Melanosis peritonei associated with enteric duplication cyst. A case report

Melanosis peritonei is extremely rare, and only five cases have been reported in the English literature, four in association with ovarian dermoid cysts, and one with a peritoneal cyst. We describe an additional case occurring in a girl two years of age who also had an enteric cyst. This is the first reported case of melanosis peritonei not associated with an ovarian teratoma, but with an enteric duplication cyst. Melanophages were present focally in the submucosa, superficial muscle layer, and ulcer bases of the cyst and extensively as small nodules on the peritoneal surface and in the omentum. The tendency of perivascular nodular aggregation of melanophages favors a hematogenous (or lymphatic) spread rather than implantation. Although clear evidence of melanocytic aggregation is lacking, are speculate that the melanin originated from the esophageal-like squamous mucosa of the cyst.     

A case report of multiple hepatic hilar cyst associated with hepatocellular carcinoma

Two types of cDNA encoding gonadotropin beta subunits (GTH beta) were isolated from a cDNA library prepared from pituitary gland of Baikal omul (Coregonus autumnalis migratorius Georgi). The nucleotide sequences of cDNA were determined. The CTHI beta and GTHII beta cDNAs code for polypeptides of 137 and 142 amino acids, respectively. Both of them include a putative signal peptide of 24 amino acids. The predicted amino acid structures of omul gonadotropins were compared with those of other vertebrate species.     

Syringomyelia associated with posterior fossa cyst: a case report

We report a case of a 47-year-old woman with a posterior fossa cyst associated with syringomyelia and hydrocephalus. Her birth was traumatic and she had suffered a fractured skull. About 10 years prior to coming to our department she had occipitalgia and a pain had developed over a month from her right shoulder to hand. Shortly before presenting occasional electric-like shocks were felt in her right hand associated with coughing and hiccuping. Magnetic resonance imaging (MRI) revealed a large midline posterior fossa cyst, hydrocephalus and syrinx (C1-Th11). Cisternography could not demonstrate communication between the cyst and the subarachnoid space and the 4th ventricle was present but without communication with the cyst. The cyst was tentatively diagnosed as an arachnoid cyst. One week after placement of a cyst-peritoneal shunt, CT scans showed a decrease in cyst and ventricle size and 2 months later a follow-up MRI revealed resolution of the syringomyelia. We suspected that cyst-peritoneal shunt was effective for this patient who had syringomyelia associated with incommunicated posterior fossa cyst.     

Colobomatous orbital cyst associated with microphthalmos. Apropos of a case

The aims of the present study were: (1) to establish the incidence of gingival abrasion as a result of toothbrushing, using a manual and electric toothbrush; (2) to establish the influence of filament end-rounding on the incidence of gingival abrasion and the efficacy of toothbrushing; (3) to assess whether the speed of the electric brush has a feedback-effect on the brushing force used and to correlate the incidence of gingival abrasion with force. 2 experiments were carried out. In the first experiment, 50 subjects brushed for 3 weeks every other day with either a manual (Butler 411) or an electric toothbrush (Braun/Oral-B Ultra Plaque Remover-D9). All received brief instructions and were asked to abstain from oral hygiene 24 hrs before their appointment. After disclosing the teeth and gums with Mira-2-Tone solution, plaque and gingival abrasion were assessed. Next, the panelists brushed in a random split-mouth order. After brushing and a second disclosing, plaque and abrasion were re-assessed. The results showed that the incidence of gingival abrasion was comparable for the manual and the D9. Using a similar design as in experiment no. 1, in experiment no. 2 a new group of 47 subjects brushed for 3 weeks alternating between the Braun/Oral-B Plaque Remover-D7 and D9. At the appointment, the subjects first brushed in a split-mouth order with the D9 with 2 different types of endrounding. Plaque and abrasion were assessed. Immediately following this brushing exercise, the subjects re-brushed with the D7 (2800 rot/min) and the D9 (3600 rot/min) during which brushing force was measured. The results of this experiment showed that endrounding has no effect on plaque removal but does effect the incidence of gingival abrasion. Brushing force is not influenced by the speed of the brushhead and no correlation with the incidence of gingival abrasion was observed. In conclusion, the results of this study show that gingival abrasion is not influenced by brushing force, but is affected by filament endrounding.     

