cyst

囊肿
  • 文章类型: Journal Article
    目的:该研究的目的是比较语音手术后7天和3天语音休息(VR)对客观声乐(声学)参数的短期影响。
    方法:一项在三级转诊医疗中心进行的前瞻性随机研究。声带结节患者,息肉,从语音诊所招募或囊肿并计划进行语音手术。他们被随机分为术后7天或3天的VR组,并在术前和术后4周记录他们的声音。混合线性模型统计分析(MLMSA)用于比较术前和术后抖动,shimmer,谐波噪声比,两组之间的最大发声时间。
    结果:招募了65名患者,但只有34个完全符合研究方案,他们的数据被纳入最终分析(19名男性,20名女性;平均年龄:40.6岁;7天VR组17名患者,3天VR组16名)。两组的年龄相当,性别,声带病变分布类型。术前MLMSA在测试的声带参数中没有显着差异。两组在术后第4周时在所有声带参数方面均表现出显着(p<0.05)和相当的改善。
    结论:7天的VR持续时间对检查的声音参数没有比术后4周的3天方案更大的益处。我们的结果表明,接受语音手术的患者可以进行为期3天的VR方案,而不会损害声音效果。需要更大规模和更长时间的研究来证实我们的发现。
    方法:2喉镜,2024.
    OBJECTIVE: The aim of the study is to compare the short-term effect of 7 versus 3 days of voice rest (VR) on objective vocal (acoustic) parameters following phonosurgery.
    METHODS: A prospective randomized study conducted at a tertiary referral medical center. Patients with vocal fold nodules, polyps, or cysts and scheduled for phonosurgery were recruited from the Voice Clinic. They were randomized into groups of 7- or 3-day postoperative VR periods and their voices were recorded preoperatively and at 4-week postoperatively. A mixed linear model statistical analysis (MLMSA) was used to compare pre- and postoperative jitter, shimmer, harmonic-to-noise ratio, and maximum phonation time between the two groups.
    RESULTS: Sixty-five patients were recruited, but only 34 fully complied with the study protocol, and their data were included in the final analysis (19 males, 20 females; mean age: 40.6 years; 17 patients in the 7-day VR group and 16 in the 3-day VR group). The groups were comparable in age, sex, and type of vocal lesion distribution. The preoperative MLMSA showed no significant group differences in the tested vocal parameters. Both groups exhibited significant (p < 0.05) and comparable improvement in all vocal parameters at postoperative week 4.
    CONCLUSIONS: A VR duration of 7 days showed no greater benefit on the examined vocal parameters than the 3-day protocol 4-week postoperatively. Our results suggest that a 3-day VR regimen can be followed by patients who undergo phonosurgery without compromising the vocal results. Larger-scale and longer-duration studies are needed to confirm our findings.
    METHODS: 2 Laryngoscope, 2024.
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  • 文章类型: Journal Article
    甲状腺肿是世界上发病率的主要来源,尤其是在发展中国家,那里的膳食碘缺乏,这种情况的已知原因,是地方性的。诊断主要是通过超声(USG)扫描,这可以给解剖学,病态,和管理甲状腺肿的功能信息。这项研究旨在确定加纳甲状腺肿最常见的超声检查结果。
    检索了5年内通过USG扫描诊断的所有213例甲状腺肿患者的记录。收集的数据是社会人口统计学,超声特征,甲状腺结节直径,甲状腺成像报告和数据系统(TI-RADS)评分,使用GNUPSPP进行分析,版本1.2.0-3。还采用χ2和双尾独立样本t检验,p≤0.05。
    在研究期间共获得213例通过USG扫描诊断为甲状腺肿的患者。参与者的平均年龄为50.01±17.27岁,年龄在16-92岁之间,女性占多数(82.16%)。最常见的超声特征是明确的实性结节。大多数患者的病变部位是整个甲状腺(28.17%),两个裂片(24.41%),和右叶(20.19%)。性别间囊肿和实性结节大小的平均差异为0.26(CI:-0.14至0.67,p=0.20)和0.12(CI:-0.43至0.66,p=0.67),分别。TI-RADS评分包括TI-RADS4(36.62%),TI-RADS1(28.17%),TI-RADS3(25.82%),TI-RADS5(5.16%),和TI-RADS2(4.23%)。实性结节(49.32%,p=0.001)和囊肿(35.71%,p=0.003)在41-60年内更常见,而在<21年内频率较低。在这项研究中,p≤0.05被认为是有意义的。
    主要的超声特征是明确的实性结节,简单囊肿,实性结节伴有囊性改变,主要位于整个甲状腺,最少仅位于峡部。囊肿和实性结节多见于41-60岁年龄组。
    UNASSIGNED: Goiter is a major source of morbidity in the world, especially in the developing world, where dietary iodine deficiency, a known cause of this condition, is endemic. The diagnosis is mostly by ultrasonography (USG) scan, which can give anatomical, pathological, and functional information for the management of goiter. This study aimed to determine the commonest ultrasound findings of goiter in Ghana.
