Cyst Volume Research Articles

A prospective study examining the effect of dienogest treatment on endometrioma size and symptoms

Objective We aimed to determine the effect of dienogest on cyst volume, symptoms, and quality of life in patients with endometrioma. Method This prospective cohort study included 37 patients diagnosed with endometrioma and planned for medical treatment. Subjects were treated with a 3-month oral dose of dienogest 2 mg/day. Pre-treatment and post-treatment endometriosis measurements were assessed via 3D ultrasonography, pain symptoms via 100-mm visual analog scale (VAS), and quality of life via Short Form-36. Results The mean age of the patients was 36.0 ± 6.6 years. The mean endometrioma volume was significantly reduced by 31% after treatment (26.7 ± 19.7 mm3) compared to the pre-treatment volume (17.4 ± 11.2 mm3, p < .001). Post-treatment VAS scores of dysmenorrhea, dyspareunia, and chronic pelvic pain VAS values were significantly decreased by 35.5% (p < .001), 37.5% (p < .001), and 38.5% (p < .001), respectively. The mean physical function score and mental health score significantly increased by 15% (p = .009) and 28% (p < .001), respectively. Conclusion Our findings showed dienogest treatment at oral doses of 2 mg/day for 3 months significantly reducing the size of endometrioma, reducing pain level, and increasing quality of life in women with endometriosis.

MiR-518c-3p alleviates endometriosis by inhibiting ectopic endometrial migration and epithelial-mesenchymal transition via targeting ZNF608.

The present study was performed to clarify the regulatory mechanism of miR-518c-3p in the progression of endometriosis (EMs). MicroRNAs (miRNAs) potentially acting on EMs were predicted by bioinformatics databases and validated in normal and ectopic endometrium. The miR-518c-3p mimics were transfected into endometrial stromal cells (ESCs), and cell growth, death, and proliferation marker proteins expression were detected. The targeting relationship of miR-518c-3p with zinc finger protein 608 (ZNF608) was validated by luciferase reporter assay. ESCs were incubated with miR-518c-3p mimics alone or co-transfected with pcDNA-ZNF608, and growth, death, as well as proliferation and epithelial-mesenchymal transition (EMT) marker protein expression were detected. A rat model of EMs overexpressing miR-518c-3p alone or ZNF608 simultaneously was constructed to detect ectopic endometrial cell apoptosis and cyst volume in rats. MiR-518c-3p expression was downregulated in ectopic endometrium. MiR-518c-3p mimic inhibited migration, invasion and proliferation of ESCs, and promoted apoptosis. MiR-518c-3p targeted the 3'UTR of ZNF608. ZNF608 expression was upregulated in ESCs and ectopic endometrium, and the regulatory effect of pcDNA-ZNF608 on ESCs was opposite to that of miR-518c-3p mimics. ZNF608 overexpressing rats had greater endometrial cyst weight and volume, and decreased endometrial apoptosis compared with miR-518c-3p overexpressing alone. MiR-518c-3p inhibited growth, metastasis and EMT of ESCs and decreased ectopic endometrial area in rats with EMs by targeting ZNF608.

Introducing Ethanol Ablation as a treatment for thyroid cysts in the emergency setting

Abstract Introduction New techniques have been adopted for minimally invasive management of thyroid lesions which has been well explored by Nixon et al. Ethanol ablation (EA) for the treatment of thyroid cysts has been well documented in the literature as a safe, effective treatment option in the elective setting. Our unit has introduced this service in the elective setting for treatment of thyroid cysts. This study demonstrates the use of EA in the emergency setting, which has potential to reduce recurrence rates and avoid a general anaesthetic in patients who present acutely. Methods Three patients presenting with airway threatening compressive symptoms secondary to thyroid cysts. Treated with EA within 24 hours of presentation to hospital. Patients were followed up radiologically and clinically and a telephone consultation to gather the GBI (Glasgow Benefit Inventory) survey. Results 2 patients female and 1 male, median age of 41 years old. Median Pre-ablation cyst volume was 97.3mls. Median 100% radiological resolution of cystic component. 100% resolution of symptoms at median 9-month follow-up post procedure. 66% of patients requiring only one treatment for 100% resolution, with 1 patient with the largest cyst requiring three ablations and two aspirations. No complications reported. GBI (Glasgow Benefit Inventory) score mean +27.7, similar GBI of a tonsillectomy. Discussion EA is a safe, cost effective and efficient treatment option for thyroid cysts in the acute setting. Larger thyroids cysts may require repeated procedures for symptom resolution. Patient will require long term follow up to assess the rate of recurrence.

