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A new in vitro bioassay for cyst formation by renal cells from an autosomal dominant rat model of polycystic kidney disease.

Autosomal dominant polycystic kidney disease (ADPKD) is one of the most frequent human inherited diseases. The main feature of the disease is the development of renal cysts, first occurring in the proximal tubules, and with time, dominating all segments of the nephron, leading to end-stage renal disease in 50% of the patients in their fifth decade of life. A therapy for polycystic kidney disease (PKD) has not yet been developed. Patients coming to end-stage ADPKD require long-term dialysis and/or transplantation. A suitable animal model to study ADPKD is the spontaneously mutated Han:SPRD (cy/+) rat, but a method to cultivate Han:SPRD (cy/+) derived renal cells which preserves their ability to form cyst-like structures in vitro has previously not been reported. Based on this well-characterized animal model, we developed a cell culture model of renal cyst formation in vitro. When renal cells of the Han:SPRD (cy/+) rat were isolated and cultured under conditions that prevent cell-substratum adhesion, large amounts of cyst-like structures were formed de novo from Han:SPRD (cy/+) derived renal cells, but only a few from control rat renal cells. In contrast, when cultivated on plastic as monolayer cultures, Han:SPRD (cy/+)-derived and control rat-derived renal cells were indistinguishable and did not form cyst-like structures. Immunohistochemical characterization of the cyst-like structures suggests tubular epithelial origin of the cyst-forming cells. The amount of cysts formed from Han:SPRD (cy/+)-derived renal cells grown in a stationary suspension culture is susceptible to modulation by different conditions. Human cyst fluid and epidermal growth factor both stimulated the formation of cysts from Han:SPRD (cy/+)-derived renal cells whereas taxol inhibited cystogenesis. In contrast, neither human cyst fluid nor epidermal growth factor affected the amount of cysts formed by control rat renal cells. As the culture model reported here allows not only the distinction of PKD-derived tubular epithelium from its normal counterpart, but also the modulation of cyst formation especially by Han:SPRD (cy/+)-derived renal cells, it might be a useful prescreening protocol for potential treatments for PKD and thus reduce the need for animal experiments.

Animals↗

Anionic sites on Toxoplasma gondii tissue cyst wall: expression, uptake and characterization.

Toxoplasmosis, caused by Toxoplasma gondii, is an important parasitic disease worldwide, which causes widespread human and animal diseases. The need for new therapeutic agents along with the biology of these parasites has fueled a keen interest in the understanding of the nutrients acquisition by these parasites. Studies on the characterization of the T. gondii cyst wall as well as the contribution of the host cell to this formation have been little explored. The aim of this paper was to investigate the electric surface charge of the T. gondii tissue cysts by ultrastructural cytochemistry, through polycationic markers, employing ruthenium red (RR) and cationized ferritin (CF). Glycosaminoglycans revealed by RR were localized on the cyst wall as a homogeneous granular layer electrondense, all over its surface. The incubation of living tissue cysts with CF for 20 min at 4 degrees C followed by the increase of temperature to 37 degrees C indicated that T. gondii cyst wall is negatively charged and that occurs an incorporation of anionic sites by the cyst wall, through vesicles and tubules, and their posterior location in the cyst matrix. So, as to identify which group of molecules produces negative charge in the cyst wall, we used enzymes for cleavage on different types of molecules, demonstrating that the negative charge in the cyst wall is mainly produced by phospholipids. Our results, described in this work show, for the first time, the negativities of the cyst wall, the incorporation and the traffic of intracellular surface molecules by T. gondii cyst wall. Our model of study can give an important contribution to the knowledge of the biology and the processes involved in nutrients acquisition by bradyzoites living inside the cysts and, and also be applied as a target for the direct action of drugs against the cyst.

Animals↗

Hydatid cyst of the liver-criteria for the selection of appropriate treatment.

