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Chen EJ, Ang BCH, Yong VKY. Isolated "conjunctival cyst" following trabeculectomy surgery - a masquerade. J Fr Ophtalmol 2024; 47:104049. [PMID: 38238143 DOI: 10.1016/j.jfo.2023.104049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 11/03/2023] [Indexed: 04/08/2024]
Affiliation(s)
- E J Chen
- Department of Ophthalmology, National Healthcare Group Eye Institute, Tan Tock Seng Hospital, 308433 Jln Tan Tock Seng, Singapore
| | - B C H Ang
- Department of Ophthalmology, National Healthcare Group Eye Institute, Tan Tock Seng Hospital, 308433 Jln Tan Tock Seng, Singapore.
| | - V K Y Yong
- Department of Ophthalmology, National Healthcare Group Eye Institute, Tan Tock Seng Hospital, 308433 Jln Tan Tock Seng, Singapore
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Zhai J, Gao B, Huang T, Zhang L. Reoperation of postoperative discal pseudocyst occurring after unilateral biprotal endoscopic surgery for HIVD: A rare case report. Asian J Surg 2024; 47:1811-1812. [PMID: 38160141 DOI: 10.1016/j.asjsur.2023.12.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 12/15/2023] [Indexed: 01/03/2024] Open
Affiliation(s)
- Jinshuai Zhai
- The Department of Orthopedics,Hebei General Hospital, Shijiazhuang, 050051, Hebei, China
| | - Bo Gao
- The Department of Orthopedics,Hebei General Hospital, Shijiazhuang, 050051, Hebei, China
| | - Teng Huang
- The Department of Orthopedics,Hebei General Hospital, Shijiazhuang, 050051, Hebei, China
| | - Long Zhang
- The Department of Orthopedics,Hebei General Hospital, Shijiazhuang, 050051, Hebei, China.
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Arif N, Hetjens S, Hübers C, Felcht M. [Analysis of the postoperative outcome of 81 cases of nasal reconstruction with direct closure]. Dermatologie (Heidelb) 2024; 75:309-319. [PMID: 38042760 DOI: 10.1007/s00105-023-05262-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/24/2023] [Indexed: 12/04/2023]
Abstract
BACKGROUND Direct wound closure (side-to-side closure) for closing nasal defects, is controversially discussed. Yet, data supporting one or the other are lacking. MATERIAL AND METHOD An explorative, partly retrospective, partly prospective observational study including 81 patients was carried out for assessment of the operative results of after direct wound closure stretching rhinoplasty. The occurrence of complications, the esthetic result and influencing factors were examined. To assess the esthetic result the patient and observer scar assessment scale (POSAS) scores of patients and observers were determined. In both scores seven values were determined (1 point normal skin, 10 points worst imaginable scar). The individual values were added to give a total value (minimum 7-maximum 70). RESULTS After direct wound closure stretching rhinoplasty, 12 out of 81 patients (15 %) developed complications, in 5 cases suture dehiscence, in 5 cases cyst formation, in 4 cases a wound infection and 2 patients developed cyst formation and a wound infection. All suture dehiscences occurred on the lower third of the nose. Most of the patients were satisfied and assessed the scar with an average total value of 13.4 ± 7.07 (minimum 7, maximum 70, n = 42). In the individual assessments pain (1.14 ± 0.57; minimum 1, maximum 10) was rated best and scar color (2.50 ± 1.76; minimum 1, maximum 10) was rated worst. The total assessment in the observer-POSAS was also good with 12.9 ± 4.8 (minimum 7, maximum 70; n = 32). Elasticity was rated best (1.47 ± 0.88; minimum 1, maximum 7) and scar pigmentation (2.34 ± 1.54; minimum 1, maximum 7) worst. No correlations with a complication were found. CONCLUSION Direct wound closure stretching rhinoplasty is a safe method, especially for defect coverage in the upper two thirds of the soft tissue covering the nose, which in most cases achieved a good cosmetic result.
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Affiliation(s)
- Nawa Arif
- Klinik für Dermatologie, Venerologie und Allergologie, Exzellenzzentrum Dermatologie Mannheim des Landes Baden-Württemberg, Universitätsklinikum Mannheim, Medizinische Fakultät Mannheim der Universität Heidelberg, Heidelberg, Deutschland
| | - Svetlana Hetjens
- Abteilung für Medizinische Statistik und Biomathematik, Universitätsklinikum Mannheim, Medizinische Fakultät Mannheim der Universität Heidelberg, Heidelberg, Deutschland
| | - Corinne Hübers
- Klinik für Dermatologie, Venerologie und Allergologie, Exzellenzzentrum Dermatologie Mannheim des Landes Baden-Württemberg, Universitätsklinikum Mannheim, Medizinische Fakultät Mannheim der Universität Heidelberg, Heidelberg, Deutschland
| | - Moritz Felcht
- Klinik für Dermatologie, Venerologie und Allergologie, Exzellenzzentrum Dermatologie Mannheim des Landes Baden-Württemberg, Universitätsklinikum Mannheim, Medizinische Fakultät Mannheim der Universität Heidelberg, Heidelberg, Deutschland.
- Zentrum für Dermatochirurgie, St. Josefskrankenhaus Heidelberg, Akademisches Lehrkrankenhaus des Universitätsklinikum Mannheim, Medizinische Fakultät Mannheim der Universität Heidelberg, Landhausstr. 25, 69115, Heidelberg, Deutschland.
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Yoshimoto T, Takajo T, Iijima H, Yamamoto R, Takihara H, Nishimoto F. Comparison of endoscopic ultrasound-guided drainage and percutaneous drainage combined with minocycline sclerotherapy for symptomatic hepatic cysts: A retrospective study. Medicine (Baltimore) 2024; 103:e37677. [PMID: 38552057 PMCID: PMC10977566 DOI: 10.1097/md.0000000000037677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 03/01/2024] [Indexed: 04/02/2024] Open
Abstract
Simple hepatic cysts (SHC) are generally asymptomatic and incidentally diagnosed using imaging studies. Asymptomatic SHC does not require treatment, but symptomatic SHC warrants treatment using different modalities, including intravenous antibiotic therapy, ultrasound-guided percutaneous catheter drainage (PCD) with sclerotherapy, and surgery. The dissemination of endoscopic ultrasonography (EUS) intervention techniques has enabled the performance of puncture and drainage via the transgastrointestinal route for intra-abdominal abscesses. Despite the development of an EUS-guided drainage method for treating symptomatic SHC, only a few case reports using this method have been reported. This study retrospectively analyzed the safety and feasibility of EUS-guided drainage of symptomatic SHC as well as its clinical outcomes and compared it with combined therapy using PCD and minocycline sclerotherapy. The records of 10 consecutive patients with 11 symptomatic SHCs treated with either EUS-guided drainage or PCD combined with minocycline sclerotherapy at the Musashino Tokushukai Hospital from August 2019 to January 2024 were retrospectively examined. All cases in both groups achieved technical and clinical success, with no reported adverse events. The median reduction rates of the major cyst diameters in the EUS-guided drainage and PCD with sclerotherapy groups were 100% (interquartile range [IQR]: 94%-100%) and 67% (IQR: 48.5%-85%). The length of hospital stay was 7 and 22.5 days in the EUS-guided and PCD with sclerotherapy groups (P = .01). EUS-guided drainage of symptomatic SHC is a safe and effective therapeutic alternative to percutaneous drainage with sclerotherapy and surgery for treating symptomatic SHC.
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Affiliation(s)
- Taiji Yoshimoto
- Department of Gastroenterology, Musashino Tokushukai Hospital, Tokyo, Japan
| | - Takeshi Takajo
- Department of Gastroenterology, Musashino Tokushukai Hospital, Tokyo, Japan
| | - Hirokazu Iijima
- Department of Surgery, Musashino Tokushukai Hospital, Tokyo, Japan
| | - Ryuichi Yamamoto
- Department of Gastroenterology, Tokyo-west Tokushukai Hospital, Tokyo, Japan
| | - Hiroshi Takihara
- Department of Gastroenterology, Uji Tokushukai Hospital, Uji, Kyoto, Japan
| | - Fumiya Nishimoto
- Division of Gastroenterology Department of Internal Medicine Showa University Fujigaoka Hospital Kanagawa Japan
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Palot Manzil FF, Hameed MY, Eichhorn J. Scintigraphic Detection of Abdominal Pseudocyst: A Complication of Ventriculoperitoneal Shunt. J Nucl Med Technol 2024; 52:71-72. [PMID: 37699641 DOI: 10.2967/jnmt.123.266042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 08/04/2023] [Indexed: 09/14/2023] Open
Abstract
We report a case of a large abdominal pseudocyst detected on scintigraphy in a patient with a history of ventriculoperitoneal shunt placement who presented with headache and suspected shunt malfunction.
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Affiliation(s)
| | | | - Joshua Eichhorn
- University of Arkansas for Medical Sciences, Little Rock, Arkansas
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Long Q, Li J, Wen Y. A rare postoperative complication of procedure for prolapse and hemorrhoids (PPH): The rectal cyst. Asian J Surg 2024; 47:1699-1700. [PMID: 38143167 DOI: 10.1016/j.asjsur.2023.12.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 12/08/2023] [Indexed: 12/26/2023] Open
Affiliation(s)
- Qing Long
- Department of Traditional Chinese Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan province, China
| | - Jun Li
- Department of Traditional Chinese Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan province, China.
| | - Yong Wen
- Department of Traditional Chinese Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan province, China.
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Tseng HS, Lin CF, Yang HC, Chen CJ, Lin SC, Wu HM, Hu YS, Lin CJ, Chung WY, Shiau CY, Guo WY, Hung-Chi Pan D, Lee CC. Natural History and Histopathology of Expanding Cysts and Hematomas After Stereotactic Radiosurgery for Arteriovenous Malformations of the Brain: A Case Series. World Neurosurg 2024; 182:e854-e865. [PMID: 38104931 DOI: 10.1016/j.wneu.2023.12.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 12/10/2023] [Accepted: 12/11/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND We reviewed the clinical course and histopathologic findings for cases involving the formation of expanding cysts and/or hematomas after gamma knife surgery (GKS) for arteriovenous malformations (AVMs). METHODS We report a single-center retrospective review of 18 patients who presented with cyst and/or hematoma expansion after GKS for AVMs between 1993 and 2023. Expanding cysts and hematomas were defined as well-demarcated cavities filled with fluid or well-marginated heterogenous hematomas presenting with expansion proximal to or in the location of the original AVM, respectively. Patient demographics, AVM characteristics, history of interventions and surgeries, and imaging and histopathologic features of expanding cysts and hematomas were collected for analysis. RESULTS Among 1072 AVM patients treated using GKS, 18 presented with expanding cysts or hematomas during a total follow-up period of 16,757 patient-years (0.11 case/100 persons/patient-year). The time to cyst or hematoma identification was 4-13 years after initial GKS, with a mean duration of 8.6 years. Among the patients examined, 7 (38.9%) presented mainly with hematoma, 10 (55.6%) presented mainly with cysts, and 1 presented with approximately equal components of both. Among the 18 patients, 13 (72.2%) underwent craniotomy to treat cyst or hematoma expansion. All the specimens had similar histopathologic characteristics, including organizing hematoma with fresh and old hemorrhage, fibrinoid necrosis of the vessels, gliosis of normal brain tissue, infiltration of hemosiderin-laden histiocytes, and extravascular protein leakage. CONCLUSIONS Our findings suggest that the formation of these 2 complications can be attributed to a common mechanism involving radiation-induced vascular damage in brain tissue adjacent to the AVM and subsequent chronic inflammation and capillary dilatation.
