Gastric volvulus is an uncommon condition more so in the paediatric age group. The cause of gastric volvulus may be idiopathic or secondary to various congenital or acquired conditions. In this short series of three patients, one had volvulus which was due to ligamentous laxity and mobile spleen, second had congenital postero-lateral diaphragmatic defect and the third had hiatus hernia.

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Human seminal plasma is known to possess considerable proteolytic activity, much of which is associated with lysosomes. The activities of lysosomal hydrolases like alkaline proteinase, cathepsin-D, aryl-sulfatase and N-acetyl-beta-D-glucosaminidase in seminal plasma from randomly chosen infertile and vasectomised men have been compared. These enzymes have been implicated in the coagulation and liquefaction processes. The role of fructose and proteins in these processes has also been studied. The results indicate that cathepsin-D and aryl-sulfatase activity in infertile men were significantly lower than normo-spermic subjects. N-acetyl-beta-D-glucosaminidase was lowest in azoospermia suggesting that it could be used as a biochemical marker for azoospermia. Conversely, alkaline proteinase showed increased levels in all the infertile cases.

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The healing of wounds caused by accident, assault, welfare and surgical operations has always been a central consideration in surgical practice because any breach in continuity of skin or mucous membrane exposes the deeper tissues to the danger of infections. The understanding of the mechanism of wound healing has increased dramatically during last few years. Today wound healing abnormalities are among the greatest causes of disability and deformity. "I dressed the wound, God healed it" (Ambroise Pare) wound healing involves multiple complicated events. It is the amount and quality of scar tissue and ultimately its remodelling that is of greater importance. The understanding of this process of wound healing and factors affecting it forms the basis of any surgical procedure.

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Dermoid cyst of the omentum is an extremely rare condition. We report a case of multiple dermoid cysts of omentum in a 50 years old woman. The aetiopathogenesis, clinical presentation and relevant literature is briefly reviewed.

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Vascular tumors of the breast are uncommon. Perilobular hemangiomas, the commonest histologic subtype of breast hemangiomas, constitute majority of microscopic, vascular mammary tumors. Macroscopic hemangiomas and vascular hamartomas of the breast are distinctly rare. We describe a giant, vascular hamartoma of the right breast in a five year old girl and discuss pertinent literature.

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The effect of closed mitral valvotomy on the spirometric pulmonary functions was studied in 25 patients with mitral stenosis. The tests were performed before and after operation, the latter at varying intervals (4 to 6 weeks and 8 to 12 months). The preoperative values were considerably low. After 4 to 6 weeks following surgery, further significant reduction in Forced Vital Capacity (FVC) and Forced Expiratory Volume in one second (FEV1) was observed. This was ascribed to the residual healing process and thoracotomy pain. However, Forced expiratory flow rate during mid segment of FVC (FEF25-75%), which reflects obstruction in small airways, did not show any variation. There was improvement in all the above parameters, 8-12 months after surgery. This suggests definite reversibility in the pulmonary functions following valvotomy.

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Sphenoid ridge is the third commonest site of intracranial meningiomas. Although sphenoid ridge meningiomas often involve the optic canal, calcification along the optic nerve has not been reported with these tumors. We describe CT features of a calcified optic nerve in a patient with a calcified sphenoid ridge meningioma.

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A new concept--Tissue Requisitions (Principle I)/Relinquishes (Principle II) Arterial Supply--of TRAS principles is introduced to help appreciate the failures/successes of modern medicine's attempts at restoring arterial flow in luminally compromised coronary/carotid fields, an invasive branch rightly called vascular ReRheology, which comprises diagnosing/treating arterial blocks. The technical wizardry of arterial reconstruction (bypass) or lumen--restoration (plasty) has to reckon with the TRAS principles all the time.

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Duplication cysts of the pylorus are the rarest of alimentary tract duplications with very few reported cases. We present such a cyst in a neonate presenting with gastric outlet obstruction. We have also reviewed the literature and outlined the theories of origin, modes of presentation, diagnosis and the surgical procedures. Even though several modes of surgery have been described, it is best to individualize the surgical option in each case. The results depend on the nature and site of duplication, complications and the associated anomalies.

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