Single Cyst Research Articles

Analysis of Complications of a Neglected Disease: 13 Years of Experience with Liver Hydatid Cysts in a High-Volume Hospital

Background and Objectives: The aim of this study was to evaluate the clinical presentation, treatment outcomes, and complications associated with hepatic hydatid cysts in a pediatric population. Materials and Methods: This retrospective study analyzed 214 pediatric patients with liver hydatid cysts, focusing on clinical presentation, treatment outcomes, and associated complications. Patients were classified based on treatment modality, including non-operative management with albendazole, PAIR, and surgical intervention. This study compared cyst characteristics, recurrence rates, and complications such as cysto-biliary fistulas. Results: Among the patients, 68% (n = 145) had a single cyst and 86% (n = 184) were found to have isolated liver cysts. No significant statistical difference was observed between Group 1 and Group 2 in terms of age, gender, and basic laboratory values and general characteristics of the cysts, such as the lobe where the cyst was located, involvement of multiple organs, number of cysts, the state of cyst rupture, and recurrence; no statistically significant difference was found between the groups (p > 0.05 for each comparison). Cyst rupture incidence was 6%, and the average incidence of recurrence was 2%, with a surgical recurrence incidence of 3%. A total of 37 patients had a laparotomy, while 7 had laparoscopic surgery. In total, capitonnage was performed in 68 patients, omentopexy in 4, and cystostomy in 6. Consequently, among the treated patients (PAIR + surgery), the incidence of cysto-biliary fistula was 11%, anaphylaxis was 2%, surgical recurrence was 3%, and the incidence of reoperation (Clavien–Dindo ≥ 3) was 6%. The average follow-up period was 72 months, during which no mortality was observed. Conclusions: We identified key clinical outcomes related to both non-surgical treatments (cyst rupture and recurrence) and surgical groups (cysto-biliary fistulas, anaphylaxis, the need for reoperation, rupture, and recurrence).

A New Cyst Nematode, Heterodera luodingensis n. sp. (Nematoda: Heteroderinae) From Rice In China.

A unique cyst nematode population (Heterodera spp.) was collected from rice roots in Luoding County, Guangdong Province, China. Morphological and molecular analyses revealed it is significantly different from all previously described cyst nematode species. It is described as Heterodera luodingensis n. sp. and classified in the Cyperi group. H. luodingensis n. sp. is characterized by its lemon-shaped cyst with a prominent terminal vulval cone that is ambifenestrate with abundant bullae and a relatively short vulval slit, 31.3 (24.4 -38.7) μm long. The second-stage juveniles (J2) are characterized by dumbbell shaped labials, three lip annules and a lateral field with three incisures. The J2 stylet is 18.7 (16.9 -19.8) μm long with anterior concave or spherical knobs. The tail is elongate conoid, tapering to a rounded terminus or zig tapering to a rounded terminus that is 54.9 (43.9 - 64.3) μm long with a hyaline region comprising 40.3%-52.5% of the tail. Phylogenetic tree analysis based on rDNA 28S D2D3 and ITS fragments showed that the H. luodingensis n. sp. is unique and clearly separated it from other cyst nematodes. It is most closely related to H. oryzicola, H. fengi, H. elachista, H. oryzae, and H. guangdongensis. H. luodingensis n. sp. can be distinguished from H. oryzicola by its shorter vulval slit and underbridge, from H. elachista by abundant bullae, shorter vulval slit and fenestrate width, from H. oryzae by a shorter vulval slit and underbridge, from H. fengi by a shorter vulval slit, from H. guangdongensis by a longer cyst length and abundant bulla. Based on PCR-RFLP of rDNA-ITS, H. luodingensis n. sp. can be clearly distinguished from H. oryzicola, H. mothi, H. elachista, H. guangdongensis and H. cyperi. A parasitism test from a pure culture derived from a single cyst in greenhouse showed that H. luodingensis n. sp. can successfully complete its life cycle on rice and rice is its type host.

Evolving Pattern of Human Cystic Echinococcosis: A Cross-Sectional Study

Introduction Cystic echinococcosis (CE) poses a considerable public health challenge in many countries. Due to the absence of comprehensive CE surveillance and management guidelines and varying demographic and geographical factors across countries, examining the disease's epidemiology and clinical manifestations within specific regions is essential. The current study aims to investigate CE trends, clinical features, and patient complaints in an endemic area of Iraq. Methods This retrospective cross-sectional study was conducted at Smart Health Tower in Sulaymaniyah, Iraq, from May 2020 to May 2024. It involved patients diagnosed and treated for CE. Data was collected using detailed case forms covering patient demographics, cyst location, presentation, medical and surgical history, and recurrence. Results The study involved 605 CE patients with nearly equal gender distribution and a mean age of 40.1 ± 18.6 years. Most patients, 217(35.9%), were aged 31-50 and lived in urban areas 505(83.5%). The majority, 382(63.1%), were asymptomatic, with liver cysts being the most common 361(59.7%). Single cysts were more prevalent in 513(84.8%) cases, with surgery performed in 222(36.7%) of cases, and recurrence was rare 8(1.3%). Conclusion This study highlights a significant burden of CE in urban areas, where asymptomatic cases often lead to delayed diagnosis. The high prevalence of liver and lung cysts underscores the necessity for targeted public health strategies and enhanced control measures for free-roaming dogs.

