Cystic Group Research Articles

Evaluation of the neurodevelopment outcome of prenatally diagnosed periventricular pseudocysts using MRI

Objective To evaluate alterations of periventricular pseudocysts (PVPC) on MRI before and after birth, and to assess the prognosis. Methods We retrospectively analyzed the data of 67 cases that were diagnosed with PVPC on prenatal MRI, of which 24 cases were lost to follow-up, 2 died after birth. A total of 41 surviving fetuses were included in this prognosis study. The gestational ages in this group were between 23 and 39 weeks, with an average of (33±3) weeks.All the subjects underwent brain MRI examinations and Gesell Developmental Scale (GDS) testing between 0-3 years of age. According to the location of cysts and with or without other intracranial and extracranial malformations (dilated ventricles orcerebella medulla, hypoxic-ischemic encephalopathy, TORCH virus infection, corporal hypoplasia, chromosomal malformations and nodular sclerosis) , the patients were divided into four groups: isolated connatal cysts, connatal cysts with additional findings,isolated subependymal pseudocysts, and subependymal pseudocysts with additional findings.The MR images were independently reviewed by two radiologists blinded to the clinical information. Intraclass correlation efficient (ICC) was used to analyze the consistency between the two reviewers.Chi-square test was used to compare the location of cysts (single/bilateral), the number of cyst cavities (single/multi-chamber), and other abnormalities in the connatal cyst group and subependymal cyst group. The mean anteroposterior diameter and mean height of cysts between the connatal cyst group and subependymal cyst group were compared by independent sample t-test.The ANOVA test was used to compare the differences in GDS outcomes among the groups. Multiple comparisons were conducted using the LSD test. Results Inter-observer agreements between the two radiologists were good for the collected data (all ICC>0.75). Eleven isolated connatal cysts and 7 connatal cysts with additional findings became smaller or disappeared, and all had good prognosis. Of the 14 isolated subependymal cysts, 12 became smaller or disappeared, 2 had no change in size, and 13 had good prognosis. The subependymal cysts with additional findings group included 9 cases: 6 became smaller or disappeared, only 3 showed no apparent changes, and 7 had an abnormal outcome. Subependymal cysts with additional findings were significantly reduced and patients demonstrated significant differences compared with the those with isolated subependymal cysts in the development quotients (DQ) of adaptability, large movements, fine movements, personal social interaction, and language DQ (P all 0.05). When associated with additional findings, connatal cysts and subependymal cysts could induce significant different DQ outcome (P all<0.05). Conclusions Isolated PVPC usually become smaller or disappeared and have a benign presentation after birth, whereas patients with subependymal cysts with additional findings usually have a poor prognosis. Connatal cysts usually have a good prognosis. Key words: Fetus; Ventricular; Cysts; Magnetic resonance imaging; Prognosis

Specific liver volume parameters in cirrhotic patients with peribiliary cysts

The presence of peribiliary cysts and morphological changes in the volumes of lobes in the livers of patients with cirrhosis are both related to the alteration of portal flow. Our study explored the relationship between these two features in patients with cirrhosis. We retrospectively selected 150 computed tomography (CT) images of cirrhotic livers and 105 CT images of healthy livers. The cirrhotic livers were further classified according to the presence of peribiliary cysts (peribiliary cysts group) or the absence of peribiliary cysts (control cirrhotic group). The characteristic features of liver cirrhosis, including modified caudate-right lobe ratio (mCR ratio), splenomegaly, ascites, and collateral shunts, were reviewed. Liver volume calculations included the sum of the left hepatic volume (LHV) and right hepatic volume (RHV; LHV + RHV) and the ratio of LHV to RHV (LHV/RHV). The two groups did not differ in the presence of splenomegaly, ascites, or collateral shunts. The control cirrhotic group exhibited a significantly higher mCR ratio and LHV/RHV ratio than the peribiliary cysts group did (p < 0.001). The healthy liver group exhibited a significantly higher LHV + RHV value than either the peribiliary cysts group or the control cirrhotic group did (p < 0.001). The peribiliary cysts group and the control cirrhotic group did not differ significantly for LHV + RHV (p > 0.05). The control cirrhotic group exhibited a significantly higher mCR ratio and LHV/RHV ratio than the peribiliary cysts group did, but the two groups were similar for most measurements. Peribiliary cysts might result in reduction of portal flow, causing cirrhotic liver with peribiliary cysts with left-sided dominance not to demonstrate the typical morphological appearance of the common cirrhotic liver.

Impacts of medroxyprogesterone acetate on oocytes and embryos: matched case-control study in women with stage III-IV ovarian endometriosis undergoing controlled ovarian hyperstimulation for in vitro fertilization.