    UNASSIGNED: The records of all 213 patients with goiter diagnosed by USG scan over a 5-year period were retrieved. Data collected were sociodemographics, ultrasound features, thyroid nodules diameter, and Thyroid Imaging Reporting and Data System (TI-RADS) scores, which were analyzed using GNU PSPP, version 1.2.0-3. χ 2 and two-tailed independent samples t-test were also employed, with p ≤ 0.05.
    UNASSIGNED: A total of 213 patients with goiter diagnosed by USG scan were obtained over the study period. The mean age of the participants was 50.01 ± 17.27 years, with an age range of 16-92 years and females constituting the majority (82.16%). The commonest ultrasound features were well-defined solid nodules. The lesion sites for most patients were the whole thyroid (28.17%), both lobes (24.41%), and the right lobe (20.19%). The mean difference in sizes of cysts and solid nodules among genders was 0.26 (CI: -0.14 to 0.67, p = 0.20) and 0.12 (CI: -0.43 to 0.66, p = 0.67), respectively. The TI-RADS score featured TI-RADS 4 (36.62%), TI-RADS 1 (28.17%), TI-RADS 3 (25.82%), TI-RADS 5 (5.16%), and TI-RADS 2 (4.23%). Solid nodules (49.32%, p = 0.001) and cysts (35.71%, p = 0.003) were more common within 41-60 years and less frequent in those <21 years. A p ≤ 0.05 was considered significant in this study.
    UNASSIGNED: The predominant ultrasound features were well-defined solid nodules, simple cysts, and solid nodules with cystic changes, mostly located in the entire thyroid gland and least located in the isthmus only. Cysts and solid nodules were mostly seen in the 41-60 years age group.
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  • 文章类型: Journal Article
    目的:肝脏粘液性囊性肿瘤(MCN-L)是一种恶性潜能较低的肝囊肿。最近的欧洲肝脏研究协会(EASL)指南为MCN-L的影像学特征和手术管理提供了指导。然而,由于缺乏符合修订后的世界卫生组织(WHO)标准的研究而受到阻碍。这项研究试图在一项回顾性队列研究中验证新的2022年EASL指南,该研究针对可疑MCN-L接受手术的患者进行了回顾性队列研究。
    方法:纳入2010年至2020年在单中心接受疑似MCN-L手术的患者。根据EASL指南评估影像学特征,并与最终病理诊断进行比较。根据WHO标准。
    结果:总计,包括35名患者。在三个病人中,没有令人担忧的成像特征,最终病理诊断为MCN-L。相反,6例具有令人担忧的影像学特征的患者没有MCN-L。5例患者最终病理诊断为MCN-L。EASL指南诊断MCN-L的敏感性为40%(95CI:5.3-85%),特异性为80%(95%CI:61-92%)。
    结论:尽管新的EASL指南提供了一些指导,他们无法可靠地将MCN-L与我们系列中的其他囊肿区分开来。因此,MCN-L的术前诊断仍然具有挑战性,我们在根据这些标准选择手术策略时应谨慎.