A case of Rathke''s cleft cyst with apoplexy

OBJECTIVE: To develop and evaluate a model of integrated primary dental and medical care. DESIGN: 3-year prospective study. SETTING: A general dental practice and a general medical practice occupying the same building in Glasgow. INTERVENTION: Regular staff meetings, joint use of patient records systems and information derived from patient questionnaires. Dentistry was included in established screening programmes such as child health surveillance and care of elderly. Staff were encouraged to participate in joint work practices and joint consultations were carried out. MAIN OUTCOME MEASURES: Patient registration, avoidance of discrepancies in information, reduction of secondary referrals, joint work practices. RESULTS: The number of registered joint patients attending both medical and dental practices increased by 90%. The joint use of patient record systems avoided discrepancies in patient information which would have affected the quality of patient care. Including dentistry in child health surveillance and care of elderly screening programmes resulted in an increase in 0-5 year olds registering with dentists from 36% to 68% (P < 0.001) and with > 75 year olds from 47% to 71% (P < 0.001). Joint consultations reduced the need for secondary referrals. CONCLUSIONS: This model of health care demonstrated the potential for coordination and integration of functions between the dental team and the primary care team. Integrated primary dental and medical care requires attitudinal change in health care professionals and requires greater emphasis in education and training of health care professionals in the future.     

A case of functioning parathyroid cyst

A case of functioning parathyroid cyst is reported. A 63-year-old woman consulted our hospital with the chief complaint of neck and joint pain. At that time, laboratory data showed a serum calcium level of 12.8 mg/dl and a phosphorus level of 2.2 mg/dl. Plasma levels of intact PTH were elevated to 278 pg/ml. Computerized tomography, ultrasonography and magnetic resonance imaging suggested parathyroid cyst on the left side of the thyroid gland. We performed left superior parathyroidectomy. The cyst measured 30 x 40 x 30 mm and was chocolate colored. The histopathological diagnosis was a functioning parathyroid cyst. Her postoperative course was uneventful and she was discharged on the 10th postoperative day without symptoms. To our knowledge, only 38 cases of functioning parathyroid cyst have been reported in the Japanese literature.     

Subdural hematoma associated with arachnoid cyst

We describe 3 young patients with history of mild cranial trauma who presented the rare association of subdural hematoma and arachnoid cyst. Clinical and radiological signs are reviewed.     

Dacryocystitis associated with nasolacrimal duct cyst

An infant presented with persistent epiphora after successful probing of the lacrimal system. Examination of the nose showed a cystic structure occluding lower portion of the lacrimal drainage system. In cases of recurrent obstruction, nasal examination and endoscopic marsupialization may help guide the clinician towards the most appropriate treatment.     

Extralobar pulmonary sequestration with an associated cyst of mixed bronchogenic and esophageal type--a case report

The aim of the study was to evaluate leakage of liquid past the low-pressure cuffs of tracheal tubes. Ten samples of each of nine different types of tubes were tested in a PVC mock trachea, using intracuff pressures of 20, 30, 40 and 50 cmH2O. In five types of tubes, 6-10 cuffs allowed profuse leakage (> 20 ml water in 5 min) even at the highest intracuff pressure, i.e. 50 cmH2O. In the most efficient tube, all the cuffs were leak-proof (leakage < 5 ml in 5 min) at 40 cmH2O and in the second best type the cuffs were leak-proof at 50 cmH2O. The leakage of fluid past the tracheal tube remains an unresolved problem with low-pressure cuffs.     

