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Biomedical subjects

A Rastogi

Publications and source records attributed to A Rastogi.

At least 37 records · Page 2Linked to original sources
PubMed1998

Tc-99m MIBI thoracic SPECT for the detection of intrathoracic tumor masses.

Thirty-one men (age range, 46-76 years; mean age, 64.8 years) with intrathoracic masses suggesting possible malignancy on the basis of chest radiography or CT underwent preoperative Tc-99m MIBI SPECT examinations. Diagnosis was confirmed on pathologic examinations of samples obtained either at thoracotomy, esophagectomy, or by biopsy. Twenty-five patients had primary lung cancer, including squamous cell carcinoma, large cell carcinoma, adenocarcinoma, and small cell carcinoma. Two patients had lymphomas with spread to the mediastinum, and three patients had extrathoracic primary cancers (one squamous cell carcinoma of esophagus, one squamous cell carcinoma originating from a head and neck tumor, and one metastatic mediastinal leiomyosarcoma). One patient with a tuberculoma had negative results of the Tc-99m MIBI examination. Tc-99m MIBI had a 86.7% sensitivity rate, a 0% false-positive rate, and a 100% positive predictive value to detect malignant intrathoracic masses. There was a 13% false-negative rate, however, suggesting that MIBI-SPECT may underdiagnose malignant lesions. SPECT findings of these 31 patients can be classified as 1) mass with increased uptake, n = 23; 2) ring-like appearance of increased uptake, n = 3; 3) mass with absent uptake, n = 4; and 4) photon-deficient mass, n = 1. Absent uptake in patients with mass lesions could be explained by necrosis of the lesion (caseation necrosis or massive tumor necrosis with or without bleeding). Most malignant intrathoracic masses are Tc-99m MIBI avid and may be detected with a high degree of sensitivity and with an excellent positive predictive value. A positive MIBI scan may help in the clinical diagnosis of malignancy. The use of Tc-99m MIBI could serve not only as a tumor imaging agent, but also may be used to determine the extent of spread and potentially the chemotherapeutic responsiveness of a tumor.

Aged↗
PubMed1998

Exercise induced proteinuria as an early indicator of diabetic nephropathy.

Diabetic nephropathy is a life threatening microvascular complication of diabetes characterized by presence of proteinuria and progressive impairment of renal function. This study was carried out on 25 patients of diabetes mellitus and 25 healthy individuals who served as controls. All the persons were asked to perform certain programmed amount of exercise and protein excretion rates were measured in urine collected over following three periods: just before exercise, just after exercise and one hour post exercise. It was observed that basal urinary protein excretion rate as well as exercise induced urinary protein levels were significantly higher in diabetics than in control (p < 0.001). Values were significantly higher in uncontrolled diabetes as compared to those with good metabolic control. Urinary protein values were also related to the duration of diabetes. Higher values were observed in patients having diabetes of more than 5 years as compared to those with less than 5 years duration. This test is good and easy to perform for early detection and management of diabetic nephropathy which is essential to reduce long term morbidity and mortality in diabetics.

Adolescent↗
PubMed1998

Effect of enalapril therapy on ventilatory pulmonary function tests in hypertensive patients.

Fifty newly diagnosed nonsmoker patients suffering from mild to moderate hypertension (diastolic BP 90 to 114 mmHg), randomly selected and not having respiratory or other systemic diseases which may affect pulmonary functions were subjected to thorough interrogation and clinical examination. Twenty five normal age and sex matched healthy volunteers served as control. All patients and controls were subjected to ventilatory pulmonary function tests (VPFT), done by computerized spirometer. Hypertensive patients were put on oral enalapril, doses were titrated and maintained on 2.5 to 10 mg once daily. Twenty percent of the total hypertensive patients reported mild to moderate dry cough and was more frequently observed among females (27%). Significant decline was observed in MEF 50% and MEF 25% of vital capacity values (p 0.0204 and 0.0001) after 10 days of enalapril therapy. These two VPFT parameters showed significantly higher decline among patients who developed cough as compared to patients who did not develop cough. Decline in VPFT parameters were directly related to doses of enalapril.

Adult↗
PubMed1997

Stimulation of IL-2 production and CD2R expression by splenopentin analogs.

Splenopentin (SP-5), is a pentapeptide corresponding to the amino acid sequence 32-36 (Arg-Lys-Glu-Val-Tyr) of the splenic hormone splenin. Its synthetic analogs: Lys-Lys-Glu-Val-Tyr(1) and D-Lys-Lys-Glu-Val-Tyr (2) have been evaluated for active T-cell rosette (CD2R), total T-cell rosette (CD2), interleukin-2 (IL-2) stimulation and effect on antibody production. SP-5 as well as both the analogs stimulated CD2R. Analogs (1) and (2) were also found to stimulate IL-2 production. These observations suggest that in vitro human NK cell augmentation with analogs (1) and (2) reported earlier may be due to enhanced IL-2 production.