The appropriate treatment of hydatid cysts of the liver is determined by several factors, namely the patient, the cyst, the therapeutic resources and the physician. Characteristics of cysts, can be described by ultrasonography (US). Based on US images, we can classify hydatid cysts, according the evolutionary phase of the larval parasite and to choose the most appropriate therapeutic approach. US is also important to evaluate the efficacy of the treatment. Concerning the therapeutic methods, surgery had long been the only treatment available for the hydatid cyst of the liver. Beginning the 1970s benzimidazoles, Mebendazole and Albendazole, have been used for the treatment of the hydatid disease and in the early 1980s, with the development of diagnostic US, the deliberate puncture of abdominal cysts, particularly those in the liver, was evaluated this lead to puncture/aspiration, followed by injection of a scolicide which became a therapeutic method known as puncture, aspiration, injection and re-aspiration (PAIR). So, according to the cyst's characteristics based on US evaluation we can establish a therapeutic strategy: cysts type 1 and 3 may be treated by chemotherapy. Alternative treatment should be PAIR but only if the cysts cannot be treated with benzimidazoles. If there are contraindications for PAIR and chemotherapy the treatment should be surgical. Type 2 hydatid cysts can be treated by PAIR following initial treatment with benzimidazoles. If PAIR is not feasible or there is no evidence of degenerative changes after chemotherapy, surgery is indicated. Type 4 cysts are usually inactive and, in these cases, treatment is not indicated. If there is evidence that the cysts contents are still viable PAIR may be indicate. If PAIR is not possible, surgery is the method of choice. Cysts type 5 do not require treatment.

Age Factors↗

Cyst production and transmission of Entamoeba and Endolimax.

We studied the cyst production of 340 asymptomatic carriers with single or mixed infections of Entamoeba histolytica/Entamoeba dispar, Endolimax nana and Entamoeba coli. It was found that the main source of transmission was a small group of 37 (10.9%) carriers who produced 70.2% of all cysts. Gender was an important factor for cyst production of Ent. histolytica/Ent. dispar, since males produced 6-fold more cysts than females. Females produced 'large' (13-15 microns) Ent. histolytica/Ent. dispar cysts and males small (10-12 microns) cysts when concentration was > 2000 cysts/g. When concentration was < 2000 cysts/g, cysts were the same size for both sexes (11.6 +/- 0.3 microns). In Ent. coli infections, an inverse relationship between the number and size of cyst was found for both sexes. Cysts of End. nana were not affected by gender or cyst concentration. Following cyst production by a carrier infected with Ent. coli and Ent. histolytica for 28 days, we identified synchronized cycles of cyst production for both species. Altogether, these data suggest that cyst-mediated transmission is a highly regulated process in which synchronization among different species and gender of the host have an important role in transmission.

Amebiasis↗

Ultrastructure and function of cysts from human adult polycystic kidneys.

Twenty cysts from five patients with adult polycystic kidney disease were evaluated morphologically by electron microscopy and functionally by cyst fluid chemical analysis in order to correlate the structure with the function of the cyst wall. Thirteen proximal cysts, as defined by cyst fluid/serum sodium ratios of 0.8 to 1.2, were lined by epithelial cells with open or short closed apical junctions that appeared permeable to lanthanum. In contrast, seven distal cysts, as defined by cyst fluid/serum sodium ratios of less than 0.4, were lined by epithelial cells with long closed apical junctions that appeared impermeable to lanthanum. Cell organelles showed no distinction between proximal and distal cysts. Cyst basement membranes appeared abnormal, but there was no consistent pattern. The fluid of proximal cysts contained lower creatinine, potassium, and hydrogen ion, and higher chloride concentrations than did the distal cysts. These studies provide morphologic and chemical evidence consistent with te view that cysts originate from nephrons. Moreover, the maintenance of the epithelial lining and transmembrane solute gradients over many years extending up to and beyond the development of renal insufficiency suggests that the cysts function as nephronsthrughout the life of the patient.

Adult↗

Prevalence of hydatid cysts in livestock from five regions of Jordan.