    OBJECTIVE: Mucinous cystic neoplasms of the liver (MCN-L) are hepatic cysts with a low malignant potential. The recent European Association for the Study of the Liver (EASL) guidelines provide guidance on the imaging features and surgical management of MCN-L, yet are hampered by a lack of studies adhering to the revised World Health Organization (WHO) criteria. This study attempted to validate the new 2022 EASL-guidelines in a retrospective cohort study of patients who underwent surgery for suspected MCN-L.
    METHODS: Patients undergoing surgery for suspected MCN-L in a single center between 2010 and 2020 were included. Imaging features were assessed according to the EASL guidelines and were compared to final pathological diagnoses, according to the WHO criteria.
    RESULTS: In total, 35 patients were included. In three patients, there were no worrisome imaging features, yet final pathological diagnosis showed MCN-L. Contrarily, six patients with worrisome imaging features did not have MCN-L. Five patients were diagnosed with MCN-L on final pathology. The sensitivity of the EASL-guidelines for the diagnosis of MCN-L was 40% (95%CI: 5.3-85%) and the specificity was 80% (95% CI: 61-92%).
    CONCLUSIONS: Although the new EASL-guidelines provide some guidance, they could not reliably distinguish MCN-L from other cysts in our series. Thus, preoperative diagnosis of MCN-L remains challenging and we should be careful in selecting surgical strategies based on these criteria.
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  • 文章类型: Journal Article
    目的小儿牙囊肿可能因地区和人群而异。大的囊性病变通常在摘除前用袋袋化术治疗,以减压病变并减小其体积;然而,在小儿囊性病变中,保守的有袋化和减压可用于控制病情,而无需额外的摘除。本研究的目的是介绍一系列儿科牙轮囊肿,并讨论与混合牙列相关的囊性病变的保守治疗。方法对2016年至2023年确诊的囊性病变患者进行回顾性队列分析。临床数据,放射学,病态,收集牙源性原因。在所有情况下都进行了有袋化方法。还检查了患者的人口统计信息,并进行了文献综述以确定可比病例。结果16例青年患者诊断为牙轮囊肿,临床证实了这一点,放射学,和病理检查。女性占56.2%,右侧占主导地位(62.5%)。与病变相关的乳牙在所有情况下都可以正常拔除。所有相关的恒牙在干预后迅速萌出。结论袋状化技术应用于目前混合牙列相关的牙囊囊肿是非常成功的。所有恒牙阻生,没有任何囊性复发。
    Objectives The pediatric dentigerous cysts might vary by region and population group. Large cystic lesions are typically treated with marsupialization before enucleation in order to decompress the lesion and reduce its volume; however, in pediatric cystic lesions, conservative marsupialization and decompression can be used to manage the condition without additional enucleation. The current study\'s objectives were to present a case series of pediatric dentigerous cysts and discuss the conservative management of these cystic lesions associated with mixed dentition. Methods A retrospective cohort analysis of patients diagnosed with cystic lesions between 2016 and 2023 was identified. Data on clinical, radiological, pathological, and odontogenic causes were collected. The marsupialization approach was performed in all cases. Patient demographic information was also examined, and a literature review was carried out to identify comparable cases. Results Sixteen young patients were diagnosed with dentigerous cysts, and this was confirmed by clinical, radiological, and pathological examinations. Females comprised 56.2% of the cases, with the right side predominating (62.5%). Deciduous teeth related to the lesion could be extracted normally in all cases. All associated permanent teeth erupted rapidly after the intervention. Conclusion The marsupialization technique used in the current cases of dentigerous cysts associated with mixed dentition was highly successful, and all permanent impacted teeth erupted without any cystic recurrence.