Intracardiac epithelial cyst associated with esophageal atresia

The purpose of this study was to investigate whether MR angiography (MRA) of the portal venous system may be improved by means of superparamagnetic iron oxides (SPIOs) during accumulation phase imaging and to study the underlying contrast mechanisms. MRA of the portal venous system was performed on 48 patients before and after intravenous injection of a new SPIO (Resovist, Schering AG, Berlin, Germany). Resovist, as a predominantly liver parenchymal darkening agent on T2-weighted MR images with uptake into the reticuloendothelial cell system, was administered intravenously by bolus injection of 8 to 12 micromol Fe/kg body weight. Patients were scanned with breath-hold coronal and axial two-dimensional (2D) time of flight (TOF) MRA (TR = 31.0 msec, TE = 9.8 msec, flip angle (FA) = 50 degrees, and 6.9-second acquisition time per section) sequences. Signal intensity values of liver parenchyma, the portal venous system, and background were obtained for quantitative analysis. The clinical relevance of additional plain and contrast-enhanced MRA studies for surgical planning was assessed by independent reading of three readers. Liver signal-to-noise ratio (SNR) significantly decreased following iv injection of Resovist; however, SNR values of the portal veins or hepatic veins did not change significantly. Visibility of the portal venous system improved significantly (tertiary branches visible: pre in 15.2% versus post in 87.0% of patients). Resovist-enhanced 2D-TOF MRA may improve planning of liver resections by better demonstrating the relationship of central liver lesions and vessels on source images. The decrease in liver SNR at a constant vessel SNR after iv injection of Resovist improves MRA of the liver. SPIO-enhanced 2D-TOF MRA scans are superior to plain 2D-TOF MRA studies and may be added for the workup of preoperative patients.     

Intrapericardial foregut cyst associated with intrauterine death

Intrapericardial developmental foregut cysts are rare and are most frequently incidental findings at necropsy in adults. A 29 year old Asian woman delivered a 24 week stillborn fetus seven days after diagnosis of intrauterine death caused by rupture of a foregut cyst. Multiple cysts occupied the wall of the right atrium and its rupture caused haemopericardium and cardiac tamponade.     

A case of migraine with aura associated with meningioma

We reported a case of migraine with aura associated with meningioma. A 66-year-old female visited to our department in 1985, with occipital throbbing pain following visual hallucination and nausea. She had been diagnosed as migraine. CT scan, magnetic resonance image and angiography showed a right occipital tumor, which was totally removed in 1990. Postoperatively, the migraine disappeared completely. The tumor was histologically diagnosed as fibroblastic meningioma. We supposed that the migraine had been associated with meningioma. Although some previous papers reported correlation with brain tumor and migraine, as example of arteriovenous malformation or angioma, migraine associated with meningioma is very rare. In arteriovenous malformation, pathophysiology of migraine is unclear, but induction of circulatory disturbance in the distribution of the posterior cerebral, posterior communicating and basilar artery is supposed. And then a space occupying lesion in the occipital lobe is possible to cause in the circulatory disturbance of the posterior cerebral and basilar artery. In the diagnosis of migraine, we should consider its relation to brain tumors, such as meningioma.     

A case of diffuse panbronchiolitis associated with tracheomalacia

A 71-year-old male had suffered from cough with purulent sputum. He was admitted to our hospital because of worsening of his symptoms. The chest X-ray film showed diffuse nodular shadows and emphysematous changes in both lung fields. Transbronchial lung biopsy demonstrated findings compatible with diffuse panbronchiolitis (DPB). Bronchoscopy showed the tracheal lumen was sagittaly narrowed and membranous portion was protruded into the lumen. The trachea completely collapsed when coughing. His disease was diagnosed as saber-sheath type tracheomalacia (Johnson III). Tracheomalacia was reported to be observed in 0.9% of patients examined by bronchoscopy. The dominant type of tracheomalacia is crescent type, and saber-sheath type is rare. Chronic airway inflammation with DPB might have exacerbated the tracheomalacia in this case.     

Occipital encephalocele associated with mediastinal enteric duplication cyst

We report a new case of tracheobronchopathia osteoplastica revealed by bronchopulmonary infections. The review of the literature enables us to summarize the clinical, endoscopic, morphological features, as well as pathogenic hypotheses.