BackgroundThis study investigated the effects of medroxyprogesterone acetate (MPA) on the oocytes and embryos in patients with advanced endometriosis who had a normal ovarian reserve and tubal infertility and received controlled ovarian hyperstimulation (COH) and explored the characteristics and pregnancy outcomes in subsequent frozen-thawed embryo transfer (FET) cycles.MethodsIn this prospective controlled study, 150 advanced endometriosis patients involving 150 in vitro fertilisation/intracytoplasmic sperm injection (IVF/ICSI) cycles and 163 FET cycles and 150 age-matched tubal infertility patients requiring 150 IVF/ICSI cycles and 115 FET cycles were recruited. Patients with endometriosis were sub-grouped into surgery group (n=102) (they were diagnosed with ovarian endometriomas and underwent 102 IVF/ICSI and 115FET cycles) and aspiration group (n=48) [they had ovarian “chocolate” cysts (>3 cm) that were aspirated and underwent 48 IVF/ICSI and 74 FET cycles].ResultsLower oocyte retrieval rate was noted in the endometriosis group than in the control group. Similar oocyte yield and peak estrogen (E2) level were found in two groups. The rates of mature oocyte, fertilization, cleavage, high-quality embryo, viable embryo, cancellation, implantation, and clinical pregnancy were similar between two groups. A higher oocyte yield was observed in the EMS cyst group than in the surgery group.ConclusionsThe ovary response, oocytes, embryos and pregnancy outcome were not influenced by the advanced endometriosis and the use of MPA and also independent of endometrioma or cyst surgery.

Early and middle Eocene dinoflagellate cysts from the Aktulagay section, Kazakhstan

A mid neritic-upper bathyal Ypresian section at Aktulagay, western Kazakhstan, has been analyzed palynologically. A number of key dinoflagellate cyst events are directly calibrated with published calcareous nannofossil data from the same section. The events are used to identify eight dinoflagellate cyst zones from a recently established zonation, used elsewhere in the eastern Peri-Tethys, and to calibrate these zones with the standard nannofossil zonation (NP zones). The events include the lowermost occurrences of Deflandrea oebisfeldensis (∼1%), Dracodinium simile, Eatonicysta ursulae, Dracodinium varielongitudum, Charlesdowniea coleothrypta, Ochetodinium romanum, Charlesdowniea columna, Samlandia chlamydophora, Areosphaeridium diktyoplokum, and Wetzeliella eocaenica. An important regional unconformity separates the Ypresian section from overlying non-calcareous strata with the age-diagnostic species Enneadocysta arcuata, Wetzeliella ovalis, Wilsonidium echinosuturatum, and Rhombodinium draco, indicating the Rhombodinium draco Zone of latest Lutetian–Bartonian age. Based on fluctuations of ecological groups of dinoflagellate cysts, a series of different depositional environments are interpreted and related to the existing sequence stratigraphic model of the section. In most cases dinoflagellate cyst agree with, or supplement, calcareous micro- and nannofossil indications, and support the sequence stratigraphic model. Impagidinium wardii sp. nov. is atypical for the otherwise oceanic genus as it bloomed in a mid-neritic environment. The first cooling at the end of the Early Eocene Climatic Optimum (EECO) is suggested to have caused a strong acme of Eatonicysta ursulae and distinct lowering of the sea level in the NP13 zone. Four new species are formally described: Cribroperidinium cavagnettiae sp. nov., Dracodinium robertknoxii sp. nov., Impagidinium wardii sp. nov., and Samlandia chriskingii sp. nov. The Aktulagay Formation of King et al. (2013) is renamed the Kulsary Formation.

Renal Syndromic Hearing Loss Is Common in Childhood-onset Chronic Kidney Disease.

BackgroundHearing loss (HL) in children may adversely affect their development. HL is more prevalent in patients with chronic kidney disease (CKD) than in the general population. This study evaluated the prevalence of HL and its underlying diseases in patients with childhood-onset in CKD.MethodsIn this retrospective study of a tertiary referral center, childhood-onset CKD patients (stage 2–5, age at onset of renal symptom < 18 years) were recruited. We referred to the “renal” syndromic HL as cases with genetic or syndromic diseases, or extra-renal anomalies in addition to HL and CKD.ResultsA total of 421 patients (male:female = 279:142) were reviewed according to the causes of CKD: congenital anomalies of the kidney and urinary tract (CAKUT; n = 184, 43.7%), glomerulopathies (GP; n = 105, 24.9%), cystic kidney diseases (CYST; n = 39, 9.3%), perinatal problems (PP; n = 29, 6.9%), and others (n = 64, 15.2%). HL was detected in 82 (19.5%) patients, including 51 (12.1%) patients with sensorineural hearing loss (SNHL), 30 (7.1%) with conductive hearing loss (CHL), and 1 patient with mixed HL. The prevalence of HL in each group was as follows: 16.8% in the CAKUT group, 28.6% in the GP group, 12.8% in the CYST group, 24.1% in the PP group, and 14.1% in the others group. HL was more common in higher CKD stages, especially CHL in end-stage renal disease. SNHL was more prevalent in CKD from GP. Of the 82 patients with HL, 50% had renal syndromic HL: 58.8% of SNHL and one-third of CHL were renal syndromic HL.ConclusionOne-fifth of the childhood-onset CKD had HL. Collectively, renal syndromic HL comprised half of the HL in this study. To improve the quality of life in patients with childhood-onset CKD, we suggest that HL should be considered, requiring surveillance, and if necessary, early intervention.

