Congenital malformations of the lung (CML) are rare with similar embryological and clinical spectra and could result in mortality if left untreated. Bronchogenic cysts are formed during the budding of the tracheal diverticula and ventral foregut in the embryological period. In this paper we want to present a case of bronchogenic cyst with continuous intrauterine cyst aspiration follow-up. After the baby birth was operated and the postoperative period was uneventful. The pathological examination revealed a bronchogenic cyst.

Preoperative and postoperative psychological factors, postoperative pain, analgesic consumption, treatment satisfaction were compared in patients treated with intravenous patient-controlled analgesia (IV-PCA) or intramuscular analgesics after laparoscopic ovarian cystectomy. Thirty-one women with laparoscopically operated benign ovarian cysts were recruited in Zonguldak Karaelmas University Faculty of Medicine, Department of Obstetrics and Gynecology. Postoperatively sixteen women received morphine delivered by IV-PCA pump system and 15 women were prescribed another opioid (meperidine) intramuscularly. Two weeks before and one day after the surgery, Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) were self-administered. Afterwards, the operation visual analog scale (VAS) and satisfaction with pain control scale were recorded. Preoperative BDI and BAI scores of both groups were comparable. Postoperative BDI (7.9 ± 7.2 versus 13.8 ± 6.9, P = 0.03) and BAI (11.4 ± 9.1 versus 17.4 ± 6.2, P = 0.045) scores were significantly lower in the IV-PCA group. Morphine usage with PCA resulted in significantly higher pain scores than equivalent doses of meperidine administered intramuscularly (2.94 ± 1.0 versus 1.67 ± 0.7, P = 0.001). Although higher pain scores were obtained from IV-PCA group, self-reported satisfaction rates were higher in this group (8.3 ± 1.1 versus 7.4 ± 1.1, P = 0.04). Involvement of patients in their pain management might increase the awareness of pain but their satisfaction about the control of postoperative pain was significantly improved.

Objective: Ultrasonographic findings, CA-125 levels, risk of malignity index, resistance index and pathologic results of pelvic masses were examined to determine their efficacy in malignant and benign differentiation.Materials and Methods: One hundred and fourteen patients with a diagnosis of pelvic mass between 2002 and 2004 were evaluated. The menopausal status, ultrasonographic appearance (mass lesion greater than 4 cm, solid, cystic, multiloculated, uniloculated, septated, complicated and existence of papillary structures), serum CA-125 levels (cut-of 3 35 U/ml), Doppler sonographic resistance index (cut-off <= 0.42) and RMI (risk of malignancy index, cut-off 3 200) were recorded. Ovarian carcinomas and borderline tumours were classified in the malignant group in the evaluation of the efficacy of these paramaters in malignant/benign differentiation.Results: Mean age of the patients was 39 years (range 12-75 years). Sixteen patients were postmenopausal. Ninety-one (79%) of 114 patients were operated. Fifty-four patients (59%) were laparoscopically operated (none of them was malignant), whereas explorative laparotomy was performed for 37 (41%) patients (13 of them were malignant). Eighteen (15.8%) of the remaining patients were followed-up by ultrasonography and serum CA-125 determinations, and ultrasonographic cyst aspiration was performed in 5 patients (4.4%). Postoperative histopathology of 13 patients showed malignant characteristics (1 clear cell carcinoma, 1 undifferentiated carcinoma, 1 adenocarcinoma, 1 Brenner tumor, 1 carcinoma metastasis, and 4 borderline tumors) and 78 patients showed benign characteristics (13 endometriomas, 3 mature cystic teratomas, 3 ovarian torsions, 2 tuboovarian abcesses, 1 degenerated myoma, 56 benign cysts). The sensitivity of RMI, CA-125 and RI in the differentiation of malignant/benign tumors ranged between 38% and 69%, the specificity between 71% and 99%, the positive predictive value between 23% and 83% and the negative predictive value between 92% and 94%.Discussion: In the differentiation of malignant/benign lesions Doppler ultrasonography was found to be more effective than only ultrasonography and CA-125 or RMI. The low sensitivity of RMI was attributed to the insufficient number of cases in our study. The combination of these 3 parameters will increase the effectivity of clinical judgement of pelvic masses.