Ultrasound study of natural progression of ovarian endometrioma.

To determine the natural progression of ovarian endometrioma in women who are managed expectantly. This was a retrospective cohort study of 83 women with evidence of ovarian endometrioma who were managed expectantly between April 2007 and May 2022. The study was conducted in the Department of Women's Health, University College London Hospitals and The Gynecology Ultrasound Centre, London, UK. We searched our ultrasound clinic databases to identify women aged 18 years or older with evidence of ovarian endometrioma who were managed expectantly for ≥ 6 months. All women attended for a minimum of two ultrasound scans performed by a single expert ultrasound operator. In addition to patient demographics, we recorded the number, mean diameter and location of each cyst. The cyst growth rate was expressed as annual change in the mean diameter. A total of 1922 women who attended our gynecology clinic during the study period were found to have evidence of moderate or severe endometriosis on pelvic ultrasound examination. Of those, 83 women had evidence of ovarian endometrioma and were managed expectantly. The median age of women was 39 (range, 26-51) years at the initial visit. Each woman had at least two ultrasound scans performed by a single expert operator at a minimum interval of ≥ 6 months. Of 83 women diagnosed with endometrioma, 50 (60% (95% CI, 49-71%)) had a single cyst and the remainder had multiple cysts. The median number of endometriomas per patient was 1 (range, 1-5) and the median follow-up time was 634 (range, 187-2984) days. A total of 39/83 (47% (95% CI, 36-58%)) women experienced an overall reduction in size of cysts, in 18/83 (22% (95% CI, 13-32%)) the cysts increased in size and in 26/83 (31% (95% CI, 22-42%)) women, no meaningful change in size was observed. The median change in mean cyst diameter per woman during the study period was -2.7 (range, -57.7 to 39.3) mm, with a median annual regression rate of -1.7 (range, -24.6 to 42.0) mm/year/woman. Overall, when compared with the initial visit, cysts were significantly smaller at follow-up (median diameter, 22.3 (range, 6.7-77.0) mm vs 18.5 (range, 5.0-72.0) mm; P = 0.009). We did not identify any clinical characteristics that could reliably predict the chance of endometrioma progression. In the majority of women with an ultrasound diagnosis of ovarian endometrioma, the cysts do not increase in size significantly over time and they could be managed expectantly. This evidence may help clinicians when counseling asymptomatic or minimally symptomatic women about management of ovarian endometrioma. © 2024 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

Transcorneal aspiration for management of primary iris cysts in the standing horse.

Equine primary iris cysts are usually incidental findings but, if associated with clinical signs, may require intervention. The use of laser (Nd:Yag or diode) has been reported but requires specialised equipment. Transcorneal aspiration has not been previously evaluated in the standing horse. To review outcomes of standing transcorneal aspiration of primary iris cysts (STAPIC) in horses. Horses were identified from electronic patient records from 2018 to 2024 across four collaborating centres. Clinical presentation and outcomes were identified and reported using descriptive statistics. Eighteen horses were identified. Behavioural signs reported included 'spooking' and changes in rideability often associated with jumping. Single large unilateral cysts were present in 11 horses, bilateral cysts in three horses and multiple unilateral cysts in four horses. Following treatment, one horse developed uveitis and fibrin in the anterior chamber associated with needle contact with the iris stroma due to movement, and a second horse developed fibrin within the anterior chamber. Both conditions resolved with anti-inflammatory medication and administration of tissue plasminogen activator. No other adverse effects were reported. Follow-up was available from all horses (median: 6months, interquartile range [IQR]: 4-11months) with no recurrence, although one horse developed an iris cyst in the contralateral eye after 3years. All owners reported improvement in clinical signs, with 61% reporting no further signs. STAPIC is an effective and easily accessible alternative for treating iris cysts in horses rarely associated with complications.

Magnetic Resonance Imaging Features of Sporadic Optic Chiasmatic-Hypothalamic Gliomas and Correlation with Histopathology and BRAF Gene Alterations.