Volume Progression and Imaging Classification of Polycystic Liver in Early Autosomal Dominant Polycystic Kidney Disease.

The progression of polycystic liver disease is not well understood. The purpose of the study is to evaluate the associations of polycystic liver progression with other disease progression variables and classify liver progression on the basis of patient's age, height-adjusted liver cystic volume, and height-adjusted liver volume. Prospective longitudinal magnetic resonance images from 670 patients with early autosomal dominant polycystic kidney disease for up to 14 years of follow-up were evaluated to measure height-adjusted liver cystic volume and height-adjusted liver volume. Among them, 245 patients with liver cyst volume >50 ml at baseline were included in the longitudinal analysis. Linear mixed models on log-transformed height-adjusted liver cystic volume and height-adjusted liver volume were fitted to approximate mean annual rate of change for each outcome. The association of sex, body mass index, genotype, baseline height-adjusted total kidney volume, and Mayo imaging class was assessed. We calculated height-adjusted liver cystic volume ranges for each specific age and divided them into five classes on the basis of annual percentage increase in height-adjusted liver cystic volume. The mean annual growth rate of height-adjusted liver cystic volume was 12% (95% confidence interval, 11.1% to 13.1%; P<0.001), whereas that for height-adjusted liver volume was 2% (95% confidence interval, 1.9% to 2.6%; P<0.001). Women had higher baseline height-adjusted liver cystic volume than men, but men had higher height-adjusted liver cystic volume growth rate than women by 2% (95% confidence interval, 0.4% to 4.5%; P=0.02). Whereas the height-adjusted liver cystic volume growth rate decreased in women after menopause, no decrease was observed in men at any age. Body mass index, genotype, and baseline height-adjusted total kidney volume were not associated with the growth rate of height-adjusted liver cystic volume or height-adjusted liver volume. According to the height-adjusted liver cystic volume growth rate, patients were classified into five classes (number of women, men in each class): A (24, six); B (44, 13); C (43, 48); D (28, 17); and E (13, nine). Compared with height-adjusted liver volume, the use of height-adjusted liver cystic volume showed greater separations in volumetric progression of polycystic liver disease. Similar to the Mayo imaging classification for the kidney, the progression of polycystic liver disease may be categorized on the basis of patient's age and height-adjusted liver cystic volume.

Multiple therapeutic effects of human neural stem cells derived from induced pluripotent stem cells in a rat model of post-traumatic syringomyelia.

SummaryBackgroundPost-traumatic syringomyelia (PTS) affects patients with chronic spinal cord injury (SCI) and is characterized by progressive deterioration of neurological symptoms. To improve surgical treatment, we studied the therapeutic effects of neuroepithelial-like stem cells (NESCs) derived from induced pluripotent stem cells (iPSCs) in a rat model of PTS. To facilitate clinical translation, we studied NESCs derived from Good Manufacturing Practice (GMP)-compliant iPSCs.MethodsHuman GMP-compliant iPSCs were used to derive NESCs. Cryo-preserved NESCs were used off-the-shelf for intraspinal implantation to PTS rats 1 or 10 weeks post-injury, and rats were sacrificed 10 weeks later. In vivo cyst volumes were measured with micro-MRI. Phenotypes of differentiated NESCs and host responses were analyzed by immunohistochemistry.FindingsOff-the-shelf NESCs transplanted to PTS rats 10 weeks post-injury reduced cyst volume. The grafted NESCs differentiated mainly into glial cells. Importantly, NESCs also stimulated tissue repair. They reduced the density of glial scars and neurite-inhibiting chondroitin sulfate proteoglycan 4 (CSPG4), stimulated host oligodendrocyte precursor cells to migrate and proliferate, reduced active microglia/macrophages, and promoted axonal regrowth after subacute as well as chronic transplantation.InterpretationSignificant neural repair promoted by NESCs demonstrated that human NESCs could be used as a complement to standard surgery in PTS. We envisage that future PTS patients transplanted with NESCs will benefit both from eliminating the symptoms of PTS, as well as a long-term improvement of the neurological symptoms of SCI.FundingThis work was supported by Vinnova (2016-04134), Karolinska Institutet StratRegen, and the Chinese Scholarship Council.