Is there a correlation between inflammatory markers and coagulation parameters in women with advanced ovarian endometriosis?

BackgroundEndometriosis is defined as a chronic inflammatory disease. Recent studies have shown that increased coagulation parameters including fibrinogen and platelets are associated with endometriosis. The objective of this study was to determine the levels of inflammatory markers and coagulation parameters and their correlations in women with endometriomas compared to those with benign ovarian cysts or normal pelvic anatomy.MethodsBetween June 2015 and June 2017, a total of 548 women who underwent laparoscopic/laparotomic surgery for ovarian endometriomas (OMA group, n = 226), non-endometriosis benign ovarian cysts (Cyst group, n = 210) and tubal reanastomosis (Control group, n = 112) were recruited in this study. Inflammatory markers including c-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and coagulation parameters including platelet count, thrombin time (TT), prothrombin time (PT), activated partial thromboplastin time, and plasma fibrinogen as well as CA-125 were determined.ResultsCompared with Cyst group and Control group, TT and PT in OMA group were significantly shorter and plasma fibrinogen levels were significantly higher (P < 0.05). Moreover, the levels of plasma fibrinogen were positively correlated with CRP, NLR and PLR (P < 0.05). In addition, the confidence intervals for the area under the curve (AUC) for CA-125 × fibrinogen were significantly higher than those for CA-125 (0.904–0.952 vs. 0.899–0.949) in the diagnosis of endometrioma.ConclusionsThese results indicate that women with endometriomas demonstrate a hypercoagulable status due to the inflammatory nature of endometriosis. The combined determination for CA-125 and fibrinogen demonstrate a higher area under the curve than the single detection of CA-125 in those with endometriomas compared to these with benign ovarian cysts.Trial registrationThis study was approved by the Human Ethics Committee of the Women’s Hospital, School of Medicine, Zhejiang University (No.20170174) and all women provided written informed consent.

The relationship between ovarian endometriosis and clinical pregnancy and abortion rate based on logistic regression model.

In order to study the relationship between ovarian endometriosis and clinical pregnancy, explore the correlation between endometriosis (EMT) and abortion rate and its mechanism, and provide a new theoretical basis for clinical diagnosis as well as treatment of endometriosis, in this study, pelvic endometriosis under 40 years old and have in vitro fertilization-embryo transfer (IVF-ET) operation will be selected as subjects of study. SPSS20.0 statistical software is used to analyze the data. When the measurement data between groups are compared, it is necessary to use t-test. It is necessary to use mean ± standard deviation () to expressed the results. When the counting data between groups is compared, it is necessary to use Chi-square test. Finally, the binomial classification logistic regression model is established by stepwise regression method to screen out the significant factors. The results show that the infertility duration of ovarian endometriosis cyst is (3.1 ± 1.9). The infertility years of other pelvic endometriosis are (3.9 ± 2.2). The infertility years of ovarian endometriosis cyst group are shorter than those of other pelvic endometriosis groups. Significant difference cannot be seen in follicle stimulating hormone (FSH) between the two groups of patients, and the basal FSH of other pelvic endometriosis groups is obviously lower in the two groups between the ages of 29 and 40 years. In the ovarian endometriotic cyst group, the significant difference can be seen (P < 0.05). Moreover, in the comparison of ovulation induction, the Gn dosage of fresh-cycle ovarian endometriosis patients is obviously higher than that of patients with ovarian endometriosis during the freezing cycle. The fertilization rate of patients with fresh cycle ovarian endometriosis is higher than that of patients with ovarian endometriosis during the freezing cycle. The two groups of patients with the factor of ovarian endometriosis after fresh embryo transplantation and the factor of fallopian tube are compared, and the abortion rate of the ovarian endometriosis group is lower than that of the fallopian tube group. Therefore, controlling the development of ovarian endometriosis can help to improve the pregnancy rate, reduce the abortion rate and improve the pregnancy outcome of patients with ovarian endometriosis.

Association between ELP4 rs986527 polymorphism and the occurrence and development of intracranial arachnoid cyst.