Adjuvants, Immunologic↗
PubMed1997

Combined orthotopic heart and liver transplantation for genetic hemochromatosis.

A 47-year-old man with cirrhotic liver disease complicated by encephalopathy and class IV congestive heart failure caused by genetic hemochromatosis underwent combined orthotopic heart and liver transplantation. The patient remains well, working full time, 4 years after operation. Combined heart and liver transplantation is an effective therapy for selected patients with concurrent heart and liver failure caused by systemic iron overload.

Heart Failure↗
PubMed1997

Molecular typing of HLA class I and class II antigens in Indian kala-azar patients.

HLA has been shown to be associated with many diseases. To find out whether host genetic factors like the HLA are involved in susceptibility to kala-azar (visceral leishmaniasis) in India, we formulated an association study with genetically related controls. All samples were typed by PCR SSOP (sequence specific oligonucleotide probes) for HLA class I (A and B) and class II (DR) antigens. The test of association we used was the transmission disequilibrium test (TDT). No significant evidence for association with any of the three HLA loci was obtained.

Disease Susceptibility↗
PubMed1996

Fenvalerate-induced alterations in circulatory thyroid hormones and calcium stores in rat brain.

Intraperitoneal administration of fenvalerate, a synthetic pyrethroid, in male rats for 45 days in doses of 100 and 200 mg/kg body weight/day induced hyperexcitability, tremors and paralysis. Tremors were observed after 7 days and gradually reached maxima on 45th day. The symptoms were more marked in rats treated with 200 mg/kg body weight/day. Fenvalerate provoked significant elevation of circulatory thyroid hormones, namely tri-iodothyronine (T3) and thyroxine (T4). A significant increase in total calcium as well as protein-bound calcium in whole brain and hypothalamus were recorded. The elevation of circulatory thyroid hormones as well as the active calcium pool could be together responsible for impairment of motor activity by altering various neuronal processes.

Animals↗
PubMed1996

A controlled trial of dexamethasone to prevent bronchopulmonary dysplasia in surfactant-treated infants.

BACKGROUND: Surfactant therapy now has a well-established role in the treatment of neonates with respiratory distress syndrome but has failed to reduce the incidence of bronchopulmonary dysplasia (BPD). We conducted a double-blind, placebo-controlled trial to test the hypothesis that dexamethasone therapy given during the first 12 days of life to very low birth weight infants would be synergistic to surfactant in preventing BPD. METHODS: Seventy surfactant-pretreated infants (700-1500 g) who had severe respiratory distress syndrome (a/A ratio, 0.18 +/- 0.10; mean airway pressure, 11.1 +/- 1.9 cm H2O; fraction of inspired oxygen, 0.81 +/- 0.22) were enrolled to receive a 12-day course of dexamethasone (n = 36) or saline placebo (n = 34) starting within the first 12 hours after birth. The starting dose of dexamethasone was 0.5 mg/kg per day, and it was tapered progressively. RESULTS: Ventilator variables at 5 to 14 days were significantly improved in those infants who received dexamethasone compared with those who received the placebo. The effect seem to be more marked in infants weighting less than 1250 g at birth. Significantly more infants could be extubated by 14 days of age in the dexamethasone group (26 of 32 vs 14 of 32). Dexamethasone therapy reduced the incidence of BPD at 28 days (odds ratio, 0.1; 95% confidence interval, 0.03 to 0.3) and eliminated BPD at 36 weeks' postconceptional age. Dexamethasone-treated infants had greater weight loss at 14 days (12.9 +/- 6.4% vs 3.7 +/- 8.6%, respectively) and higher blood pressures from days 3 to 10. However, no differences were seen in time to regain birth weight, hypertension (1 infant in each group), or incidence of intraventricular hemorrhage. CONCLUSIONS: We found an additive effect between dexamethasone and surfactant in improving pulmonary status and reducing the incidence of BPD. Compared with the placebo, dexamethasone therapy was more effective in reducing the incidence of BPD in surfactant-pretreated very low birth weight infants.

Bronchopulmonary Dysplasia↗
PubMed1994

Operation for ventricular tachyarrhythmias: refining current treatment strategies.