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Affiliation(s)
- Han-Song Tseng
- Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chun-Fu Lin
- Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Huai-Che Yang
- Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ching-Jen Chen
- Department of Neurosurgery, The University of Texas Health Science Center, Houston, Texas, USA
| | - Shih-Chieh Lin
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Pathology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hsiu-Mei Wu
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yong-Sin Hu
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chung-Jung Lin
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Wen-Yuh Chung
- Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Neurosurgery, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Cheng-Ying Shiau
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Cancer Center, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Wan-Yuo Guo
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - David Hung-Chi Pan
- Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Cheng-Chia Lee
- Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.
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8
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Stevens SM, Maeng MM, Markatia ZA, Abou Khzam R, Tang V, Dubovy SR, Johnson TE. Chronic anophthalmic socket pain in the setting of deep orbital pseudocysts. Orbit 2024; 43:131-135. [PMID: 36278956 DOI: 10.1080/01676830.2022.2083186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 05/23/2022] [Indexed: 06/16/2023]
Abstract
An 89-year-old woman presented with chronic pain and foreign body sensation in a healthy-appearing anophthalmic socket. Computed tomography of the orbits showed hyperdense, cystic lesions superior and posterior to the orbital implant. Orbital exploration was performed; the orbital implant and lesions were removed. Histopathology revealed cystic structures composed of fibrocellular tissue lined with histiocytes and multinucleated giant cells, consistent with pseudocysts. Postoperatively, the patient noted the resolution of her symptoms. While the etiology of the pseudocysts remains unclear, we hypothesize that the answer can be traced back to the original surgery. The cysts may have formed after extravasation of fluid or proteinaceous material from the eye, from glycerin on the donor sclera, or after introduction of foreign material during retrobulbar injection of local anesthesia. This is the first report of pseudocysts occurring in the orbit posterior to an implant.
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Affiliation(s)
- Shanlee M Stevens
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Michelle M Maeng
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Zahra A Markatia
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Rayan Abou Khzam
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | | | - Sander R Dubovy
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Thomas E Johnson
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
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Ali AA, Badreldin I. Recurrent urethral obstruction secondary to large vulval inclusion cyst: a remote complication of female genital mutilation: a case report. BMC Womens Health 2023; 23:495. [PMID: 37723436 PMCID: PMC10506292 DOI: 10.1186/s12905-023-02653-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 09/12/2023] [Indexed: 09/20/2023] Open
Abstract
BACKGROUND Female genital mutilation/cutting (FGM/C) is a major public health problem, particularly in developing countries. CASE PRESENTATION The authors reported a case of 48-year old multiparous woman presented to Kassala Hospital, east Sudan, with recurrent urine retention resulting from urethral obstruction, which was caused by large vulval inclusion cyst. A traditional birth attendant circumcised her when she was 5 year old. Five years before her presentation the patient observed a painless swelling in her vulva, which was gradually increasing in size. She presented to the hospital with urine retention seeking medical care. Local examination showed a large cystic swelling originating in the circumcision line and covering the introitus. A diagnosis of inclusion cyst at the site of circumcision was made. The cyst was large enough causing bladder outlet obstruction and when the patient advised to tilt it away from the urethral orifice she passed urine without difficulties. The cyst was surgically removed by dissection along the lines of cleavage, which measured 10 × 9.2 cm and weighed 1.2 kg. CONCLUSION This case report indicates that FGM is a serious public health problem and there should an urgent intervention such as planned health education campaigns to end FGM practice.
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Affiliation(s)
- AbdelAziem A Ali
- Department of Obstetrics and Gynecology, Faculty of Medicine, Kassala University, P.O. Box 496, Kassala, Sudan.
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Bugazia S, Hogan MC. Extrarenal Manifestations: Polycystic Liver Disease and Its Complications. Adv Kidney Dis Health 2023; 30:440-453. [PMID: 37943238 DOI: 10.1053/j.akdh.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
The liver is the commonest site of involvement outside of the kidney in autosomal dominant polycystic kidney disease. Most individuals with polycystic liver disease are asymptomatic and require no therapeutic interventions, but a small number of affected individuals who experience symptomatic polycystic liver disease develop medical complications as a result of massive enlargement of cyst number and size and hepatic parenchyma and its subsequent associated complications. This can lead to deterioration in overall health and quality of life, increasing morbidity and mortality. In this review, we will touch upon disease pathogenesis, prevalence, and complications and discuss recent advances in surgical and medical management.
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Affiliation(s)
- Seif Bugazia
- Division of Nephrology & Hypertension, Department of Internal Medicine, Mayo Clinic, Rochester, MN
| | - Marie C Hogan
- Division of Nephrology & Hypertension, Department of Internal Medicine, Mayo Clinic, Rochester, MN.
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Hüseyinhan Z, Gürez C, Ülgen Y. How to reduce conjunctival cyst formation after strabismus surgery? Strabismus 2023; 31:166-171. [PMID: 37581336 DOI: 10.1080/09273972.2023.2242428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/16/2023]
Abstract
PURPOSE To determine our rate of conjunctival cyst developing after strabismus surgery and to minimize its formation. MATERIALS AND METHODS The data of 4026 eyes of 2662 patients were included in our retrospective analysis of, those that underwent strabismus surgery at the Beyoğlu Eye Training and Research Hospital Strabismus Unit between 2015 and 2021. Clinical characteristics and follow-up data of patients were recorded together with age, sex, and operation type. All patients were examined postoperatively on 1st day, 1st month and 6th month. RESULTS The mean age of the patients was 15.66 ± 11.81 (1-59 years). While two eyes were operated on in 1494 patients, one eye was operated on in 1168 patients. The surgeries performed were recession and/or resection of the horizontal and vertical rectus muscles and inferior and superior oblique procedures. The conjunctival cyst was detected in 11 patients postoperatively between 20 days and 8 months. The cyst was detected on the nasal side in 7 cases and temporal in 4. CONCLUSION Conjunctival cyst is a rare complication after strabismus surgery and it is thought to be caused by a proliferation of the conjunctival epithelium. In addition to proper closure of the conjunctiva, attention to personal hygiene, avoidance of contacts that may increase suture contamination, and attention to the fact that the operation period is not long are actions that can help prevent conjunctival cyst formation.
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Affiliation(s)
- Zahid Hüseyinhan
- University of Health Sciences Beyoğlu Eye Training and Research Hospital, Istanbul, Turkey
| | - Ceren Gürez
- University of Health Sciences Beyoğlu Eye Training and Research Hospital, Istanbul, Turkey
| | - Yiğit Ülgen
- University of Health Sciences Bağcılar Training and Research Hospital, Istanbul, Turkey
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Ravindra VM, Jensen H, Riva-Cambrin J, Wellons JC, Limbrick DD, Pindrik J, Jackson EM, Pollack IF, Hankinson TC, Hauptman JS, Tamber MS, Kulkarni AV, Rocque BG, Rozzelle C, Whitehead WE, Chu J, Krieger MD, Simon TD, Reeder R, McDonald PJ, Nunn N, Kestle JRW. Comparison of outcomes in the management of abdominal pseudocyst in children with shunted hydrocephalus: a Hydrocephalus Clinical Research Network study. J Neurosurg Pediatr 2023; 32:312-323. [PMID: 37327184 DOI: 10.3171/2023.4.peds23129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 04/26/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE Abdominal pseudocyst (APC) can cause distal site failure in children with ventriculoperitoneal shunts and is specifically designated as an infection in Hydrocephalus Clinical Research Network (HCRN) protocols. Specific management and outcomes of children with APCs have not been reported in a multicenter study. In this study, the authors investigated the management and outcomes of APC in children with shunted hydrocephalus who were treated at centers in the HCRN. METHODS The HCRN Registry was queried to identify children < 18 years old with shunts who were diagnosed with an APC (i.e., a loculated abdominal fluid collection containing the peritoneal catheter with abdominal distention and/or displacement of peritoneal contents). The primary outcome was shunt failure after APC treatment. The primary variable was reimplantation of the distal catheter after pseudocyst treatment back into the peritoneum versus implantation in a nonperitoneal site. Other risk factors for shunt failure after APC treatment and variability in APC management were investigated. RESULTS Among 141 children from 14 centers who underwent first-time management of an APC over a 14-year period, the median time from previous shunt surgery to APC diagnosis was 3.8 months. Overall, 17.7% of children had a positive culture: APC cultures were positive in 14.2% and CSF cultures in 15.6%. Six other children underwent shunt revision without removal; all underwent reoperation within 1 month. There was no difference in shunt survival (log-rank test, p = 0.42) or number of subsequent revisions within 6, 12, or 24 months for shunts reimplanted in the abdomen versus those implanted in a nonperitoneal location. Nonperitoneal implantation was associated with more noninfectious revisions (42.3% vs 22.9%, p = 0.019), whereas infection was more common after reimplantation in the abdomen (25.7% vs 7.0%, p = 0.003). Univariable analysis demonstrated that younger age at APC diagnosis (8.3 vs 12.2 years, p = 0.006) and prior shunt procedure within 12 weeks of APC diagnosis (59.5% vs 40.5%, p = 0.012) were associated with shunt failure after APC treatment. Multivariable modeling confirmed that prior shunt surgery within 12 weeks of APC diagnosis was independently associated with failure (HR 1.79 [95% CI 1.04-3.07], p = 0.035). CONCLUSIONS In the HCRN, APCs in the setting of CSF shunts are usually managed with externalization. Shunt surgery within 12 weeks of APC diagnosis was associated with risk of failure after APC treatment. Although no differences were found in overall shunt failure rate, noninfectious shunt revisions were more common in the nonperitoneal distal catheter sites, and infection was a more common reason for failure after reimplantation of the shunt in the abdomen.
