Is electrosurgery fulguration a better procedure for Bartholins gland cyst?

SUMMARY OBJECTIVE To evaluate the effectiveness of electrosurgery fulguration as a treatment for Bartholin's gland cysts. DESIGN Retrospective study with a comparative control group performed on Hospital Brigadeiro and in the Disciplina de Ginecologia do Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo from February 2005 to March 2009. Patients: Patients with Bartholin's gland cyst were divided into three treatment groups: group 1 electrosurgery (n=169 cases); group 2 - gland excision with the conventional technique using a cold scalpel (n = 51 cases); group 3 - marsupialization (n=11 cases). We reviewed the clinical and surgical history, physical examination, description of the surgical technique, postoperative results (success and complications), and follow-up data. RESULTS There is no difference between groups in relation to intraoperative bleeding, hematoma, and complete healing in a single treatment session. However, electrosurgery shows the lower percentage of recurrences 18 (10,7%) compared to the Marsupialization technique (group 3, p=.031). Recurrences occurred in 18 (10,7%), 3 (5,9%), and 4 (36,4%) cases. After retreatment by the same technique, there was a complete cure rate of 90% (152/169) for group 1, and 98% (50/51) for group 2. The cost of group 1 was lower than that of other groups. CONCLUSION The fulguration with electrosurgery of the capsule of Bartholin's cyst is an effective method of treatment, andthe cost of this technique is lower than the conventional technique and marsupialization.

RESUMO OBJETIVO Avaliar a eficácia da fulguração da eletrocirurgia como tratamento para os cistos da glândula de Bartholin. MÉTODOS Estudo retrospectivo, grupo controle comparativo realizado no Hospital Brigadeiro e disciplina de Ginecologia do Departamento de Obstetrícia e Ginecologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, de fevereiro de 2005 a março de 2009. Pacientes com cisto de glândula de Bartholin foram divididos em três grupos de tratamento: grupo 1 - eletrocirurgia (n = 169 casos); grupo 2 - excisão da glândula com técnica convencional utilizando bisturi frio (n = 51 casos); grupo 3 - marsupialização (n = 11 casos). Revisamos a história clínica e cirúrgica, o exame físico, a descrição da técnica cirúrgica, os resultados pós-operatórios (sucesso e complicações) e os dados de acompanhamento. RESULTADOS Não há diferença entre os grupos em relação ao sangramento intraoperatório, hematoma e cicatrização completa em uma única sessão de tratamento. No entanto, a eletrocirurgia mostrou o percentual mínimo de recidivas, 18 (10,7%), em relação à técnica de marsupialização (grupo 3, p = 0,031). Recorrências ocorreram em 18 (10,7%), três (5,9%) e quatro (36,4%) casos. Após o retratamento pela mesma técnica, houve taxa de cura completa: 90% (152/169) para o grupo 1 e 98% (50/51) para o grupo 2. O custo do grupo 1 foi menor do que os dos outros grupos. CONCLUSÃO A fulguração com eletrocirurgia da cápsula do cisto de Bartholin é um método efetivo de tratamento, mas o custo dessa técnica é menor do que a técnica de convenção e a marsupialização.

Research advances in diagnosis and treatment of primary biliary cirrhosis / 临床肝胆病杂志

Primary biliary cirrhosis (PBC) is a chronic cholestatic liver disease, characterized by progressive non-pyogenic inflammation in the small intrahepatic bile ducts, and can cause hepatic fibrosis and liver cirrhosis. The etiology and pathogenesis of PBC remain unknown. The development and progression of PBC are caused by various factors, and the major factor is environmental factors acting on patients with genetic susceptibility. Ursodesoxycholic acid is thought to be the only effective drug, but the complete response rate remains low. This article reviews the diagnosis and treatment of PBC with reference to the literature in the world.

Relationship of visual function with the diagnosis and therapy of eye-related diseases——require for further research / 中华实验眼科杂志

Visual cognition is a comprehensive procedure of information processing from eyes,visual pathway through cerebral cortex.Visual function covers down multiple concepts of ocular structures,psycophysics,photochemistry and photoelectric information transformation,reflecting visual acuity,contrast visual acuity,visual field,color vision,binocular vision,visual perception and many other detailed parameters.Ocular abnormal status is reflected to certain visual function while visual function is various and anfractuous from kinds of ocular problems.These complex networks lead to some misunderstanding of research in the filed of visual function concept.An expatiation of the diversified visual function is helpful for us to integrate visual function and ocular ailment process.This paper tried to explicit some misconceptions,and accentuated the importance of clinical research around visual function for the diagnosis and treatment of eye diseases and nervous system diseases.

