Surgical treatment of recurrent borderline serous ovarian tumor

Recurrences of serous borderline tumors (PCOS) are quite rare and, as a result, have not been sufficiently studied and presented in the literature. Despite the obvious relative «benignity» of borderline tumors, the course and prognosis of recurrent PCOS may be unfavorable. The article describes the reasons influencing the development of recurrence of PCOS, presents various options for recurrence of PCOS, methods of their treatment. This publication highlights the factors influencing the effectiveness of treatment, survival and prognosis of the disease. The article is illustrated with a rare clinical observation of multiple recurrence of PCOS with a favorable outcome.

A Case of Multiple Recurrences of Trigeminal Neuralgia: Attributed to Central Sensitization?

Background Although many hypotheses about the pathogenesis of trigeminal neuralgia have been developed, there is little discussion about the multiple recurrences of trigeminal neuralgia. Case presentation Here we report a patient with refractory multiple recurrent trigeminal neuralgia, in which we accordingly found that an increase in facial pain trigger points and a rapid movement of the upper limb extremity could trigger an onset of trigeminal neuralgia. We offer hypothesis on the multiple recurrences of trigeminal neuralgia by explaining the cause of multiple trigger points in this patient. Conclusions Given that central sensitization is involved in a number of mechanisms of pain development and is associated with some of the symptoms of trigeminal neuralgia. We hypothesized that central sensitization may have been involved in the disease development of this case of refractory trigeminal neuralgia, which led to the development of trigger point generalization and multiple recurrence after surgical treatments.

REPEATED CRANIOSPINAL IRRADIATION IN PATIENTS WITH RECURRENCE OF MEDULLOBLASTOMA

Medulloblastoma is the most common malignant CNS tumor in children, which occurs in the posterior cranial fossa and has a high risk of metastasis along the cerebrospinal fluid. A modern approach to treatment for patients older than 3 years includes the removal of the tumor with mandatory postoperative craniospinal irradiation with “boost” on the postoperative bed, followed by chemotherapy with platinum-containing drugs, which allows reaching a level of 80% for 5-year progression-free survival. In case of recurrence of the disease, the prognosis remains unfavorable. With multiple recurrence of supra-sub tentorial localization, it may be necessary to conduct repeated craniospinal irradiation. In this work, we considered the possibility of repeated craniospinal irradiation, which in some cases, subject to the use of modern radiation therapy techniques with a high degree of conformity, can be an effective form of treatment for multiple relapses of meduloblastoma with an acceptable level of toxicity.

Multiple contralateral recurrence of bilateral chronic subdural hematoma: case report and literature review

We report a case of bilateral chronic subdural hematoma (CSDH) operated with a single burr-hole on the more symptomatic side (left) followed by a symptomatic expansion of the contralateral (right) hematoma 7 days after the surgery treated again with a burr-hole on the other side. A week later the patient presented again a bilateral CSDH that was re-operated on both side with a good outcome at 6 months follow-up. Relevant literature was reviewed, and we believe that the multiple recurrence of these hematomas in the opposite hemisphere resulted from the rapid drainage of the hematoma, which caused the rupture of weak bridging veins during drainage. Slow decompression is recommended to avoid rapid intracranial changes during drainage of a subdural hematoma.

Optimal lower bounds for multiple recurrence

Let $(X,{\mathcal{B}},\unicode[STIX]{x1D707},T)$ be an ergodic measure-preserving system, let $A\in {\mathcal{B}}$ and let $\unicode[STIX]{x1D716}>0$. We study the largeness of sets of the form $$\begin{eqnarray}S=\{n\in \mathbb{N}:\unicode[STIX]{x1D707}(A\cap T^{-f_{1}(n)}A\cap T^{-f_{2}(n)}A\cap \cdots \cap T^{-f_{k}(n)}A)>\unicode[STIX]{x1D707}(A)^{k+1}-\unicode[STIX]{x1D716}\}\end{eqnarray}$$ for various families $\{f_{1},\ldots ,f_{k}\}$ of sequences $f_{i}:\mathbb{N}\rightarrow \mathbb{N}$. For $k\leq 3$ and $f_{i}(n)=if(n)$, we show that $S$ has positive density if $f(n)=q(p_{n})$, where $q\in \mathbb{Z}[x]$ satisfies $q(1)$ or $q(-1)=0$ and $p_{n}$ denotes the $n$th prime; or when $f$ is a certain Hardy field sequence. If $T^{q}$ is ergodic for some $q\in \mathbb{N}$, then, for all $r\in \mathbb{Z}$, $S$ is syndetic if $f(n)=qn+r$. For $f_{i}(n)=a_{i}n$, where $a_{i}$ are distinct integers, we show that $S$ can be empty for $k\geq 4$, and, for $k=3$, we found an interesting relation between the largeness of $S$ and the abundance of solutions to certain linear equations in sparse sets of integers. We also provide some partial results when the $f_{i}$ are distinct polynomials.