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Affiliation(s)
- Vijay M Ravindra
- Departments of1Neurosurgery and
- 2Division of Neurosurgery, University of California, San Diego
- 3Department of Neurosurgery, Naval Medical Center San Diego, California
| | - Hailey Jensen
- 4Pediatrics, University of Utah, Salt Lake City, Utah
| | - Jay Riva-Cambrin
- 5Department of Clinical Neurosciences, Section of Neurosurgery, University of Calgary, Alberta, Canada
| | - John C Wellons
- 6Division of Pediatric Neurosurgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - David D Limbrick
- 7Department of Neurosurgery, St. Louis Children's Hospital, Washington University in St. Louis, Missouri
| | - Jonathan Pindrik
- 8Department of Neurological Surgery, Division of Pediatric Neurosurgery, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio
| | - Eric M Jackson
- 9Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Ian F Pollack
- 10Department of Neurosurgery, Children's Hospital of Pittsburgh, University of Pittsburgh, Pennsylvania
| | - Todd C Hankinson
- 11Department of Neurosurgery, Children's Hospital Colorado, University of Colorado, Aurora, Colorado
| | - Jason S Hauptman
- 12Department of Neurosurgery, University of Washington, Seattle Children's Hospital, Seattle, Washington
| | - Mandeep S Tamber
- 13Department of Surgery, Division of Neurosurgery, British Columbia Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Abhaya V Kulkarni
- 14Division of Neurosurgery, The Hospital for Sick Children, University of Toronto, Ontario, Canada
| | - Brandon G Rocque
- 15Department of Neurosurgery, Division of Pediatric Neurosurgery, University of Alabama at Birmingham, Children's of Alabama, Birmingham, Alabama
| | - Curtis Rozzelle
- 15Department of Neurosurgery, Division of Pediatric Neurosurgery, University of Alabama at Birmingham, Children's of Alabama, Birmingham, Alabama
| | - William E Whitehead
- 16Department of Neurosurgery, Division of Pediatric Neurosurgery, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas
| | - Jason Chu
- Departments of17Neurosurgery, Division of Neurosurgery, and
| | - Mark D Krieger
- Departments of17Neurosurgery, Division of Neurosurgery, and
| | - Tamara D Simon
- 18Pediatrics, Children's Hospital Los Angeles, University of Southern California, Los Angeles, California; and
| | - Ron Reeder
- 4Pediatrics, University of Utah, Salt Lake City, Utah
| | - Patrick J McDonald
- 19Department of Surgery, Section of Neurosurgery, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Nichol Nunn
- 4Pediatrics, University of Utah, Salt Lake City, Utah
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Teuwafeu DG, Dongmo A, Fomekong SD, Amougou M, Mahamat M, Nono A, Kaze FF, Ashuntantang G. Acquired cystic kidney disease in patients on maintenance hemodialysis, prevalence and associated factors: a cross-sectional study. Pan Afr Med J 2023; 45:175. [PMID: 37954434 PMCID: PMC10632177 DOI: 10.11604/pamj.2023.45.175.31773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 04/07/2023] [Indexed: 11/14/2023] Open
Abstract
Introduction Acquired Cystic Kidney Disease (ACKD) is a known complication in patients on maintenance hemodialysis, and it is associated with a high risk of malignant transformation. There is a paucity of data on ACKD in sub-Saharan Africa. Objectives: To determine the prevalence and factors associated with acquired cystic kidney disease in patients on maintenance hemodialysis. Methods patients on maintenance hemodialysis were screened for ACKD. Patients with hereditary cystic kidney disease were excluded. Renal ultrasounds were performed by two radiologists. ACKD was defined as 3 or more bilateral renal cysts in a small or normal size kidney. Associated factors were determined using logistic regression. A p-value <0.05 was significant. Results a total of 158 participants were enrolled and 61.4% (97) were male. Their mean (SD) age was 45.8 (14.9) years. The median dialysis vintage was 33.5 [10.7-63.2] months. The mean (SD) length of the kidneys was 85.1 (17.5) mm on the left and 81.2 (17.1) mm on the right. The prevalence of ACKD was 31.6% (n=50). Septated cysts (4), calcification of the wall of the cysts (2), irregular thick calcified wall (1), septated cysts with calcification (1) and hemorrhagic cyst (1) cysts were also observed. Dialysis vintage > 36 months (OR 7.1, 95% CI: 3.3 - 15.5) and male sex (OR 2.6, 95% CI: 1.2-5.6) were independently associated with ACKD. Conclusion the prevalence of ACKD is high in a population of Cameroonians on maintenance. This result calls for the implementation of strategies to screen for the condition and its complications.
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Affiliation(s)
- Denis Georges Teuwafeu
- Department of Internal Medicine and Paediatrics, Faculty of Health Sciences, University of Buea, Buea, Cameroon
| | - Aicha Dongmo
- Faculty of Health Sciences, University of Buea, Buea, Cameroon
| | - Sylviane Dongmo Fomekong
- Department of Internal Medicine and Paediatrics, Faculty of Health Sciences, University of Buea, Buea, Cameroon
| | - Mballa Amougou
- Department of Clinical Sciences, Faculty of Medicine and Pharmaceutics Sciences, University of Douala, Douala, Cameroon
| | - Maimouna Mahamat
- Department of Nephrology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Aristide Nono
- Department of Nephrology, Yaoundé General Hospital, Yaoundé, Cameroon
| | - François Folefack Kaze
- Department of Nephrology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Gloria Ashuntantang
- Department of Nephrology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
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14
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Andrienko DI, Bulynko SA, Evgrafova KA, Soldatskiy YL, Amirbekov MA, Patrik YA. [A case of subglottic cysts in monochorionic monoamniotic twins]. Vestn Otorinolaringol 2023; 88:90-93. [PMID: 37450398 DOI: 10.17116/otorino20228803190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
The first observation in the world literature of the development of subglottic cysts in the larynx in monochorionic monoamniotic twins is presented. The girls were born prematurely at 34 weeks of gestation, from the first day of life for 7 and 8 days, respectively, were transferred to mechanical ventilation. At the fourth month of life, symptoms of laryngeal stenosis appeared and began to gradually progress, conservative therapy had no effect. The diagnosis of subglottic cysts was established on the basis of fibrolaryngoscopy; after endolaryngeal surgery, breathing returned to normal. This case demonstrates the importance of timely endoscopic examination of the respiratory tract in children with stridor.
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Affiliation(s)
- D I Andrienko
- Morozov Children's City Clinical Hospital, Moscow, Russia
| | - S A Bulynko
- Morozov Children's City Clinical Hospital, Moscow, Russia
| | - K A Evgrafova
- Morozov Children's City Clinical Hospital, Moscow, Russia
| | | | - M A Amirbekov
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - Ya A Patrik
- Pirogov Russian National Research Medical University, Moscow, Russia
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15
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Wang H, Wang S, Yu H, Chen Y, Zheng L, Ma J. Surgical treatment of recurrent postoperative discal pseudocyst: A case report and literature review. Medicine (Baltimore) 2022; 101:e31756. [PMID: 36397328 PMCID: PMC9666085 DOI: 10.1097/md.0000000000031756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Postoperative discal pseudocyst (PDP) is rare. Few studies have reported on the recurrence of PDPs, and there is a lack of understanding of their clinical features and treatment methods. This study discusses the clinical characteristics and treatment of recurrent PDPs. PATIENT CONCERNS A 25-year-old man presented with radiating pain and numbness in the lateral left calf and dorsum of the foot. DIAGNOSIS Postoperative discal pseudocyst. INTERVENTIONS He underwent lumbar discectomy, which provided immediate postoperative relief. However, the symptoms recurred 45 days later. Magnetic resonance imaging (MRI) showed a lesion compressing the dura and nerve roots at the site of the previous surgery. The lesion appeared hypointense on T1-weighted imaging and hyperintense on T2-weighted imaging. The patient was treated conservatively for 1 month without significant relief. He then underwent lumbar discectomy and cyst removal, which immediately relieved his symptoms. However, 27 days later, the patient again developed the same symptoms. MRI examination showed recurrence of PDP. As 1 month of conservative treatment failed to relieve the patient's symptoms, we performed posterior instrumented lumbar fusion and cyst removal. OUTCOMES The patient's symptoms disappeared, and have not recurred for 1 year at the time of writing. CONCLUSIONS PDP is a rare complication of lumbar discectomy. Repeat lumbar discectomy can effectively treat PDP, but the cyst can recur. We, for the first time, used posterior instrumented lumbar fusion to successfully treat recurrent PDP.
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Affiliation(s)
- Hong Wang
- Department of Orthopedics, General Hospital of Northern Theater Command of Chinese PLA, Shenyang, Liaoning Province, China
| | - Shuang Wang
- Department of Orthopedics, General Hospital of Northern Theater Command of Chinese PLA, Shenyang, Liaoning Province, China
| | - Hailong Yu
- Department of Orthopedics, General Hospital of Northern Theater Command of Chinese PLA, Shenyang, Liaoning Province, China
| | - Yu Chen
- Department of Orthopedics, General Hospital of Northern Theater Command of Chinese PLA, Shenyang, Liaoning Province, China
| | - Liang Zheng
- Department of Orthopedics, General Hospital of Northern Theater Command of Chinese PLA, Shenyang, Liaoning Province, China
| | - Junxiong Ma
- Department of Orthopedics, General Hospital of Northern Theater Command of Chinese PLA, Shenyang, Liaoning Province, China
- * Correspondence: Junxiong Ma, Department of Orthopedics, General Hospital of Northern Theater Command of Chinese PLA, No. 83 Wenhua Road, Shenhe District, Shenyang 110000, Liaoning Province, China (e-mail: )
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16
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Kim MS, Rhee SM, Cho NS. Perianchor cyst formation in all-suture anchor after rotator cuff repair: an evaluation of anchor insertion angle. J Shoulder Elbow Surg 2022; 31:1831-1839. [PMID: 35367621 DOI: 10.1016/j.jse.2022.02.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 02/21/2022] [Accepted: 02/24/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Previous studies reported that micromotion after all-suture anchor implantation can lead to perianchor cyst formation (PCF), leading to risk of retear. Modifying anchor insertion angle (AIA) is known to be one of the various ways to increase anchor stability. However, there currently are few studies that assess the correlation between PCF, AIA, and retear. PURPOSE To find the correlation of PCF and the repaired rotator cuff integrity with AIA after arthroscopic double-row suture-bridge rotator cuff repair (RCR) using an all-suture anchor in the medial row. METHODS A total of 218 patients who underwent arthroscopic double-row suture-bridge RCR were retrospectively reviewed. All patients underwent RCR using all-suture anchors and polyether ketone anchors in the medial and lateral rows, respectively. Magnetic resonance imaging was conducted 6 months after the surgery to evaluate PCF, AIA, and integrity of the repaired cuff. The all-suture anchor insertion angle in the medial row was measured with reference to the greater tuberosity to assess the relationship between the AIA and PCF. The correlations between PCF, AIA, and post-RCR integrity were evaluated including various demographic and radiologic factors. RESULTS Perianchor cysts were formed in 93 patients (42.7%). Mediolateral tear size (2.1 ± 1.2 cm vs. 1.7 ± 0.9 cm, P = .034) and AIA (61.9° ± 15.2° vs. 68.4° ± 13.0°, P = .001) were significantly different between patient groups with and without perianchor cysts. Multivariate logistic regression analysis showed that mediolateral tear size (odds ratio [OR] 1.318, 95% confidence interval [CI] 1.008-1.724; P = .043) and AIA (OR 0.967, 95% CI 0.947-0.988; P = .002) were independent risk factors for PCF. In addition, PCF was observed more frequently (69.6% vs. 32.1%, P < .001) and the AIA was lower (59.4° ± 13.7° vs. 67.8° ± 13.8°, P < .001) in the retear group than in the healed group. CONCLUSIONS Perianchor cysts were formed in approximately 40% of patients who underwent arthroscopic double-row suture-bridge RCR using all-suture anchors. Low AIA and large mediolateral tear size were risk factors for PCF. Moreover, perianchor cyst and AIA were correlated with post-RCR integrity. Therefore, a high AIA must be carefully considered when all-suture anchors are inserted into the medial row when performing RCR.
