Temporary tricuspid valve leaflet detachment for closure of perimembranous ventricular septal defect: Early experiences

Background  

Detachment of the Tricuspid Valve Leaflet (TVD) has been described for better access to repair Perimembranous Ventricular Septal Defects (pVSD). The present report is our early experience with which has been found to be safe and easy with reproducible results.     

Endothelial cell infection and hemostasis

As an important component of the vasculature, endothelial cell lining covers the inner surface of blood vessels and provides an active barrier interface between the vascular and perivascular compartments. In addition to maintaining vasomotor equilibrium and organ homeostasis and communicating with circulating blood cells, the vascular endothelium also serves as the preferred target for a number of infectious agents. This review article focuses on the roles of interactions between vascular endothelial cells and invading pathogens and resultant endothelial activation in the pathogenesis of important human diseases with viral and bacterial etiologies. In this perspective, the signal transduction events that regulate vascular inflammation and basis for endothelial cell tropism exhibited by certain specific viruses and pathogenic bacteria are also discussed.     

The new NHS colorectal cancer screening programme and the potential role of radiology?

The NHS Bowel Cancer Screening Programme is the first nationally coordinated screening programme to be introduced in the UK for 18 years. Currently, the screening algorithm is based upon faecal occult blood testing and colonoscopy for those screenees testing positive. This commentary provides radiologists with an update on the rationale for colorectal cancer screening, explains the organizational structure of the new UK NHS programme, and explores the possible role for radiology in the current and future screening algorithms.     

Giant Haemangioma of the Liver: Is Enucleation Better than Resection?

INTRODUCTION

Haemangioma is the most common liver tumour. Treatment is indicated for symptomatic tumours, rapid increase in size, rupture or doubt in diagnosis. There is continuing debate regarding the ideal method of surgical treatment for liver haemangiomas, with some surgeons favouring enucleation over liver resection.

PATIENTS AND METHODS

Retrospective analysis of prospectively compiled database of patients who were surgically treated for liver haemangioma.

RESULTS

Between 1987 and 2003, we operated on 21 patients with liver haemangioma. Pre-operative diagnosis on imaging was made in 16 patients (13 symptomatic, 3 had progressive increase in size). In five patients, the indication of surgery was uncertain diagnosis. Enucleation was performed in 9 patients and liver resection in 12. The size of the haemangioma was similar in the enucleation and resection groups (8.9 cm versus 10 cm; P = 0.85). The mean intra-operatiive blood loss was significantly less in the enucleation group (400 ml versus 1330 ml; P = 0.004). The mean operative time was significantly less in the enucleation group as compared to the resection group (170 min versus 230 min; P = 0.035). Five patients had major postoperative morbidity in the resection group as compared to none in the enucleation group (P = 0.045). The duration of hospital stay was significantly longer in the resection group.(9.9 days versus 5.6 days; P = 0.005).

CONCLUSIONS

Enucleation of liver haemangiomas is safer, quicker and associated with less morbidity than liver resection. Except for some situations, such as uncertain diagnosis or total replacement of a lobe, we recommend enucleation as the surgical procedures of choice for the treatment of hepatic haemangiomas.     

Rifampicin-induced upper gastrointestinal bleeding

Gastrointestinal disturbances like anorexia, nausea, vomiting, abdominal discomfort and diarrhoea are known adverse effects of rifampicin. We report an upper gastrointestinal bleeding due to haemorrhagic gastric erosions after ingestion of rifampicin for pulmonary tuberculosis. The cause and effect relationship between development of haemorrhagic gastric erosions and rifampicin administration was confirmed by rechallenge with rifampicin. To our knowledge no such adverse effect of rifampicin has been reported previously.