When the prevalences of cystic echinococcosis in indigenous sheep, goats, cattle and camels from five regions of Jordan were investigated, from March to December 1992, they were found to be 12.9%, 12.7%, 0.9% and 11%, respectively. They were substantially higher in sheep from Karak (27.6%) and in cattle from central Jordan (18.0% in Amman and 14.3% in Sahab) than in the same animals in other regions. Age-intensity data indicated that the parasite population is endemic in sheep and cattle and hyperendemic in goats. Infection rate increased steadily with age in sheep, but became constant in goats and cattle when they were about 2 years of age. The most common locations of cysts were the liver in sheep and goats and the lungs in cattle. Co-infection of the liver and lungs was common in sheep and cattle. Although the majority of the sheep, cattle and goats had 1-10 cysts, 20.4% of the sheep and 22.2% of the cattle had 11-50 and 11-30 cysts, respectively. Although 38.1% of the cysts in sheep were fertile, only 8.7% of the cattle cysts and 4.5% of the goat cysts were in this condition. The overall mean number of protoscolices/sheep cyst was 2.7 x 10(3); although the liver cysts had more protoscolices than the lung cysts (3.2 x 10(3) v. 1.9 x 10(3)/cyst), more of the lung cysts were viable (71.1% v. 62.3%). Some 0.2% of 13,436 sheep and 6.1% of 786 cattle imported live into Jordan were infected with hydatid cysts; 16.3% of the sheep cysts (61.4% viable) and 9.6% of the cattle cysts (76.1% viable) were fertile.

Age Distribution↗

Cyst fluid proteases.

The precise origin of breast cyst fluid remains obscure. Molina has presented evidence that type II cysts (high Na/K ratio) may be transudative, that is, partly derived from plasma elements which enter through gap junctions, while Type I cysts (high K/Na ratio) are primarily secretory. In transudative cysts, plasma protease inhibitors may be present, but the balance between protease and its inhibitors may fluctuate as a result of as yet undetermined circumstances. An imbalance between the protease activity of cyst fluid and its inhibitors may be involved in the pathogenesis of breast gross cystic disease. Accumulation of protein fragments with resistant bonds would produce an elevated oncotic pressure causing a shift of fluid into the cyst capsule. Albumin is a good substrate for the protease, which may account for its low concentration in cyst fluid. The major protease fraction closely corresponds to the progesterone binding protein (GCDFP-24) described by Haagensen. Affinity columns containing aprotinin or benzamidine ligands retain the protease which can then be eluted with 0.5 M NaCl. The HD1 protease and progesterone binding protein are either tightly complexed or are the same protein. Cyst fluid is a complex mixture of biomolecules. If the progesterone binding protein is a protease, many questions must be answered concerning the influence of cyst fluid steroids, lipids, anions, and cations on enzyme action. Determination of the amino acid sequence of HD1 may help elucidate the source of the enzyme and its relationship to other tissue proteases. Human plasma contains inhibitors of this protease activity. When pooled, dialyzed plasma was mixed with pooled, dialyzed cyst fluid, the ratio of plasma/cyst fluid at which all activity was inhibited was 6/1. A comparison of the rate of cleavage of three 14C-protein substrates shows that cyst fluid proteases cleave in a characteristic manner, distinct from either trypsin or calpain. A simple method for semiquantitative estimation of protease activity in cyst fluid is described which utilizes prestained Coomassie blue-albumin containing agarose gel plates. All cyst fluids tested had protease activity but showed variability in their ability to cleave 14C-albumin by a factor of 4. There is much direct and indirect evidence that proteases are involved in the cancer process. In view of the higher than normal incidence of breast cancer in women who have had gross cystic breast disease, the possibility exists that an imbalance between these proteases and their inhibitors is somehow involved.

Exudates and Transudates↗

Inhibition of Giardia lamblia excystation by antibodies against cyst walls and by wheat germ agglutinin.

