Of 1055 patients treated surgically for pulmonary hydatid disease, most (950) had isolated lung cysts, the other 105 having both liver and lung cysts. The chest radiograph was most valuable in diagnosis; the Casoni and Weinberg tests and blood eosinophil counts were found to be diagnostically unreliable. One thousand and seventy seven primary operations were performed. Cystotomy and capitonnage were carried out in 906 patients, 40 of whom also had decortication of the pleura. Other procedures included cystotomy with wedge resection of locally damaged lung (29 patients) and cyst removal with capitonnage by Ugon's method (33) or the Perez-Fontana procedure (8) and with costal resection for osteomyelitis in two cases. More radical surgery was carried out in 99 patients for longstanding infection or severe lung destruction. Postoperative complications occurred in 37 patients (3 5%) and the 30 day mortality rate was 1-7%. It is concluded that a lung conserving surgical operation is the treatment of choice for most patients with pulmonary hydatid disease. In patients with coexisting liver cysts the thoracic transpleural approach allowed the lung and liver cysts to be removed at the same session.

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De partment of Thoracic Su rgery. Atatu rk Chest Disea ses a nd Surg ical Cente r . Ankara . Tu rkey Sum ma ry Sixty patients w ho unde rwent operation betwee n 1979-t 98 7 for bilateral pulmon ary hyda tid disease usin g median ste rnoto my a pproac h a rc reported 01 1. Although some au tho rs pre fer two -stage thoracoto my a nd ope rat e on th e side with the large r cyst first, or perform si multaneou s bilatera l thoracotomies . we ha ve pr eferred one-stage ope rati on via media n st ern otomy.T he re were 29 fem al e a nd 3 1 ma le pa tients . ranging in a ge fro m 5 to 55 vea rs (mean 26.4 ± 6.31. A total of 173 cysts we re o pe ra ted in 12lJ lun gs. The usu al opera tive tech nique was cystotomy a nd ca pito n na gc. Operative an d postoperative courses we re uneventful in a ll but th ree case s /5' %> 1.Thc ca us es of mort a lity in th ese pa tie nts were excess ive hemorrh a ge. mediastinitis. a nd sept ic shock rcsp ecttvelv.'It is concluded that medi an ste rn otomy is a better alt ernat ive method for the trea tmen t of bilate ra l hydati d disease of the lung. as HlP du ra tion of hospital isa tio n is shorte r. the a pproach is better tolera ted by the pa tien ts tha n thora cotomy. a nd it possibly prevents a second general a nesthes ia.Chiru r gtsche Beh andlun g \"0 11 bil at e r alen Eehl noke kkuszysten der Lun ge via medl am-r Ste r nntomie: lirfah r un gen a n c.o Path-m en Nachde m die Autoren his 1()i 8 22 Patie men mit bilate ral cn Echiuokokkuszysten mittels zweizeitig er lat eraler Tbora kotomie behan -dclt hauen . bcriehten sic [ctzt Ilbcr 60 Patien ten mit der glcichen Kra nkheit . die sie in den .la hre n von t979 -87 ei nzeiti g via med lanc r Sterno tomie opc rienen . Es ha ndeh e sich urn 29 Fra uen und 3 1Hin n er im Alter von 5-55 Jahr en lim Mittel 26 J a hrel. bel de nen insgesam t I i3 Echinckokkuszyste n chirurgtsch a ngcgan ge n wu rde n. In otncm Vie rtel del' Fallo warcn die Zysten prao pera tiv bcreits rup turie rt und inflztert. Nach sorgfalu ger Losung aller Verw achsu ngen wu rden in del' HC'gC'1 e ine Zys totom ic und eine Ca pito nna ge vorgenomm cn . xur bel emcm Pa tien ten wa r zusa tzllch n och cine Teil rese kticn der Ung ula erforderlich. Bei 5 Pa tienten bcst an den gleichze ltig noch Le berzyste n. in 3 Fallen wu rde dics e in de l' gleiche n Sitz ung operte rt . 3 Patie nte n (5 %) ve rs ta r be n. ein e r a n c ine r Blutung lind zwei an ci ner Infek tion mit folgendem scptischcn Schoc k. Die Autoren stellcn die Vorteile de l' mcdia ne n Sternc tomie he ra LIS: Diese l' Zuga ng ver ursac ht ge ringe re Sch me rz en und beei ntrach tigt postop e rat lv die l.ungen fun ktion wcni ger. De r kor nplikationsa r me rc Verla u f zeig t sich a uch d eutlich a n eine m kur ze ren Kra nk enha usa ufen th alt : 17 Taw ' be l de l' media nen Ste ruotomlc und 4 7 Ta ge bel d cm bllatc ra lcn . zweiz citig en Ein griff Key wordsHyd atid cyst -Bilate ral pulmonary hydati d disease -Media n stemotcm y equ a l. Forty-eight pa tient s (80 %) wer e from the ru ral pop ul...

Records of 59 patients (41 males and 18 females) who underwent 70 operations for pulmonary aspergilloma in a 23-year period were examined retrospectively. Sixty-three operations were for primary treatment of pulmonary aspergilloma, and 7 were for complications of surgery. Twenty-six postoperative complications occurred in 19 patients. Three lobectomies that resulted in bronchopleural fistula were managed by intercostal muscle-flap closure and partial thoracomyoplasty. Two patients died within the first week of surgery. Surgery is the treatment of choice for most patients with pulmonary aspergilloma. Selective bronchial artery embolization is helpful only in combating hemoptysis, and this has been considered a temporary measure in most reports. Thus, open thoracotomy and anatomical resection are recommended as early as possible after the diagnosis is established.

SummaryBackgroundTo investigate correlation between lumbar opening pressure (LOP) and radiological scores based on cranial MRI and contrast-enhanced MR venography in patients with idiopathic intracranial hypertension (IIH).Material/MethodsPatients with IIH who underwent brain MRI and contrast-enhanced MR venography before measurement of LOP between 2010–2014 were evaluated retrospectively. Three experienced radiologists (blinded to LOP values) evaluated a total of 51 patients. They reached a consensus on the presence or absence of 6 radiological findings identified in the literature as characteristic for IIH: empty sella, perioptic dilation, optical tortuosity, flattening of the posterior globe, swelling of the optic disc, and bilateral transverse sinus stenosis. The radiological score was obtained by giving 1 point for the presence of each finding, with the highest possible score of 6 points. The correlation between the calculated radiological scores and LOP was evaluated.ResultsThere was no significant correlation between LOP and radiological scores (r=0.095; p=0.525, Spearman’s rank coefficient). Similarly, no significant correlation was detected between LOP and each of the radiological findings (partial empty sella [p=0.137], perioptic dilation [p=0.265], optical tortuosity [p=0.948], flattening of the posterior globe [p=0.491], swelling of the optic disc [p=0.881], and bilateral dural sinus stenosis [p=0.837], Mann-Whitney U test).ConclusionsThere was no significant correlation between LOP and reliable radiological features of IIH.