Nodular regenerative hyperplasia of liver.

Nodular regenerative hyperplasia of the liver (NRHL) is a very rare cause of portal hypertension and liver failure. The condition is characterized by diffuse micronodular transformation of hepatic parenchyma without fibrous septa between the nodules. We present our experience with a 32-year-old woman who presented with recurrent episodes of upper gastrointestinal bleeding associated with massive splenomegaly who was subsequently found to have NRHL. This article considers the salient aspects of this rare condition, how it affects the patients and the options available in its management. A plea is made for the need for liver biopsy for all patients with portal hypertension especially those being considered for surgery.

Spontaneous cholecysto-cutaneous fistula mimicking postoperative scar sinus.

Although biliary fistulae are common, spontaneous biliary fistulae are very rare. Even more rare are spontaneous cholecysto-cutaneous fistulae. A case of spontaneous cholecysto-cutaneous fistula presenting through an abdominal scar mimicking a postoperative scar sinus is presented, the literature is reviewed and the reasons for occurrence of such a fistula are discussed.

Value of serum CEA and AFP in the diagnosis and prognosis of carcinoma gallbladder.

BACKGROUND/OBJECTIVE: The poor prognosis of carcinoma of the gallbladder (CAGB) is attributable to delayed presentation in the absence of specific clinical findings in the early stages. To ascertain whether the commonly available serum tumour markers (carcino-embryonic antigen-CEA and alpha foeto protein-AFP) could be used for distinguishing CAGB from other biliary disorders and in assessing the prognosis of patients with CAGB, serum levels of these markers in patients with CAGB and those with cholelithiasis were studied. METHODS: Estimation of serum CEA in 28 patients with CAGB and 30 patients with cholelithiasis and AFP in some of these cases was done by enzyme immunoassay. RESULTS: The mean values of CEA and AFP were 15.1 ng/ml and 166.5 ng/ml respectively for the CAGB group and 12.6 ng/ml and 166.5 ng/ml respectively for the cholelithiasis group. There was no statistical difference between the groups (p > 0.05). These markers did not show any statistically significant correlation with the stage of disease or length of survival in the patients with CAGB. CONCLUSION: Serum levels of CEA and AFP do not have any diagnostic or prognostic significance in the management of CAGB.

Sub chronic toxicity studies of lactulose in rats.

Lactulose has profound health benefits by way of increasing bifidobacterial flora in the intestine of infants thereby protecting them against enteric infection, constipation and systemic encephalopathy. In the present study to assess the sub chronic toxicity of lactulose syrup, the rats were fed on a basal feed supplemented with lactulose syrup at 0.5, 1.0, 2.0 and 5.0% for a period of 21 weeks. Monitoring of food consumption, gain in body weight and physical observations did not reveal any treatment-related toxicity in any of the group of rats. Terminal autopsy also did not reveal any signs of toxicity. Further, no significant alterations in relative organ weight, serum biochemistry and urinalysis were observed up to 1% lactulose supplementation level. The results suggest that supplementation of lactulose in the diet does not produce any toxicity at the doses tested.

Assessment of protein quality of infant milk food formula supplemented with lactulose.

To examine the protein quality of infant food formula supplemented with lactulose (bifidogenic factor), groups of 21 day male weanling rats were fed diet containing lactulose at 0.5% for 4 weeks. The gain in body weight of rats fed lactulose supplemented diet were similar to that of rats fed lactulose free and skim milk powder fed diet as controls. No difference in overall acceptability pattern was also observed in studies conducted with human subjects for organoleptic evaluation. The results suggest that supplementation of lactulose in infant food formula does not affect either the protein quality as indicated by protein efficiency ratio in rats as compared to control formulae or overall acceptability by human subjects.