Sporadic optic chiasmatic-hypothalamic gliomas (OCHGs), though histologically low-grade tumors, manifest as aggressive neoplasms radiologically, leading to difficulty in diagnosis. Molecular alterations of the BRAF gene are detectable in a majority of sporadic OCHGs. The purpose of our study was to elucidate the characteristic imaging features of sporadic OCHGs and to investigate whether imaging phenotypes could potentially correlate with specific BRAF gene alterations associated with these tumors. We retrospectively reviewed baseline magnetic resonance (MR) images and medical records of 26 patients with histopathologically proven sporadic OCHGs. MR imaging (MRI) features were systematically evaluated. Statistical analysis was performed to determine whether there was a significant association between imaging findings and BRAF molecular alterations. Twenty-two cases (84.6%) presented with solid-cystic masses, while four (15.4%) presented with purely solid lesions. In all 26 cases, the solid component revealed central necrosis; there was minimal necrosis in 11 cases (42.3%), moderate in 8 (30.7%), and marked in 7 (26.9%). The presence of multiple cysts (>4) and minimal necrosis showed a significant association with BRAFV600E mutation (P < 0.005). Marked necrosis in the solid component significantly correlated with BRAF wild genotype (P < 0.001). The presence of a single peripheral cyst significantly correlated with BRAF fusion (P = 0.04). Sporadic OCHGs have a distinctive appearance on imaging. The solid-cystic composition coupled with varying degrees of central necrosis are clues to the radiological diagnosis of this entity and can facilitate early recognition in clinical practice. Imaging could potentially serve as a non-invasive predictor of the BRAF alteration status, thereby serving as a prognostic marker and guiding personalized management.

Pathomorphological and gender-age aspects of echinococosis of the liver

Background. Echinococcosis is a chronic parasitic disease that belongs to zooanthropohelminthosis and is characterized by the development of solitary or multiple cystic formations in the liver, lungs, brain and other organs. Today, the incidence is increasing dramatically in non-endemic countries, and the spread of the disease is largely linked to global population migration. Purpose – To analyze the pathomorphological and sex-age characteristics of operated patients with echinococcosis of the liver for the period 2011–2021. Materials and Methods. Medical documentation and autopsy material of all cases of surgical intervention in patients with liver echinococcosis at the pathology department of the State Institution «Zaycev V.T. Institute of general and urgent surgery of the National Academy of Medical Sciences of Ukraine» for the period 2011–2021. Sex-age characteristics of patients with echinococcosis were studied. A pathomorphological study of the postoperative material was carried out, taking into account the size and type of cysts, and the location of their formation. The preparations were stained with hematoxylin and eosin and by the Van Gieson method. Results. During the period 2011–2021, 36 operated patients with echinococcosis were recorded. Liver echinococcosis was mostly detected in men – 52.8% (р ≤ 0.05), the average age of patients was 46.9 ± 3.1 years. Among the operated, the percentage of people under 50 was 69.4%, with a predominance of men (52%). In the case of primary and recurrent echinococcosis of the liver, single cysts were found in most patients, namely in 26 (72.2%) with predominant localization in the right lobe (88.5%). Multiple cysts were found in 10 patients (27.8%); lesions of the right lobe of the liver – 70.0%, left – 10.0%, both lobes – 20.0%. It was established that the average diameter of echinococcal cysts was 13.8 ± 2.5 cm, individual cysts reached 17 cm. The thickness of all layers of the cyst wall was 1.3 ± 0.3 cm. The outer acellular layer of the cyst wall was 0.8 ± 0.1 cm. In most cases (61.1%, p ≤ 0.05), the parasite was alive, as evidenced by the clear, colorless cyst fluid with the presence of single daughter cysts with a diameter of 0.1 to 2 cm, which had the same macro- and microscopic characteristics as the mother cyst structure The color of the entire membrane of the parasite was white-pink. Conclusions. Over a 10-year period, 36 patients operated on for echinococcosis of the liver were recorded, the majority of cases were men (52.8%, p ≤ 0.05). The average age of the patients was 46.9 ± 3.1 years and ranged from 26 to 69 years. Among those operated on, the percentage of people under 50 was 69.4%, with a predominance of males in the gender structure. In the case of primary and recurrent echinococcosis of the liver, single cysts were found in most patients, namely in 26 (72.2%) with predominant localization in the right lobe (88.5%). Multiple cysts were found in 10 patients (27.8%); lesions of the right lobe of the liver – 70.0%, left – 10.0%, both lobes – 20.0%. The average diameter of echinococcal cysts was 13.8 ± 2.5 cm, individual cysts reached 17 cm. The thickness of all layers of the cyst wall was 1.3 ± 0.3 cm. The outer acellular layer of the cyst wall was 0.8 ± 0.1 cm In most cases, the parasite was alive (61.1%, p ≤ 0.05).