ObjectiveThe association between ELP4 rs986527 polymorphism and the occurrence and development of intracranial arachnoid cyst was studied in this paper.MethodsEighty‐five patients diagnosed with intracranial arachnoid cysts by cerebral computed tomography scan were selected. Sixty‐three healthy volunteers for medical examination in hospitals served as controls. The cognition, depressive symptoms, and the likelihood of headache, dizziness, head trauma history, dementia, depression, and epilepsy were assessed. ELP4 genotypes and its allele frequency were determined by PCR, endonuclease restriction analysis, and gel electrophoresis.ResultsELP4 rs986527 had three genotypes: TT, TC, and CC. The intracranial arachnoid cyst group showed no statistically significant difference in genotype frequencies compared with healthy controls. There was no significant correlation between ELP4 rs986527 polymorphism and location of intracranial arachnoid cyst. TC and C genotype frequencies were associated with a higher incidence of clinical symptoms than TT genotype frequencies, and C allele frequencies were associated with a significantly higher incidence of clinical symptoms compared with T allele frequencies. There was no significant difference in TNF‐α and IL‐1β levels between TT/TC/CC genotypes before treatment. After treatment, the levels of TNF‐α and IL‐1β were significantly decreased in different genotypes, and the decrease in CC was the greatest. The frequency of TT and TC genotypes was higher than that of CC genotypes.ConclusionELP4 rs986527 polymorphism affected the incidence of clinical symptoms and the levels of TNF‐α and IL‐1β in patients with intracranial arachnoid cysts.

Identification of differentially expressed proteins associated with recurrence in ovarian endometriotic cysts

ABSTRACTThe objective of this study was to identify proteins that are differentially expressed in the cystic wall tissues of ovarian endometriotic cysts, simple ovarian cysts, and in normal ovarian tissues. Specimens of ovarian endometriotic cyst wall tissue, simple ovarian cyst wall tissue, and normal ovarian tissue (six specimens per group) were collected from patients who received gynecologic surgery, respectively. Differentially expressed proteins related to the ovarian endometriotic cysts were screened by use of isobaric tags for relative and absolute quantitation (iTRAQ) combined with functional annotation and bioinformatics analyses. All differentially expressed proteins related to cysts were validated using immunohistochemistry methods in recurrent and non-recurrent ovarian endometriotic cyst. A total of 359 proteins were identified as up-regulated in ovarian endometriotic cyst groups when compared with both the normal ovary and simple ovarian cyst groups. The levels of 27 proteins were >two-fold higher in the ovarian endometriotic cyst group than that in the other two groups. Of note, the five most significantly upregulated proteins were Charcot-Leyden Crystal Galectin (CLC), Defensin, alpha 1 (DEFA1), S100 calcium-binding protein A9 (S100A9), S100 calcium-binding protein A8 (S100A8), and Ferritin Light Chain (FTL). Immunohistochemistry results showed that the changes of S100A9 and S100A8 were consistent with the results shown by iTRAQ. However, no similarity of CLC, DEFA1, and FTL proteins was found between iTRAQ and immunohistochemistry. The ratio of patients with abnormally high S100A9 and S100A8 expression in the recurrent ovarian endometriotic cyst group was significantly higher than that in the non-recurrent group (P < 0.05). Our data identify differentially expressed proteins S100A9 and S100A8, and suggest they may serve as novel molecular markers to predict postoperative recurrence of an ovarian endometriotic cysts.Abbreviations: iTRAQ: isobaric tags for relative and absolute quantitation; HPRD: Human Protein Reference Database; GO: Gene Ontology; KEGG: Kyoto Encyclopedia of Genes and Genomes; EM: Endometriosis; COX-2: cyclooxyenase-2; NF-kB: nuclear factor kappa-B; PR-B: progesterone receptor type B.

Diagnosis and management ofpancreatic cystic neoplasms: current evidence and guidelines.

Pancreatic cystic neoplasms (PCN) are a heterogeneous group of pancreatic cysts that include intraductal papillary mucinous neoplasms, mucinous cystic neoplasms, serous cystic neoplasms and other rare cystic lesions, all with different biological behaviours and variable risk of progression to malignancy. As more pancreatic cysts are incidentally discovered on routine cross-sectional imaging, optimal surveillance for patients with PCN is becoming an increasingly common clinical problem, highlighting the need to balance cancer prevention with the risk of (surgical) overtreatment. This Review summarizes the latest developments in the diagnosis and management of PCN, including the quality of available evidence. Also discussed are the most important differences between the PCN guidelines from the American Gastroenterological Association, the International Association of Pancreatology and the European Study Group on Cystic Tumours of the Pancreas, including diagnostic and follow-up strategies and indications for surgery. Finally, new developments in the management of patients with PCN are addressed.