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  • 文章类型: Journal Article
    Polidocanol硬化疗法治疗有或没有病理性骨折的动脉瘤性骨囊肿(ABC)一直是争论的话题。虽然一些研究推荐病灶内刮治作为首选治疗方法,其他人建议病灶内硬化剂作为一种有效的替代品。
    本研究评估了28例ABCs患者使用以脊髓灰质炎为基础的经皮硬化剂治疗,其中病理性骨折8例。根据囊肿的临床和放射学评估,患者每四周接受一次注射,该研究评估了治疗的结果和并发症。
    A组(无病理性骨折),17个病变中有14个(82.4%)已治愈,无任何明显残留病变。17例患者中有3例(17.6%)需要进一步的手术治疗,并接受刮除和植骨治疗,确定。3例患者出现轻微的局部炎症反应,在没有干预的情况下在3-4天内解决。B组,8例(100%)病理性骨折患者病灶均愈合为1级愈合,没有任何明显的残留病变。一名患者出现了与麻醉相关的并发症(延迟恢复),该并发症在一小时内消退。没有任何残余效应。在最后的后续行动中,所有患者均未出现复发.
    该研究得出结论,脊髓灰质炎硬化疗法是ABCs患者的有效治疗选择,有或没有病理性骨折,并且由于其低侵入性,有可能成为病理性骨折的新治疗选择,低发病率,和负担能力。然而,需要进一步的研究来证实脊髓灰质炎硬化疗法在较大患者人群中的疗效,并将其与其他治疗方案的有效性进行比较.
    UNASSIGNED: Polidocanol sclerotherapy in the treatment of aneurysmal bone cysts (ABCs) with or without pathological fractures has been a topic of debate. While some studies recommend intralesional curettage as the preferred treatment, others suggest intralesional sclerosants as an effective alternative.
    UNASSIGNED: This study evaluates the use of polidocanol-based percutaneous sclerosant therapy in 28 patients with ABCs, of which 8 patients had pathological fracture. The patients received injections every four weeks based on clinical and radiological evaluation of the cyst, and the study assessed the results and complications of the treatment.
    UNASSIGNED: In group A (without pathological fractures), 14 out of 17 (82.4 %) lesions healed without any significant residual lesion. Three out of 17 (17.6 %) patients required further surgical intervention and were treated by curettage and bone grafting, definitively. Minor local inflammatory reaction was observed in 3 patients, which resolved without intervention within 3-4 days. In group B, all the 8 patients (100 %) with pathological fracture in their lesions healed as Grade 1 healing, without any significant residual lesion. One patient developed an episode of anesthesia related complication (delayed recovery) which resolved within an hour, without any residual effect. At final follow up, no recurrence was seen in any patient.
    UNASSIGNED: The study concludes that polidocanol sclerotherapy is an effective treatment option for patients with ABCs, with or without pathological fractures, and has the potential to become the new treatment of choice for pathological fractures due to its low invasiveness, low morbidity, and affordability. However, further research is needed to confirm the efficacy of polidocanol sclerotherapy in larger patient populations and to compare its effectiveness with other treatment options.
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  • 文章类型: Journal Article
    目前的囊性疾病实验模型是不够的,需要进一步研究。
    在这项研究中,评价了一种产生囊肿和囊性肿瘤组织模拟模型的新方法.
    为了模拟囊肿和囊性肿瘤,体外生产兔正常膀胱和VX2植入的肿瘤膀胱,固定,并包埋在琼脂糖凝胶中。
    根据肿瘤特征和兔膀胱的最大横径将样品分为四组,使用计算机断层扫描(CT)成像进行评估并进行统计分析。
    使用社会科学统计软件包(SPSS)软件进行统计分析。t检验用于分析枚举数据。
    21只兔子膀胱(21/24)被成功地取出并准备进行此实验,包括11个正常膀胱(11/24)和10个植入VX2肿瘤(10/24)。用于形成可视化和固定基质的胶凝成分是浓度为4g/200mL的琼脂糖。琼脂糖溶液的温度保持恒定在40-45°C,这是离体正常膀胱和植入VX2肿瘤膀胱插入的最佳温度范围。在琼脂糖凝胶中嵌入和固定膀胱所需的平均时间为每次45.0±5.2分钟。凝胶固定基质的强度和透光率足以构建模型。
    我们创建了一个具有稳定物理化学特征的囊肿和囊性肿瘤的实验性组织模拟模型,一种安全的制造方法,和高重复性。这些模型可用于辅助囊性病变的诊断和治疗技术。
    UNASSIGNED: The present experimental models of cystic diseases are not adequate and require further investigation.
