The feasibility and advantages of billroth-I reconstruction in distal gastric cancers following resection.

Background: Gastric carcinomas are common malignancies in southern India and distal stomach remains the commonest site in low socio economic groups. Surgery still remains an important modality of treatment to achieve local control and also relieve obstructive symptoms. In this study we investigated the feasibility of performing a gastrectomy and billroth-1 type of anastomosis in a rural cancer center setting, with parameters like adequacy of margins, ease of anastomosis and its functional results were analysed Materials and Methods: Eight patients presenting to a rurally based cancer center underwent a distal gastrectomy and billroth-1 type of anastomosis for continuity restoration Results: All the patients had adequate proximal and distal marg. The surgical time varied between-hrs. The anastomosis was constructed without any tension on bowel ends in all patients. The average time to start oral feeds varied between- None of the patients showed symptoms of bile reflux nor dumping. The average hospital stay varied between- Conclusions: Billroth-1 anastomosis is a physiologically more natural way of restoring continuity following a gastrectomy and it is a procedure which would be technically more simpler and decrease per and post operative complications and allow speedier post operative recovery following surgery on distal gastric cancers.

Direct estimation of absolute glomerular filtration rate from dynamic renal scintigraphy using gamma camera.

Absolute glomerular filtration rate (GFR), which can serve as a useful parameter of renal function, is not applied in clinical practice due to various technical constraints. We estimated GFR in 20 subjects (10 controls, 10 patients) by two different techniques simultaneously with a single intravenous injection of TC99m DTPA. The GFR results obtained by a conventional plasma clearance technique were compared with that of a simpler, scintigraphic technique which does not require any blood or urine sample, and these were found to correlate significantly (r = 0.75, p less than 0.001). The linear relationship between the fraction of the dose injected taken up by the kidneys during the parenchymal phase of the dynamic imaging study and the overall plasma clearance was also found to be significant (r = 0.932, p less than 0.001) our study shows that reliable estimation of absolute GFR is possible from the routine dynamic renal scinti-scanning procedure using the gamma camera - computer system, and hence might prove applicable in clinical practice.

Significance of transplant perfusion index in the diagnosis of acute rejection in live related renal allograft recipients.

The study was undertaken to assess the usefulness of transplant perfusion index (TPI) in the differential diagnosis of renal allograft dysfunction with special reference to acute rejection. It was observed that the TPI has a sensitivity of 100 per cent and specificity of 98.1 per cent in the diagnosis of acute rejection. It was also observed that the serial values of TPI provided valuable clues and guide in the management of transplant dysfunction and helped in the immediate and long term follow-up of patients with renal allografts.