Ultrasound differential diagnosis of hepatic hilar cystic lesions in neonates and infants

Objective To explore the value of ultrasound in differential diagnosis of hepatic hilar cyst in neonates and infants. Methods The ultrasonographic characteristics of 93 children with hilar cysts under 6 months of age admitted to the General Surgery Department of Beijing Children′s Hospital.Affiliated to Capital Medical University from January 2014 to December 2018 were retrospectively analyzed.According to the surgical results, they were divided into two groups: cystic biliary atresia (CBA) group and congenital choledochal cyst (CC) group, 21 cases in the CBA group and 72 cases in the CC group.The size of cyst in hepatic portal area, the shape of gallbladder in empty stomach, the expansion of intrahepatic and extrahepatic bile ducts, the deposition of biliary sludge and the communication between cyst and intrahepatic bile duct were observed by ultrasound. Results The cyst volume of CBA group was 0.4(0.1, 1.3)cm3, and that of CC group was 18.3(5.4, 50.3)cm3.The cyst volume of CBA group was significantly smaller than that of CC group (P<0.01); 19 cases had abnormal gallbladder morphology in CBA group and 4 cases in CC group (P<0.01); 1 case had biliary sludge in hilar cyst in CBA group and 51 cases had biliary sludge in cyst in CC group (P<0.01); no intrahepatic bile duct dilatation was observed in CBA group, and 54 cases had intrahepatic bile duct dilatation in CC group (P<0.01); no cyst communicated with intrahepatic bile duct in CBA group, and all cysts communicated with intrahepatic bile duct in CC group (P<0.01). Conclusion Gallbladder shape, cyst size, biliary sludge deposition, intrahepatic bile duct dilatation and the communication between cyst and intrahepatic bile duct can be used as sonographic features to differentiate CBA from CC. Key words: Ultrasound; Cystic biliary atresia; Choledochal cyst

Utility of CT Texture Analysis in Differentiating Low-Attenuation Renal Cell Carcinoma From Cysts: A Bi-Institutional Retrospective Study.

OBJECTIVE. The purpose of this study was to evaluate the utility of CT texture analysis (CTTA) in differentiating low-attenuation renal cell carcinoma (RCC) from renal cysts on unenhanced CT. MATERIALS AND METHODS. Ninety-four patients with low-attenuation RCC on unenhanced CT were compared with a cohort of 192 patients with benign renal cysts. CT characteristics (size and minimum, maximum, and mean attenuation) and CTTA features were recorded using an ROI approximately two-thirds the size of the mass. Masses were subjectively assessed by two expert genitourinary readers and two novice readers using a 5-point Likert scale (1 = definite cyst, 5 = definite renal cell carcinoma). Results of first-order CTTA and subjective evaluation were compared using ROC analysis. RESULTS. The group of 94 patients with low-attenuation RCC included 62 men and 32 women (mean age, 58.0 years). On unenhanced CT, the RCC were larger than 10 mm and of a median size of 50 mm with less than or equal to 20 HU (mean attenuation, 16 ± 4 HU). Of the RCC cohort, 83 were clear cell subtype. The cohort of 192 patients included 134 men and 58 women (mean age, 64.7 years) with benign renal cysts greater than 10 mm and a median size of 27 mm and less than or equal to 20 HU (mean attenuation, 9 ± 6 HU). The mean follow-up time was 6.2 years. Mean entropy in the low-attenuation RCC group (4.1 ± 0.7) was significantly higher than in the cyst group (2.8 ± 1.3, p < 0.0001). Entropy showed an ROC AUC of 0.89, with sensitivity of 84% and specificity of 80% at threshold 3.9. The AUC was better than subjective evaluation by novice readers (AUC, 0.77) and comparable to subjective evaluation by two expert readers (AUC, 0.90). A model combining the three best texture features (unfiltered mean gray-level attenuation, coarse entropy, and kurtosis) showed an improved AUC of 0.92. CONCLUSION. High entropy revealed with CTTA may be used to differentiate low-attenuation RCC from cysts at unenhanced CT; this technique performs as well as expert readers.

Comparison of efficacy and safety of three different surgical methods for nasal vestibular cyst