Three-dimensional evaluation of dentigerous cysts in the Turkish subpopulation

BackgroundTo investigate the radiological and demographic features, types, distribution, and treatment methods of dentigerous cysts (DC).MethodsPanoramic radiographs and cone beam computed tomography (CBCT) images of patients diagnosed with DC based on biopsy results between January 2020 and December 2023 were examined. In patients from different age groups, the numbers, types and locations, and radiological features of DCs, associated changes in surrounding tissues, and treatment methods used were reviewed.ResultsAmong 95 patients with DC (66 males, 29 females), sex and age distributions were comparable between those with a single cyst (n = 86) and those with two cysts (n = 9). Of 104 DCs, 44 were central, 38 were lateral, and 22 were circumferential. DC types were not significantly affected by sex, age group, or anatomical location. Circumferential DCs often caused displacement of the mandibular canal inferiorly. While enucleation was preferred for the treatment of central DCs, circumferential DCs were treated with marsupialization.ConclusionsIn this study, which is the first to evaluate the DC types on CBCT images, the central type was the most common. Circumferential DCs were mostly treated with marsupialization. CBCT imaging can assist in determining DC types, and may provide guidance for treatment planning.

Liver cystic echinococcosis: A retrospective study on the demographics and clinical profile of patients managed at a single tertiary institution in central Eastern Cape Province, South Africa.

Cystic echinococcosis (CE) is a zoonotic disease with an Africa-wide prevalence of 1.7%. CE is caused by the tapeworm Echinococcus granulosus sensu lato, with the liver being the most commonly affected organ. In South Africa (SA), there is a paucity of data on liver CE demographics and management. To describe the demographics and clinical profile of patients with liver CE in a single tertiary hospital in Eastern Cape Province, SA. A 4-year (2019 - 2022) retrospective clinical record review study was conducted on patients presenting with liver CE to the Department of Surgery at Frere Hospital. The demographics, clinical characteristics and management of patients with liver CE are reported. A total of 56 patients diagnosed with and managed for liver CE were included in the study. The mean age of the patients was 37.5 years. Abdominal pain (n=39; 69.6%) was the most common presenting symptom, and a palpable abdominal mass (n=36; 64.3%) was the predominant presenting sign. Most patients had disease confined to the liver (n=35; 62.5%). The right lobe of the liver was most commonly affected (n=38; 67.9%), and most patients had a single liver cyst on imaging (n=32; 57.1%). The majority of the patients (n=36; 64.3%) were managed with surgical partial cystectomy, with a perioperative bile leak being the most common complication. In our setting, liver CE contributes to a significant local burden of the disease. The disease often has a nonspecific clinical presentation, necessitating imaging for the diagnosis. We observed good short-term outcomes in patients managed with combined partial cystectomy and medical therapy, although there is a risk of perioperative bile leak.

Treatment Options and the Management of Complications in Hydatid Cysts of the Liver in Endemic Regions.

Hydatid cyst of the liver induced by Echinococcus granulosus is a pervasive zoonotic disease in our region. Its incidence varies across age groups, contingent on community lifespans and hygiene standards. Therapeutic modalities include Puncture, Aspiration, Injection, Re-aspiration (PAIR), and surgery. Due the limited feasability of PAIR, we suggest that surgery represents the optimal treatment in all stages, especially in endemic regions, depending on patient-specific variables. Patients with hydatid cyst of the liver treated with PAIR and surgery in our center between January 2016 and January 2022 were analyzed retrospectively. PAIR or cystectomy were applied in treatment. These were then compared in terms of efficacy, feasibility, and complications. A single hydatid cyst of the liver was detected in 184 of the 225 cases, two cysts in 33, and three or more cysts in eight. The largest cyst diameter was 233 × 124 mm in the surgery group and 100 × 90 mm in the PAIR group. One hundred thirty-three of the 225 patients underwent open surgery, and no recurrence was encountered in these. However, recurrence was observed 19 patients treated with PAIR. Allergic reaction developed in one case during surgery, postoperative abscess in two cases, biliary fistula in five, and pneumonia in one. Surgical treatment should represent the standard procedure since it is safe and effective, ensures complete elimination of the parasite, involves no intraoperative shedding, preserves healthy tissues, and minimizes the risk of long-term recurrence and cavity-related complications.

Concordance between two monoclonal antibody-based antigen detection enzyme-linked immunosorbent assays for measuring cysticercal antigen levels in sera from pigs experimentally infected with Taenia solium and Taenia hydatigena

