the mass. The giant mass was observed between RA and RV (panel G) with numerous thrombi inside (panels H and I). Coronary artery bypass surgery was performed successfully after CAA resection.

Conservative management of large unicystic ameloblastoma in a young patient: A case report

Objectives: Ameloblastoma is a benign neoplasm with origin from odontogenic epithelium. Unicystic ameloblastoma has clinical and radiographically features resemble to other odontogenic cysts but it has a typical ameloblastomatous epithelium lining the cyst cavity.&#x0D; Case: In this case report study, we presented a 9-year-old girl who was referred to Oral and Maxillofacial Surgery of Isfahan Dental School for the management of a large swelling on the right posterior mandiblular region. The histopathologic examination of the specimen showed mural type of unicystic ameloblastoma. In the first step, the patient was treated by decompression of the lesion. Five month after it, shrinkage of the lesion was observed and in the second stage of surgery, curettage of the remaining lesion and extraction of tooth buds in the areas of lesion was performed. After two years, radiographic image showed new bone formation and complete healing of the lesion. &#x0D; Conclusion: Choosing the best treatment for children with unicystic ameloblastoma requires more attention and all clinical and histopathological parameters should be considered. Conservative treatment for ameloblastoma leads to reduce complications after treatment and affect the patient's quality of life.

Influence of the Neuroprotective Properties of Quercetin on Regeneration and Functional Recovery of the Nervous System.

Quercetin is a dietary flavonoid present in vegetables, fruits, and beverages, such as onions, apples, broccoli, berries, citrus fruits, tea, and red wine. Flavonoids have antioxidant and anti-inflammatory effects, acting in the prevention of several diseases. Quercetin also has neuroprotective properties and may exert a beneficial effect on nervous tissue. In this literature review, we compiled in vivo studies that investigated the effect of quercetin on regeneration and functional recovery of the central and peripheral nervous system. In spinal cord injuries (SCI), quercetin administration favored axonal regeneration and recovery of locomotor capacity, significantly improving electrophysiological parameters. Quercetin reduced edema, neutrophil infiltration, cystic cavity formation, reactive oxygen species production, and pro-inflammatory cytokine synthesis, while favoring an increase in levels of anti-inflammatory cytokines, minimizing tissue damage in SCI models. In addition, the association of quercetin with mesenchymal stromal cells transplantation had a synergistic neuroprotective effect on spinal cord injury. Similarly, in sciatic nerve injuries, quercetin favored and accelerated sensory and motor recovery, reducing muscle atrophy. In these models, quercetin significantly inhibited oxidative stress and cell apoptosis, favoring Schwann cell proliferation and nerve fiber remyelination, thus promoting a significant increase in the number and diameter of myelinated fibers. Although there is still a lack of clinical research, in vivo studies have shown that quercetin contributed to the recovery of neurological functions, exerting a beneficial effect on the regeneration of the central and peripheral nervous system.

Possibilities of MRI in the differential diagnosis of non-lactative mastitis and cancer

Non-lactational mastitis is an inflammatory process in the breast tissue that is not associated with lactation. The detection of a malignant transformation during inflammation process is often difficult, because it has similar clinical manifestations. Medical approach depends on the characteristics of the processes which are received from the data obtained from radiation diagnostic methods: whether or not there is a nodular formation or infiltrate, cystic cavities, dilatation of the ducts, how the axillary lymph nodes are changed. Diagnostic errors in inflammatory breast diseases are quite common; according to the literature, errors in the interpretation of clinical, mammographic, and ultrasound signs of cancer during inflammation account for up to 53.1% of cases. Inflammation, as well as cancer, in majority of cases is accompanied by a visually detectable increase in blood flow due to proliferation and neoangiogenesis. Magnetic resonance imaging with dynamic contrast enhancement (MRI) is highly sensitive in detecting areas with increased vascularization and makes it possible to assess their nature with a high degree of probability during any changes in the structure of the breast tissue, including edema and inflammatory infiltration. MR signs that allow to make differential diagnosis are a combination of pathological accumulation and lymphadenopathy, which are coded by the BIRADS system as category 4 and only the absence of contrast agent accumulation may suggest an inflammatory nature of the changes. According to the literature, MRI-DCE is a highly sensitive diagnostic method of identifying cancer during inflammation processes. The results of 85 MR studies with clinical manifestations of non-lactational mastitis were analyzed.The purpose of study: is to evaluate the possibilities of magnetic resonance mammography in making a differential diagnosis of non-lactational mastitis and breast cancer.

