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B Venugopal

Publications and source records attributed to B Venugopal.

13 recordsLinked to original sources
PubMed2003

Port-site tuberculosis after laparoscopy: report of eight cases.

In light of the explosive increase in laparoscopic surgery, there is concern about the effectiveness of sterilizing reusable laparoscopic instruments by immersion in 2% glutaraldehyde. This article describes the clinical features of eight patients who presented with biopsy-proven tuberculosis at the port-site unassociated with other clinical features of tuberculosis. Three of the eight patients had positive cultures for Mycobacterium tuberculosis. The port-site sinuses healed with antituberculous chemotherapy. There is conflicting information in the literature regarding the effectiveness of a 20-min instrument soak in 2% glutaraldehyde to clear M. tuberculosis. In light of the preceding information, the current practice of glutaraldehyde disinfection for reusable laparoscopes needs to be reexamined.

Adult↗
PubMed2003

Biliary access loops for intrahepatic stones: results of jejunoduodenal anastomosis.

BACKGROUND: Patients with intrahepatic calculi require multiple interventions following successful surgical stone clearance for recurrent stones and cholangitis. The present paper describes the results of a technique of in-continuity side-to-side jejunoduodenal anastomosis (JDA) that provides endoscopic access to the hepaticojejunostomy and intrahepatic ducts. This operation is compared to other techniques in a critical appraisal of various biliary access procedures described for long-term management of intrahepatic -calculi. METHODS: A retrospective analysis of clinical data of 13 patients who underwent biliary drainage procedures with access loops for intrahepatic calculi during the period March 1990 to December 2000 was performed. The postoperative course of patients and the feasibility of postoperative endoscopic access to the hepaticojejunostomy and intrahepatic ductal system in treatment of recurrent cholangitis were assessed. Nine patients underwent JDA, two underwent permanent-access hepaticojejunostomy (PAH) and two others underwent an interposition hepaticojejunoduodenostomy (IHJ). RESULTS: The analysis revealed no major procedure-related complications or mortality. Endoscopic access (using forward-viewing gastroscope) was possible in 100% of cases following JDA, and with difficulty in both cases after PAH. Endoscopic access in the two patients with IHJ failed because of technical reasons. Recurrent cholangitis was seen in seven patients (54%) - two out of two patients in the PAH group, one out of two in the IHJ group and four out of nine in the JDA group. This required 12 endotherapy sessions (mean: 1.5 procedures per patient). CONCLUSION: In-continuity side-to-side JDA allows easy access of conventional gastroduodenoscopes to the biliary tree for removal of recurrent/residual intrahepatic stones. The technique has advantages over other access loop procedures in the long term management of recurrent intrahepatic stones.

Adult↗
PubMed2001

Laparoscopic cholecystectomy in acute cholecystitis.

BACKGROUND: In the light of laparoscopic cholecystectomy increasingly applied to all forms of cholecystitis, this study aimed at evaluating the safety of laparoscopic cholecystectomy applied to all cases of acute cholecystitis, and at determining factors associated with the risk of conversion to open cholecystectomy. METHODS: The clinical, biochemical, radiologic, and operative data from 124 consecutive cases of acute cholecystitis were analyzed retrospectively to determine the complications and morbidity after operation. The data were analyzed further by univariate and multivariate analysis to identify factors associated with conversion. RESULTS: No major bile duct injury or mortality occurred. Bile leak from the stump of the cystic duct developed in four patients. These were managed successfully by endoscopic biliary stent placement. The mean duration of hospital stay was 3.8 days in the laparoscopic group and 8.2 days in the open group. Of the 124 patients (18.5%), 23 underwent conversion to open cholecystectomy. Univariate analysis identified the following factors as associated with conversion: common duct dilation greater than 7 mm observed on ultrasound, (p < 0.05), pericholecystic collection seen on ultrasound (p < 0.0001), emphysematous cholecystitis (p < 0.01), endoscopic retrograde cholangiopancreatographic evidence of Mirizzi syndrome (p < 0.05), and pericholecystic collection at operation (p < 0.0001). On multivariate analysis, only pericholecystic collection (p < 0.015) and gallbladder wall thickness greater than 5 mm (p < 0.013) were statistically significant. CONCLUSIONS: Laparoscopic cholecystectomy for acute cholecystitis can be applied safely to all comers, offering the advantage of a shortened hospital stay. Pericholecystic collection, as observed on ultrasound, is associated with a high risk of conversion to open cholecystectomy.

Acute Disease↗
PubMed2001

Plasminogen activator inhibitor-1 in cardiovascular cells: rapid induction after injecting mice with kainate or adrenergic agents.