    UNASSIGNED: In this study, a new way of producing a tissue-mimicking model of cysts and cystic neoplasms was evaluated.
    UNASSIGNED: To simulate cysts and cystic neoplasms, ex vivo rabbit normal bladders and VX2-implanted tumor bladders were produced, fixed, and embedded in agarose gel.
    UNASSIGNED: The samples were classified into four groups based on tumor features and the maximal transverse diameter of the rabbit bladder, which were assessed using computer tomography (CT) imaging and statistically analyzed.
    UNASSIGNED: Statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) software. The t-test was used for analyzing enumeration data.
    UNASSIGNED: Twenty-one rabbit bladders (21/24) were successfully removed and prepped for this experiment, comprising eleven normal bladders (11/24) and ten implanted with VX2 tumors (10/24). The gelling ingredient used to form the visualization and fixation matrix was agarose at a concentration of 4 g/200 mL. The temperature of the agarose solution was kept constant at 40-45°C, which is the optimal temperature range for ex vivo normal bladder and implanted VX2 tumor bladder insertion. The average time required to embed and fix the bladders in agarose gel was 45.0 ± 5.2 minutes per instance. The gel-fixing matrix\'s strength and light transmittance were enough for building the models.
    UNASSIGNED: We created an experimental tissue-mimicking model of cysts and cystic neoplasms with stable physicochemical features, a safe manufacturing method, and high repeatability. These models may be used to assist with cystic lesion diagnosis and treatment techniques.
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  • 文章类型: Journal Article
    背景:占中学人口绝大多数的青少年正处于受痤疮影响很大的阶段。这个条件,这是广泛可见和容易被同行识别,围绕它有许多误解,这可能会影响人们对受影响的人的态度。关于痤疮的患病率以及乔斯的青少年如何,尼日利亚,查看条件。
    目的:本研究旨在确定痤疮的患病率,感知的风险因素,以及乔斯青少年自我报告的准确性,尼日利亚。该研究还试图了解这个年龄组对痤疮的看法。
    方法:这项描述性横断面研究是在乔斯的私立和公立中学就读的青少年中进行的,尼日利亚。总的来说,通过多阶段分层随机抽样方法招募了482名学生。自制半结构化问卷用于收集痤疮病史的信息,对原因的看法,以及对有条件的人的态度。检查所有参与者是否存在痤疮。单变量,双变量,和多变量分析使用SPSS(版本26;IBMCorp)进行。
    结果:自我报告的痤疮患病率为44%,临床检查为55%。自我报告显示与临床诊断有中等程度的一致性(Cohenκ=57.3%;P<.001)。总体上,痤疮存在的预测因素是年龄≥15岁(比值比[OR]1.79,95%CI1.12-2.87;P=0.02),在私立学校(OR2.17,95%CI1.38-3.42;P=.001),处于高中阶段(OR2.14,95%CI1.32-3.47;P=0.002)。女性性别(OR3.03,95%CI1.64-5.61;P=0.001)和宗教(OR3.24,95%CI1.27-8.24;P=0.02)仅在年龄<15岁的青少年中预测痤疮,而在年龄≥15岁的人群中,阳性家族史具有预测价值(OR2.04,95%CI1.15-3.61;P=.02)。观察到围绕痤疮的独特感知和态度模式,作为一个显著的比例(84/131,64.1%vs47/131,35.9%;P=.02)的痤疮与生物学现象相关的人有痤疮本身;然而,认为痤疮是由美白治疗引起的,在无痤疮患者中(19/28,67.9%)明显多于有痤疮患者(9/28,32.1%;P=.01).四分之一的青少年(n=122,25.3%)不知道痤疮的可能原因。
    结论:尽管痤疮是尼日利亚青少年中普遍存在的皮肤病,许多误解和不利的态度围绕痤疮和受影响的人。我们的发现表明,需要与学校健康计划合作,对普通青少年人群进行痤疮教育,指和管理青少年痤疮。
    BACKGROUND: Adolescents who make up a vast majority of the secondary school population are at a stage at which they are largely affected by acne. This condition, which is widely visible and easily recognized by peers, has numerous misperceptions surrounding it, which may influence attitudes toward people affected by it. There is a paucity of information on the prevalence of acne and how adolescents in Jos, Nigeria, view the condition.