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Affiliation(s)
- Myung Seo Kim
- Shoulder & Elbow Clinic, Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea; College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Sung Min Rhee
- College of Medicine, Kyung Hee University, Seoul, Republic of Korea; Shoulder & Elbow Clinic, Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University Hospital, Seoul, Republic of Korea
| | - Nam Su Cho
- Department of Orthopedic Surgery, Cheil Orthopedic Hospital, Seoul, Republic of Korea.
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17
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Ongaro M, Bronstein FN, Goossens N, Spahr L, Bresson Hadni S. [Polycystic liver disease]. Rev Med Suisse 2022; 18:1599-1605. [PMID: 36047551 DOI: 10.53738/revmed.2022.18.793.1599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Polycystic liver disease (PLD) includes three entities in adults : biliary hamartomas which develop as a result of ductal plate malformation, autosomal dominant polycystic liver disease (ADPLD) and autosomal dominant polycystic kidney disease (ADPKD) which occur in the setting of genetic disorders. Hamartomas are asymptomatic and benign. PLD are marked by a steady growth of cysts over time, clinically silent in the majority of cases. Symptomatic forms mainly affect women due to the influence of estrogens on the growth of cysts therefore estrogen treatments are contraindicated in this setting. Diagnosis is based on imaging. Complications are rare but must be identified early in order to offer appropriate care in an expert center.
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Affiliation(s)
- Marie Ongaro
- Service de gastroentérologie et hépatologie, Hôpitaux universitaires de Genève, 1211 Genève 14
| | | | - Nicolas Goossens
- Service de gastroentérologie et hépatologie, Hôpitaux universitaires de Genève, 1211 Genève 14
| | - Laurent Spahr
- Service de gastroentérologie et hépatologie, Hôpitaux universitaires de Genève, 1211 Genève 14
| | - Solange Bresson Hadni
- Service de gastroentérologie et hépatologie, Hôpitaux universitaires de Genève, 1211 Genève 14
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18
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Çetin MÜ, Özçelik İB. Treatment of persistent large cystic lesions of the humerus with vascularized fibular grafts. Jt Dis Relat Surg 2022; 33:426-434. [PMID: 35852204 PMCID: PMC9361091 DOI: 10.52312/jdrs.2022.578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 04/18/2022] [Indexed: 11/30/2022] Open
Abstract
Objectives
In this study, we aimed to evaluate the short-to-midterm results of the resection and reconstruction of large cystic lesions of the humerus. Patients and methods
Eight male patients (median age: 22.9±10.4 years; range, 12 to 42 years) with large cystic lesions of the humerus operated between January 2017 and December 2019 were retrospectively analyzed. The age of the patients, their previous treatments and follow-up periods, the size and location of the cysts, postoperative functional scores, presence of a union, recurrence of the cyst, and graft resorption were examined. Results
The mean follow-up was 42.8±7.5 (range, 34 to 54) months. Preoperatively, the mean length of the cystic lesions was 15.1±2.6 (range, 10 to 18) cm. At the final follow-up, the patients had a normal range of shoulder flexion-extension, internal rotation-external, abduction-adduction, and elbow flexion-extension, pronation-supination. The patients had a mean DASH score of 1.13±1.1 (range, 0 to 3.3) and MSTS score of 28.75±1.8 (range, 26 to 30) postoperatively. Complications such as pseudoarthrosis, graft resorption, or cyst recurrence were not observed in any of the patients. Conclusion
Although the risk of recurrence is low in small cystic lesions of the humerus, it increases as the size of the lesion increases. This reconstruction technique using vascularized fibular grafts, which we applied, seems to be extremely successful in ensuring biological healing and preventing recurrence and complications in patients with large cystic lesions of the humerus.
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Affiliation(s)
- Mehmet Ümit Çetin
- Tekirdağ Namık Kemal Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalı, 59030 Tekirdağ, Türkiye.
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19
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Monera Lucas CE, Fernández Martínez C, Martínez Toldos JJ. Acute intraocular pressure elevation after Nd:YAG laser-puncture of a post-traumatic iris cyst. Am J Ophthalmol 2022; 242:e1-e2. [PMID: 35760116 DOI: 10.1016/j.ajo.2022.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 05/29/2022] [Accepted: 06/06/2022] [Indexed: 11/18/2022]
Affiliation(s)
- Carlos Enrique Monera Lucas
- Ophthalmology Department, General University Hospital of Elche (C.E.M.L., C.F.M., J.J.M.T.), Alicante, Spain; Miguel Hernández University of Elche (C.E.M.L.), Alicante, Spain.
| | - Cristian Fernández Martínez
- Ophthalmology Department, General University Hospital of Elche (C.E.M.L., C.F.M., J.J.M.T.), Alicante, Spain
| | - José Juan Martínez Toldos
- Ophthalmology Department, General University Hospital of Elche (C.E.M.L., C.F.M., J.J.M.T.), Alicante, Spain
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20
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Huang CW, Yen YH, Lu SY, Pu CM. Oil Cyst Formation after Lower Blepharoplasty with Fat Grafts. Ann Plast Surg 2022; 88:S73-S77. [PMID: 35225851 DOI: 10.1097/sap.0000000000003086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Fat grafting is increasingly used as an adjuvant surgery to blepharoplasty to refill the volume loss of an aged face and promote cellular regeneration. Complications, such as hematoma, infection, seroma, and palpable mass, may occur. We collected the patients that underwent lower blepharoplasty combined with fat graft to evaluate the incidence of oil cyst formation in the lower eyelid and to identify risk factors. MATERIAL AND METHODS A retrospective review was performed of all patients who underwent lower or total blepharoplasty combined with fat graft at the authors' institution between January 2018 and June 2020. Complication rates were observed, and associations between preoperative variables and outcomes were assessed. RESULTS A total of 119 patients were included in the series (all bilateral, 238 eyelids). The average patient age was 54.88 ± 11.94 years, and the average grafted fat was 1.88 ± 1.0 mL. On a per-eyelid basis for all patients, the complication rate of oil cyst formation was 6.72% (16 of 238 eyelids). The occurrence of oil cyst formation was associated with hypertension (P = 0.012; adjusted odds ratio, 9.27; 95% confidence interval, 1.62-52.99) and diabetes mellitus (P = 0.005; adjusted odds ratio, 14.02; 95% confidence interval, 2.22-88.45), but not associated with anticoagulants use (P = 0.931), age (P = 0.784), sex (P = 0.317), or fat volume (P = 0.215). The mean interval between the fat graft procedure and oil cyst noted was 236.5 ± 118.9 days. CONCLUSIONS Oil cyst in lower eyelid can be defined as a palpable, firm, and persistent subcutaneous cystic lesion found postoperatively in any size during physical examination. The complication rate of oil cyst formation occurring after lower blepharoplasty with autologous fat grafting is 6.72%. Hypertension and diabetes mellitus maybe are risk factors of oil cyst formation. Steroid injection, needle capsulotomy, liposuction, and excision are safe and effective treatments. Reduce surgical trauma by diminishing anterior lamina trauma and capsulopalpebral fascia repair might decrease the complication rate of oil cyst formation.Transconjunctival lower blepharoplasty with fat graft or 2-stage surgery may be a choice to prevent oil cyst formation.
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Affiliation(s)
- Chih-Wei Huang
- From the Division of Plastic Surgery, Department of Surgery, Cathay General Hospital, Taipei, Taiwan
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21
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Mizuno H, Sekine A, Suwabe T, Ikuma D, Yamanouchi M, Hasegawa E, Sawa N, Ubara Y, Hoshino J. Potential effect of tolvaptan on polycystic liver disease for patients with ADPKD meeting the Japanese criteria of tolvaptan use. PLoS One 2022; 17:e0264065. [PMID: 35176098 PMCID: PMC8853523 DOI: 10.1371/journal.pone.0264065] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 01/31/2022] [Indexed: 11/18/2022] Open
Abstract
Polycystic liver disease (PLD) is a common extrarenal complication of autosomal dominant polycystic kidney disease (ADPKD), which causes compression-related syndrome and ultimately leads to liver dysfunction. Tolvaptan, a V2 receptor antagonist, is widely used to protect kidney function in ADPKD but its effect on PLD remains unknown. An observational cohort study was conducted to evaluate tolvaptan’s effect on patients with PLD due to ADPKD. After screening 902 patients, we found the 107 ADPKD patients with PLD who met the criteria of tolvaptan use in Japan. Among them, tolvaptan was prescribed for 62 patients (tolvaptan group), while the other was defined as the non-tolvaptan group. Compared with the non-tolvaptan group, the tolvaptan group had larger height-adjusted total kidney volume (median 994(range 450–4152) mL/m, 513 (405–1928) mL/m, p = 0.01), lower albumin level (mean 3.9±SD 0.4 g/dL, 4.3±0.4g/dL, p<0.01), and higher serum creatinine level (1.2±0.4 mg/dL, 0.9±0.2 mg/dL, p<0.01). Although the median change in annual growth rate of total liver volume (TLV) was not statistically different between the tolvaptan group (-0.8 (-15.9, 16.7) %/year) and the non-tolvaptan group (1.7 (-15.6–18.7) %/year)(p = 0.52), 20 (43.5%) patients in the tolvaptan group experienced a decrease in the growth rate of TLV (responders). A multivariable logistic regression model adjusting for related variables showed that older age (odds ratio 1.15 [95% CI 1.01–1.32]) and a higher growth rate of TLV in the non-tolvaptan period (odds 1.45 95% CI 1.10–1.90) were significantly associated with responders. In conclusion, the change in annual growth rate of TLV in ADPKD patients taking tolvaptan was not statistically different compared with that in ADPKD patients without taking tolvaptan. However, tolvaptan may have the potential to suppress the growth rate of TLV in some PLD patients due to ADPKD, especially in older patients or those that are rapid progressors of PLD. Several limitations were included in this study, therefore well-designed prospective studies were required to confirm the effect of tolvaptan on PLD.