BackgroundAntigen detection in Taenia solium cysticercosis confirms viable infection in the intermediate host (either pig or human). The reference B158/B60 monoclonal antibody (mAb)-based Ag-enzyme-linked immunosorbent assay (ELISA) has acceptable levels of sensitivity and specificity in human neurocysticercosis with multiple brain cysts, although its sensitivity is lower in cases with single brain cysts, whereas in porcine cysticercosis the assay specificity is affected by its frequent cross-reaction with Taenia hydatigena, another common cestode found in pigs. Our group has produced 21 anti-T. solium mAbs reacting against antigens of the whole cyst, vesicular fluid, and secretory/excretory products, identifying TsW8/TsW5 as the most promising pair of mAbs for an Ag-ELISA.MethodsWe report the use of the TsW8/TsW5 Ag-ELISA to measure cysticercus antigen levels [expressed as optical density (OD) values] in two panels of sera collected from day 0 (baseline) to day 90 postinfection (PI) from pigs experimentally infected with T. solium (n = 26) and T. hydatigena (n = 12). At baseline and on days 28 and 90 PI, we used Bland–Altman (BA) analysis and Lin’s concordance correlation coefficients (CCC) to determine the concordance between the TsW8/TsW5 and the B158/B60 Ag-ELISA.ResultsThe TsW8/TsW5 Ag-ELISA was able to efficiently measure circulating antigen levels in T. solium-infected pigs, similar to that obtained with the B158/B60 Ag-ELISA. Almost all paired log-OD differences between assays were within the limits of agreement (LoA) in the BA analysis at baseline and on days 28 and 90 PI (92.3%, 100%, and 100%, respectively), and a high concordance of log-ODs between assays was also found (Lin’s CCC: 0.69, 0.92, and 0.96, respectively, all P < 0.001). In pigs infected with T. hydatigena, almost all paired log-OD differences were within the LoA in the BA analysis, whereas the concordance of log-ODs between assays was low at baseline (Lin’s CCC: 0.24) but increased on days 28 and 90 PI (Lins’ CCC: 0.88 and 0.98, P < 0.001).Conclusions/significanceThe TsW8/TsW5 Ag-ELISA recognizes antigens in pigs with T. solium cysticercosis and is highly concordant with the B158/B60 Ag-ELISA. However, its diagnostic use is hampered by cross-reactions with T. hydatigena, as in other mAb-based Ag-ELISAs.Graphical

Lumbar parafacetal cyst-spinal segmental instability is the cause and stabilization is the treatment: A clinical report of eight surgically-treated patients.

The authors report the results of "only-fixation" of the affected spinal segment without any decompression of the bones or soft tissue or manipulation of the cyst wall or contents in eight cases having lumbar parafacetal cyst (LPFC). This surgical strategy was based on the concept that LPFCs are secondary to spinal instability, has a protective or adaptive role, and is reversible following stabilization. During the period from January 2018 to January 2023, eight consecutive patients having LPFC were surgically treated. There were 5 males and 3 females, and their ages ranged from 48 to 72 years (average 63 years). Seven patients had a single cyst and one patient had multiple cysts. The patients presented with symptoms classically attributed to lumbar canal stenosis. Apart from the cyst-affected spinal segment, degenerative alterations were observed in adjoining spinal segments in six out of seven patients having a single cyst. All patients underwent "only fixation" of the unstable spinal segments without any kind of bone or soft-tissue resection and without any manipulation or handling of the cyst wall or contents. During the follow-up period that ranged from 12 to 57 months (average 29 months), all patients improved from their symptoms. The recovery was observed in the immediate postoperative period and was lasting. LPFCs are one of the several secondary alterations observed in spinal degeneration. Identification of unstable spinal segments and their fixation constitutes rational treatment of lumbar parafacetal cysts. Direct handling and resection of cysts are unnecessary.

Safety and Feasibility of Single-Port Nephroscopy Combined with a Needle Electrode Technique to Treat Dorsal Simple Renal Cysts

Introduction: The aim of this study was to explore the safety and feasibility of single-port nephroscopy combined with a needle electrode technique to unroof single dorsal simple renal cysts (SRCs). Methods: This was a retrospective analysis of the clinical data for 18 patients with single dorsal SRCs treated with single-port nephroscopy and a needle electrode technique at Zhongshan City People’s Hospital from August 2021 to August 2022. The basic information included the cyst condition, surgical methods and recurrence rate, and follow-up was conducted with CT imaging. Results: The surgery was successful in all 18 patients. The duration of surgery ranged from 24 to 46 min, with an average of 35.83 ± 1.62 min; the intraoperative bleeding volume ranged from 2 to 20 mL, with an average of 9.0 ± 1.3 mL; and the visual analog scale (VAS) score within 24 h after surgery ranged from 1 to 6 points, with an average of 2.72 ± 0.36 points. There were no significant postoperative complications, such as bleeding, urinary fistula, or infection. All drainage tubes were removed on the first day after surgery. After 1 year of postoperative follow-up, 1 patient experienced recurrence, for a recurrence rate of 5.6%. Conclusion: Single-port nephroscopy combined with a needle electrode technique is a safe, feasible, and effective minimally invasive surgical approach for treating single dorsal SRCs.