Recent advances in Acanthamoeba keratitis / 中华实验眼科杂志

Acanthamoeba keratitis is a refractory and progressive eye disease caused by Acanthamoeba.Acanthamoeba exists in natural environment,tap water and corneal contact lens care solution,so the incidence of Acanthamoeba keratitis is increasing because of the corneal contact lens.The diagnosis of Acanthamoeba keratitis depends on the history of disease,signs and symptoms as well as rapidly developed laboratory examinations.The management of Acanthamoeba keratitis includes medical therapy and surgery,and photorefractive keratectomy is a new operation for Acanthamoeba keratitis.Some new knowledge in our understanding of the disease is being produced in recent years.The etiology,novel diagnosis and therapy for this disease were reviewed.

Solitary Rectal Ulcer Syndrome in Patients with Spinal Cord Injury: 28 Cases Report / 中国康复理论与实践

@#Objective To explore the diagnosis, treatment and pathogenesis of solitary rectal ulcer syndrome (SRUS) in patients with spinal cord injury (SCI). Methods 260 patients with SCI accepted rectal diseases survey, anal examination and anus straight endoscopic. Those who had rectal ulcer also performed biopsy, and patients who had been diagnosed as SRUS were evaluated by the index of International bowel function basic SCI data set, then further accepted non-operative or surgical treatment, and regular reexamination with anal straight colonoscopy for clinical evaluation after discharge. Results and Conclusion Bowel dysfunction, constipation, and anal rectum prolapsed, improper uses of glycerine enema were important causes of SRUS after SCI. Non-operative therapy as well as strengthening defecate management could be an effective treatment for SRUS after SCI.

Breast Cancer During Pregnancy / 中国普外基础与临床杂志

Objective To study the advances in research of breast cancer during pregnancy. Methods The literatures in recent years were reviewed. Results A lot of evidences suggested that the diagnosis may be delayed easily. The diagnosis was primarily made by needle aspiration cytology and biopsy. The treatment of pregnant breast cancer was not different from ordinary breast cancer, however the factor of foetus should be taken into account. Termination of pregnancy did not improve survival.Conclusion Pregnant breast cancer is mostly at later stage at the time of diagnosis and has poorer prognosis than ordinary breast cancer. The patients with breast cancer during pregnancy usually have an equivalent survival rate when compared with age and stage-matched ordinary group. Future pregnancy may be allowed after two years of treatment in patients with early breast cancer.

Clinical characteristics of Huntington's disease in 5 kindreds and review / 中国康复理论与实践

@#ObjectiveTo understand the clinical characteristics and therapy of Huntington's disease (HD).MethodsThe clinical characteristics of five typical kindreds with HD were analysed. The therapeutic progression after reviewing literature was summarized.ResultsFive kindreds inherited in an autosomal dominant manner. They were all adult-onset HD.Progressive motor dysfunction,cognitive decline,emotional and behavioral disturbance were the key clinical presentations. At an early stage, manifestations include subtle emotional symptoms and involuntary movements.The reason of visiting doctor was chorea. CT scans demonstrated brain atrophy.ConclusionsTypical clinical manifestation and clear family history may be enough to make primary diagnosis. Psychological evaluation at risk individual may help to diagnose early. Gene testing may confirm the diagnosis of HD. The drugs and occupational,physical therapy and psychotherapy for HD patients can help maintain the highest level of function and improve the quality of life.

Hemorrhage of Gastrointestinal Vascular Malformation:Value of Diagnosis and Therapy of Interventional Radiology / 介入放射学杂志

Purpose:To evaluate the accuracy of diagnosing the gastrointestinal vascular malformation and the value of treatment of the hemorrhage of the interventional radiology.Materials and Methods:The superior mesenteric arteriography or/and the inferior mesenteric arteriography or arteriography of coeliac axis were performed by applying Seldinger's techniques in 22 cases with the gastrointestinal bleeding which were suspicous of the gastrointestinal vascular malformation,otherwise were negative or equivocal in di- agnosis by performing with non-interventional study.Results:Focci were detected in 31 arteriographies (22 cases)with the positive gastrointestinal vascular malformation.Operative treatment were performed in 14 of 22 cases,with confimation of the vascular malformation pathologically.Conclusion:The se- lective coeliac arteriography may be a reliably unique method in detection of the gastrointestinal vascular malformation.