    OBJECTIVE: This study aimed to determine the prevalence of acne, perceived risk factors, and the accuracy of self-report among adolescents in Jos, Nigeria. The study also sought to understand perceptions surrounding acne in this age group.
    METHODS: This descriptive cross-sectional study was conducted among adolescents attending private and public secondary schools in Jos, Nigeria. In total, 482 students were recruited through a multistaged stratified random sampling method. A self-administered semistructured questionnaire was used to collect information on history of acne, perceptions of causes, and the attitude toward those who have the condition. All participants were examined for the presence of acne. Univariate, bivariate, and multivariate analysis were conducted using SPSS (version 26; IBM Corp).
    RESULTS: The self-reported prevalence of acne was 44% and that upon clinical examination was 55%. Self-report showed a moderate degree of agreement with clinical diagnosis (Cohen κ=57.3%; P<.001). Predictive factors for the presence of acne in general were age of ≥15 years (odds ratio [OR] 1.79, 95% CI 1.12-2.87; P=.02), being in a private school (OR 2.17, 95% CI 1.38-3.42; P=.001), and being in a senior secondary class (OR 2.14, 95% CI 1.32-3.47; P=.002). The female gender (OR 3.03, 95% CI 1.64-5.61; P=.001) and religion (OR 3.24, 95% CI 1.27-8.24; P=.02) were predictive for acne only among adolescents aged <15 years, while a positive family history was predictive in those aged ≥15 years (OR 2.04, 95% CI 1.15-3.61; P=.02). A distinct perception and attitude pattern surrounding acne was observed, as a significant proportion (84/131, 64.1% vs 47/131, 35.9%; P=.02) of those who related acne to a biological phenomenon had acne themselves; however, the belief that acne is caused by skin lightening practices was significantly more common in those without acne (19/28, 67.9%) than in those with acne (9/28, 32.1%; P=.01). One-fourth of the adolescents (n=122, 25.3%) had no idea of the possible causes of acne.
    CONCLUSIONS: Though acne is a prevalent skin condition among Nigerian adolescents, many misperceptions and unfavorable attitudes surround acne and persons affected by the condition. Our findings have revealed the need to work with the school health program to educate the general adolescent population about acne, to refer and manage teenagers with acne.
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  • 文章类型: Case Reports
    青少年的双侧肺包虫囊肿是罕见的,存在独特的诊断和治疗挑战。患有肺包虫病的青少年通常表现为咳嗽等非特异性症状,腹痛,恶心,呕吐,和肝脾肿大.
