Sciatic schwannoma of the thigh detected on bone scan: a case report

Sciatic nerve schwannomas are rare and may present diagnostic difficulties. This case was incidentally detected on a three-phase bone scan to rule out reflex sympathetic dystrophy (RSD) of the right foot.     

Hepatobiliary scintigraphy. An effective tool in the management of bile leak following laparoscopic cholecystectomy

Bile leaks and bile duct injury has been the major postoperative complications described after laparoscopic cholecystectomy. In this study, we evaluated the role of hepatobiliary scintigraphy (HBS) in patients who underwent laparoscopic cholecystectomy, and there was a clinical suspicion of bile leak in postoperative period. METHOD: Twenty-five patients (M/F=11:14, mean age 39+/-8 years; range 24-58 years) with suspected bile leak postlaparoscopic cholecystectomy underwent sequential HBS. RESULTS: Thirteen patients had normal hepatobiliary scintigraphic studies. Five patients had small bile leak in gall bladder fossa with primary route of bile flow into the gut. All these 18 patients improved on conservative management alone. Significant bile leak from the cystic stump region was demonstrated in four patients. All of them were subjected to endoscopic cholangiography (ERCP), which confirmed the site of leak. All patients had stenting and sphincterotomy. One patient showed bile leak and obstruction at the lower end of common bile duct, he improved spontaneously. Another patient showed poor hepatocytes function and no excretion of radiotracer and underwent ERCP followed by hepaticojejunostomy for common hepatic duct ligation. One patient had frank bile leak in the right paracolic gutter and had to undergo hepaticojejunostomy. CONCLUSIONS: HBS is a valuable noninvasive method of investigating possible bile leaks or other biliary disruptions in postlaparoscopic cholecystectomy patients. Negative study for significant bile leak can assure the surgeon to manage the patient conservatively. However, it cannot be relied on absolutely when determining the need for reoperation for a significant bile leak in early postoperative period.     

Laparoscopic excision of uterine adenomatoid tumour: two cases and literature review

Introduction  

Adenomatoid tumours are rare, benign neoplasms of the genital tract, occurring most commonly during the reproductive years. In females, the uterus is the most common site. These tumours can be associated with fibroids and tend to mimic them clinically and radiologically, making pre-operative diagnosis very difficult. We report two cases of uterine adenomatoid tumours that were excised laparoscopically. Intraoperatively, there was no clear line of demarcation between the uterus and the tumours and laparoscopic manipulation of the tumours was difficult due to their friable nature. Simple excision with uterine conservation is the treatment of choice, especially in women who desire future fertility, as degeneration, recurrence, malignant transformation or metastasis has not been reported.     

Delayed cytotoxic effects of methyl jasmonate and cis-jasmone induced apoptosis in prostate cancer cells

Advanced prostate cancer cells are typically hormone independent, resistant to apoptosis and do not respond to chemotherapeutic agents. The ability of methyl jasmonate (MJ) and cis-jasmone (CJ) to inhibit growth in hormone independent prostate cancer cell lines, PC-3 and DU-145, was evaluated. CJ and MJ inhibited cell growth, induced cell cycle arrest and apoptosis. Detailed studies with the PC-3 cell line revealed that 2 mM CJ or MJ treatment resulted in caspase 3 activation and Tumor Necrosis Factor Receptor 1 (TNFR1) activation, all hallmarks of apoptosis. These phytochemicals could be useful in the management of advanced prostate cancer.     

A rare case of Moebius sequence

We report a case of an 18-year-old male who presented with watering and inability to close the left eye completely since 6 months and inability to move both eyes outward and to close the mouth since childhood. Ocular, facial, and systemic examination revealed that the patient had bilateral complete lateral rectus and bilateral incomplete medial rectus palsy, left-sided facial nerve paralysis, thickening of lower lip and inability to close the mouth, along with other common musculoskeletal abnormalities. This is a typical presentation of Moebius syndrome which is a very rare congenital neurological disorder characterized by bilateral facial and abducens nerve paralysis. This patient had bilateral incomplete medial rectus palsy which is suggestive of the presence of horizontal gaze palsy or occulomotor nerve involvement as a component of Moebius sequence.     

Effect of yoga on exercise tolerance in normal healthy volunteers

Twelve normal healthy volunteers (6 males and 6 females) undergoing yoga training for 90 days were studied for the effect of yoga on exercise tolerance. Their ages ranged from 18 to 28 years. The volunteers were taught only Pranayama for the first 20 days and later on yogic asanas were added. Sub-maximal exercise tolerance test was done on a motorized treadmill by using Balke's modified protocol, initially, after 20 days (Phase-I) and after 90 days of yoga training (Phase-II). Pyruvate and lactate in venous blood and blood gases in capillary blood were estimated immediately before and after the exercise. Minute ventilation and oxygen consumption were estimated before and during the test. Post exercise blood lactate was elevated significantly during initial and Phase-I, but not in Phase-II. There was significant reduction of minute ventilation and oxygen consumption only in males in Phase-I and II at the time when the volunteers reached their 80% of the predicted heart rate. Female volunteers were able to go to higher loads of exercise in Phase-I and II.