IRIS-Intelligent Rapid Interactive Segmentation for Measuring Liver Cyst Volumes in Autosomal Dominant Polycystic Kidney Disease.

Purpose: To develop and integrate interactive features with automatic methods for accurate liver cyst segmentation in patients with autosomal dominant polycystic kidney and liver disease (ADPKD). Methods: SmartClick and antiSmartClick were developed using iterative region growth guided by spatial and intensity connections and were integrated with automated level set (LS) segmentation and graphical user interface, forming an intelligent rapid interactive segmentation (IRIS) tool. IRIS and LS segmentations of liver cysts on weighted images of patients with ADPKD (n = 17) were compared with manual segmentation as ground truth (GT). Results: Compared to manual GT, IRIS reduced the segmentation time by more than 10-fold. Compared to automated LS, IRIS reduced the mean liver cyst volume error from 42.22% to 13.44% (p < 0.001). IRIS segmentation agreed well with manual GT (79% dice score and 99% intraclass correlation coefficient). Conclusion: IRIS is feasible for fast, accurate liver cyst segmentation in patients with ADPKD.

Correlative analysis of lung CT findings in patients with Birt\u2013Hogg\u2013Dub\xe9 Syndrome and the occurrence of spontaneous pneumothorax: a preliminary study

BackgroundThe diagnosis of patients with Birt–Hogg–Dubé (BHD) syndrome is always delayed (even for more than 10 years). Improving the understanding and diagnosis of this disease is vital for clinicians and radiologists. In this study we presented the chest computed tomography (CT) findings of BHD syndrome and offered suggestions for BHD cases with spontaneous pneumothorax.MethodsTwenty-six BHD patients from 11 families (10 men, 16 women; mean age: 46 ± 12 years, 20–68 years) were included. The clinical features of the patients included pneumothorax, renal lesions, and skin lesions. Twenty-three patients underwent chest CT imaging. The cyst condition of each patient derived from reconstructed chest CT imaging was recorded, including the cyst number, size, volume, pattern, and distribution.ResultsPneumothorax occurred in 54% (14/26) of patients. Among them, 43% (6/14) had pneumothorax more than twice. However, typical skin and renal lesions were absent. Four patients had renal hamartoma. CT showed that 23 (100%) patients had lung cysts. Pulmonary cysts were bilateral and multiple, round, irregular, or willow-like. And 93.6% of the large cysts (long-axis diameter ≥ 20 mm) were under the pleura, and near the mediastinum and spine. The long-axis diameter, short-axis diameter and volume of the largest cysts were associated with the occurrence of pneumothorax (all P < 0.05).ConclusionsChest CT imaging can reveal some characteristic features of BHD syndrome. The occurrence of pneumothorax in BHD patients is closely related to their pulmonary cystic lesions.