    方法:这个病例是大约14岁的青少年,他报告说他的胸部有肿块,并经历了食欲不振。进行了影像学检查,结果显示肺部存在双侧包虫囊肿。囊肿内容物被送去组织病理学分析,证实了包虫囊肿的诊断。
    包虫囊肿的临床表现因所涉及的器官而异。双侧包虫囊肿可能发生在各种器官,如肝脏,肺,大脑,脾,脾肾,骨头和其他部位。青少年双侧包虫囊肿的诊断很困难,因为症状可能是非特异性的,并且囊肿在达到足够的大小之前可能不会明显。手术方法的类型取决于位置,尺寸,和囊肿的数量。
    结论:双侧肺包虫囊肿已成为青少年患者越来越重要的诊断。影像学在及时诊断中起着至关重要的作用,手术干预仍然是管理的支柱。关于这种罕见病例的管理研究有限,但是通过多学科的方法,可以取得更好的成果。
    UNASSIGNED: Bilateral pulmonary hydatid cysts in adolescents are rare and present unique diagnostic and treatment challenges. Adolescents with pulmonary hydatid disease often present with nonspecific symptoms such as cough, abdominal pain, nausea, vomiting, and hepatosplenomegaly.
    METHODS: This case is about 14-year-old adolescent who reported feeling a mass in his chest and experienced a loss of appetite. Imaging studies were performed which showed the presence of bilateral hydatid cyst in the lung. The cyst contents were sent for histopathological analysis, which confirmed the diagnosis of hydatid cysts.
    UNASSIGNED: The clinical presentation of hydatid cysts varies depending on the organs involved. Bilateral hydatid cysts may occur in various organs such as liver, lung, brain, spleen, kidney, bone and other sites. Diagnosis of bilateral hydatid cysts in adolescents is difficult because symptoms may be nonspecific and the cysts may not be apparent until they reach a sufficient size. The type of surgical approach depends on the location, size, and number of cysts.
    CONCLUSIONS: Bilateral pulmonary hydatid cysts have become an increasingly important diagnosis in adolescent patients. Imaging plays a critical role in prompt diagnosis, and surgical intervention remains the mainstay of management. There are limited studies regarding the management of such rare cases, but through a multidisciplinary approach, improved outcomes can be achieved.
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  • 文章类型: Journal Article
    微波消融(MWA)是一种有前途的方式,需要进一步研究囊性病变。本研究旨在通过组织模拟模型确定MWA对囊肿和囊性肿瘤的影响。
    20只新西兰白兔随机分为A组(囊肿模拟模型,n=10,φ=5cm)和B组(囊性肿瘤模拟模型,n=10,φ=5cm)。对于每个小组,将离体兔健康膀胱和植入VX2的肿瘤膀胱固定并包埋在琼脂糖凝胶中以模拟囊肿和囊性肿瘤。在MWA实验亚组中,在这些模型中引入了由计算机断层扫描(CT)引导的微波天线。将系统温度计放置在膀胱壁的外边缘以监测温度变化。在MWA之后,收集离体兔健康膀胱和VX2植入的肿瘤膀胱用于大体解剖结构并准备用于病理学评估。
    总共成功地建立了20个囊肿和囊性肿瘤模拟模型。90%的MWA程序成功,并且没有遇到围手术期并发症.在两个MWA实验亚组中,囊壁的温度随着持续时间而增加,并且实现了有效消融温度(>60°C)。囊肿和囊性肿瘤模拟模型的病理检查显示膀胱壁粘膜上皮细胞变性坏死,膀胱壁组织结构丢失和VX2肿瘤细胞凝固性坏死。
    我们的数据表明,MWA可能对囊肿和囊性肿瘤的组织结构造成热损伤,它是治疗囊性疾病的有效技术。将体内兔健康膀胱和VX2植入的肿瘤膀胱固定并包埋在琼脂糖凝胶中以模拟囊肿和囊性肿瘤。囊壁的温度随着MWA持续时间的增加而增加,并且达到了有效的消融温度(>60°C)。MWA可对囊肿和囊性肿瘤的组织结构造成热损伤,可有效治疗囊性疾病。根据组织病理学评估。
    Microwave ablation (MWA) is a promising modality that needs to be further investigated for cystic lesions. The present study aimed to determine the effects of MWA on cysts and cystic neoplasms with a tissue-mimicking model.