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Affiliation(s)
- Hiroki Mizuno
- Nephrology Center, Toranomon Hospital Kajigaya, Kawasaki, Kanagawa, Japan
- Okinaka Memorial Institute for Medical Research, Tokyo, Japan
- * E-mail:
| | | | - Tatsuya Suwabe
- Nephrology Center, Toranomon Hospital Kajigaya, Kawasaki, Kanagawa, Japan
| | - Daisuke Ikuma
- Nephrology Center, Toranomon Hospital Kajigaya, Kawasaki, Kanagawa, Japan
| | | | | | - Naoki Sawa
- Nephrology Center, Toranomon Hospital Kajigaya, Kawasaki, Kanagawa, Japan
| | - Yoshifumi Ubara
- Nephrology Center, Toranomon Hospital Kajigaya, Kawasaki, Kanagawa, Japan
| | - Junichi Hoshino
- Okinaka Memorial Institute for Medical Research, Tokyo, Japan
- Nephrology Center, Toranomon Hospital, Tokyo, Japan
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22
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Risfandi M, Celia C, Shen R. Abdominal wall pseudocyst as a complication of ventriculoperitoneal shunt insertion: a case report. Pan Afr Med J 2022; 41:23. [PMID: 35291355 PMCID: PMC8895582 DOI: 10.11604/pamj.2022.41.23.29426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 01/03/2022] [Indexed: 11/24/2022] Open
Abstract
The abdominal cavity has long been used to absorb cerebrospinal fluid (CSF) in a ventriculoperitoneal (VP) procedure in hydrocephalus patients. Although this procedure is quite common, some complications can potentially arise. This study aimed to report a case of pseudocyst formation as a rare complication (<5% incidences) following a VP shunt insertion. A case of a 62-year-old male patient with a history of communicating hydrocephalus post-VP shunt insertion presented with symptoms of acute progressive right abdominal pain and was found a formation of large abdominal wall pseudocyst. An upper abdominal computed tomography (CT) scan showed a well-defined cystic mass lesion located intraperitoneally in the right hypochondrium. He subsequently underwent an exploratory laparotomy and surgical excision of the pseudocyst, followed by improved symptoms experienced. Clinicians must be aware of this complication because early diagnosis and prompt management will eventually improve outcomes for reducing abdominal pain and improving the patient's quality of life.
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Affiliation(s)
- Marsal Risfandi
- Department of Neurosurgery, Faculty of Medicine, University of North Sumatra, Sumatera Utara, Indonesia
- Department of Neurosurgery, Putri Bidadari General Hospital, Jalan Stabat Tanjung Pura Langkat, Sumatera Utara, Indonesia
| | - Celia Celia
- Department of Surgery, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jalan Pluit Raya, Jakarta, Indonesia
- Corresponding author: Celia Celia, Department of Surgery, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jalan Pluit Raya, Jakarta, Indonesia.
| | - Robert Shen
- Department of Surgery, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jalan Pluit Raya, Jakarta, Indonesia
- Atma Jaya Neuroscience Research (ANR), Master Study Program in Biomedical Sciences, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jalan Pluit Raya, Jakarta, Indonesia
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23
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De Jesus O, Rios-Vicil C, Pellot Cestero JE, Carro-Figueroa EF. Huge subcutaneous extraperitoneal pseudocyst after migration of the ventriculoperitoneal shunt catheter. BMJ Case Rep 2021; 14:e246681. [PMID: 34853048 PMCID: PMC8638129 DOI: 10.1136/bcr-2021-246681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2021] [Indexed: 11/03/2022] Open
Abstract
The formation of an intraperitoneal pseudocyst as a complication of ventriculoperitoneal shunts is well known. However, the formation of a pseudocyst at the subcutaneous extraperitoneal abdominal space is unusual and likely secondary to the migration of the peritoneal catheter. We present a 53-year-old male who had placement of a ventriculoperitoneal shunt for hydrocephalus secondary to a vestibular schwannoma. Five months later, he presented with an enormously distended abdomen. Investigations showed the peritoneal catheter in the extraperitoneal space within a large right lower quadrant abdominal wall pseudocyst. The patient was taken to the operating theatre, and the shunt was externalised at the original abdominal incision. Approximately 3 L of cerebrospinal fluid were aspirated from the distal peritoneal catheter. After negative cultures, a new peritoneal catheter was placed intraperitoneally at the contralateral lower abdominal quadrant. The contralateral quadrant was utilised to prevent fluid accumulation into the old extraperitoneal cavity.
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Affiliation(s)
- Orlando De Jesus
- Neurosurgery, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico, Puerto Rico
| | - Christian Rios-Vicil
- Neurosurgery, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico, Puerto Rico
| | - Joel E Pellot Cestero
- Neurosurgery, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico, Puerto Rico
| | - Eric F Carro-Figueroa
- Neurosurgery, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico, Puerto Rico
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24
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Heitmiller K, Albornoz C, Saedi N, MacGregor J. Foreign Body Granuloma Secondary to a Ruptured Cyst After Dermal Filler Injection. Dermatol Surg 2021; 47:1522-1524. [PMID: 34387277 DOI: 10.1097/dss.0000000000003210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Kerry Heitmiller
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Christian Albornoz
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Nazanin Saedi
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Jennifer MacGregor
- Department of Dermatology, Union Square Laser Dermatology, New York, New York
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25
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Crimp C, Hand M, Chesnut C. Identification and Management of Postoperative Sialoceles in Dermatologic Surgery. Dermatol Surg 2021; 47:1163-1165. [PMID: 34115689 DOI: 10.1097/dss.0000000000003123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Caitlin Crimp
- University of Washington School of Medicine, Seattle, Washington
| | - Matthew Hand
- University of Washington School of Medicine, Seattle, Washington
- Cosmetic Surgery Fellowship at Clinic 5C, Spokane, Washington
| | - Cameron Chesnut
- University of Washington School of Medicine, Seattle, Washington
- Cosmetic Surgery Fellowship at Clinic 5C, Spokane, Washington
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26
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Tan AP, Yeo TT, Yong HRC, Karlsson B. Dynamic radiation-induced imaging changes more than 20 years following gamma knife surgery. Acta Neurochir (Wien) 2021; 163:1935-1939. [PMID: 33999264 DOI: 10.1007/s00701-021-04865-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 04/22/2021] [Indexed: 11/28/2022]
Abstract
Gamma knife radiosurgery (GKS), a technique which involves delivery of a high dose of radiation to a precisely defined target, has become the predominant treatment option for brain metastases (BM) because of its high effectiveness and relatively minimal toxicity. Herein, we report a case of late-onset radiation-induced edema around an asymptomatic cyst, more than 20 years after salvage GKS, with 27 years of imaging follow-up, allowing the description of the evolutionary trajectory of these relatively rare complications. Our reported case also demonstrated the benign nature of delayed cyst formation (DCF), emphasizing that observation alone is reasonable for asymptomatic patients.
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Affiliation(s)
- Ai Peng Tan
- Department of Diagnostic Imaging, National University Hospital, 1E Kent Ridge Rd, Singapore, 119228, Singapore.
- Singapore Institute for Clinical Sciences (SICS), A*STAR Research Entities (ARES), 30 Medical Dr, Singapore, 117609, Singapore.
- Yong Loo Lin School of Medicine, National University of Singapore (NUS), 21 Lower Kent Ridge Road, Singapore, 119077, Singapore.
| | - Tseng Tsai Yeo
- Division of Neurosurgery, Department of Surgery, National University Hospital, 1E Kent Ridge Rd, Singapore, 119228, Singapore
| | - Hsiang Rong Clement Yong
- Department of Diagnostic Imaging, National University Hospital, 1E Kent Ridge Rd, Singapore, 119228, Singapore
| | - Bengt Karlsson
- Division of Neurosurgery, Department of Surgery, National University Hospital, 1E Kent Ridge Rd, Singapore, 119228, Singapore
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Abstract
Branchial cleft anomalies (BCA) are among the most common congenital anomalies found in the pediatric head and neck. The embryology of these congenital anomalies is well understood, which allows clinicians to anticipate their diagnosis when a pediatric patient presents with a head or neck mass. The predictable anatomy of the various types of BCA allows for improved surgical planning to prevent recurrence and ensure complete resection. This report details an unusual location of a first BCA located in the ear lobule of a 10-month old male. There has been no documented first BCA at the ear lobule in the literature.
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Affiliation(s)
- Jennifer N Shehan
- Boston Medical Center, Department of Otolaryngology - Head & Neck Surgery, United States of America.
| | - Jessica R Levi
- Boston Medical Center, Department of Otolaryngology - Head & Neck Surgery, United States of America; Boston University School of Medicine, Boston, MA, United States of America
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O'Dowd DP, Dow D, Rosenfeldt MP. Apricot oil as a cause for multi-lobulated oil cysts in the deltoid muscle of a bodybuilder. N Z Med J 2021; 134:110-114. [PMID: 33927429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- Dominic P O'Dowd
- Sports Orthopaedic Fellow - Unisports Sports Medicine, Auckland, New Zealand
| | - David Dow
- Consultant Radiologist, Auckland Radiology Group, Auckland, New Zealand
| | - Michael P Rosenfeldt
- Consultant Orthopaedic Surgeon - Unisports Sports Medicine, Auckland, New Zealand
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29
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Jimenez-Rolando B, Carreño E, Alonso-Peralta MA, Lopez-Molina MI, Fernandez-Sanz G. Multicolor Imaging for the Detection of Inner Nuclear Layer Microcysts Secondary to Optic Nerve Atrophy. J Neuroophthalmol 2021; 41:e107-e110. [PMID: 33587537 DOI: 10.1097/wno.0000000000000976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT Inner nuclear layer (INL) microcysts have been reported in diseases affecting the optic nerve. The new ocular imaging techniques detect minimal structural alterations at the macula and correlate these findings to different etiologies with less invasive procedures. The relationship between ganglion cells distribution at the macula and chiasmal nerve fibers enables the diagnosis and location of neurological lesions by new generation optical coherence tomography (SD-OCT) imaging devices. We report the evaluation of a patient with a history of optic nerve trauma and macular INL microcysts with multicolor SD-OCT technology that shows a pattern that localizes the lesion to the left optic nerve and proximal segment of the chiasm.