Although excystation is crucial to the initiation of infection by Giardia lamblia, little is known about the regulation of this important process. We have been able to reliably induce excystation in vitro by mimicking cyst passage through the stomach and upper small intestine by the exposure of in vitro-derived cysts to an acidic, reducing environment (stage I) followed by protease treatment at a slightly alkaline pH (stage II). Preexposure of cysts to polyclonal rabbit antiserum against purified cyst walls (PCWs) or to wheat germ agglutinin (WGA) inhibited excystation by > 90%. Adsorption of either ligand with PCWs eliminated inhibition, demonstrating specificity for cyst wall epitopes. Inhibition by WGA was reversed by either chitotriose or sialic acid, while inhibition by polyclonal antibodies against PCWs (anti-PCW) was reversed only by sialic acid, which also inhibited binding of both ligands to intact cysts and to cyst wall antigens in immunoblots. Binding of anti-PCW did not affect acidification of cyst cytoplasm during stage I. Exposure of cysts to anti-PCW and WGA prior to, but not after, stage II was sufficient to inhibit excystation, and inhibition could be partially reversed by increasing the protease concentration during stage II. A 7- to 10-fold higher proportion of WGA- and anti-PCW-treated cysts than control cysts remained intact after stage II. Our results suggest that these ligands, which bind cyst wall epitopes, inhibit excystation, most likely by interfering with proteolysis of cyst wall glycoproteins during stage II.

Animals↗

Renal cysts: is attenuation artifactually increased on contrast-enhanced CT images?

PURPOSE: To determine if the attenuation values of simple renal cysts are artifactually increased on contrast material-enhanced, clinically acquired spiral computed tomographic (CT) images. MATERIALS AND METHODS: Dual-phase renal spiral CT studies (5-mm collimation; pitch, 1.0) were retrospectively analyzed in 24 consecutive patients who had ultrasonographic (US) documentation of simple renal cysts. Forty-eight cysts were identified. The attenuation values of each cyst were measured on nonenhanced, cortical phase, and nephrographic phase images. The size and the location of each cyst in relation to the renal parenchyma were also recorded. RESULTS: The cysts were 0.6-10.8 cm in diameter (mean, 2.6 cm; SD, 2.0). The mean attenuation change in the cysts from nonenhanced to contrast-enhanced images was statistically significant in a comparison of cortical phase and nephrographic phase images (P: <.01): +1.8 HU (SD, 3.8) for cortical phase and +3. 6 HU (SD, 5.6) for nephrographic phase images. Renal cysts 1.0 cm or smaller showed a higher attenuation increase (mean, +4.0 HU for cortical phase and +11.0 HU for nephrographic phase). None of the renal cysts larger than 1.0 cm demonstrated an increase greater than 10 HU (mean, +1.4 HU for cortical phase and +2.3 HU for nephrographic phase). Intraparenchymal cysts showed higher mean attenuation changes than the exophytic cysts. CONCLUSION: Attenuation values in the renal cysts increased artifactually on contrast-enhanced images, but this pseudoenhancement was not substantial and was less than 10 HU when the cyst was larger than 1. 0 cm in diameter.

Adult↗

High-resolution immunogold localization of Giardia cyst wall antigens using field emission SEM with secondary and backscatter electron imaging.

We describe here the ultrastructural localization of Giardia cyst antigens in the filaments associated with the outer portion of intact cysts and on developing cyst wall filaments in encysting trophozoites. Post-embedding immunogold labeling of thin sections of intact Giardia cysts with polyclonal and monoclonal antibodies specific for cyst wall antigens (major protein bands of approximately 29, 75, 88, and 102 KD on Western blots) showed strong labeling of the filamentous cyst wall, whereas no labeling was seen on the membranous portion. High-resolution field emission scanning electron microscopy (FESEM) of Giardia cysts revealed that the cyst wall-specific polyclonal rabbit antisera and monoclonal mouse antibody produced gold labeling of 20-nm filaments in the cyst wall as detected with secondary electron imaging (SEI) and backscatter electron imaging (BEI) at 10 kV, despite coating of the cells with platinum by ion sputtering. FESEM studies of encysting Giardia trophozoites demonstrated that immunostaining with antibodies to cyst wall antigens produced colloidal gold labeling of developing cyst wall filaments on the cell surface; however, the intervening membrane domains were unlabeled. Substitution of normal serum for cyst wall-specific antibodies, or preabsorption of specific antibodies with Giardia cysts, eliminated immunolabeling of the filaments.

