Carcinoma oesophagus--an unusual cause of hypertrophic osteoarthropathy.

A rare case of Hypertrophic Osteoarthropathy in association with carcinoma of the oesophagus has been reported from Indian subcontinent. In addition to long bones short tubular bones are also involved in our case. Neurogenic theory is the most feasible pathogenesis for hypertrophic osteoarthropathy in the present case.     

Protection against carbon-tetrachloride-induced lymphoid organotoxicity in rats by protein A

In a previous study we described protection of rats from carbon tetrachloride (CCl4)-induced hepatotoxicity by protein A (PA). In the present report we described protection against CCl4-induced lymphoid organotoxicity in rats by PA. Our data indicate that CCl4 administration produced a significant increase in the number of total leukocytes and polymorphs in blood, a significant decrease in leukocyte count in bone marrow, and a significant loss in weight of spleen and adrenals. In the animals receiving PA prior to and after CCl4, these values were found to be near those of controls. Histological examination revealed thymocyte depletion in thymic lobe and degenerative changes of tissue in spleen of CCl4-exposed animals. PA treatment to CCl4-exposed animals exhibited improvement and recovery from the damage caused by CCl4. These observations throw a new light on the field of CCl4 toxicity to lymphoid organs and their protection by PA.     

Result of suprapubic cystostomy only as primary management of posterior urethral rupture following pelvic fracture

Forty-five patients with posterior urethral injury following pelvic fractures were managed by suprapubic cystostomy alone as primary management. Simultaneous voiding cystourethrogram with retrograde urethrogram six weeks later revealed non-obliterative stricture in eight and total block in 36. Impotence was seen in 20 patients. Eight patients with non-obliterative stricture responded to optical internal urethrotomy. Out of 36 total block, 30 had long strictures in the posterior urethra and required transpubic urethroplasty. Impotence was not affected by transpubic urethroplasty.     

The Rotational Effect of Scarf Osteotomy With Transarticular Lateral Release on Hallux Valgus Correction

The purpose of this study was to explore the rotational effect of scarf osteotomy with transarticular lateral release (TALR) on hallux valgus correction. From January 2016 to January 2018, 28 consecutive patients (30 feet) were included in this study. The first intermetatarsal angle (IMA), hallux valgus angle (HVA), and round-shaped lateral edge of the first metatarsal head (R sign), and sesamoid rotation angle (SRA) were recorded prior to and 3 months after the surgery. The rotation of the capital fragment of the first metatarsal was termed the capital rotation angle (CRA) and was measured intraoperatively after the completion of scarf osteotomy. The IMA, HVA, and SRA were significantly reduced from 13.9 ± 4.9°, 34.6 ± 7.4°, and 28.7 ± 9.8° to 2.4 ± 2.3°, 7.3 ± 4.7°, and 13.4 ± 8.8°, respectively (p < .01 for all). The mean CRA was 7.0 ± 3.4° and was not significantly correlated with the reduction of IMA and SRA (p > .05 for all); nor was it significantly correlated with IMA preoperatively and postoperatively (p > .05 for all) or the reduction of SRA and IMA (p > .05). The R sign was positive in 40% (12/30) of the feet preoperatively compared to 13.3% (4/30) postoperatively (p < .001). Scarf osteotomy produced a supination effect on the capital fragment of the first metatarsal and supinated the sesamoids via lateral translation of the first metatarsal head. These changes may contribute to the correction of the pronation component of hallux valgus deformity.     

CT depiction of ovarian dermoid showing spontaneous fistulous communication with small bowel

Dermoidcysts of the ovary represent the most common form of benign ovarian tumors. Their site, size and clinical presentations are extremely variablecausing confusion with various medical and surgical entities. Uncomplicated dermoid cysts are often asymptomatic andare relatively easy to diagnose on imaging. Symptomatic complicated dermoids may lead to diagnostic dilemmas. Of the various complications of ovarian dermoid, spontaneous rupture into theadjacent viscera is the least common. We report a case of a 55-year-old patient presenting with abdominal pain and passage of hair-like and cheesy material in stools, in which contrast enhanced CT scan demonstrated bilateral ovarian dermoids with the right oneruptured into asmall bowel loop.