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Affiliation(s)
- Belen Jimenez-Rolando
- Department of Ophthalmology (BJ-R, EC, MAA-P), Fundacion Jimenez-Diaz University Hospital, Madrid, Spain ; Centro Oftalmologico Integrado (MIL-M), Madrid, Spain ; and Department of Ophthalmology (GF-S), Clínica Universidad de Navarra, Madrid, Spain
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30
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Li J, Liang S, Xie W, Luo J, Tang J, Liu L, Li Y, Wu C, Li X. Symptomatic postoperative discal pseudocyst following percutaneous endoscopic lumbar discectomy: A case report and review of the literature. Medicine (Baltimore) 2021; 100:e24026. [PMID: 33545999 PMCID: PMC7837847 DOI: 10.1097/md.0000000000024026] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 12/03/2020] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Percutaneous endoscopic lumbar discectomy (PELD) is an effective treatment for lumbar disc herniation and postoperative discal pseudocyst (PDP) can rarely develop after PELD. PATIENT CONCERNS A 30-year-old man experienced low back pain and pain in the right lower extremity for 1 month, which aggravated for 3 days. DIAGNOSES Preoperative CT and MRI showed lumbar disc herniation at the L4/5 level. Then the patient underwent PELD under local anesthesia and his symptoms disappeared immediately after surgery. After 37 days of PELD, the patient complained of recurrent low back pain on the right side, and pain on the outer side of his lower leg. MR imaging revealed cystic mass with low signal on T1-weighted images (T1WI), and high signal on T2-weighted images (T2WI). The patient was diagnosed with a symptomatic PDP after PELD. INTERVENTIONS Initially, the patient was treated with conservative treatment, including administration of aescin and mannitol by intravenous infusion, physical therapy, sacral canal injection. Then he underwent discography at L4/5 and ozone ablation under local anesthesia. OUTCOMES The patient's condition improved significantly after 1 week of surgery and was discharged. One-year and 3-month follow-up revealed no recurrence of low back pain and leg pain. LESSONS PDP is one of the rare complications of PELD, usually occurs in young patients. Patients with PDP have a low signal intensity on T1WI and high signal intensity on T2WI, which can be treated by conservative treatment, interventional therapy, and surgical treatment.
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Affiliation(s)
- Junjie Li
- Hubei 672 Orthopaedics Hospital of Integrated Chinese & Western Medicine, Wuhan, 430079, Hubei
| | - Shuhan Liang
- Hubei 672 Orthopaedics Hospital of Integrated Chinese & Western Medicine, Wuhan, 430079, Hubei
| | - Wei Xie
- Hubei 672 Orthopaedics Hospital of Integrated Chinese & Western Medicine, Wuhan, 430079, Hubei
| | - Jinxin Luo
- Hunan Liuyang Orthopaedics Hospital, Liuyang, 410327, Hunan, China
| | - Jin Tang
- Hubei 672 Orthopaedics Hospital of Integrated Chinese & Western Medicine, Wuhan, 430079, Hubei
| | - Liu Liu
- Hubei 672 Orthopaedics Hospital of Integrated Chinese & Western Medicine, Wuhan, 430079, Hubei
| | - Ying Li
- Hubei 672 Orthopaedics Hospital of Integrated Chinese & Western Medicine, Wuhan, 430079, Hubei
| | - Congjun Wu
- Hubei 672 Orthopaedics Hospital of Integrated Chinese & Western Medicine, Wuhan, 430079, Hubei
| | - Xugui Li
- Hubei 672 Orthopaedics Hospital of Integrated Chinese & Western Medicine, Wuhan, 430079, Hubei
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31
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Wu PY, Wu MH, Wu CC, Sun CC. Iris cyst after femtosecond laser-assisted cataract surgery: a case report. BMC Ophthalmol 2021; 21:36. [PMID: 33441104 PMCID: PMC7807450 DOI: 10.1186/s12886-021-01803-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 01/04/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Secondary iris cysts are uncommon complication after cataract surgery. The reports of an iris cyst after conventional phacoemulsification surgery are scanty, let alone the iris cyst following femtosecond laser-assisted cataract surgery (FLACS). We herein report an unusual case of an iris cyst after an uneventful FLACS. CASE PRESENTATION A 64-year-old man who was healthy underwent FLACS for a moderate cataract of his left eye. Shortly after surgery, he achieved 20/20 vision, but anterior bowing of temporal iris was noted on postoperative day 9 with a retro-pupillary iris cyst at temporal-inferior quadrant found after pupil dilatation. The cyst was confirmed by ultrasound bio-microscopy afterward. Four weeks later, argon laser cystotomy was performed, and the cyst disappeared 3 days later. The patient's vision remained stable thereafter. CONCLUSION Although rare, secondary iris cyst may be one of the complications after FLACS. Argon laser cystotomy is effective in the management of post-FLACS iris cyst.
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Affiliation(s)
- Po-Ying Wu
- Department of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Meng-Hsien Wu
- Cheng-Ching Eye Institute, Kaohsiung, Taiwan
- Department of Business Management, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Chi-Cheng Wu
- Department of Business Management, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Chi-Chin Sun
- Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
- Department of Ophthalmology, Chang Gung Memorial Hospital, 222 Mai Chin Road, An Leh District, Keelung, Taiwan.
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32
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Suwabe T, Oguro M, Ubara Y, Ikuma D, Mizuno H, Hayami N, Yamanouchi M, Sawa N. Repetitive Refractory Renal Cyst Infection in Autosomal Dominant Polycystic Kidney Disease for which Renal Transcatheter Arterial Embolization Was Effective in Preventing Recurrence. Intern Med 2021; 60:3261-3265. [PMID: 34657906 PMCID: PMC8580762 DOI: 10.2169/internalmedicine.6974-20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Renal cyst infection is a frequent and serious complication of autosomal dominant polycystic kidney disease (ADPKD) that is often difficult to treat and can be fatal. While nephrectomy is the standard therapy for severe refractory renal cyst infection, it can be associated with severe adverse events. We experienced a case of repetitive renal cyst infection in a 58-year-old Japanese man with ADPKD on dialysis. He underwent renal transcatheter arterial embolization (TAE) four months after the last episodes of renal cyst infection, and his renal cyst infection has not recurred since renal TAE. This case suggested that renal TAE is effective for preventing repetitive renal cyst infection.
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Affiliation(s)
- Tatsuya Suwabe
- Department of Nephrology, Toranomon Hospital Kajigaya, Japan
- Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Japan
| | - Masahiko Oguro
- Department of Nephrology, Toranomon Hospital Kajigaya, Japan
| | - Yoshifumi Ubara
- Department of Nephrology, Toranomon Hospital Kajigaya, Japan
- Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Japan
| | - Daisuke Ikuma
- Department of Nephrology, Toranomon Hospital Kajigaya, Japan
| | - Hiroki Mizuno
- Department of Nephrology, Toranomon Hospital Kajigaya, Japan
| | - Noriko Hayami
- Department of Nephrology, Toranomon Hospital Kajigaya, Japan
| | | | - Naoki Sawa
- Department of Nephrology, Toranomon Hospital Kajigaya, Japan
- Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Japan
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33
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Klein JJ, Skertich NJ, Shah AN. Appendicitis Within a Pseudocyst: Rare Presentation in a Child With a Ventriculoperitoneal Shunt. Am Surg 2020; 88:1312-1313. [PMID: 33174435 DOI: 10.1177/0003134820940628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- John J Klein
- 2468 Department of Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Nicholas J Skertich
- 2468 Department of Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Ami N Shah
- Department of Surgery, Division of Pediatric Surgery Rush University Medical Center, Chicago, IL, USA
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34
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Affiliation(s)
- Abdullah M Khubrani
- Department of Plastic Surgery, Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia. E-mail.
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35
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Promelle V, Aroichane M. Large Muscle Cyst Following Use of Non-absorbable Suture for Strabismus Surgery. J Pediatr Ophthalmol Strabismus 2020; 57:e74-e77. [PMID: 33090230 DOI: 10.3928/01913913-20200817-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 05/27/2020] [Indexed: 11/20/2022]
Abstract
Giant orbital cysts are a rare complication of strabismus surgery or orbital foreign body. A patient with a history of multiple surgeries presented with an orbital cyst that developed in the medial rectus muscle. Surgical exploration found a non-absorbable suture inside the cyst. The conjunctiva was closed using amniotic membrane. [J Pediatr Ophthalmol Strabismus. 2020;57:e74-e77.].
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36
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Waldram MM, Thomas AG, Yu Y, Holscher CM, Nguyen AQ, Halpern SE, Ottman S, Muzaale AD, Henderson ML, Lentine KL, Al Ammary F, Brennan DC, Garonzik-Wang JM, Segev DL, Massie AB. Long-term renal function in living kidney donors with simple renal cysts: A retrospective cohort study. Clin Transplant 2020; 34:e13905. [PMID: 32399996 PMCID: PMC8720490 DOI: 10.1111/ctr.13905] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 04/17/2020] [Accepted: 05/06/2020] [Indexed: 01/25/2023]
Abstract
Simple (Bosniak I) renal cysts are considered acceptable in living kidney donor selection in terms of cancer risk. However, they tend to increase in number and size over time and might compromise renal function in donors. To clarify their implications for long-term renal function, we characterized the prevalence of renal cysts in 454 individuals who donated at our center from 2000 to 2007. We estimated the association between the presence of cysts in the kidney remaining after nephrectomy (ie, retained cysts) and postdonation eGFR trajectory using mixed-effects linear regression. Donors with retained cysts (N = 86) were older (P < .001) and had slightly lower predonation eGFR (median 94 vs 98 mL/min/1.73 m2 , P < .01) than those without cysts. Over a median 7.8 years, donors with retained cysts had lower baseline eGFR (-8.7 -5.6 -2.3 mL/min/1.73 m2 , P < .01) but similar yearly change in eGFR (-0.4 0.02 0.4 mL/min/1.73 m2 , P = .2) compared to those without retained cysts. Adjusting for predonation characteristics, there was no difference in baseline eGFR (P = .6) or yearly change in eGFR (P > .9). There continued to be no evidence of an association when we considered retained cyst(s) ≥10 mm or multiple retained cysts (all P > .05). These findings reaffirm current practices of accepting candidates with simple renal cysts for donor nephrectomy.
