Coexistent dermoid cysts of the pouch of the Douglas and ovary resected by laparoscopy

Dermoid cysts of the ovary are one of the most common ovarian neoplasms, but parasitic dermoid cysts as well as coexistent dermoid cysts are unusual. Almost all reports of coexistent dermoid cysts involve the omentum and ovary, but our case involved the pouch of Douglas and ovary. We managed this case by laparoscopy.

Diffusion MRI abnormalities after prolonged febrile seizures with encephalopathy

BACKGROUND

Patients with encephalopathy heralded by a prolonged seizure as the initial symptom often have abnormal subcortical white matter on diffusion-weighted MRI (DWI).

OBJECTIVE

To determine if these patients share other common features.

METHODS

Patients with encephalopathy heralded by a prolonged seizure and followed by the identification of abnormal subcortical white matter on MRI were collected retrospectively. Their clinical, laboratory, and radiologic data were reviewed.

RESULTS

Seventeen patients were identified, ages 10 months to 4 years. All had a prolonged febrile seizure (longer than 1 hour in 12 patients) as their initial symptom. Subsequent seizures, most often in clusters of complex partial seizures, were seen 4 to 6 days after the initial seizure in 16 patients. Outcome ranged from almost normal to severe mental retardation. MRI performed within 2 days of presentation showed no abnormality. Subcortical white matter lesions were observed on DWI between 3 and 9 days in all 17 patients. T2-weighted images showed linear high intensity of subcortical U fibers in 13 patients. The lesions were predominantly frontal or frontoparietal in location with sparing of the perirolandic region. The diffusion abnormality disappeared between days 9 and 25, and cerebral atrophy was detected later than 2 weeks. Three patients having only frontal lesions had relatively good clinical outcome.

CONCLUSIONS

Although the pathophysiologic mechanism remains unknown, these patients seem to have a distinctive encephalopathy syndrome. MRI is helpful in establishing the diagnosis of this encephalopathy.

[Epidemiologic study on the prevalence of the sick house syndrome in Japan]

PURPOSE

Sick house syndrome (SHS; sick house syndrome) presents healthy damage owing to the indoor environment of a building. Although SHS is recognized socially, there is no medical definition and its illness concept is also ambiguous. This time, large-scale epidemiology investigation about SHS of our country was conducted.

METHOD

The investigation paper in the "epidemiological research on SHS" group of the Ministry of Health, Labour and Welfare was used. The reply of 8737 adults and 9387 children was obtained.

RESULT

By the definition of a disease, prevalence of SHS was 8.5 to 22.1% at the adult and 5.6-19.8% in the child. Cause environmental substances were "a shampoo, makeup and a perfume", "the smell of a wall or the building materials of a floor", and "paint". There was no significant difference in SHS development of symptoms in construction years and the situation of extension and alteration of a dwelling. As a feature of a life style, symptoms developed in the strong group of stress and sensitive to a smell developed mostly. CONSIDERATION: Prevalence differed greatly by how SHS is defined. In order to diagnose truer SHS, we think that the prudent definition based also on the international standard is required.

Laparoscopic ovarian cystectomy using double balloon catheter: a new technical application

In the present study, a modified application of the surgical instrument with double balloon is described in the ovarian cystectomy procedure. This technique has been proved effective and safe especially in removing chocolate-like cystoma. This new instrument, which we originally designed, has two balloons at the tip of the catheter. After a cyst is punctured, the inner and outer balloons are inflated to fix the cyst well. After fixing the cyst with two balloons, the internal needle of the instrument can be removed. This catheter, named the SAND balloon catheter, is advantageous in laparoscopic ovarian cystectomy.

Chemical assay of iron in ovarian cysts: a new diagnostic method to evaluate endometriotic cysts

CA-125 is abundantly secreted from ovarian endometriotic cysts, but is not specific to endometriosis. In order to develop a new, more specific diagnostic marker for endometriosis, the iron concentrations in various ovarian cysts were assayed. The ovarian cysts were punctured and the contents aspirated laparoscopically, laparotomically, or transvaginally. The iron concentration in the ovarian cystic fluid was assayed using a spectrophotometer after protein precipitations and chromogen treatment. The iron concentrations in ovarian cysts were 69.5+/-10.4 micromol/l in serous cystadenomas, 73.5+/-29.3 in mucinous cystadenomas, 65.4+/-12.4 in dermoid cysts, and 92.5+/-18.2 micromol/l in adenocarcinomas. On the other hand, high iron concentrations were demonstrated in endometriotic cysts (1,749.6+/-41.5 micromol/l), a lutein cyst (1,393.8), hemorrhagic corpus luteum (1,957.5) and endometrioid adenocarcinomas (1,860.9+/-157.9 micromol/l). Cytological smear tests of the contents as well as histological examination allowed differential diagnosis between endometriosis and endometrioid adenocarcinoma. In conclusion, assay of the ovarian cystic iron concentration is a useful diagnostic tool for the evaluation of ovarian endometriotic cysts.

Laparoscopic colpopoiesis using sigmoid colon

A new technique for colpopoiesis using sigmoid colon autograft by a laparoscopic surgery is introduced for the first time. This technique requires advanced skills perform and may be the choice in respect to naturalness and permanency of the neovagina with minimum invasion.

Laparoscopic reconstruction of vagina using sigmoid autograft

With the advent of advanced laparoscopic techniques in surgery, new applications have been found, which have expanded the role of laparoscopy in the gynecological field. The aim of this paper is to introduce our laparoscopic technique of taking a sigmoid colon autograft for colpopoiesis in a patient with congenital agenesis of the vagina. This technique is less invasive and is easy to perform, and it may be the best choice of operation in respect to the naturalness and the permanency of the vagina that results. The success of this laparoscopic technique of taking a sigmoid autograft for colpopoiesis suggests diverse possible applications in the future.

Laparoscopic ovarian cystectomy: extraperitoneal method

A laparoscopic method for resecting benign ovarian cysts has been devised and involves excising the cyst wall extraperitoneally after aspirating the cystic fluid. In this report, the technique and clinical results are described and mini-laparotomy which is used in this technique is discussed. A total of 104patients were treated by this method. The diagnosis was simple cyst in 46,dermoid cyst in 33,and chocolate cyst in 25. The method was successful in 90 patients (87%).The remaining 14(14%)were converted to open surgery, 9 be- cause of severe adhesions. The remaining 5 patients had various complications: malignancy, bladder injury, dermoid content too solid to aspirate, and bleeding. We found endometrioid adenocarcinoma in 1 patient whose chocolate cyst could be removed completely.