Primary malignant melanoma of right colon.

We report a 62-year-old lady who presented with abdominal lump and neurological deficit. Investigations showed ascending colon mass, subcutaneous nodule and right parietal lobe lesion. Histology and immunohistochemistry were suggestive of malignant melanoma. The search for primary site was negative.     

Bi-directional Glenn shunt in presence of anomalous pulmonary venous connection; modified Bi-directional Glenn shunt

Bi-directional Glenn shunt is a common procedure in a patient with functional single ventricle on the way to Fontan completion. The procedure becomes challenging when there is an associated anomalous pulmonary venous connection to the superior vena cava. We describe an infant with an anomalous pulmonary venous connection high up in the superior venacava, which was managed surgically by performing an anastomosis between the superior venacava and pulmonary artery leaving the anomalous venous drainage intact.     

Adjuvant high dose rate brachytherapy (Ir-192) in the management of keloids which have recurred after surgical excision and external radiation.

We describe our experience with adjuvant high dose rate brachytherapy (Ir-192) (HDRB) in patients, who failed surgery and post-operative external radiation therapy. The salvage treatment consisted of excision of the keloid and wound closure followed by HDRB (15 Gy in three fractions given on three consecutive business days beginning the day of surgery). At the time of last follow up, 88% (15/17) of the keloids were without any evidence of recurrence.     

“Extended length” endoscopic harvest of the great saphenous vein for coronary artery bypass grafting

Introduction The endoscopically harvested vein from thigh usually falls short by half to one length in patients requiring multiple conduits. Increased risk of complications precludes routine endoscopic vein harvest from the leg and an extra incision for open technique is often required thereby nullifying the sole purpose of the former. We employed the endoscope to harvest this extra length of vein from the upper half of the leg with little or no extra risk. Methods From January 2006 to September 2006 we endoscopically harvested the vein in thigh as well as the leg using the same entry point incision over the medial epicondyle in 40 cases. The only exclusion criterion for the study was a superficial location and subcutaneous visibility of the vein in the leg. We made 3 incisions in each patient of average size 2.5 cm. Results Five patients required conversion to the open technique. The average harvest time was 59 minutes. Average length of the conduit was 48 cms. Complications included 1 minor wound infection, 1 case of superificial wound dehiscence, 1 haematoma requiring aspiration and minor erythema at the incision site in 2 patients. Most common complication observed was ecchymosis in 6 patients (5 high; 3 leg). None of the patient developed lymphoedema and none required re-hospitalization for vein harvest related wound complications. Conclusion “Extended endoscopic vein harvest” and avoidance of the open incision was possible in most patients with no additional risk and that the procedure could be routinely employed in patients requiring multiple conduits.     

A robust point-matching algorithm for autoradiograph alignment

We present a novel method for the geometric alignment of autoradiographs of the brain. The method is based on finding the spatial mapping and the one-to-one correspondences (or homologies) between point features extracted from the images and rejecting non-homologies as outliers. In this way, we attempt to account for the local, natural and artifactual differences between the autoradiograph slices. We have used the resulting automated algorithm on a set of left prefrontal cortex autoradiograph slices, specifically demonstrated its ability to perform point outlier rejection, validated its robustness property using synthetically generated spatial mappings and provided an anecdotal visual comparison with the well-known iterated closest-point (ICP) algorithm. Visualization of a stack of aligned left prefrontal cortex autoradiograph slices is also provided.     

Abnormal styloid process in a human skull

Summary In a survey of 232 Indian human skulls, unusually long and stout, bilateral styloid processes were found in one of them. The length, thickness, the inter-styloid distance and the relations of the styloid processes to other associated structures at the base of the skull are discussed, highlighting the possible importance in clinical and surgical conditions.

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Processus styloïde anormal dans un croan humain

Résumé Lors de l'examen d'une série de 232 crânes provenant d'Inde, les auteurs ont trouvé un cas de processus styloïde anormalement long et résistant. Le diamètre, la distance entre ces deux processus styloïdes, ainsi que leurs relations avec les autres structures de la base du crâne sont étudiés en soulignant l'intêret potentiel de cette variation en clinique et en pratique chirurgicale.

     

Cardiotoxicity and hypertension in rats after oral lead exposure

The rats were exposed to lead (0.25, 0.5 and 1.0 per cent lead acetate through drinking water) for 90 days to study its effect on some physiological and morphological parameters of the cardiovascular system. Blood lead levels increased in a dose dependent manner but heart tissue showed rise at only two higher doses in exposed animals. The two higher doses of lead resulted in an increased arterial blood pressure and calcium influx in atrial trabeculae and papillary muscles. No marked pathological or histochemical changes were observed in heart tissue excepting congestion and slightly reduced activity of succinic dehydrogenase in the highest dosed group. It was concluded that lead exposure through drinking water may produce increased arterial blood pressure and minor changes in the myocardium. Whether these changes are mediated through the effect of lead on the calcium transport needs further investigation.     

Metal Hypersensitivity : Can It Mimic Infection?

Metal hypersensitivity leading onto hardware rejection is reported as a rare phenomenon. If not suspected, it can be a harrowing experience for the patient because it can lead to a seemingly never-ending cycle of tests and procedures. This case highlights the fact that although metal hypersensitivity is rare, it should be included in the differential once infection has been excluded.     

A comparison of fast MR scan techniques for cerebral activation studies at 1.5 Tesla

To evaluate the sensitivity of fast, gradient-echo MR scan techniques in their ability to detect blood oxygenation level dependent (BOLD) signal changes in task activation studies, three dedicated fast scan techniques, each with whole-brain coverage, were compared during a 3-min finger tapping paradigm on nine normal volunteers on a clinical 1.5 T scanner. Multislice (2D) single-shot spiral, 3D spiral, and multislice (2D) single-shot EPI scan techniques were done with similar temporal and spatial resolutions on each of the volunteers in random order. After image registration and statistical analysis, the sensitivity to detect activation was evaluated for the techniques by calculating t scores and number of activated voxels in predetermined regions of interest, including the contralateral primary sensorimotor cortex, the premotor region, the parietal region, the supplementary motor area, and the ipsilateral cerebellum. Baseline images acquired with the three techniques were qualitatively comparable and had a similar effective spatial resolution of around 5 × 5 × 5 mm³, as determined from autocorrelation analysis. The anatomical coverage was somewhat reduced (4 less slices per volume) with EPI at the identical temporal resolution of 1.76 s for all techniques. The use of multislice 2D spiral scan for motor cortex fMRI experiments provided for a superior overall temporal stability, and an increased sensitivity compared with multislice 2D EPI, and 3D spiral scan. The difference in sensitivity between multislice 2D spiral and EPI scans was small, in particular in the case of a ramp-sampled version of EPI. The difference in performance is attributed mainly to the difference in scan-to-scan stability.