Animals↗

The interaction of Acanthamoeba castellanii cysts with macrophages and neutrophils.

Acanthamoeba castellanii, a free-living amoeba, causes a sight-threatening form of keratitis. Even after extensive therapies, corneal damage can be severe, often requiring corneal transplantation to restore vision. However, A. castellanii cysts are not eliminated from the conjunctiva and stroma of humans and can excyst, resulting in infection of the corneal transplant. The aim of this study was to determine whether elements of the innate immune apparatus, neutrophils and macrophages, were capable of detecting and eliminating A. castellanii cysts and to examine the mechanism by which they kill the cysts. Results show that neither innate immune cell is attracted chemotactically to intact cysts, yet both were attracted to lysed cysts. Both macrophages and neutrophils were capable of killing significant numbers of cysts, yet neutrophils were 3-fold more efficient than macrophages. Activation of macrophages with lipopolysaccharide and interferon-gamma did not increase their cytolytic ability. Conditioned medium isolated from macrophages did not lyse the cysts; however, prevention of phagocytosis by cytochalasin D inhibited 100% of macrophage-mediated killing of the cysts. Conditioned medium from neutrophils did kill significant numbers of the cysts, and this killing was blocked by quercetin, a potent inhibitor of myeloperoxidase (MPO). These results indicate that neither macrophages nor neutrophils are chemoattracted to intact cysts, yet both are capable of killing the cysts. Macrophages killed the cysts by phagocytosis, whereas neutrophils killed cysts through the secretion of MPO.

Acanthamoeba↗

Aspiration and sclerotherapy of symptomatic simple renal cysts: value of two injections of a sclerosing agent.

OBJECTIVE: The purpose of our study was to determine whether two injections of sclerosant were more effective than a single injection in treating symptomatic simple renal cysts. SUBJECTS AND METHODS: We reviewed our results obtained by simple aspiration, by aspiration and a single sclerosant injection, and by aspiration followed by two injections of sclerosing agent over 48 hr. We used 95% alcohol because of its capacity to safely sclerose the epithelial lining of renal cyst walls without damaging the renal parenchyma. After 1-3 min of contact with the alcohol, the epithelial cells lining the cyst become fixed and nonviable; the cyst capsule is penetrated only after 4-12 hr. Longer contact of alcohol with the epithelial cell lining should theoretically result in the nonviability of more epithelial cells and therefore in a lower recurrence rate of cysts after aspiration and sclerotherapy. Our subjects were 46 patients, 30 men and 16 women, treated over a 13-year period. They ranged in age from 38 to 75 years old (mean age, 47 years). Fifty-two cysts were treated. Twenty patients (20 cysts) had simple aspiration only, 15 patients (19 cysts) had a single injection of sclerosant after aspiration, and 11 patients (13 cysts) had two sclerosant injections after aspiration. RESULTS: Of the 20 patients who had simple aspiration only, 16 cysts had recurred after 2 years. In the single-injection group of patients, we found six recurrences after 2 years. No recurrence has occurred in the group of patients who had two sclerosant injections after aspiration. CONCLUSION: Our findings suggest that the results of treating symptomatic simple renal cysts are better in terms of recurrence with two successive injections of 95% alcohol, probably because of the nonviability of more epithelial cells lining the cyst as a result of a longer period of contact with the alcohol. Our sonographic finding of pseudotumors at the sites of previously aspirated giant cysts in two patients is recorded.

Combined Modality Therapy↗

Sclerosis of gross cysts of the breast: a three-year study.