OBJECTIVES: Plasminogen activator inhibitor-1 (PAI-1) is a major anti-fibrinolytic glycoprotein thought to promote vascular diseases. Recently we have shown that systemically injecting mice with kainate, an analog of the principal brain excitatory neurotransmitter glutamate, immediately induced PAI-1 mRNA in brain vascular cells which are not known to contain glutamate receptors. Here we further investigated whether: (a) kainate also increases PAI-1 gene expression in the cardiac vascular bed; (b) subunits of kainate/AMPA receptors could be expressed in cardiac and brain vascular cells; and (c) PAI-1 mRNA could be similarly induced by agonists of adrenergic receptors that are candidates to act downstream in kainate-activated pathways. METHODS: We analyzed cardiac and brain cryosections for PAI-1 mRNA, as well as mRNAs encoding three receptor subunits, by in situ hybridization using 35S-labeled specific riboprobes. PAI-1 activity was tested in cardiac homogenates using one-phase reverse zymography. RESULTS: Prominent PAI-1 mRNA hybridization signals were induced in the vascular cells of the heart, and unexpectedly, also in cardiocytes, within 1-2 h after injection of kainate (i.p., 11-25 mg/kg body weight); the signals persisted for at least 8 h and disappeared after 24 h. In addition, PAI-1 activity increased ( approximately 5 fold) 2-10 h after the treatment. In contrast, mRNAs encoding the kainate/AMPA receptor subunits could not be detected. The adrenergic agents adrenaline (3.5 mg/kg) and isoproterenol (200 mg/kg) exerted kainate-like effects in cardiovascular cells. CONCLUSIONS: These results revealed, for the first time, that PAI-1 gene expression can be enhanced locally in the cardiovascular system by a fast-acting neurological mechanism triggered by glutamate receptors, whose pathway and relation to catecholamines, which exerted similar effects, have yet to be resolved. These findings raised the possibility that excessive glutamate, or stress-related catecholamines, may increase the risk of stroke and myocardial infarction.

Adrenergic Agonists↗
PubMed1979

Lanthanide markers in a single sample for nutrient studies in humans.

Multiple Lanthanide markers were used to develop procedures for determinations of intake and apparent utilization of four nutrients using data from fecal analysis and known concentrations of markers in nutrients. Terbium oxide was given as the intake marker. All foods contained the other non-absorbed markers, each marker in direct proportion to the amount of a specific nutrient in each food. Nutrient markers were oxides of samarium, scandium, ytterbium, and europium. Fecal collection and subsequent analysis of nutrients and markers were completed. Fecal marker concentration stabilized 2 days following initiation of the marker regime. Thus, after 3 days, a single grab sample could be utilized to analyze for nutrient utilization. The ratio of nutrient marker proportional to nutrient and intake to nutrient excretion provides the data for the calculation of apparent utilization for as many nutrients as nutrient markers incorporated into the food. When direct and marker methods of determining nutrient intake and apparent utilization were compared, no significant differences were found for gross energy, fat, protein, and calcium.

Adult↗
PubMed1977

pT, a new classification system for toxic compounds.

The use of pT, the reciprocal of the logarithm of the molar concentration of harmful compounds, allows a simple, quantitative expression of the potential for toxicity of a wide variety of compounds on a molar basis. Comparison of representative toxic compounds gives a valuable perspective on some chemical hazards shared by the biomedical community and society.

Animals↗
PubMed1976

Quantification of two basic proteins related to a thymic hormone (LSH) and their occurrence in serum of normal and cancerous adults.

A quantitative assay for a thymic hormone (LSHr) was developed and utilized for biologic materials. The protein was isolated from tissue extracts or biologic fluids by precipitation with 20% (NH4)2SO4 and reprecipitation with 75% methanol with subsequent disc-electrophoresis on polyacrylamide gel. The proteins on the gel were stained with amido black. One of the two protein bands was readily identified with LSHr by its electrophoretic mobility and agar immunodiffusion tests. Comparison of the intensity of the protein bands obtained from biologic tissues with those of graded amounts of the pure LSHr allowed quantitative estimation. Another basic protein of the serum is found along with LSHr by the above fractionation procedure; it was tentatively named GEM 126 on the basis of its electrophoretic mobility. The total quantity of each of these serum basic proteins and their ratios to each other showed no correlation to any of 20 clinical and laboratory parameters in either healthy or cancerous adults. The lack of correlation between the quantity of serum protein presumed to be LSHr and cancer susceptibility suggests this thymic hormone is not deficient in patients with cancer. Treatment of female cancer patients with radiation and chemotherapy caused a decrease in serum GEM 126 when compared to healthy adults, and untreated or surgically treated cancer patients.