THE RELATIONSHIP BETWEEN CYST DIAMETER AND LONG-TERM RESULTS OF PAIR TREATMENT

Aim: The PAIR (Puncture, Aspiration, Injection of scolicidal agent, and Reaspiration) treatment is used for echinococcosis type 1 (CE1) liver hydatid cysts. The aim of this study is to show the relationship between the cyst diameter and long-term results of PAIR. Materials and Methods: Between 2016-2021, fifthy patients with 54 liver CE1 hydatid cysts who underwent PAIR treatment were included in the study. Under general anesthesia, procedures were carried out. Technical success (completing the required steps in a procedure), clinical success (absence of recurrence or major complication upon follow-up), complications, cyst cavities' long-term alterations were evaluated. Inactivation times of cysts smaller than 6 cm and larger than 6 cm were compared. Results: The long axis of the cysts was between 3 cm and 12 cm. Technical success rate was 100%. The average follow-up time was 996 ± 250 days. The cysts showed a mean volume reduction of 70.1% on follow up. The treatment was effective in 48 patients and 52 hydatid cysts. The effectiveness of the long-term treatment was 96%. Cysts smaller than 6 cm had a significantly shorter inactivation time than cysts larger than 6 cm (p=0.01). Recurrence (CE2) was detected in one patient (2 %). This patient was treated with the modified catheterization (MoCAT) technique. Major complication (abscess) was detected in one patients (2 %) and abscess was drained using the percutaneous seldinger technique. Intra-abdominal spread, anaphylaxis, or mortality did not develop in any patient. Post-procedural pain developed in 3 patients as a minor complication (6 %). Conclusion: Although the inactivation time is longer in cysts larger than 6 cm, PAIR technique used to treat liver CE 1 hydatid cysts are effective and secure.

Chapter 12 - Neuroimaging in mitochondrial disease

The anatomic complexity of the brain in combination with its high energy demands makes this organ specifically vulnerable to defects of mitochondrial oxidative phosphorylation. Therefore, neurodegeneration is a hallmark of mitochondrial diseases. The nervous system of affected individuals typically shows selective regional vulnerability leading to distinct patterns of tissue damage. A classic example is Leigh syndrome, which causes symmetric alterations of basal ganglia and brain stem. Leigh syndrome can be caused by different genetic defects (>75 known disease genes) with variable disease onset ranging from infancy to adulthood. Other mitochondrial diseases are characterized by focal brain lesions, which is a core feature of MELAS syndrome (mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes). Apart from gray matter, also white matter can be affected by mitochondrial dysfunction. White matter lesions vary depending on the underlying genetic defect and may progress into cystic cavities. In view of the recognizable patterns of brain damage in mitochondrial diseases, neuroimaging techniques play a key role in diagnostic work-up. In the clinical setting, magnetic resonance imaging (MRI) and MR spectroscopy (MRS) are the mainstay of diagnostic work-up. Apart from visualization of brain anatomy, MRS allows the detection of metabolites such as lactate, which is of specific interest in the context of mitochondrial dysfunction. However, it is important to note that findings like symmetric basal ganglia lesions on MRI or a lactate peak on MRS are not specific, and that there is a broad range of disorders that can mimic mitochondrial diseases on neuroimaging. In this chapter, we will review the spectrum of neuroimaging findings in mitochondrial diseases and discuss important differential diagnoses. Moreover, we will give an outlook on novel biomedical imaging tools that may provide interesting insights into mitochondrial disease pathophysiology.

Isolation and molecular characterization of infectious bursal disease virus circulating in western and central India.

Infectious bursal disease (IBD) caused substantial economic loss in central and western India during 2020 and 2021. The study was conducted to characterize IBD virus (IBDV) from field outbreaks. The study was conducted on 360 samples from 42 poultry flocks. The samples were subjected to histopathology and molecular detection, followed by phylogenetic typing of the partial VP2 gene. The mortality ranged from 15.25 to 60.18%. The necropsy showed hemorrhages on thigh muscles, mottled spleen, swelling of kidneys and bursae with hemorrhages, and cheesy exudate. Histopathology revealed extensive necrosis and depletion of follicular lymphoid cells within the cortex and medulla, along with widespread hemorrhages, edema, and cystic cavities in the bursa. The field isolates showed cytopathic effects in the seventh passage. The cytopathic effects included swelling, rounding, granulation of cytoplasm around the nucleus, fragmentation of the infected cells, and detachment. The reverse transcription-polymerase chain reaction amplified 664 bp partial VP2 gene. The phylogenetic analysis identified 19 field isolates as very virulent IBDVs (vvIBDVs) and three as classical strains. The results indicated that different vvIBDV strains are involved in disease outbreaks in central and western India.

Minimally invasive treatment of a giant pancreatic pseudocyst

The authors present minimally invasive treatment of a giant infected pancreatic pseudocyst. Throughout in-hospital period, the patient underwent endosonography-guided transgastric drainage of the pseudocyst, 7 endoscopic debridement of the cavity with sequestrectomy, laparoscopy for enzymatic peritonitis and external percutaneous drainage of the pseudocyst. Effectiveness of minimally invasive treatment was assessed considering laboratory data (CRP, white blood cell count), clinical data (hyperthermia, complaints) and follow-up ultrasound and computed tomography data (cyst dimension, sequestration). We observed with positive dynamics with decrease of intoxication syndrome, serum CRP and white blood cell count after two debridement procedures. After the seventh endoscopic debridement and sequestrectomy, granulations occurred in the cyst cavity and there was no further sequestration. At discharge, CT revealed dry residual small cavity 1.5×3 cm. There were no any complaints.