Objective To explore the efficacy and safety of endoscopic nasal vestibule cysts, lip gingival trench path nasal vestibule excision and low temperature plasma radiofrequency ablation under nasal endoscope in the treatment of nasal vestibule cyst. Methods From January 2013 to December 2017, ninety patients with nasal vestibule cyst admitted in Taiyuan Central Hospital were selected.According to different surgical methods, the patients were divided into nasal endoscope nasal vestibule cyst group(A group, 26 cases), cleft lip gingival vestibule cyst excision group(B group, 36 cases), low temperature plasma radiofrequency ablation group under nasal endoscopy(C group, 28 cases). The efficacy and safety of the three types of operation were compared. Results The operation time[(15.5±3.6)min]and wound healing time[(2.3±0.9)d] in A group and the operation time[(16.3±4.5)min], wound healing time[(2.1±0.5)d] in C group were all significantly shorter than those in B group, the differences were statistically significant(t=5.268, 4.698, 5.624, 4.267, all P<0.05). The amount of bleeding in C group[(9.3±0.6)mL] was the least, followed by A group[(12.2±1.7)mL], and the difference among the three groups was statistically significant(t=8.256, 7.254, all P<0.05). The postoperative wound VAS score among the three groups was statistically significant(F=12.674, P<0.001), and the VAS score in C group[(1.6±0.7)points]<A group[(3.2±1.5)points]<B group[(4.9±2.3)points], the differences among the three groups were statistically significant(t=4.256, 3.998, 2.989, all P<0.05). The degree of facial swelling in C group was mild(39.29%) and moderate(60.71%), the differences were statistically significant compared with those in A group and B group(χ2=5.226, 11.651, all P<0.05). The incidence rate of complications in C group (0.00%) was significantly lower than that in A group(11.54%) and B group(16.67%), the difference was statistically significant(χ2=3.934, P<0.05). Conclusion Compared with the endoscopic nasal vestibule cysts, lip gingival trench path nasal vestibule excision, the low temperature plasma ablation under nasal endoscopy in the treatment of nasal vestibular cyst has the best efficacy, it is safe, less painful, and not easy to relapse. Key words: Cysts; Vestibular diseases; Nose; Catheter ablation; Natural orifice endoscopic Surgery; Surgical procedures, operative; Postoperative complications; Comparative effectiveness research

Endoscopic removal of recurrent colloid cysts.

Removal of colloid cysts of the third ventricle using a purely endoscopic method has been established as a safe and advantageous technique. It is hypothesized that endoscopic removal in recurrent cases might pose more technical challenges and result in less success. The objective of this study was to assess the feasibility and outcomes of using a purely endoscopic approach for the management of recurrent colloid cysts compared to primary cysts. A retrospective cohort study was performed on patients who underwent purely endoscopic removal of their colloid cyst. Descriptive statistics were compared for patients undergoing surgery for a recurrent cyst and those for a control cohort undergoing surgery for a primary cyst. Bivariate analysis was conducted using a Fisher's exact test for categorical variables and Mann-Whitney U-test for continuous variables. In total, 121 patients had a primary colloid cyst endoscopically removed and 10 patients had a total of 11 recurrent cysts removed. Recurrence or progression after surgery occurred in 3 (2.5%) cases in the primary cyst group and 2 (18.2%) cases in the recurrent cyst group. Symptomatic presentation during the follow-up period occurred in 6 (54.5%) cases in the recurrent cyst group versus 75 (62%) cases in the primary cyst group (p = 0.749). Two patients (20%) in the recurrent group had a second recurrence in a mean period of 30 months (1 patient at 15 and 1 patient at 45 months). One of these patients required a tertiary endoscopic removal 8 years after the second resection. No immediate postoperative complications or new morbidities were observed after repeat endoscopic surgery. The authors' findings indicated a nonsignificant trend toward a higher recurrence rate (18.2% vs 2.5%, p = 0.055) and a decreased proportion of complete removal (90.9% vs 81.8%, p = 0.296) in the recurrent cyst group compared to the primary cyst group. However, a significantly higher rate of preoperative hydrocephalus was observed in the primary cyst group compared with the recurrent cyst group (63.6% vs 18.2%, p = 0.007). Purely endoscopic approaches for the removal of recurrent colloid cysts of the third ventricle are feasible and equally safe compared with endoscopic removal of primary cysts. The study's findings did not show a statistically significant difference in the rate of recurrence between the 2 groups. The proportion of patients with symptomatic cysts on presentation was lower in patients with recurrent cysts than in patients with primary cysts. Due to the high rate of complete removal with negligible morbidity, the authors continue to advocate for an endoscopic removal at the time of cyst recurrence.

Clinical significance of incidentally discovered renal cysts in pediatric patients.

To determine the clinical significance of incidentally discovered renal cysts in pediatric patients and identify imaging predictors of autosomal dominant polycystic kidney disease (ADPKD). A retrospective search of radiology reports from 2000 to 2016 was performed to identify patients < 18years old with an imaging exam identifying at least one renal cyst and a ≥ 1-year follow-up renal imaging exam for cyst evaluation and/or diagnosis of ADPKD. Cysts with clear solid mass components were excluded. 84 pediatric patients with renal cysts were identified (mean age, 9.5 years), including 76 patients with incidentally discovered cysts and 8 patients with cysts identified from screening for ADPKD family history. Among the incidentally discovered cyst group, 7.9% were found to have ADPKD compared with 100% of patients with cysts and ADPKD family history. Maximum cyst diameter was significantly increased in patients with ADPKD compared to patients without ADPKD (22.0mm vs 12.7mm; P < 0.001, Fisher's Exact test). Multiple cysts or bilateral cysts were imaging features associated with a significantly higher (P < 0.01) incidence of ADPKD, both for the entire study population and the incidentally discovered cyst group. An increase in cyst size on the follow-up study was associated with higher incidence of ADPKD (P < 0.05). No malignancies were identified. Incidentally discovered renal cysts in pediatric patients are associated with a small but non-zero risk of ADPKD. Among cyst characteristics, bilaterality, multiplicity, large size, and increased size on follow-up imaging were associated with a statistically significant elevation of ADPKD risk, and should prompt diagnostic evaluation.

