Hyperamylasaemia & related enzyme factors in renal failure associated with benign & malignant conditions.

Total serum amylase activity, its isoenzymes and pancreatic to salivary amylase (P/S) ratio were studied in 40 normal subjects and 47 patients with renal failure, 32 with benign and 15 with malignant conditions. Amylase to creatinine clearance (Cam/Ccr) was studied in 17 normals and 14 patients with renal failure, 10 benign and 4 with malignant diseases. Total amylase activity, and pancreatic and salivary fractions were found to be increased by about 3.4 times the normal in both benign and malignant conditions producing renal failure though the P/S ratio was within the normal range. However, the increase in the urea and creatinine levels in patients could not be related to the increase in serum total amylase. Besides the Cam/Ccr ratio was elevated in patients with both benign and malignant conditions producing renal insufficiency whereas the Cam and Ccr were individually found to be decreased. Why patients with chronic renal failure in both conditions without clinical evidence of pancreatitis should have elevated Cam/Ccr ratio is not clear.

Reconstruction following limb-sparing en bloc resection of the shoulder girdle--Tikhoff-Linberg procedure.

The Tikhoff-Linberg procedure is a limb salvage technique that permits a resection of the shoulder girdle with preservation of neuromuscular function of the upper extremity. Though shoulder movements are lost, useful wrist and hand functions are retained. Reconstruction was carried out in four patients to provide stability and thus facilitating function. To date, there is no local recurrence but one patient with osteosarcoma succumbed from lung metastasis within one year of surgery.