RADIOLOGICAL FEATURES OF THE LOCATION OF CYSTIC FORMATIONS IN THE MAXILLARY SINUS AND THEIR RELATIONSHIP WITH ALVEOLAR BONE PATHOLOGY OF THE UPPER JAW

The aim of the study. To study the features of the location of cystic formations in the maxillary sinus based on CT scans and to determine their relationship with the pathology of the upper jaw teeth.&#x0D; Materials and methods. The study involved the analysis of 552 head computed tomography scans of patients referred for examination by an otolaryngologist or dentist. The total number of individuals examined was 552, comprising 44.7% females and 55.3% males, aged 18-74 years. The investigation was conducted using the NewTom GO device with a measurement range of 155-172 mGy/cm±10%, with an error of ±4.24%. Statistical processing of data was carried out using the STATISTICA v.12.6 software.&#x0D; Results. Out of 552 computed tomography images analyzed, 92 images of individual maxillary sinuses (MS) of 79 patients with single cysts were selected. They were divided into two groups. Group 1 involved patients with cysts on the lower wall of MS (n=76). Group 2 included patients with cysts on other walls (n=16). The assessment of the ratio of 4, 5, 6, 7 tooth roots of the upper jaw to the lower wall of the upper jaw showed that the protrusion frequency in Group 1 was significantly higher (42.1%) compared to Group 2 (18.7%). Meanwhile, the average thickness of the bone over these teeth in Group 2 was significantly greater (3.4 ± 1.09 mm) than in Group 1 (1.9 ± 0.92 mm) (p=0.0003). In both patient groups, the greatest thickness was observed over tooth 4, and the smallest over tooth 7. Additionally, in 33.7% of cases, the cyst was associated with involvement of deep structures of the projecting teeth and the spread of inflammation to the lower wall of MS.&#x0D; Conclusions. Among patients referred by an otolaryngologist or dentist for CT examination to radiologically verify pathological processes in the nasal cavity, paranasal sinuses, and the upper jaw teeth, MS cysts were detected in 19.6% of cases, with 83% of them being localized in its lower parts. In patients with cysts located in the lower parts of MS, the roots protruding into the sinus cavity and a thinner layer of bone over them are more frequently observed compared to those where cysts are located in other areas of MS. In patients with cystic formations in the alveolar recess of MS, radiological signs of pathology of the upper jaw teeth are detected in 34% of cases.

First report of the maize cyst nematode Heterodera zeae in Sichuan Province of Southwest China.

Maize is the largest crop planted in China. Nine species of cyst nematodes have been reported to affect maize production. Heterodera zeae, H. avenae and Punctodera chalcoensis can cause significant maize yield losses annually (Luc et al. 2005). In 1971, the maize cyst nematode H. zeae was first detected in Rajasthan, India (Koshy et al. 1971). Subsequently, it has been reported in many other countries such as the United States, Greece, Pakistan, and Egypt. In China, H. zeae was first identified in the maize fields of Laibin City, Guangxi Zhuang Autonomous Region (Wu et al., 2017). Cui et al. (2020) identified H. zeae in a maize field of Yuzhou City, Henan Province of Central China in 2018. From 2018 to 2022, a survey of cyst-forming nematodes was conducted in Southwest China. Fifteen soil samples of about 500 g each were collected from Luding County, Ganzi Prefecture of Sichuan Province. No major aboveground symptoms were shown on maize, but a few females were observed on the roots of maize in one field. The cysts and second-stage juveniles (J2s) were collected from each soil sample using Cobb's screening gravity method. A total of 8.50±2.0 cysts per 100 ml of soil on the average were observed in the field. A thin subcrystalline layer was discernible only in young cysts. Morphological and molecular studies of cysts and J2s indicated that the nematodes were identified to be H. zeae in a maize-field. Morphologically, the cysts were in a lemon shape, light brown or pearly white in color. The vulval cone was prominent. Fenestra ambifenestrate, and semifenestra were separated by a fairly wide vulval bridge, fenestral length and width were variable, and the cyst wall was shown in a zigzag pattern. The J2s' body was in a vermiform, tapering at both ends, with a hyaline tail. Stylet was strongly developed with round or slightly anteriorly directed knobs. Morphological measurements of the cysts (n = 9) determined that the mean body length was 417.2 μm (403.6 to 439.4 μm), body width was 429.7 μm (397.6 to 456.9μm); length-width ratio was 1.4 (0.75 to 3); fenestra length was 525.3 μm (498.5 to 570.7 μm); and the mean semifenestra width was 458.6 μm (403.6 to 546.3 μm). Morphometric measurements of second-stage juveniles (n = 20) showed a body length of 419.7μm (355.8 to 492.5 μm); a stylet length of 20.8 μm (19.51 to 23.3μm); a tail length of 41.5 μm (20 to 49.4 μm); and a hyaline tail length of 20.7 μm (16.6 to 24 μm). The main morphological characteristics and measured values were basically consistent with those described by Cui et al. (2022), and all of which were similar to those of H. zeae. Amplification of DNA from random single cysts (n = 5) was conducted using the protocol described by Cui et al. (2022). The rDNA-internal transcribed spacer (ITS) was amplified and sequenced using a pair of universal primers TW81 (5'-GTTTCCGTAGGTGAA CCTGC-3') and AB28 (5'-ATATGCTTAAGTTCAGCGGGT-3'). The ITS sequences were deposited at GenBank with the accession number OR811029.1. Alignments of sequences showed an identity of 98% with H. zeae sequences from China (OP692769.2, MW785772.1) and the USA (GU145616.1), which were confirmed using a pair of species-specific primers HzF1 (5'-GGGGAGGTGAATGTGGG-3') and HzR1 (5'-CCTTTGGCAATCGGTGA-3') of H. zeae with a targeted PCR fragment of 393 bp (Cui et al. 2022). Pathogenicity was conducted and confirmed by infection and reproduction on maize. Seeds (cv. Zhengda 619) were sown in three pots that contained 150 ml of a sterile soil mixture (loamy soil: sand=1:1), and 5 cysts (103 eggs/cyst on the average) were inoculated in each pot at 25/30°C, under a 12-h dark/12-h light condition (Cui et al. 2023). Fifteen days after sowing, third- and fourth-stage juveniles were observed in the rootstained with acid fuchsin, and a total of 32 cysts per maize plant on the average were collected at 40 days after sowing. The new cysts' morphological and molecular characteristics were identical to the cysts from the original soil samples. To the best of our knowledge, this is the first report of H. zeae as a pathogen on maize in Sichuan Province, Southwest China. Our findings will be useful for management and further research of maize cyst nematodes.