LABORATORY PREDATORS OF SPONTANEOUS PREGNANCY OCCURRENCE IN WOMEN WITH OVARIAN CYSTS AFTER LAPAROSCOPIC TREATMENT OF INFERTILITY

The main goal of treating couples with infertility is achieving pregnancy and successful delivery of the newborn. Laparoscopy is used worldwide for treating patients with infertility due to endometriosis or recurrent functional uni- or bilateral ovarian cysts. In our prospective study we examined 258 women with the diagnosis of benign mass of the ovaries who underwent treatment for infertility at Samara State Clinical Hospital n.a. V.D. Seredavin within the period from November 2015 to December 2017. 54 women with infertility were enrolled in the current study. We divided them into two groups: the first group included patients with endometrioid cysts (n = 20) and the second one included patients diagnosed with functionalovarian cysts (n = 34). Exclusion criteria comprised the tubal factor of infertility, male factor, BMI &gt; 25 of female and other metabolic disorders. Anti-Mullerian hormone (AMH) ng/ml and CA-125 were determined preoperatively. Patients were compatible with age, parity, and duration of infertility. Post-operative levels of AMH were measured on the first cycle after surgery. Postoperatively the patients were followed up for 6 monthsin order to confirm the presence/absence of pregnancy by ultrasound examination and the level of human chorionic gonadotropin in blood. 42,6% of total women enrolled in this study became pregnant within 6 months after surgery. The proportion of pregnancies in the group with treated endometriomas was significantly lower in comparison with the group of functional cysts: 7 patients (35%)in the first groupand 16 patients (47,05%) in the second one, p &lt; 0.007 respectively. We consider post-operative AMH level to be more accurate prognostic tool for predicting results of laparoscopic infertility treatment in women both with ovarian cysts and endometriomas.

Serum antimüllerian hormone concentration increases with ovarian endometrioma size

To examine whether serum antimüllerian hormone (AMH) levels correlate with the size of ovarian endometrioma (OMA). An observational cross-sectional study. University hospital. Two hundred and sixty-seven nonpregnant women, aged 18-42years, with no prior history of surgery for endometriosis and a histologically documented ovarian cyst. Surgical management for a benign ovarian cyst. Correlation between serum AMH concentration and cyst size according to OMA and non-OMA benign cyst. Women with OMA were compared with a control group of women who had non-OMA benign ovarian cysts. The AMH assay samples were collected less than a month before the surgery. Between January 2004 and September 2016, 148 women were allocated to the OMA group and 119 to the non-OMA benign cyst group. The AMH concentrations were not statistically significantly different between the two groups (3.7 ± 2.8ng/mL vs. 4.1 ± 3.3ng/mL). A multiple linear regression model accounting for potential confounders revealed that the log10 of the serum AMH concentration positively correlated with the log10 of the OMA cyst volume (R2 = 0.23; coefficient = 0.05; 95% CI, 0.007-0.10). In women no prior history of surgery for endometriosis, serum AMH levels increased with cyst size in cases of OMA.