Effects of Intraoperatively Ruptured Ovarian Dermoid Cysts

Objective: The most-dreaded complications of dermoid cyst spills are chemical peritonitis, iatrogenic implantation of malignant cells, and recurrences. This study recorded the incidence of chemical peritonitis after dermoid-cyst excision with intraoperative cyst spilling and examined short- and long-term postoperative complications and recurrence rates. Materials and Methods: This retrospective analysis included 72 females who underwent ovarian cystectomies and who had ovarian dermoid cysts excisions from January 2016 to December 2020. Data pertaining to types of procedures, intraoperative cyst ruptures, chemical peritonitis, readmissions, and recurrences were analyzed. Results: Females (72) underwent dermoid-cyst excisions (laparotomy: 12; laparoscopy: 60). The mean age of presentation was 29.3 ± 11 years, mean cyst volume was 488.08 ± 1852.8 cc; 88.9% of cysts ruptured during excision; 0 cases of chemical peritonitis; and 1 patient had a cyst recur 4 months after removal. The laparotomy group, had a higher incidence of raised cancer antigen–125 levels (p < 0.001), torsions (p < 0.05), salpingo-oophorectomies (p < 0.001), estimated blood losses (p < 0.003), and longer operative times (p < 0.002), compared to the laparoscopy group. However, there was no significant difference between the 2 groups in spillages, chemical peritonitis, postoperative complications, and recurrences. In a subgroup analysis of laparoscopy cases, spillage was commonly associated with larger cysts (p < 0.0001), cystectomies (p < 0.0001), and longer operative times (p < 0.06). Conclusions: Intraoperative cyst content spillage does not influence the outcome of dermoid-cyst removal. Hence, laparoscopy is a safe and effective method of managing dermoid cysts. (J GYNECOL SURG 38:221)

Comparison of Autologous Osteoperiosteal and Osteochondral Transplantation for the Treatment of Large, Medial Cystic Osteochondral Lesions of the Talus

Background: Autologous osteoperiosteal transplantation (AOPT) using graft harvested from the iliac crest is used to treat large cystic osteochondral lesions of the talus (OLTs). However, no studies have compared clinical and radiologic outcomes between AOPT and autologous osteochondral transplantation (AOCT) using graft harvested from the nonweightbearing zone of the femoral condyle of the ipsilateral knee in patients with large cystic OLTs. Purpose: To compare clinical and radiologic outcomes between patients undergoing AOPT and those undergoing AOCT for large cystic OLTs. Study Design: Cohort study; Level of evidence, 3. Methods: Between March 2015 and March 2018, patients who underwent AOCT and AOPT to treat medial large cystic OLTs (>10 mm) were retrospectively evaluated. For comparability, the 2 groups were matched 1:1 based on their characteristics, including sex, age, body mass index, side of injury, follow-up period, and the preoperative cyst volume. After propensity score matching, 23 patients were enrolled in each group for the analysis. Clinical outcomes were assessed using the visual analog scale (VAS), the American Orthopaedic Foot & Ankle Society (AOFAS) score, and the Tegner score. Donor-site morbidity was recorded according to the symptoms, including pain, stiffness, swelling, and discomfort. In addition, the Lysholm score was used to assess the most common knee donor-site morbidity. Radiologic outcomes were evaluated using the magnetic resonance observation of cartilage repair tissue (MOCART) score, and the International Cartilage Regeneration & Joint Preservation Society (ICRS) score was obtained during second-look surgery. Results: The mean follow-up period was about 48 months. There were no significant differences in patient characteristics and lesion volumes between groups. Postoperative ankle pain VAS score, AOFAS score, and Tegner score were not significantly different between groups at final follow-up. Total donor-site morbidity (P = .004) and discomfort morbidity (P = .009) were significantly lower in the AOPT group than in the AOCT group. However, the Lysholm score showed no significant difference between the donor knee and the opposite knee (P = .503) in the AOCT group. The MOCART and ICRS scores were not significantly different between groups. Conclusion: Clinical and radiologic outcomes of patients who underwent AOPT from the iliac crest were found to be comparable with those of patients who underwent AOCT from the ipsilateral knee for the treatment of medial large cystic OLTs. These results may be helpful for orthopaedic surgeons to decide appropriate treatments for patients with large cystic OLTs.