    Twenty New Zealand White rabbits were randomly divided into Group A (cyst mimic models, n = 10, φ = 5 cm) and Group B (cystic neoplasm mimicking models, n = 10, φ = 5 cm). For each group, ex vivo rabbit healthy bladder and VX2-implanted tumor bladder were fixed and embedded in agarose gel to mimic cyst and cystic neoplasm. In the MWA experimental subgroups, microwave antennas guided by computed tomography (CT) were introduced into these models. A system thermometer was placed at the outer edge of the bladder wall to monitor temperature changes. Immediately after MWA, ex vivo rabbit healthy bladders and VX2-implanted tumor bladders were harvested for gross anatomy and prepared for pathological evaluation.
    A total of twenty cyst and cystic neoplasm mimicking models were successfully developed. Ninety percent of the MWA procedures were successful, and no peri-procedural complications were encountered. The temperature of the cystic wall increased with duration in both MWA experimental subgroups and an effective ablation temperature (>60 °C) was achieved. Pathological examination of the cyst and cystic neoplasm mimic models revealed degenerative necrosis of the bladder wall mucosal epithelial cells, loss of bladder wall tissue structure and coagulative necrosis of VX2 tumor cells.
    Our data indicate that MWA could cause thermal damage to the tissue structure of cyst and cystic neoplasm, and it is an effective technique for treating cystic diseases.HIGHLIGHTSex vivo rabbit healthy bladder and VX2-implanted tumor bladder were fixed and embedded in agarose gel to mimic cyst and cystic neoplasm.The temperature of the cystic wall increased with MWA duration and an effective ablation temperature (> 60 °C) was achieved.MWA could cause thermal damage to the tissue structure of the cyst and cystic neoplasm and it is effective in treating cystic diseases, as assessed by histopathology.
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  • 文章类型: Multicenter Study
    背景:我们试图确定类固醇治疗作为自身免疫性胰腺炎(AIP)伴囊肿形成(ACF)患者一线治疗的适应症和局限性。
    方法:这项日本多中心调查旨在研究类固醇治疗作为ACF初始治疗的优缺点。
    结果:分析了115例ACF患者的数据。86%(86/100)接受类固醇治疗的患者完全缓解,但只有33.3%(5/15)的患者没有接受类固醇治疗。在接受类固醇治疗的患者中,有7.6%(6/86)在缓解后复发(n=86)。但40%(2/5)的患者没有接受类固醇治疗。多变量分析确定采用不使用类固醇治疗的观望方法(比值比=0.126,P<.001)是ACF缓解的重要且独立的阴性预测因子。至于复发的预测因素,静脉曲张的存在(比值比=5.83,P=.036)被确定为独立危险因素.
    结论:类固醇疗法作为胰腺囊肿形成的AIP患者的一线治疗起着重要作用,然而,静脉曲张形成,除了囊肿的直径,是类固醇治疗无效的危险因素。
    BACKGROUND: We attempted to determine the indications and limitations of steroid therapy as the first-line therapy in patients with autoimmune pancreatitis (AIP) with cyst formation (ACF).
    METHODS: This Japanese multicenter survey was conducted to examine the merits/demerits of steroid treatment as the initial therapy for ACF.
    RESULTS: Data of a total of 115 patients with ACF were analyzed. Complete remission was achieved in 86% (86/100) of patients who had received steroid treatment, but only 33.3% (5/15) of patients who had not received steroids. Relapse after the remission (n = 86) occurred in 7.6% (6/86) of patients who had received steroid therapy, but 40% (2/5) of patients who had not received steroid therapy. Multivariate analysis identified adoption of the wait and watch approach without steroid treatment (odds ratio = 0.126, P < .001) as a significant and independent negative predictor of remission of ACF. As for predictors of relapse, the presence of varix (odds ratio = 5.83, P = .036) was identified as an independent risk factor.
    CONCLUSIONS: Steroid therapy plays an important role as first-line therapy in AIP patients with pancreatic cyst formation, however, varix formation, besides the diameter of the cyst(s), is a risk factor for refractoriness to steroid therapy.
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