Radiological Spectrum of von Hippel-Lindau disease – A Case Report.

Von Hippel-Lindau (VHL) disease is an autosomal dominant genetic disorder resulting from inactivation of tumor suppression genes located at the chromosome 3p 25.5. VHL comprises of many benign and malignant tumors along affecting various systems of the body with variable manifestations. A wide variation in radiological spectrum is seen as per the involvement of particular system or organ. The imaging modalities like Ultrasonogrphy (USG), Computerized Tomography (CT) and Magnetic Resonance Imaging (MRI) play an important role in diagnosing and treating the affected individuals. These also play equally important role in the screening and follow up of such cases. We present a case of an 18 year old female, who was diagnosed with VHL at the age of 10 years, where imaging modalities helped her management and follow up.

Percutaneous transluminal coronary angioplasty in patients over the age of 65 years.

PTCA performed in 672 patients (646 patients < 65 years and 26 patients > or = 65 years) from March 1986 to September 1990 consisting of 619 males and 53 females are being discussed for the purpose of comparison of the results between patients in the < 65 years and > or = 65 years age groups. It was found that diabetes mellitus (50 vs 24.4.%, P < 0.01), obesity (46.1 vs 26%, P < 0.05), and hyperlipidaemia (66 vs 37.1%, p < 0.01) had a higher incidence among the elderly. Of the total 1047 lesions observed, 662 lesions in the < 65 years age group and 37 lesions in the > or = 65 years age group were dilated by PTCA (1.02 lesions/patient and 1.4 lesions/patient respectively). The lesion morphology showed higher degree of irregular contour in the < 65 years age group (23.6 vs 8.1%, p < 0.05), though the number of lesions with PTCA attempted in all age groups were almost similar. Major complications included one MI (3.8%) and two deaths (7.6%) in the > or = 65 years age group. During followup (mean duration: 8.2 months > or = 65 years and 13.5 months < 65 years age group) significantly higher percentage of patients < 65 years were asymptomatic when compared to elderly (50.2 vs 15.4% p < 0.05). Angina status was same more often in the elderly (23.1 vs 2.8% p < 0.01). The cumulative rate for repeat PTCA was similar for elderly and younger patients.

An analysis of initial results of percutaneous transluminal coronary angioplasty for totally occluded coronary arteries.

A retrospective analysis of 680 Percutaneous Transluminal Coronary Angioplasties (PTCA) performed from April 1986 to October 1990 revealed that 81 patients had PTCA performed on 86 totally occluded coronary arteries (1.06 lesions/patient). Four of the 86 were acute occlusions. Angiographic success in the group as a whole was achieved in 57 (66%). Multivariate analysis identified only the target vessel as a statistically significant factor predictive of angiographic success from among a host of clinical and angiographic morphologic variables. Left anterior descending artery lesions were identified with the highest success. In addition the duration of occlusion was significantly lower for the successfully versus the unsuccessfully dilated chronic occlusions.