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Affiliation(s)
- Madeleine M. Waldram
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Alvin G. Thomas
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Yifan Yu
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Courtenay M. Holscher
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Anh Q. Nguyen
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Samantha E. Halpern
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Shane Ottman
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Abimereki D. Muzaale
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Macey L. Henderson
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Acute and Chronic Care, Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
| | - Krista L. Lentine
- Saint Louis University Center for Abdominal Transplantation, St. Louis, Missouri, USA
| | - Fawaz Al Ammary
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Daniel C. Brennan
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | - Dorry L. Segev
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Acute and Chronic Care, Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
- Department of Epidemiology, Johns Hopkins University School of Public Health, Baltimore, Maryland, USA
| | - Allan B. Massie
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Epidemiology, Johns Hopkins University School of Public Health, Baltimore, Maryland, USA
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37
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González LA, Pantoja-Marquez AE, Johnson P. Diffuse Cystic Lung Disease: Consider Sjögren Syndrome in the Differential Diagnosis. Am J Med 2020; 133:e438-e439. [PMID: 32087099 DOI: 10.1016/j.amjmed.2020.01.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Accepted: 01/14/2020] [Indexed: 11/17/2022]
Affiliation(s)
- Luis Alonso González
- Division of Rheumatology, Department of Internal Medicine, School of Medicine, Universidad de Antioquia, Medellín, Colombia; Medicarte IPS, Rheumatology Unit, Medellín, Colombia.
| | | | - Philip Johnson
- Division of Rheumatology, Department of Internal Medicine, School of Medicine, Universidad de Antioquia, Medellín, Colombia
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38
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Sethi A, Lokwani P, Sethi V, Sethi S, Sethi A, Sethi R. An Unusual Case of Solitary Idiopathic Pigmented Vitreous Cyst. Middle East Afr J Ophthalmol 2020; 27:62-64. [PMID: 32549728 PMCID: PMC7276170 DOI: 10.4103/meajo.meajo_101_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 04/17/2020] [Accepted: 12/04/2020] [Indexed: 11/18/2022] Open
Abstract
Vitreous cysts are a rare finding and rarely cause any visual disturbances. They are often classified as idiopathic when their etiology cannot be determined. They may be congenital or acquired and pigmented or nonpigmented. In previous reports, it has been suggested on the basis of electron microscopy that these pigmented vitreous cysts may have originated from the pigment epithelium. We present the case of a 46-year-old female, with complaints of an oval-shaped floater, causing some visual disturbance in her right eye. On examination, it was found to be a pigmented, round, and nonlobulated cyst floating freely in the vitreous cavity with no attachments to the retina. This was documented and confirmed by the fundus images and optical coherence tomography findings. Laboratory tests in the patient were found to be negative for any Toxoplasma, cysticercoids, Echinococcus, and Toxocara, among others. She was on follow-up for the past 6 months with no change or disturbance in the cyst or the retinal findings. We describe a rare case of idiopathic pigmented vitreous cyst with no persistent hyaloid artery or connection between the cyst and the ocular structures.
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Affiliation(s)
- Aditya Sethi
- Department of Vitreo Retina, Arunodaya Deseret Eye Hospital, Gurgaon, Haryana, India
| | - Parul Lokwani
- Department of Vitreo Retina, Arunodaya Deseret Eye Hospital, Gurgaon, Haryana, India
| | - Vaibhav Sethi
- Department of Vitreo Retina, Arunodaya Deseret Eye Hospital, Gurgaon, Haryana, India
| | - Sahebaan Sethi
- Department of Vitreo Retina, Arunodaya Deseret Eye Hospital, Gurgaon, Haryana, India
| | - Arun Sethi
- Department of Vitreo Retina, Arunodaya Deseret Eye Hospital, Gurgaon, Haryana, India
| | - Reena Sethi
- Department of Vitreo Retina, Arunodaya Deseret Eye Hospital, Gurgaon, Haryana, India
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39
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Kohyama K, Arisawa K, Arisawa Y, Morishima Y. Symptomatic cystic lesions as late post-operative complications of silicone implantation for orbital wall fracture reconstruction: A long-term follow-up study. J Plast Reconstr Aesthet Surg 2019; 73:344-350. [PMID: 31810891 DOI: 10.1016/j.bjps.2019.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Accepted: 09/09/2019] [Indexed: 11/20/2022]
Abstract
Although complications of silicone implants and development of new materials have led to a decline in the use of silicone implants for orbital wall fractures, their advantages are still reported. The overall incidence, risk factor and treatment of silicone implant complications, especially those caused by cystic lesions, remain unclear. We aimed to report our experiences of patients with orbital wall fractures that were reconstructed with silicone implants and followed up for a long period. We retrospectively analysed 56 patients who underwent surgical repair of the orbital wall fractures with a silicone implant from January 2006 to December 2017 and were followed up for more than 6 months. A chart review and the assessment of demographic and surgical factors, among others, were performed. There were 47 eligible patients in this study, and the mean post-operative follow-up period was 83.1 months. When comparing the results obtained 6 months post-operatively with those obtained at the final follow-up, the overall complication rate increased from 5/47 to 13/47, and the silicone implant removal rate increased from 0/47 to 10/47. The symptoms caused by the cystic lesions were managed through silicone implant removal. The immediate post-operative bleeding was significantly associated with silicone implant survival (p = 0.008). Silicone implants used for orbital wall fractures were never stabilised during the long-term study. Much attention should be paid during the follow-up of high-risk patients. Most late complications were caused by cystic lesions, and only silicone implant removal would be sufficient and considered safe as the initial intervention.
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Affiliation(s)
- Keishi Kohyama
- Department of Plastic and Reconstructive Surgery, Ogaki Municipal Hospital, 4-86 Minaminokawa-cho Ogaki City, Gifu Pref 5038502, Japan
| | - Koki Arisawa
- Department of Plastic and Reconstructive Surgery, Ogaki Municipal Hospital, 4-86 Minaminokawa-cho Ogaki City, Gifu Pref 5038502, Japan
| | - Yuko Arisawa
- Department of Plastic and Reconstructive Surgery, Ogaki Municipal Hospital, 4-86 Minaminokawa-cho Ogaki City, Gifu Pref 5038502, Japan
| | - Yoko Morishima
- Department of Plastic and Reconstructive Surgery, Ogaki Municipal Hospital, 4-86 Minaminokawa-cho Ogaki City, Gifu Pref 5038502, Japan.
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40
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Watanabe A, Fukunari H, Mito M, Hayashi T. [Implantation Cyst at Anastomosis after Anterior Resection of the Rectum-A Report of Five Cases]. Gan To Kagaku Ryoho 2019; 46:2288-2290. [PMID: 32156907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
We report 5 cases of implantation cysts at anastomosis after rectal surgery. All patients underwent resection of the rectum usingthe double staplingtechnique (DST). Implantation cysts were recognized within a period of 3 months to 6 years after surgery. Abdominal CT showed cystic masses with calcification in all cases. Colonoscopy revealed submucosal tumor-like lesions in 3 cases, and serum CEA level was increased in 2 cases. In one patient with anal pain, transanal aspiration was performed; the other 4 patients are free from symptoms and are beingobserved without treatment.
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Affiliation(s)
- Akemi Watanabe
- Dept. of Surgery, Niigata Prefectural Tokamachi Hospital
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41
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Abstract
Phakic intraocular lenses are used to correct refractive errors. The procedure is predictable and potentially reversible. The procedure is not free of complications though. The occurrence of iris cyst after implantation of a phakic intraocular lens was not described previously in the literature. We describe two cases of iris cysts in the presence of a phakic intraocular lens; the first case describes a cyst which was not present prior to the anterior chamber phakic intraocular lens implantation. The second case describes a hidden iris cyst that affected the posterior chamber phakic intraocular lens position and lead to glaucoma.
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Affiliation(s)
- A M Gharaibeh
- Vissum Instituto Oftalmológico de Alicante, Universidad Miguel Hernández, Alicante, Spain
- Faculty of Medicine, The University of Jordan, Amman, Jordan
| | | | - P Mojzis
- Premium Clinic, Teplice, Czech Republic
| | - P Ziak
- Eye Clinic, Jessenius Faculty of Medicine, Martin, Slovakia
| | - Jorge L Alió
- Vissum Instituto Oftalmológico de Alicante, Universidad Miguel Hernández, Alicante, Spain
- Division of ophthalmology, Universidad Miguel Hernández, Alicante, Spain
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Kumar S, Narang T, Aggarwal D, Chatterjee D, Vinay K, Dogra S. Discharging Sinuses over Pre-Sternal Keloids: Quite a Hairy Problem! Skinmed 2019; 17:345-347. [PMID: 31782713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Sheetanshu Kumar
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and ResSearch, Chandigarh, India
| | - Tarun Narang
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and ResSearch, Chandigarh, India
| | - Divya Aggarwal
- Department of Histopathology, Postgraduate Institute of Medical Education and ResSearch, Chandigarh, India
| | - Debajyoti Chatterjee
- Department of Histopathology, Postgraduate Institute of Medical Education and ResSearch, Chandigarh, India
| | - Keshavamurthy Vinay
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and ResSearch, Chandigarh, India;
| | - Sunil Dogra
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and ResSearch, Chandigarh, India
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Calandra CR, García Fernández C, Raina GB, Docampo J, Barbosa N, Piedimonte F, Cersósimo MG. Intraparenchymal cystic lesion after Deep Brain Stimulation surgery: An unusual complication. Parkinsonism Relat Disord 2019; 64:354-355. [PMID: 31103488 DOI: 10.1016/j.parkreldis.2019.05.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 05/07/2019] [Accepted: 05/10/2019] [Indexed: 11/18/2022]
Affiliation(s)
- Cristian Ricardo Calandra
- Departamento de Neurología, Servicio de Clínica Médica, Hospital El Cruce, Av. Calchaquí 5401 (1888), Florencio Varela, Buenos Aires, Argentina.
| | - Cynthia García Fernández
- Programa de Parkinson y Movimientos Anormales, Hospital de Clínicas "José de San Martín", Av. Córdoba 2351 (C1121ABJ), Ciudad Autónoma de Buenos Aires, Argentina
| | - Gabriela Beatriz Raina
- Programa de Parkinson y Movimientos Anormales, Hospital de Clínicas "José de San Martín", Av. Córdoba 2351 (C1121ABJ), Ciudad Autónoma de Buenos Aires, Argentina
| | - Jorge Docampo
- Magnetic Resonance Department, Fundación Científica del Sur, Av. Hipólito Yrigoyen 8680 (1832), Lomas de Zamora, Argentina
| | - Nicolás Barbosa
- Fundación CENIT para la Investigación en Neurociencias, Juncal 2222 PB (C1125ABD), Ciudad Autónoma de Buenos Aires, Argentina
| | - Fabián Piedimonte
- Fundación CENIT para la Investigación en Neurociencias, Juncal 2222 PB (C1125ABD), Ciudad Autónoma de Buenos Aires, Argentina
| | - María Graciela Cersósimo
- Programa de Parkinson y Movimientos Anormales, Hospital de Clínicas "José de San Martín", Av. Córdoba 2351 (C1121ABJ), Ciudad Autónoma de Buenos Aires, Argentina
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Navarro-Triviño FJ, González-Ruiz L, Ruíz-Villaverde R. Flower and Milium: A Tatoo With Points in Relief. Actas Dermosifiliogr (Engl Ed) 2019; 111:164. [PMID: 31000134 DOI: 10.1016/j.ad.2018.03.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 03/21/2018] [Accepted: 03/26/2018] [Indexed: 11/18/2022] Open
Affiliation(s)
- F J Navarro-Triviño
- Unidad de Dermatología Médico-Quirúrgica y Venereología, Hospital Comarcal Santa Ana, Motril, Granada, España.
| | | | - R Ruíz-Villaverde
- Unidad de Gestión Clínica de Dermatología y Venereología, Complejo Hospitalario Universitario de Granada, Granada, España
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Xu WS, Tian XL, Yang YL, Xu KF. [Birt-Hogg-Dubé syndrome: a hereditary pulmonary cystic disease]. Zhonghua Jie He He Hu Xi Za Zhi 2019; 42:284-286. [PMID: 30955287 DOI: 10.3760/j.issn.1001-0939.2019.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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Abstract
RATIONALE Gastritis cystica profunda (GCP) is a rare gastric lesion involving cystic dilation of the gastric glands extending into the submucosa. It is usually observed at anastomotic sites in the stomach of patients who have undergone gastric procedures. Bile reflux GCP is rare in patients who have not undergone gastric surgery. Here, we report a rare case of a patient with GCP associated with bile reflux, who had no history of gastric surgery. PATIENT CONCERNS A 50-year-old man presented with intermittent abdominal fullness for 2 years, along with nausea. He had never undergone gastric surgery. Endoscopic ultrasonography (EUS) showed a thickened gastric wall and an echo-poor submucosal layer of the gastric fundus. A 3 cm × 2 cm × 1.5 cm lesion was noted. DIAGNOSIS Bile reflux GCP INTERVENTIONS:: Endoscopic retrograde cholangiopancreatography and endoscopic submucosal dissection (ESD) were performed, and the lesion was removed. Conventional pathological examination revealed GCP with glands hyperplasia and a yellow-brown deposit, which was considered bile. The findings were consistent with a diagnosis of GCP without malignancy. OUTCOMES Upper gastrointestinal barium meal revealed postoperative changes at the gastric fundus. Gastroscopy performed at 6 months after surgical resection showed superficial gastritis with bile reflux. LESSONS The findings suggest that GCP etiology varies and that GCP can be caused by bile reflux but without malignancy. Additionally, GCP is not limited to patients who have previously undergone gastric surgery. Moreover, it is difficult to identify. EUS and ESD might be good approaches for the diagnosis and treatment of GCP.