Presentation, diagnosis, management and outcome of complicated hydatid cyst of the lung

Introduction: Introduction: The complicated hydatid cyst of the lung is defined as any cyst ruptured in the bronchi tree or in the pleural cavity, infected, and rarely in the pericardial cavity. The aim of this study was to evaluate the problems of complicated pulmonary hydatid cyst, including presentation, diagnosis choice of surgical methods. and complication of delay in surgical treatment of pulmonary hydatid cysts. Methods: Between 2016 and 2021, 192 operations operated for pulmonary hydatid cysts, 42 of these patients were complicated hydatid cyst. Presentations were cough, chest pain and dyspnea.Diagnosis tools were CXR and CT-scan of chest. surgical approach was a posterolateral thoracotomy and anterolateral thoracotomyin all patients; a phrenotomy in eight patients and one-stage bilateral thoracotomy in six patients. Results: In 18 patients (67.5%), there were single hydatid cysts; whereas 4 patients (32.5%) had multiple cysts.12 patients had bilateral cyst and 8 had both lung and liver and others organs, 6 patients had preoperative hydatid cyst history. Iatrogenic rupture of an intact hydatid cyst occurred in 4 patients. Extrathoracic involvement was apparent in 6 patients (27%). Intrathoracic but extrapulmonary involvement was apparent in 4 patients (16%). Conclusion: Complicated hydatid cyst may present with different clinical and radiologically manifestations as a primary lung tumor , pleural effusion ,empyema hydropneumothorax. In patients with suspicious lung masses in endemic area or history of a hydatid cyst in patients a complicated pulmonary hydatid cyst may be in differential diagnosis.

A multidisciplinary study on Clinostomum infections in Nile tilapia: micro-morphology, oxidative stress, immunology, and histopathology

Yellow grub disease, caused by Clinostomum metacercaria, is an endemic zoonotic infection in freshwater fish, responsible for Halzoun syndrome transmitted through the consumption of raw infected fish. This study aimed to conduct a multidisciplinary investigation integrating detailed morphology, oxidative stress, immunology, and histopathology alteration to advance our understanding of Clinostomum infection. In this annual study, 400 Nile tilapia (Oreochromis niloticus) were collected from the Nile River at Al Bahr Al Aazam, Giza Governorate to assess Clinostomum infection prevalence. Of the examined fish, 160 individuals (40.0%) harboured larval Clinostomum infections. Clinostomum metacercariae were observed in various anatomical locations, with 135 fish (33.8%) in buccal cavities, 21 fish (5.25%) in gill chambers, and 4 fish (1.0%) on the skin. Infection intensity ranged from 2 to 12 cysts per fish, averaging 5 cysts, notably with skin infections characterized by a single cyst in each fish. Macroscopic encysted metacercariae were collected from buccal cavities, gills, and skin. Micro-morphology revealed distinct features in C. complanatum, including an elliptical oral sucker with collar-like rings and large sensory papilla-like structures, contrasting with the absence of these features in C. phalacrocoracis. Oxidative stress, assessed through malondialdehyde (MDA) and nitric oxide levels, revealed an elevation in MDA to 35.13 ± 6 nmol/g and nitric oxide to 25.80 ± 3.12 µmol/g in infected fish. In infected fish, MHC-I gene expression increased approximately 13-fold, MHC-II peaked at 19-fold, and IL-1β significantly upregulated by 17-fold, compared to control levels. Histopathology detailed associated lesions, such as cyst encapsulation and eosinophilic infiltration. Clinstomiasis and its impacts on fish hosts offer crucial insights to control this emerging fish-borne zoonotic disease, threatening wildlife, aquaculture, and human health.