ЛІКУВАННЯ ПАЦІЄНТІВ З КІСТОЮ ВЕРХНЬОЩЕЛЕПНОЇ ПАЗУХИ ОДОНТОГЕННОГО ГЕНЕЗУ

Кісти верхньощелепної пазухи є достатньо поширеною патологією системиприносових пазух, яка має мультифакторну етіологію, що продовжує активнодосліджуватися. Протягом останніх років особлива увага дослідників сконцентрована на роліхронічного запалення коренів зубів, які безпосередньо прилягають до нижньої стінкимакзилярного синусу, і відповідно втягують в патологічний процес навколишні структури.Одним із об’єктивних показників вираженості запалення є рівень матрикснихметалопротеїназ, зокрема матриксної металопротеїнази 9 (ММП9). Таким чином, метоюроботи є вивчення ефективністі лікування пацієнтів з кістою верхньощелепної пазухиодонтогенного генезу у віддаленому періоді. Матеріали і методи. У дослідження ввійшло 150пацієнтів. Група 1 – 125 осіб (вік 20-69 років, чоловіки - 58, жінки – 67), група 2 - 25 пацієнтів(вік 21-59 років, 11 чоловіків і 14 жінок). Всім пацієнтам з обстежуваних груп було проведенохірургічне лікування - видалення кісти верхньощелепної пазухи через нижній носовий хід, зподальшим консервативним лікуванням; пацієнтам першої групи в післяопераційному періодібуло проведено ревізію каналів зубів верхньої щелепи з заміною пломбувального матеріалу, апацієнтам другої групи дане втручання не проводилося. Критерій включення – підвищення рівняММП9 у слині. Критеріями виключення стали наявність гострого захворювання за 3 місяці дооперації, лікування у стоматолога за 3 місяці до хірургічного втручання, нормальний рівеньММП9 у слині. У процесі передопераційної підготовки, всім пацієнтам було проведено КТнавколоносових пазух, ендоскопічне дослідження порожнини носа і носоглотки,ринопневмометрію, визначення показника мукоциліарного кліренсу, активності ММП-9 в слині.Дослідження активності ММП-9 в слині проводилося з використанням ELISA kit.Статистична обробка даних виконувалася з використанням ПЗ IBM SPSS Statistics 22.Результати. Рівень ММП9 у слині пацієнтів першої групи склав 1347 (± 328) нг / мл, другої -1410 (± 220) нг / мл. Кількість рецидивів кісти в/щ пазухи у групі 1 була 8 випадків, що склало6,4% від загальної кількості. Серед інших ускладнень: міцетома в/щ пазухи - 4 ороантральнанориця - 1, хоанальний поліп - 2. . Кількість рецидивів кісти в/щ пазухи у групі 2 була 9 випадків(36%), міцетома в/щ - 3 випадки, ороантральна нориця - 1, хоанальний поліп - 1. Висновок.Отримані результати свідчать про вищу імовірність розвитку рецидиву кістиверхньощелепної пазухи за відсутності наступної ревізії коренів зубів і навколокореневихділянок, що безпосередньо межують із нижньої стінкою пазухи.

Efficacy of Bacteriophages in Propionibacterium acnes-Induced Inflammation in Mice.

BackgroundBacteriophages have been introduced as living drugs for infectious diseases; thus, they may provide an alternative to conventional acne therapeutics in patients with non-responsive acne.ObjectiveWe investigated the effect of bacteriophages using an acne mouse model with Propionibacterium acnes-induced inflammatory nodules by clinical examination, pathology, and immunohistochemical analysis.MethodsA human-isolated P. acnes suspension (109 colony forming units/µl) was injected into the backs of HR-1 mice. Group A was used as a control, Group B was injected on the back with P. acnes 4 weeks following the initial P. acnes suspension injection, and group C was injected on the back with P. acnes and bacteriophages 4 weeks following the initial P. acnes suspension injection. Clinical and histopathological evaluations were performed.ResultsInflammatory nodule size decreased with time in all groups. Group C showed the greatest decrease in size, followed by group B and group A. The histopathological findings showed a decrease in epidermal thickness and the number and size of microcomedone-like cysts in groups B and C compared to group A. Immunohistochemistry revealed similar expression of integrin α6, the epidermal proliferation marker, infiltration of CD4/CD8 T cells and neutrophils, and expression of myeloperoxidase, interleukin-1β, toll-like receptor-2, LL-37, and matrix metalloproteinase-2/3/9 in all three groups.ConclusionUsing an acne mouse model with P. acnes-induced inflammatory nodules, we demonstrate that bacteriophages may constitute an alternative to conventional acne therapies. However, additional studies are needed for human applications.

Evaluation of arthroscopic rotator cuff repair results in patients with anterior greater tubercle cysts.

The purpose of this study was to investigate the clinical results of arthroscopic rotator cuff repair in patients with anterior greater tubercle cyst in magnetic resonance imaging (MRI). The cyst-present group comprised 38 patients with anterior greater tubercle cyst in MRI, and age- and sex-matched 30 patients without cyst in humeral head were included in the control group. The cystic group was divided into two groups, smaller than 5 mm (21 patients) and larger than 5 mm (17 patients), according to the cyst size. A total of three groups were created. In the evaluation of clinical outcomes, modified University of California at Los Angeles (UCLA) and the Western Ontario Rotator Cuff Index (WORC) were used. The visual analog scale (VAS) was used to assess pain. One-way analysis of variance was used to compare VAS, UCLA, and WORC scores among the groups. There was a statistically significant difference in the clinical results of VAS, UCLA, and WORC among the cystic and noncystic groups in the anterior greater tubercle ( p < 0.05). There was also a statistically significant difference in the clinical results of UCLA, WORC, and VAS scores according to the cyst sizes in the anterior greater tubercle cyst group ( p < 0.05). Anterior greater tubercle cysts have negative effects on rotator cuff repair results. If the anterior greater tubercle cyst size is greater than 5 mm, the negative effects of rotator cuff repair results are more pronounced. An understanding of anterior greater tubercle cysts has a critical importance for rotator cuff surgery planning.