Control of the size of simple kidney cysts by a combination of dietician supplement

The effectiveness of the dietary supplement Aneza is presented with a practical approach. Aneza is positioned to control the size of simple kidney cysts. The author considers the properties of dietary supplements, which became the basis for a 6-month initiative study EFFECTIVENESS OF ANESA IN SIMPLE KIDNEY CYSTS (ETAP). The POEM study design was based on evidence-based practice and was conducted as an open prospective rando­mized in one group free of charge in 60 people aged 30 to 65 years with a diagnosed cyst I–II according to Bosniak. Exclusion criteria were as follows: invasive urological history, renal failure (chronic kidney disease stage 3 and above). The average decrease in the vo­lume of the cyst on the background of receiving Aneza in the right kidney was minus 46.5%, in the left — minus 39.9%, on average minus 42.9% (P ≤ 0.01). The best dynamics of cyst volume reduction was observed in women older than 40 years — 66.8 % vs. 52.5% up to 40 years: (t = 0.97), and in men up to 40 years old: 27.1% vs. 30.5% (t = 0.29). The study confirms the effectiveness of Aneza in people with simple kidney cysts and, in the author’s opi­nion, a dietary supplement can be recommended as an additional means of controlling the growth of kidney cysts I–II according to Bosniak.

Effect of Packaging on Polyethylene Fractures, Implant Survivorship and Cyst Formation in Mobile Bearing Total Ankle Replacements

Category:Ankle Arthritis; AnkleIntroduction/Purpose:The Scandinavian Total Ankle Replacement (STAR) is the most widely used mobile bearing total ankle arthroplasty (TAA) in the US. The polyethylene component is ultrahigh molecular weight polyethylene and is designed to articulate with both the tibial and talar component. Initial data on the STAR in the US reported polyethylene fracture rates of greater than 10% as well as a concern for cyst formation due to osteolysis. The manufacturer changed the packaging to foil to prevent potential oxidation of the polyethylene, which could predispose the polyethylene to failure. The objective of the study was to evaluate a cohort of patients with STAR performed before and after converting to foil packaging to determine if there is a difference in polyethylene survivorship and cyst formation.Methods:All primary TARs performed by the senior author from 2010-2017 were reviewed. Patients with a minimum 48 month follow up were included in the study. The two groups were stratified by those performed prior to August 2014 (PRE) and those performed after August 2014 (POST). Preoperative and most recent postoperative alignment was determined on weight bearing radiographs. The outcomes included polyethylene fractures and cyst formation in the two groups. Cysts were defined as those measuring greater than 1cm2 on plain radiographs. Patients were recommended to have surgery if cyst volume was greater than 2cm2. Chi-squared tests were used to detect significant differences in the rate of cyst formation between the two groups. Paired t- tests were used to determine difference in preoperative versus postoperative alignment, follow up length, and polyethylene component thickness and patient age at time of procedure between the two groups.Results:The PRE group had 35 patients with an average follow up of 75 months (range 48-118). The POST group had 15 patients with average follow up 55 months (range 48-60). There was no difference in preoperative versus postoperative radiographic alignment between the groups (p>0.05). Cysts were present in 9 (26%) patients in the PRE group versus 4 patients (26%) in the POST group. Nine patients (26%) needed a second surgery due to cyst formation in the PRE group versus two (16%) in the POST group (p>0.05). Four patients (11%) had a fracture of the polyethylene in the PRE group with an average thickness of 6.7mm (range 6-9) and 77 months (range 68-84) versus zero in the POST group. The average time to polyethylene exchange for cyst(s) or polyethylene fracture was 58.3 months.Conclusion:This study suggests that changes in packaging to limit oxidation of the polyethylene from plastic to foil did not appear to represent a difference in periprosthetic cyst formation. However, there was a trend for additional surgery related to periprosthetic cysts and increased risk for polyethylene fracture in the PRE group. These results could suggest the potential for oxidation changes that alter the wear characteristics and fragility of the polyethylene component. Confounding factors could include postoperative time and component thickness. Further investigation and longer follow-up will be needed to further delineate oxygenation impacts on TAA polyethylene components.