Breast cysts can be separated into two types: Type I cyst with a lining epithelium which shows apocrine metaplasia, and Type II cyst with an epithelium which is markedly attenuated or absent. The risk of subsequent breast cancer among patients with Type I cysts can be up to 4. The standard treatment is fine needle aspiration, but 20% of the cysts recur. Pharmacological treatment has been tried, which reduces size and volume, but has side-effects and a high recurrence rate post-treatment occurs. The objectives of this prospective study were to sclerose the cyst, induce its regression and prevent or reduce recurrence rate, with the administration of a sclerosing solution (Sclerovein) within the cyst post-aspiration. Fifty-seven patients were followed in the study, 37 with Type I cysts and 20 with Type II cysts. At the end of six months all patients with Type II cysts had no detectable cyst. On the other hand, two patients still had a residual Type I cyst. At the end of three years our recurrence rate appears to be less than 2%, with one patient with a possible recurrence. No significant side-effects were observed. The use of Sclerovein is a simple and safe alternative in the treatment of recurring cysts.

Adolescent↗

A comparison of Giardia microti and Spironucleus muris cysts in the vole: an immunocytochemical, light, and electron microscopic study.

We have shown that cysts of the genus Spironucleus share many common morphological features with Giardia cysts including: 2-4 nuclei, flagellar axonemes, a distinct cyst wall, and they even display the same immunostaining as Giardia cysts when labeled with antibodies specific for Giardia cyst wall. A direct comparison of Spironucleus muris and Giardia microti cysts have revealed that cysts of S. muris are significantly smaller than cysts of G. miroti. At the ultrastructural level, the cyst walls are similar in fibrillar appearance, but the width of the S. muris cyst wall is significantly less than that of G. microti. The cysts of S. muris also differ from G. microti in that they contain a striated rootlet fiber, flagellar sheath, and numerous glycogen rosettes. Characteristic features of Giardia include the adhesive disc and median body. Although the cysts of Spironucleus and Giardia are similar in appearance, these unique morphological features can be used to distinguish between the 2 protozoa and should be employed in the detection of Giardia cysts in water samples.

Animals↗

Association of host cell mitochondria with developing Toxoplasma gondii tissue cysts.

Ultrastructure of the interactions of host cell mitochondria with developing Toxoplasma gondii tissue cysts was examined in cultured cells, using transmission electron microscopy of infected cells and rhodamine 123 (a mitochondria-specific vital fluorescent dye) staining of isolated tissue cysts. Structurally mature T gondii tissue cysts were observed as early as 2 days after inoculation of cultured cells. During development of T gondii, host cell mitochondria were observed surrounding the parasitophorous vacuole membrane. Mitochondria became flat and elongated in the vicinity of the parasitophorous vacuole membrane. These mitochondria were also closely associated with T gondii tissue cysts. Incubation of tissue cysts from cultured cells and tissue cysts from mouse brains with rhodamine 123 revealed fluorescence of the tissue cyst wall in living specimens. Incubation of tissue cysts with 10 microM rotenone caused diminished fluorescence of the tissue cyst walls, and 100 microM rotenone caused complete inhibition. Mouse RBC, and tissue cysts fixed in 100% methanol did not fluoresce after exposure to rhodamine. Tissue cysts in 9 isolates of T gondii from mouse brains were examined, using rhodamine 123, and the tissue cysts walls of all isolates fluoresced, indicating no isolate effects. Our results indicate that host cell mitochondria may be closely associated with the tissue cysts of T gondii in cell cultures and in mice.

Animals↗

[The correlation between morphology, electrolytic content and risk factors in breast cysts].

