PubMed · 14196790
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J E MITCHELL. 1964. HERNIAL APPENDICITIS.. https://pubmed.ncbi.nlm.nih.gov/14196790/
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OBJECTIVE: To investigate the efficiency and safety of alcohol sclerotherapy of Bartholin's cyst or abscess by comparing it with silver nitrate insertion. STUDY DESIGN: Twenty-two patients with unilateral Bartholin's cyst or abscess were randomized into one of the treatment groups according to diameter of cyst or abscess. Group I consisted of 12 patients who were treated with alcohol sclerotherapy and Group II included 10 patients who were treated with silver nitrate insertion. In both groups, treatments were conducted under local anesthesia and in an outpatient setting. The patients were checked for morbidity of operations every 3 days until complete healing was observed and then followed up monthly for over 24 months. RESULTS: The mean duration of procedure was 7+/-2 min in group I and 15+/-3 min in group II. Healing time was 4.8+/-1.3 days in group I and 9.2+/-2.5 days in group II. In group I although 10 patients showed complete healing without any early or late morbidity; two patients suffered from severe vulval pain, edema and echymosis, and then developed a total cyst necrosis. Healing in these patients completed with mild scar formation. Only one recurrence was documented during 24 months follow-up period. All patients in group II complained labial pain, four of them suffered from severe labial pain, edema, and echymosis. Healing in these patients was completed with moderate scar formation. Follow-up of 24 months revealed no recurrence in this group. CONCLUSION: Alcohol sclerotherapy of Bartholin's cyst or abscess is as effective as silver nitrate application and is associated with less complication. It may be ideal, safe and attractive treatment modality for this gynecological disease.
Citrobacter rodentium uses virulence factors similar to the enteropathogenic Escherichia coli to produce attaching and effacing lesions in the distal colon of mice. We used this infection model to determine components of adaptive immunity needed to survive infection. During acute infection, wild-type mice develop breaks across infected epithelial surfaces but resolve infection. Surprisingly, mice markedly deficient in mucosal lymphocyte populations from beta(7) integrin deficiency resolve infection, as do CD8alpha-/- or TCR-delta-/- mice. In contrast, CD4-/- or TCR-beta-/- mice develop polymicrobial sepsis and end-organ damage, and succumb during acute infection, despite epithelial damage similar to wild-type mice. B cell-deficient (MuMT-/-) or B and T cell-deficient (recombinase-activating gene 2-/-) mice develop severe pathology in colon and internal organs, and deteriorate rapidly during acute infection. Surviving mice develop robust Citrobacter-specific serum IgM responses during acute infection, whereas mice that succumb do not. However, CD4-/- mice receiving serum Igs from infected wild-type mice survive and clear the infection. Our data show that survival of apparently self-limited and luminal mucosal infections requires a systemic T cell-dependent Ab response against bacteria that enter through damaged mucosa. These findings have implications for understanding host defense against mucosal infections, including the pathogenesis of these diseases in immunocompromised populations.
Third and fourth branchial pouch anomalies are rare and usually present as lateral neck masses, abscesses or with acute suppurative thyroiditis. An opening in the piriform sinus can be identified in most cases. We present four cases of fourth branchial pouch sinuses, one of a third branchial cyst and discuss our management. Cannulation of the sinus tract at laryngoscopy, followed by complete surgical excision, via a modified oblique thyrotomy above the cricothyroid joint after detaching the inferior constrictor was used to treat the fourth branchial pouch anomalies. This surgical approach adequately exposes the piriform sinus apex and also affords protection to the recurrent laryngeal nerve. The third pouch cyst and tract were excised at the level of the thyrohyoid membrane. There were no complications or recurrences.