Octreotide Lar in Patients with Autosomal Dominant Polycystic Kidney Disease: From Bench to A Novel Perspective of Therapy

Polycystins 1 or 2 congenital defects result in impaired Ca2+ inflow through the tubular cell membrane with reduced intracellular Ca2+ concentration and secondary adenylcyclase over-activation with increased intracellular cAMP. This activates chloride-driven fluid secretion and tubular cell proliferation and de-differentiation with cyst formation and growth. Thus, medications, such as the somatostatin analogue Octreotide LAR or the vasopressin antagonist Tolvaptan, that reduce intracellular cAMP, have been tested to inhibit cAMP-mediated chloride secretion and cell proliferation in experimental and human polycystic kidney disease. Seminal studies conducted in the early ‘80s by Franklin Epstein showed that in the shark rectal gland chloride secretion is markedly inhibited by somatostatin in a way suggesting inhibition of adenylcyclase. Evidence that specific receptors for somatostatin, in particular the sst2 subtype, are present in tubular cell membranes suggested that Octreotide LAR binding to its specific renal receptors could exert similar effects in ADPKD cells. In a pilot, cross-over safety study we found that 6-month Octreotide LAR therapy was safe and well tolerated in 12 patients with ADPKD and significantly decreased total kidney volume growth as compared to placebo. Then, the ALADIN and ALADIN II academic, prospective, randomized, placebo-controlled clinical trials found that 3-year Octreotide LAR treatment significantly slowed total kidney and cyst volume growth. In ALADIN treatment slowed chronic decline of directly measured GFR in 79 patients with estimated GFR ≥ 40 ml/min/1.73 m2. In ALADIN II treatment slowed progression to doubling of serum creatinine or ESKD in 100 patients with stage 3b-4 CKD. Treatment was equally safe and well tolerated in both studies. Sub-studies also showed that 3-year Octreotide LAR therapy reduced total liver volume in 27 ADPKD patients with associated polycystic livers and improved left ventricular twisting and untwisting function in 34 ADPKD patients assessed by speckled-tracked echocardiography. Future trials should confirm the long-term benefits of Octreotide LAR in larger populations of ADPKD patients. Moreover, recent studies found that somatostatin analogues and Tolvaptan have additional beneficial effects in experimental polycystic kidney disease. Thus, clinical trials should also explore whether Octreotide LAR and Tolvaptan in combined therapy may have an additional beneficial effect even in human disease.

Stereological Estimation of Bone Cyst Volume Using Computed Tomography Images: A Comparison with the Planimetry Technique

Stereological Estimation of Bone Cyst Volume Using Computed Tomography Images: A Comparison with the Planimetry Technique

The Management of Congenital Microphthalmia With Orbital Cyst: A Case Series.

To describe a series of patients treated for congenital microphthalmia associated with orbital cyst and recommend a management protocol. This retrospective case series comprised 6 patients (7 eyes) who attended an oculoplastic tertiary medical center from 2001 to 2018. Clinical, treatment, and outcome data were collected from the electronic files. Main outcome measures were preservation of vision and cosmetic appearance. Four patients were diagnosed at birth. Six cysts were located inferiorly and one superiorly. Two patients had a visual potential of light perception or better in the affected eye. In 4 eyes, the cyst was initially retained and the eye was fitted with a custom-made conformer. In 1 eye, the fornices were too shallow for a conformer, warranting fornix reconstruction and cyst excision. Early surgery was required in 1 eye for an expanded cyst and large orbit volume, and in another eye the cyst had overgrown the orbit, causing bone erosion and remodeling. Cosmetic results were good in 3 of the eyes in which the cyst was retained in early childhood, stimulating orbital growth. Congenital microphthalmia with orbital cyst is rare. Management should focus on preserving visual potential, especially in unilateral cyst cases when the other eye is also microphthalmic. Otherwise cosmetic symmetry is the main concern; cyst retention combined with ocular conformers may stimulate socket expansion. The authors found that, in most cases, if treated early, enucleation was avoidable during cyst excision. Early assessment, meticulous follow-up, and individually tailored treatment are warranted. [J Pediatr Ophthalmol Strabismus. 2022;59(3):192-199.].