Strobilocercus fasciolaris (Eucestoda: Taeniidae) em ratos pretos (Rattus rattus) na Ilha de Fernando de Noronha, Brasil

ABSTRACT The island of Fernando de Noronha, belonging to the state of Pernambuco, Brazil, has several animal species introduced by man, such as the black rat (Rattus rattus) and the domestic cat (Felis catus), representing a risk to the ecological balance of the island and to the public health. This study aimed to report the occurrence of Strobilocercus fasciolaris in black rats (R. rattus) in this insular environment and to contribute with epidemiological data on this parasitosis. Rodents were captured using Tomahawk traps and sedated with an association of Ketamine Hydrochloride (40mg/kg/IM) and Xylazine Hydrochloride (2mg/kg/IM) for subsequent euthanasia and necroscopic evaluation. Of the 154 captured black rats, 54 (35.06%) had single or multiple cysts in the liver. The cysts were morphologically evaluated and the metacestodes were identified as Strobilocercus fasciolaris, the larval form of Hydatigera taeniformis. This is the first report of the occurrence of Strobilocercus fasciolaris in black rats (Rattus rattus) in an island environment in Brazil. The occurrence of this metacestode in rodents on the Island demonstrates the high environmental contamination, fast reproduction, and dispersion of this parasite, being a potential risk for the conservation of susceptible species and for public health.

Sarcocystis spp.: histological examination and morphometry

The purpose of the research is localization and morphometry of sarcocysts in animals.Materials and methods. Samples of striated muscle tissue of cows and wild boars were studied to determine the infection intensity and prevalence and determine morphometric parameters of cysts. Pathological material was collected to 10 % buffered formalin solution. For histological examination, muscle tissue samples were taken from the abdominal wall and cardiac muscle. To process tissue samples, paraffin coating was used in semi-automatic equipment from Thermo Scientific. Histological specimens were stained with hematoxylin and eosin and by Mallouri. The specimen histoarchitecture was assessed using an Axio A1.0 microscope; photographs were taken with AxioVision.Results and discussion. The sarcocyst infection prevalence was 60% in cattle and 100% in the boars, with the infection intensity of 1-2 and 2-4 sarcocysts in one FOV, respectively. It was found that the cyst formed a capsule in infected boars with a thickness of 2.6±0.28 μm, while it was practically invisible in cattle, and grouped loose connective tissue fibers were observed around the cyst. The infection intensity can be assessed as low in the studied animals; however, even single parasite cysts entered the human body contribute to sarcocystosis.

THYROID STATUS IN WOMEN OF REPRODUCTIVE AGE LIVING UNDER MILD IODINE DEFICIENCY CONDITIONS

Purpose. This study aimed to examine thyroid picture in twenty-five women of reproductive age (18-35 years old, mean age 27.28 ±0.23 yrs) living in conditions of moderate iodine deficiency but being not diagnosed with obvious thyroid.&#x0D; Materials and Methods. A Beckman Coulter Dx1800 analyzer was applied to perform a serum marker test for thyroid gland performance level with the immunochemiluminescent method using paramagnetic particles. A Toshiba Aplio 500 unit was used for thyroid gland ultrasound examination with a linear sensor.&#x0D; Results. The pituitary-thyroid analysis showed no severe impairment in the examined women. Of all the 25 subjects, 8 women (32%) reported a normally high level of TSH (2.0–4.2 mME/L), which may indicate minimal thyroid insufficiency seen in its early, mild stage. We analyzed the content of hormones depending on the TSH variables, and found a statistically significant decrease in the integral thyroid index ITI (p=0.0001) in examinees with normally high TSH levels, which also indicated the initial stage of hypothyroidism, in spite of the individual blood serum iodothyronines lying within the reference ranges. The tendency to the raised free T3 concentration with a fall in free T4 showed a strong link to an increase in the processes of peripheral conversion of iodothyronines in subjects with higher TSH levels.&#x0D; By the thyroid gland ultrasound examination we revealed no structural disorders or pathologies in 18 of 25 women (72%); 5 women (20%) exhibited single or multiple cysts in different localities of the organ; 2 women (8%) demonstrated signs of autoimmune thyroiditis with grade 1 hyperplasia; and 1 woman (4%) had a node of the thyroid gland.&#x0D; Conclusion. The research showed the necessity to conduct assessment studies on thyroid performance in groups at special risk for developing iodine deficit diseases, especially in women of reproductive age who are planning pregnancy and living in conditions of moderate iodine deficiency.