For many patients with ventricular tachyarrhythmias, the optimal choice of palliative or curative therapies is not yet well established. To refine optimal current treatment strategies, baseline patient characteristics were studied in relation to likelihood of successful outcome in 240 consecutive patients undergoing operation for treatment of ventricular tachyarrhythmias from 1981 to 1991. Indications for operation were sudden cardiac death or inducible ventricular tachyarrhythmias refractory to medical therapy (or both). Treatment was directed endocardial procedures in 77 patients (32%), other cardiac procedures in 57 patients (24%) (coronary artery bypass grafting in 94% and valve procedure in 14%, either with [35%] or without [65%] concomitant implantable cardioverter-defibrillator), and implantable cardioverter-defibrillator alone in 106 patients (44%). Overall 30-day operative mortality was 5% (70% confidence interval, 4%-7%) and 2-year survival was 74% (70% confidence interval, 71%-77%). Overall 2-year freedom from sudden cardiac death was 97% (70% confidence interval, 96%-98%) and was similar (p = not significant) for all treatment modalities. For each treatment modality, multivariate analysis identified independent risk factors for operative mortality and 2-year tachyarrhythmia recurrence, advanced angina and congestive heart failure New York Heart Association classes, and overall mortality. To characterize better the use and benefit of coronary artery bypass grafting, risk factors related to outcome also were identified for patients stratified according to absence (44 patients) or presence (119 patients) of coronary artery disease excluding patients treated by directed endocardial procedures.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1994

Nebulized furosemide in infants with bronchopulmonary dysplasia.

The effects of 0.1 mg, 0.25 mg, 0.50 mg, and 1.0 mg of nebulized furosemide per kilogram of body weight on pulmonary functions were studied in eight preterm infants with bronchopulmonary dysplasia who were supported by mechanical ventilation. Doses of 1 mg/kg significantly improved lung compliance (51% at 2 hours after nebulization), pulmonary resistance (28% at 1 hour), and tidal volume (43% at 1 hour), starting as early as 30 minutes after the dose; the effect lasted for at least 4 hours in many of the infants and was not associated with diuresis or renal side effects.

Airway Resistance↗
PubMed1994

Immunomagnetic separation of subpopulations of apolipoprotein A-I.

OBJECTIVE: This study was undertaken to measure the subfractions of high-density lipoprotein (HDL) in patients with diabetes or coronary artery disease and in normal control subjects. DESIGN: A new immunomagnetic separation technique was used to characterize the lipid profile in four groups: (1) control subjects, (2) patients with diabetes but no coronary artery disease (CAD), (3) those with CAD only, and (4) those with both diabetes and CAD. MATERIAL AND METHODS: To study the individual roles of the two discrete HDL subpopulations of particles--LpAI/AII (apolipoprotein [apo] A-I associated with A-II) and LpAI (apo A-I without A-II)--in lipoprotein metabolism, we developed an immunomagnetic separation technique using magnetic beads coated with antibodies to human apo A-II. The beads bind particles that contain both apo A-II and apo A-I and are precipitated by a magnetic field. LpAI levels were measured in the supernatant by performing an apo A-I radioimmunoassay. LpAI/AII levels were determined by subtracting the LpAI levels from total plasma apo A-I. RESULTS: In comparison with control subjects, patients with diabetes, CAD, or both had significantly decreased levels of LpAI/AII. LpAI levels were normal in patients with diabetes without CAD but significantly lower than control values in those with diabetes and CAD. CONCLUSION: Our findings suggest that both subpopulations of HDL particles have implications in the development of atherosclerosis in patients with and without diabetes.

Adult↗
PubMed1994

Supravalvular aortic stenosis. Long-term results of surgical treatment.

To determine long-term outcome after operation for supravalvular aortic stenosis, we reviewed the case histories of 80 patients who had repair of the localized form (group A) (n = 67) or diffuse form (group B) (n = 13) from 1956 to 1992, including 31 patients with the Williams-Beuren syndrome. Ages ranged from 7 months to 54 years (mean = 12.6 years). Forty-six patients had one or more associated cardiovascular anomalies; the most common was aortic valve stenosis (33.8%). Eighteen patients had 22 previous cardiovascular operations, and 28 patients had one or more additional anomalies repaired during their initial procedure at our institution. In group A, the aortic root was enlarged with a teardrop-shaped patch (n = 61) or a pantaloon-shaped patch (n = 6). In group B, patch enlargement of the aorta was confined to the root (n = 4) or extended into the ascending aorta or aortic arch (n = 7); one patient had a graft placed between the ascending and descending thoracic aorta and one patient had a left ventricular-aortic conduit. There were no deaths in group A; two patients in group B in whom patch enlargement was confined to the aortic root died during the operation (2.5%). Follow-up extended to 33.4 years (mean = 14.2 years); there were five late deaths in group A and one in group B. Survival excluding operative mortality was 94% at 10 years and 91% at 20 years. All patients were in functional class I or II. There was no significant difference between patients with a teardrop-shaped or pantaloon-shaped patch in terms of late gradient, survival, or aortic insufficiency. By Cox multivariate model, the only independent predictor of late death for all patients was associated aortic valve disease (p = 0.02), which was also a risk factor for late reoperation (p = 0.02). In group B, overall survival was better in patients who received an extended patch versus aortic root patch only (p = 0.02). We reached the following conclusions: (1) Associated aortic valve disease was strongly correlated with late death and need for reoperation. (2) Both the teardrop-shaped and pantaloon-shaped patch techniques provide excellent long-term relief of localized supravalvular gradients and preservation of aortic valve competence. (3) In diffuse supravalvular aortic stenosis, aortic enlargement should be extended into the ascending aorta or beyond as required to relieve the gradient; some patients may require a graft or conduit.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1993

Augmentation of human natural killer cells by splenopentin analogs.