Diaphragmatic Mesothelial Cyst: Radiological Appearance and Follow-Up Results During Childhood.

To identify radiological findings of diaphragmatic mesothelial cysts (DMC) in the pediatric age group and to assess follow-up outcomes.In this study, 27 pediatric age group patients were evaluated with ultrasonography (US), computed tomography (CT), or magnetic resonance imaging due to various clinical indications and diagnosed with DMC from May 2014 to September 2018. Age, sex, imaging indications and DMC localization, volumes in the first diagnosis, and follow-ups were retrospectively evaluated. Descriptive statistics were used for age, sex, imaging indications, and volume are presented as numbers and percentages.Ages range from 5 months to 13 years. Nine girls and 18 boys included in this study. The most common imaging indications were abdominal pain, diarrhea, and obesity. The mean volume of DMC was at first 2.62 and 2.45 mL during the follow-ups. There was volume reduction in 24 cases, and no change in 3 cases. Mean follow-up duration was 22.4 months. The US imaging findings were similar for all cases, bilobular cystic lesion with fat indentation between the cyst and liver parenchyma.The typical localization and lateral fat sign are useful in differential diagnosis of DMC from cystic lesions of liver. The US is a very effective and beneficial radiological method for diagnosis and follow-up. Routine clinical and sonographic follow-ups may be sufficient for asymptomatic patients with stable cyst volume.

Regression and pseudoprogression of pediatric optic pathway glioma in patients treated with proton beam therapy.

We examined regression patterns in pediatric optic pathway gliomas (OPGs) after proton beam therapy (PBT) and evaluated local control and visual outcomes. A total of 42 brain magnetic resonance imaging (MRI) scans from seven consecutive sporadic OPGs that were initially treated with chemotherapy and received PBT between June 2007 and September 2016 at the National Cancer Center, Korea were analyzed. Patients underwent brain MRI regularly before and after PBT. Total tumor, cystic lesion, and solid enhancing lesion area delineation and volume calculations were performed on gadolinium-enhanced T1-weighted MRI using Eclipse version 13, Varian. The median follow-up period after PBT was 70months (range 47-88). The median age at the time of PBT was 7years (range 4-16) and the median duration of chemotherapy before referral to PBT center was 25months (range 3-70). The median time to the greatest increase in cystic volume was 32months (range 12-43) after PBT. Solid enhancing lesion volume gradually decreased throughout the follow-up period. On an individual basis, total volume change was varied. However, on average, it regressed, although at a slower rate than solid enhancing lesion volume did. The local control rate was 85.7% (5-year progression-free survival rate, 80%; 5-year overall survival rate, 100%) and the rate of vision preservation was 71.4% (five of seven patients). The regression patterns in pediatric OPGs after PBT involve significant cystic change. Therefore, total volume is not appropriate for evaluating response. Care by a multidisciplinary team is necessary to manage clinical symptoms related to radiologic changes.

Caroli disease: an update on pathogenesis.

Caroli disease: an update on pathogenesis.

Factors affecting Baker cyst volume, with emphasis on cartilage lesion degree and effusion in the young and middle-aged population

BackgroundThe principal aim of this study was to investigate the presence of factors affecting Baker’s cyst volume in young and middle-aged populations.MethodsOpen cyst excision with valve and capsule repair, as well as knee arthroscopy, were used to treat eighty-five patients. The cases were categorized in terms of age, effusion, chondral lesion degree, meniscal tear degree, and Lindgren scores. An ultrasonography (USG) device was used to calculate the cyst volume. The IBM-SPSS 22 program was used for statistical analysis and to assess the relationships between variables using Spearman’s correlation tests.ResultsThe degree of chondral lesion was moderately and positively correlated with cyst volume in the total population (correlation coefficient: 0.469; p < 0.05).The degree of the chondral lesion was moderately and positively correlated with the degree of effusion (correlation coefficient: 0.492; p < 0.005). The cyst volume was weakly and positively correlated with the degree of effusion (correlation coefficient: 0.20; the correlation was at the limits of statistical significance p = 0.07 < 0.08).ConclusionsThis study revealed that an increase in chondral lesion severity increases the amount of effusion and cyst volume.