Adult↗
PubMed1975

Studies of nutritional safety of some heavy metals in mice.

Heavy metals have been proposed as nutrient markers to allow the accurate determination of the time of passage, nutrient intake, or apparent utilization of multiple nutrients. In order to evaluate possible toxic effects of scandium, chromium, lanthanum, samarium, europium, dysprosium, terbium, thulium, and ytterbium oxides, and barium sulfate upon growth, general development, reproduction, and lactation, mice were fed different levels of these compounds for three generations. The amount of elements fed were 0,110, 100, and 1000 times the use amount. The use amounts were (in ppm2.) : Sc, 0.12; Cr, 0.02; La.0.40;; Sm. 0.80; Eu, 0.036:TB, 1.20; Dy, 1.20; Tm. 0.08; Tb, 0.12; and Ba, 0.008. The use amount was one-fifth of the concentration required for activation analysis. Mortality and morbidity were negligible. No consistent growth rate changes were observed; however, different groups showed different growth rates during different generations. The number of mice born showed no significant differences amoung treatment groups. Survival, growth rate, hematology, morphological development, maturation, reproduction, and lactational performance were comparable in mice fed the different levels of 10 heavy metal oxides to those mice fed the basal diet.

Animals↗
PubMed1975

Safety of heavy metals as nutritional markers.

The nutritional safety of La, Sm, Eu, Tb, Dy, Tm, Yb, Sc and Cr oxides and barium sulfate were studied in two species. The mouse study was conducted for three generations, including reproduction. During the three generations the mice were apparently not effected by quantities of metals in the feed which were 1000 times the anticipated levels. This level of metals did not exhibit any effect on the reproduction or growth of the mice through three generations. It is concluded that the metals used in the diet of the mouse at any of the use levels could be used in diets for nutritional markers. The monkey study, in which 10 times the anticipated use level of heavy metal markers were fed, further illustrates the nutritional safety of the metals studied. The tissues analyzed generally illustrated that the metals were not detectable. The balance study indicated that all the metals could be accounted for and that there is no apparent absorption of these metals.

Animals↗
PubMedDate not supplied

Mitochondrial disorder, diabetes mellitus, and findings in three muscles, including the heart.

The authors describe the case of a 50-year-old man with chronic progressive external ophthalmoplegia (CPEO), diabetes mellitus (DM), and coronary artery disease. The patient had no cardiac conduction abnormalities. During coronary artery bypass surgery, his heart and two skeletal muscles were biopsied. All three muscles showed ragged red fibers. The heart muscle showed significant glycogen accumulation. Analysis of mitochondrial DNA (mtDNA) showed a 5019-base-pair deletion, with no duplications. There were morphologically abnormal mitochondria in all 3 muscles, with clinically apparent difference in preservation of function. The combination of diabetes mellitus and mtDNA deletion is fortuitous, as they can be causally linked. The cardiac pathology allows speculation about the possible adaptive processes that may occur in the heart in DM. There are few reported cases with CPEO and excess glycogen in the heart. Most show deposition of fat and poorer clinical outcomes as compared to those with glycogen deposition. This observation may lend support to the hypothesis that in the myocardium, adaptive responses are mediated via changes in glucose handling, whereas alterations in fat metabolism likely represent maladaptation.

Chromosome Deletion↗
PubMedDate not supplied

Mitochondrial disorder, diabetes mellitus, and findings in three muscles, including the heart.

The authors describe the case of a 50-year-old man with chronic progressive external ophthalmoplegia (CPEO), diabetes mellitus (DM), and coronary artery disease. The patient had no cardiac conduction abnormalities. During coronary artery bypass surgery, his heart and two skeletal muscles were biopsied. All three muscles showed ragged red fibers. The heart muscle showed significant glycogen accumulation. Analysis of mitochondrial DNA (mtDNA) showed a 5019-base-pair deletion, with no duplications. There were morphologically abnormal mitochondria in all 3 muscles, with clinically apparent difference in preservation of function. The combination of diabetes mellitus and mtDNA deletion is fortuitous, as they can be causally linked. The cardiac pathology allows speculation about the possible adaptive processes that may occur in the heart in DM. There are few reported cases with CPEO and excess glycogen in the heart. Most show deposition of fat and poorer clinical outcomes as compared to those with glycogen deposition. This observation may lend support to the hypothesis that in the myocardium, adaptive responses are mediated via changes in glucose handling, whereas alterations in fat metabolism likely represent maladaptation.

Biopsy↗