Single stage bilateral common carotid artery stenting in a patient of Takayasu arteritis.

Carotid angioplasty and stenting is increasingly becoming a safe and efficacious modality of treatment in the management of carotid artery stenosis. Although atherosclerosis is the predominant cause of this morbid disease, Takayasu arteritis assumes special importance in south east Asia. The diffuse nature of this disease with associated inflammation and scarring of the vessel make revascularisation difficult. We report a case of Takayasu arteritis in which a successful bilateral common carotid stenting was done in a single sitting.

Correlation of computed tomography with second-look laparotomy in ovarian carcinoma.

BACKGROUND: Cancer of the ovary is the second commonest gynaecological malignancy after cancer of the cervix. Surgery followed by cisplatin-based chemotherapy is the standard treatment approach. In patients with persistent disease, second-look laparotomy offers an opportunity to debulk the tumour. This is usually followed by an alternative method of chemotherapy. We compared the findings at surgery (second-look laparotomy) with the preoperative computed axial tomography scan assessments. METHODS: Thirty-seven patients with epithelial ovarian carcinoma were assessed with computed axial tomography scans of the abdomen and pelvis prior to undergoing a second-look laparotomy. RESULTS: Tumour was correctly identified on computed axial tomography scan in 11 patients who had macroscopic evidence of cancer at laparotomy. In 6 patients, both computed axial tomography scan and surgery showed no disease recurrence. In the remaining 20 patients, there was a mismatch between the computed axial tomography scan and the surgical findings. In 16 of the 20 (80%) patients, computed axial tomography scans were negative but tumour was present. When the tumour was less than 1.5 cm in diameter it was missed in 8, and when equal to or greater than 1.5 cm, it was missed in 5 patients. These small tumour deposits were located in the retroperitoneal area, under the dome of the diaphragm, omentum or peritoneum, liver surface, and in the pouch of Douglas. In one case each, infiltration of the urinary bladder, sigmoid colon and rectum was also not detected. In 4 patients, computed axial tomography scans showed tumour when none was present. CONCLUSION: Computed axial tomography scan cannot detect small nodules often present in ovarian cancer, and thus even if a computed axial tomography scan is normal it should not exclude a second-look laparotomy.

Role of radiotherapy in cavernous hemangioma liver.

OBJECTIVE: To study the effectiveness of local radiotherapy for controlling cavernous hemangioma of liver. METHODS: This is a retrospective analysis of four diagnosed cases of cavernous hemangiomas of the liver treated with radiotherapy. Hepatic irradiation was given in a tumor dose of 30 Gy in 15 fractions over 3 weeks period. RESULTS: Three of the four cases showed a complete clinical regression of the liver lesions over a period of 8-14 months, but in one case there was only 75% regression of the mass at 12 months of follow up. CONCLUSIONS: Localized radiotherapy is effective in the treatment of giant cavernous hemangiomas of the liver and a tumor dose of 30 Gy is optimum with minimal morbidity.

Kinetic characteristics of soluble and brush border alkaline phosphatase and sucrase activities in developing rat intestine: effect of hormones.

Suckling rat intestine contains 35 and 65% of the cytosolic and membrane-bound alkaline phosphatase (AP) activities. The corresponding values for sucrase were 20 and 80% respectively. The amount of the soluble enzymes was reduced to 7-11% in adult rat intestine. Administration of cortisone, thyroxine or insulin to suckling animals induced adult type distribution of the enzymes. There were apparent differences in kinetic characteristics of soluble and brush border enzymes, but the kinetic properties of the normally developed and hormone-induced AP and sucrase were essentially similar. This suggested identical nature of these enzymes under these conditions. A biphasic Arrhenius plot was obtained for AP in weaned and hormone injected pups with a break point around 18 degrees C, while the soluble enzyme yielded a monophasic curve (Ea = 8-11 kcal/mole). Arrhenius plot for sucrase was monophasic in the suckling, hormone-injected and adult rat intestine (Ea = 8.3-15.1 kcal/mole). Membrane-bound enzymes were generally labile, while soluble enzyme activities were stable to heat treatment (sucrase at 50 degrees C and AP at 60 degrees C) in various experimental groups.