Sklerotizace krčních cyst alkoholem pod ultrasonografickou kontrolou jako alternativa operačního řešení

Summary Introduction: Some extrathyroidal cervical cystic lesions can be treated in selected situations by minimally invasive, low-risk method – ultrasound--guided percutaneous ethanol injection therapy (US-PEIT). Here we present 6 cases of neck cysts of various origins – ranula, thyroglossal duct cyst, branchial cleft cyst, midline neck cyst of the pyramidal lobe and dermoid cyst. Method and material: The cohort consisted of 6 patients (mean age 58 ± 13.3 years), who were followed for recurrent cervical cysts located outside the thyroid gland. The cysts were visible, palpable, aesthetically unpleasant and also mechanically compressing the surrounding tissue. After repeated evacuations, they filled in again. The patients repeatedly refused the recommended surgery and demanded an alternative solution. US-PEIT of thyroid cysts is used worldwide as a full-fledged alternative to surgical treatment. We used the same procedure for the treatment of presented neck cysts. Results: The initial volume of cysts was 2–35 mL (mean 17.7 mL); the patients underwent 1–6 sclerotization sessions (mean 3.6). The patients were followed for 12 months; the final volume of solid residue was 0.1–2 mL (mean 1 mL) representing volume reduction by 80–99% (mean 92%). Therapeutic success (volume reduction &gt; 50%) was achieved in all patients. Conclusion: US-PEIT of cervical cysts as an alternative to surgery can be used especially in elderly patients with increased surgical risk or in patients refusing surgery. In middle-aged and older adults, the possibility of a necrotic metastatic lymph node should always be considered. Therefore, a benign cytological examination and an unsuspecting ultrasonographic and CT finding are the basic conditions before performing the ethanol ablation. Key words neck cysts – ultrasound-guided percutaneous ethanol injection therapy

A Volumetric and Morphological Analysis of Recurrent Odontogenic Keratocysts by Semiautomatic Segmentation.

The authors conducted this study to provide morphological and volumetric data of recurrent odontogenic keratocysts of the upper and lower jaw to emphasize risk factors in accordance with their radiological appearance and guide clinical decisions for jeopardized patients. By applying the open-source software "ITK-Snap" on cone-beam computed tomography images, volumetric measurements of histopathologically diagnosed recurrent odontogenic keratocysts could be performed. For statistical investigations, descriptive statistics and independent Student t test were performed. The intraclass correlation coefficient was used to assess intra- and inter-rater reliabilities. P values P < 0.05 were considered significant. Forty patients (24 male and 16 female) were included in this study. Recurrent odontogenic keratocysts had a mean maximum diameter of 28.91 mm ± 12.00 mm and a mean volume of 4.48 cm3 ± 4.29 cm3. According to morphology, irregular shape (P = 0.001; P = 0.005), unclear margin (P = 0.001; P = 0.001), multilocular morphology (P = 0.001; P = 0.001), and cortical bone exceedance (P = 0.001; P = 0.007) are statistically significantly associated with a larger cyst diameter and volume. Furthermore, significant differences by diameter and volume could be shown between patients with and without iliac crest graft reconstruction (P = 0.001; P = 0.001). Volumetric analysis reveals that recurrent odontogenic keratocysts show large diametric and volumetric extension that leads to complex reconstruction by iliac crest grafts, adding an argument that special attention should be paid to this entity and its recurrence. in case of difficult histopathological examination, lesions with irregular shape and margin, multilocular morphology, cortical bone exceedance, and clinically visible symptoms should be considered for close morphological and volumetric clinico- radiological follow-up.