Splenopentin, Arg-Lys-Glu-Val-Tyr (SP-5) and its synthetic analogs; Arg-D-Lys-Glu-Val-Tyr (pentapeptide 1), Lys-Lys-Glu-Val-Tyr (2), D-Lys-Lys-Glu-Val-Tyr (3), Arg-Lys-Gly-Val-Tyr (4), and Arg-Lys-Gln-Val-Tyr (5) have been examined for augmentation of human natural killer (NK) cell activity and human T-cell transformation response. Pentapeptides 2 and 3 were found to significantly augment the in vitro human NK cell activity. However, none of them had any effect on lymphocyte proliferative responses.

Adjuvants, Immunologic↗
PubMed1993

Endocarditis in neonatal intensive care unit.

The clinical spectrum of infective endocarditis (IE) in infants is examined in four infants between 3 and 9 months of age. None of the patients had signs of IE; all four had an anatomically normal heart. Echocardiograms showed echo-dense vegetations in the left side of heart in three cases and in the right side in one. Three of the four patients recovered after the episode of endocarditis. Three of the four patients had necrotizing enterocolitis in the neonatal period. The important predisposing factor was the presence of indwelling central catheter for intravenous nutrition. Unlike previously reported cases, coagulase-negative Staphylococci and Enterococci were important causative organisms in this high-risk nursery population.

Catheterization, Central Venous↗
PubMed1993

Determinants of survival and recovery of left ventricular function after aortic valve replacement.

To determine factors that influence survival and recovery of ventricular function in patients undergoing aortic valve replacement in the current surgical era, baseline risk factors related to outcome were analyzed in 1,012 consecutive patients undergoing aortic valve replacement between 1983 and 1990. Forty-two percent of patients underwent concomitant coronary bypass. Observed survival probabilities (expressed as 30-day/5-year) were 0.97/0.81 overall, 0.99/0.89 for patients aged less than 70 years, and 0.95/0.74 for patients aged 70 years or greater. Advanced age (p < 0.0001), decreased ejection fraction (p < 0.0001), extent of coronary disease (p < 0.006), smaller prosthetic valve (p < 0.03), and advanced New York Heart Association class (p < 0.04) were incremental risk factors for mortality. In patients with preoperative ventricular dysfunction (ejection fraction < or = 0.45), ejection fraction measured 1.4 years after aortic valve replacement improved in 72% and the mean increment in ejection fraction was 0.175 (95% confidence interval, 0.154 to 0.195). The increment in ejection fraction was greater in female patients than in male patients (p < 0.02) and greater in patients without than with coronary disease (p < 0.02). Female sex (p < 0.02) and lesser extent of coronary disease (p < 0.05) were independent predictors of change in ejection fraction. In all patients, early improvement in ejection fraction conveyed an independent subsequent survival benefit (p < 0.0001). The results of aortic valve replacement in the current era are excellent, and the majority of patients with ventricular dysfunction demonstrate significant improvement. Early improvement in ejection fraction, influenced by coexistent coronary artery disease and sex-associated factors, importantly affects subsequent survival.

Aged↗
PubMed1993

Apolipoprotein A-II levels and coronary artery disease in subjects with and without diabetes: a study with use of a specific radioimmunoassay for apolipoprotein A-II.

High-density lipoprotein cholesterol (HDL-C), apolipoprotein (apo) A-I, and apo A-II levels were measured in 1,219 normal subjects with no clinical evidence of coronary artery disease, 81 subjects without diabetes but with "significant" coronary artery disease determined by coronary arteriography, and 151 subjects with non-insulin-dependent diabetes mellitus (48 with clinical coronary artery disease and 103 without such disease). In the normal subjects, apo A-II levels were less influenced by age, gender, and use of medications than were apo A-I or HDL-C levels. HDL-C, apo A-I, and apo A-II levels were significantly lower in subjects who had coronary artery disease with or without diabetes than in control subjects. After adjustments were made for age and sex, however, apo A-II levels were no longer significantly different between subjects with diabetes who had and those who did not have coronary artery disease. In subjects without diabetes, apo A-II may provide some advantages over apo A-I and HDL-C in the assessment of risk of coronary artery disease because it is influenced less by age, gender, and medications. In subjects with diabetes, however, apo A-II levels are similar in the presence or absence of coronary artery disease.

Adrenergic beta-Antagonists↗