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Peruzzu N, Borrelli S, Netti A, De Stefano T, Vita C, Sabatino M, Salzano M, Conte G, De Nicola L, Minutolo R, Garofalo C. [Infected hepatic cyst in ADPKD patient in peritoneal dialysis]. G Ital Nefrol 2019; 36:36-2-2019-11. [PMID: 30983178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Renal and hepatic cysts infections are among the most important infectious complications of ADPKD and often require hospitalization. Liver cysts are even more complex than renal cysts and their diagnosis and treatment are quite controversial. We report the case of a 58-year-old patient with ADPKD undergoing peritoneal dialysis treatment. He presented fever and severe asthenia and was diagnosed with a hepatic cyst infection. Given the presence of the peritoneal catheter, and in order to facilitate the targeted treatment of the infection, we administered antibiotics (ceftazidime and teicoplanin) in the bags used for peritoneal dialysis exchanges for 4 weeks, obtaining the complete disappearance of symptoms and laboratory and ultrasound alterations. Intraperitoneal antibiotics administration in the treatment of infected hepatic cysts represents an effective and safe therapeutic alternative, never described in literature so far.
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Affiliation(s)
- Nicola Peruzzu
- U.O. Nefrologia, Università degli Studi della Campania, "Luigi Vanvitelli", Napoli, Italia
| | - Silvio Borrelli
- U.O. Nefrologia, Università degli Studi della Campania, "Luigi Vanvitelli", Napoli, Italia
| | - Antonella Netti
- U.O. Nefrologia, Università degli Studi della Campania, "Luigi Vanvitelli", Napoli, Italia
| | - Toni De Stefano
- U.O. Nefrologia, Università degli Studi della Campania, "Luigi Vanvitelli", Napoli, Italia
| | - Carlo Vita
- U.O. Nefrologia, Università degli Studi della Campania, "Luigi Vanvitelli", Napoli, Italia
| | - Maria Sabatino
- U.O. Radiologia, Ospedale Santa Maria del Popolo degli Incurabili, Napoli, Italia
| | - Michela Salzano
- U.O. Radiologia, Ospedale Santa Maria del Popolo degli Incurabili, Napoli, Italia
| | - Giuseppe Conte
- U.O. Nefrologia, Università degli Studi della Campania, "Luigi Vanvitelli", Napoli, Italia
| | - Luca De Nicola
- U.O. Nefrologia, Università degli Studi della Campania, "Luigi Vanvitelli", Napoli, Italia
| | - Roberto Minutolo
- U.O. Nefrologia, Università degli Studi della Campania, "Luigi Vanvitelli", Napoli, Italia
| | - Carlo Garofalo
- U.O. Nefrologia, Università degli Studi della Campania, "Luigi Vanvitelli", Napoli, Italia
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Nishino K, Hashimoto Y, Nishida Y, Terai S, Takahashi S, Yamasaki S, Nakamura H. Incidence and Risk Factors for Meniscal Cyst After Meniscal Repair. Arthroscopy 2019; 35:1222-1229. [PMID: 30871908 DOI: 10.1016/j.arthro.2018.11.039] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 11/08/2018] [Accepted: 11/12/2018] [Indexed: 02/02/2023]
Abstract
PURPOSE To investigate the incidence of magnetic resonance imaging-confirmed cyst formation after meniscal repair and to analyze associated risk factors. METHODS This retrospective study included cases repaired arthroscopically with the all-inside (AI) technique (using suture anchors) and/or the inside-out (IO) technique between October 2008 and December 2014. A meniscal cyst was detected on T2 fat-suppressed magnetic resonance images. All cases were divided into 3 groups according to the repair method (AI, IO, and combined technique). The incidence of radiographically confirmed meniscal cyst formation in each group and the associated risk factors (age, sex, AI device, medial meniscus, Tegner activity scale preinjury) were analyzed. RESULTS A total of 102 menisci in 96 knees were evaluated. The mean follow-up period was 3.8 (range, 2-8) years. The mean patient age was 21.0 (range, 6-53) years. Thirty cases were in the AI group, 60 in the IO group, and 12 in the combined group. Demographically, there were significant differences among groups regarding the number of medial, lateral, and discoid tears; concomitant anterior cruciate ligament tears; Tegner scale; and suture number. Meniscal cysts developed in 14 of 102 cases. Two of the 14 cysts were symptomatic, requiring open cystectomy. The incidence of meniscal cyst was significantly higher in the AI group (12 of 30, 40%) than in the IO group (1 of 60, 1.7%) or the combined-technique group (1 of 12, 8.3%) (P < .001). Both symptomatic cysts were in the AI group and were in continuity with the anchors. Medial meniscus tear (odds ratio = 6.92) and the use of AI suture anchors (odds ratio = 15.03) significantly increased the risk of cyst formation. CONCLUSIONS The incidence of meniscal cysts after arthroscopic meniscal repair was 1.7% to 40.0%, depending on the surgical method. Medial meniscus tears and use of an AI device are suggested as risk factors for cyst formation in this retrospective study. LEVEL OF EVIDENCE Level Ⅲ, retrospective comparative study.
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Affiliation(s)
- Kazuya Nishino
- Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Yusuke Hashimoto
- Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
| | - Yohei Nishida
- Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Shozaburo Terai
- Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Shinji Takahashi
- Department of Orthopaedic Surgery, Juso City Hospital, Osaka, Japan
| | - Shinya Yamasaki
- Department of Orthopaedic Surgery, Osaka City General Hospital, Osaka, Japan
| | - Hiroaki Nakamura
- Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
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Ilatovskaya DV, Levchenko V, Pavlov TS, Isaeva E, Klemens CA, Johnson J, Liu P, Kriegel AJ, Staruschenko A. Salt-deficient diet exacerbates cystogenesis in ARPKD via epithelial sodium channel (ENaC). EBioMedicine 2019; 40:663-674. [PMID: 30745171 PMCID: PMC6413684 DOI: 10.1016/j.ebiom.2019.01.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 01/04/2019] [Accepted: 01/05/2019] [Indexed: 12/14/2022] Open
Abstract
Background Autosomal Recessive Polycystic Kidney Disease (ARPKD) is marked by cyst formation in the renal tubules, primarily in the collecting duct (CD) system, ultimately leading to end-stage renal disease. Patients with PKD are generally advised to restrict their dietary sodium intake. This study was aimed at testing the outcomes of dietary salt manipulation in ARPKD. Methods PCK/CrljCrlPkhd1pck/CRL (PCK) rats, a model of ARPKD, were fed a normal (0.4% NaCl; NS), high salt (4% NaCl; HS), and sodium-deficient (0.01% NaCl; SD) diets for 8 weeks. Immunohistochemistry, GFR measurements, balance studies, and molecular biology approaches were applied to evaluate the outcomes of the protocol. Renin-angiotensin-aldosterone system (RAAS) levels were assessed using LC-MS/MS, and renal miRNA profiles were studied. Findings Both HS and SD diets resulted in an increase in cystogenesis. However, SD diet caused extensive growth of cysts in the renal cortical area, and hypertrophy of the tissue; RAAS components were enhanced in the SD group. We observed a reduction in epithelial Na+ channel (ENaC) expression in the SD group, accompanied with mRNA level increase. miRNA assay revealed that renal miR-9a-5p level was augmented in the SD group; we showed that this miRNA decreases ENaC channel number in CD cells. Interpretation Our data demonstrate a mechanism of ARPKD progression during salt restriction that involves activity of ENaC. We further show that miR-9a-5p potentially implicated in this mechanism and that miR-9a-5p downregulates ENaC in cultured CD cells. Our findings open new therapeutic possibilities and highlight the importance of understanding salt reabsorption in ARPKD.
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Affiliation(s)
- Daria V Ilatovskaya
- Department of Physiology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA
| | - Vladislav Levchenko
- Department of Physiology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA
| | - Tengis S Pavlov
- Department of Physiology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA
| | - Elena Isaeva
- Department of Physiology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA
| | - Christine A Klemens
- Department of Physiology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA
| | - Jessica Johnson
- Department of Physiology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA
| | - Pengyuan Liu
- Department of Physiology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA
| | - Alison J Kriegel
- Department of Physiology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA
| | - Alexander Staruschenko
- Department of Physiology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA; Clement J. Zablocki VA Medical Center, 5000 West National Avenue, Milwaukee, WI, 53295, USA.
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Abstract
A 51-year-old woman presented with dyspnea that had progressed over the previous year. On a physical examination, harsh, hollow breath sounds with a high-pitched timbre, termed "amphoric breathing", were identified during inspiration and expiration. Chest radiography and thoracic computed tomography performed over the previous three years revealed an enlarging cyst in the right lung arising from an area of consolidation. Pulmonary adenocarcinoma (T4 N0 M1a, stage IV) was diagnosed and considered a possible cause of the cyst, resulting in amphoric breathing.
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Affiliation(s)
- Takeshi Saraya
- Department of Respiratory Medicine, Kyorin University School of Medicine, Japan
| | | | - Sunao Mikura
- Department of Respiratory Medicine, Kyorin University School of Medicine, Japan
| | - Nozomi Fukuda
- Department of Respiratory Medicine, Kyorin University School of Medicine, Japan
| | - Haruyuki Ishii
- Department of Respiratory Medicine, Kyorin University School of Medicine, Japan
- Department of Pathology, Kyorin University School of Medicine, Japan
| | - Hajime Takizawa
- Department of Respiratory Medicine, Kyorin University School of Medicine, Japan
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