Massive chondroid hamartoma of the lung clinically masquerading as bronchogenic carcinoma.

Chondroid hamartomas of the lung are uncommon lesions which are generally small sized and asymptomatic. Herein we describe a case of a large-sized pulmonary chondroid hamartoma which clinically mimicked bronchogenic carcinoma. A large hilar growth was detected in the left lung on radiological studies. Left upper lobectomy was done. The growth was well defined with a lobulated bluish cut surface. Histopathology disclosed lobules of mature cartilage rimmed by long slit-like epithelial channels admixed with mature adipose tissue.

Transabdominal gastroesophageal devascularization without esophageal transection for emergency treatment of variceal hemorrhage.

BACKGROUND: The Suguira procedure is an effective non-shunting operation to treat life-threatening hemorrhage from esophageal or gastric varices. The goal of esophageal transection is interruption of submucosal varices, but this leads to high morbidity and mortality rates from esophageal fistulization. AIM: To evaluate a variant of this procedure in which the esophagus is not transected, but the varices are underrun from outside the lumen. METHODS: During the last four and a half years, we performed this modified gastroesophageal devascularization with or without splenectomy in 18 patients as emergency treatment of bleeding esophageal and gastric varices. The data were analyzed retrospectively. RESULTS: Bleeding was controlled in all patients. Three patients with Child's class C disease undergoing emergency surgery died during the early postoperative period. Rebleeding rate was 17% (3 patients). The overall survival was 72.2% (13 of 18). No patient had encephalopathy over a mean follow up of 30 months. CONCLUSION: Gastroesophageal devascularization with variceal under-running without esophageal transection is an effective and safe alternative to shunt surgery in the emergency situation.

Purification and characterization of a type II phosphatidylinositol 4-kinase from rat spleen and comparison with a PtdIns 4-kinase from lymphocytes.

A PtdIns 4-kinase from rat spleen particulate fraction was purified to homogeneity and its molecular properties were compared with a PtdIns 4-kinase from splenic lymphocytes. The enzyme activity was solubilized from spleen particulate fraction with Triton X-100 and chromatographed sequentially on phosphocellulose, DEAE-sephacel, heparin acrylamide and hydroxyapatite columns. The purified enzyme preparation showed a 55 kDa band on SDS-PAGE with silver staining. Renaturation of the enzyme activity from SDS-PAGE showed that it comigrated with the 55 kDa protein. Characterization of the enzyme showed that it was a type II PtdIns 4-kinase. Polyclonal antibodies raised against PtdIns 4-kinase inhibited the enzyme activity in in vitro assays. Analysis of adult rat tissue particulate fractions on immunoblots showed restricted immunoreactivity among PtdIns 4-kinases. However, the immunoreactivity is conserved in lymphoid tissues from mouse to human, suggesting that lymphoid tissue has a distinct PtdIns 4-kinase. Activation of rat splenocytes with Con A showed two fold increase in PtdIns 4-kinase activity. Comparison of PtdIns 4-kinases from spleen and splenic lymphocytes showed identical chromatographic behaviour, molecular mass, immunoreactivity, K(m) values for PtdIns and inhibition by adenosine.

Gastric tuberculosis presenting with hematemesis.

The stomach is rarely involved by tuberculosis. We report a patient with gastric tuberculosis who presented with exsanguinating hematemesis.

Cystadenoma with mesenchymal stroma mistaken for hepatic hydatid cyst.

Hepatobiliary cystadenoma with mesenchymal stroma occurs uniquely in women, can be associated with other hepatobiliary anomalies, and has the potential for malignant transformation. We describe a case of hepatobiliary cystadenoma with mesenchymal stroma which was initially treated as hepatic hydatid cyst.

Cholecystectomy under regional anesthesia in a patient with total Kartagener's syndrome.

A 41-year-old woman with complete Kartagener's syndrome developed cholecystitis in a left-sided gall bladder. Bilateral diffuse bronchiectasis ruled her unfit for general anesthesia; chronic cough, copious expectoration and dyspnea prevented her from lying down supine for more than a few minutes. Successful cholecystectomy was performed in a semi-reclined position using thoracic epidural anesthesia, the anatomy being the mirror image of that of a gall bladder in normal position. The gall bladder was full of stones and operative cholangiogram revealed a normal but transposed biliary system.

Giant mesenteric hemangioma.

Hemangioma is a rare cause of mesenteric cysts. It usually occurs in infancy and childhood. We report an adult with a mesenteric hemangioma which presented as a mesenteric cyst.

A comparative evaluation of metoprolol and methyldopa in the management of pregnancy induced hypertension.

Thirty patients matched for age, parity, socioeconomic status and severity of pregnancy induced hypertension (PIH) were randomly allocated to treatment with metoprolol or methyldopa. The average fall in diastolic blood pressure was significant in the group treated with metoprolol as compared with the methyldopa group (p less than 0.01). There were 3 perinatal deaths in the methyldopa group and 1 in the metoprolol group; the mean birth weight of the babies was higher in cases treated with metoprolol. The results suggest metoprolol to be more efficacious with regard to control of hypertension and fetal outcome in cases of pregnancy induced hypertension.