Many studies on the biochemical composition of the liquid aspirated from breast cysts have identified three types of cysts: type I (apocrine) cysts, with a high concentration of K+ and low levels of Na+ and C1-; type II (transudate) cysts, with an electrolytic content similar to that of plasma and high Na+ levels and, finally, type III cysts, with intermediate characteristics. The literature data appear to indicate that the women with type I cysts are at higher risk for breast cancer. The authors report the results of a study carried out on 143 women from October, 1991, through October, 1994, in the Radiology Department of the University of Bologna, to investigate the correlations between some risk factors for breast cancer, the characteristics of cyst fluid and the morphology of the cysts after pneumocystography. Of 186 cysts, 104 (55.9%) were type I, 49 (26.4%) were type II, and 33 (17.7%) were type III. Among the risk factors we considered, only the premenopausal state (41 to 45 years of age) exhibited a statistically significant correlation with the presence of type I cysts. The morphological study of the cysts after pneumocystography showed a surprisingly high correlation between the honeycomb pattern and type I cysts. The constant correlation between cyst morphology and electrolytic content may allow the easy identification of the subgroups of patients eligible for a closer follow-up.

Adult↗

Dentigerous cysts of inflammatory origin. A clinicopathologic study.

The exact histogenesis of dentigerous cysts remains unknown, but most authors favor a developmental origin from the tooth follicle. The aim of this article is to report a series of 15 dentigerous cysts that we believe to be of inflammatory origin. These inflammatory dentigerous cysts occurred in the first and early part of the second decades of life. Males were affected more frequently, and there did not appear to be any racial predilection. All of the cases involved permanent teeth: premolars in nine cases, canines in four cases, and second molars in two cases. The mandible was affected twice as frequently as the maxilla. In 13 cases, nonvital grossly carious or heavily restored deciduous teeth were associated with the cysts. Some of these teeth had been extracted before the cysts were diagnosed. In the remaining two cases, both of which involved the second permanent molars, there were no nonvital deciduous teeth, however both had concomitant proliferative periostitis. All of the cysts were moderately or intensely inflamed and were lined predominantly or entirely by nonkeratinized stratified squamous epithelium that in some cases was markedly hyperplastic and exhibited anastomosing rete ridges mimicking radicular cysts. In the majority of cases, parts of the cysts were lined with a 2 to 3 cell layer thick cuboidal epithelium that we believe was derived from reduced enamel epithelium. Rests of odontogenic epithelium frequently were evident in the cyst walls. We suggest that these cysts arose as a result of periapical inflammation from any source but usually from a nonvital deciduous tooth and spreading to involve the follicles of the unerupted permanent successors. The inflammatory exudate causes separation of the reduced enamel epithelium from the enamel with resultant cyst formation. This study proposes the existence of two types of dentigerous cysts: one developmental and the other inflammatory in nature.

Bicuspid↗

Peritoneal inclusion cysts and their relationship to the ovaries: evaluation with sonography.

PURPOSE: To evaluate with sonography the relationship of the ovary to the peritoneal inclusion cyst. MATERIALS AND METHODS: The medical records, sonograms, and sonographic reports of 15 premenopausal women with surgically proved peritoneal inclusion cysts were examined. Twelve of these cases were examined prospectively. In another prospectively evaluated case, the sonogram was interpreted as revealing a peritoneal inclusion cyst; however, hydrosalpinx was confirmed with surgery. Thirteen women with peritoneal inclusion cysts had undergone pelvic surgery before sonography. Additional examination with computed tomography was performed in three women and with magnetic resonance imaging in another. RESULTS: The ovary was detected on sonograms in 12 of 15 women with peritoneal inclusion cysts. In nine of the 12 women, the ovary was demonstrated to be inside the cyst. Ten of 12 ovaries appeared normal. Cyst diameter ranged from 7.5 to 17.4 cm (mean, 11.6 cm). Sonograms of two cysts demonstrated internal echoes. Septa were seen in 11 of the 15 cysts. Cysts were ovoid in six women and irregular in nine; they were defined by adjacent pelvic structures. CONCLUSION: In premenopausal women with a history of pelvic surgery, the appearance on sonograms of the ovary inside a large, ovoid or irregular, anechoic cyst is characteristic of a peritoneal inclusion cyst.

Adult↗