RESUMEN
Dermoid nasal cysts (congenital nasal median heterotopias) are a rare congenital pathology in children. OBJECTIVE: Yo consider the clinical picture, methods of radiation diagnosis and to study the surgical results of a dermoid cyst of the nose according to the literature. MATERIALS AND METHODS: A retrospective review of medical histories with the diagnosis of "Dermoid cyst of the back of the nose and nasal cavity, epidermal cyst of the back of the nose, glioma, encephalocele" was conducted from 2017 to 2022 in the Pediatric Otorhinolaryngological Department of the National Medical Research Center for Otorhinolaryngology of the Federal Medical-Biological Agency of Russia. The case histories were analyzed by the nature of the lesion, the imaging techniques performed, the course of the operation and the results obtained. MATERIAL AND METHODS: A total of 16 medical histories were analyzed, the average age was 4.5 years (range 10 months - 15 years), over the past 5 years with a diagnosis of "Dermoid cyst of the nasal dorsum and nasal cavity, glioma, epidermal cyst of the nasal dorsum, encephalocele". All patients underwent magnetic resonance imaging (MRI) in the preoperative period, 14 patients also underwent computed tomography (CT). RESULT: Of these, 7 had a confirmed dermoid cyst with a fistula, 3 patients without a fistula, 3 patients had glioma, and 1 had encephalocele, 2 patients had an epidermoid cyst. A fistulous opening of the dermoid cyst of the nasal dorsum and nasal cavity was observed in the upper third of the nasal dorsum in 3 children, in the middle third in 2 patients and in the lower third in 2 children. The article presents a scheme for the characteristics of the lesion and the tactics of surgical treatment in comparison with the data of foreign authors. Intraoperatively, intracranial spread occurred in 6 patients. Various surgical approaches for intracranial proliferation and a corresponding literature review are also presented. Catamnestic follow-up ranged from 1 to 5 years (on average, 3.5 years), no relapses or postoperative complications were noted. CONCLUSION: Nasal median heterotopias are a rare congenital anomaly. Preoperative preparation should include CT and MRI to assess the lesion and exclude intracranial spread. The surgical approach depended directly on the localization of heterotopia and its spread. All patients had a good cosmetic result after the surgical treatment performed by us according to the author's method.
Asunto(s)
Quiste Dermoide , Imagen por Resonancia Magnética , Humanos , Niño , Femenino , Masculino , Preescolar , Quiste Dermoide/cirugía , Quiste Dermoide/congénito , Quiste Dermoide/diagnóstico , Estudios Retrospectivos , Imagen por Resonancia Magnética/métodos , Lactante , Tomografía Computarizada por Rayos X/métodos , Adolescente , Neoplasias Nasales/cirugía , Neoplasias Nasales/congénito , Neoplasias Nasales/diagnóstico , Neoplasias Nasales/diagnóstico por imagen , Federación de Rusia , Cavidad Nasal/anomalías , Cavidad Nasal/cirugía , Cavidad Nasal/diagnóstico por imagen , Resultado del TratamientoRESUMEN
The clinical manifestations of myocarditis are extremely variable and it may commonly manifest as acute myocardial infarction. The diagnosis of acute myocarditis is frequently empiric and substantiated by the clinical picture of the disease, ECG changes, elevated enzyme levels, and the lack of any data on coronary heart disease. Until recently, endomyocardial biopsy has been considered to be the most accurate diagnostic method. However, endomyocardial biopsy has a low sensitivity and is associated with the high risk of complications. This paper describes a clinical case of a patient with cardialgias occurring after acute respiratory viral disease, with ST segment elevation, and higher levels of cardiospecific enzymes. The diagnosis of myocarditis was verified by contrast-enhanced cardiac magnetic resonance imaging.
Asunto(s)
Cefalosporinas/uso terapéutico , Glucocorticoides/uso terapéutico , Imagen por Resonancia Magnética/métodos , Infarto del Miocardio/diagnóstico , Miocarditis/diagnóstico , Inhibidores de Agregación Plaquetaria/uso terapéutico , Adulto , Forma MB de la Creatina-Quinasa/sangre , Diagnóstico Diferencial , Ecocardiografía , Electrocardiografía , Humanos , Masculino , Miocarditis/sangre , Miocarditis/tratamiento farmacológico , Miocarditis/fisiopatología , Resultado del Tratamiento , Troponina I/sangreRESUMEN
The study was purposed to evaluate the contribution of the reflectory and local components during the chronic stretch of the postural muscle to the attenuation of the unloading-induced fiber size reduction and changes in the myosin heavy chain (MHC) profile. The surgical unilateral deafferentation (dorsal rhizotomy) was used. It was shown that unilateral deafferentation didn't influence on the amelioration of unloading-induced fiber size reduction in chronically stretched soleus muscle. Thus, the results obtained in the present study don't confirm the hypothesis, supposing the predominant contribution of the muscle afferent activation to the attenuation of unloading-induced fiber atrophy. Deafferentation of unloaded as well as control rats leads to the increase of the percentage of fibers expressing slow MYC isoforms.