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Biomedical subjects

Gurpreet Singh Ranger

Publications and source records attributed to Gurpreet Singh Ranger.

9 recordsLinked to original sources

Surgery results in significant improvement in growth in children with Crohn's disease refractory to medical therapy.

Inflammatory bowel disease (IBD) in children can cause significant impairment in linear growth, and delay in pubertal onset. The aim of this study was to assess the impact of surgery on linear growth in children with Crohn's disease (CD) who were resistant to medical therapy, and had documented evidence of growth impairment. We performed a retrospective study on eight consecutive patients with refractory disease who had attended the paediatric IBD clinic. All patients underwent surgery as part of their treatment. Height and weight were recorded at least 6 months prior to surgery, at the time of surgery, and 6 months post surgery. Growth velocities and height Z-scores were calculated. All patients had evidence of sustained growth suppression prior to surgery. Three patients had evidence of growth failure. There was a significant increase in height velocity from 0.15 cm/month before surgery to 0.54 cm/month after surgery (P = 0.006). There was also a significant decrease in the modified Harvey-Bradshaw index (HBI) of disease activity from 2.00 before surgery, to 0.84 after surgery (P = 0.003). Improvements in height Z-score and weight velocity after surgery were not significant on statistical analysis. Our study demonstrates that before surgery, children with CD refractory to therapy have sustained growth suppression, and in some cases may even have growth failure. Surgical intervention before puberty appears to result in a significant improvement in height velocity and disease activity. These findings need to be further investigated with carefully designed prospective studies.

Adolescent↗

Sclerosing mesenteritis presenting with small bowel obstruction and subsequent retroperitoneal fibrosis.

Sclerosing mesenteritis is a rare inflammatory disease of the bowel mesentery of unknown aetiology. It poses a diagnostic challenge for clinicians, as it can be mistaken for malignancy. We report a case of sclerosing mesenteritis initially presented with abdominal pain, tender abdominal mass and small bowel obstruction. Emergency laparotomy revealed fibrous thickening of the small bowel mesentery mimicking small bowel lymphoma. An ileo-ileal bypass procedure was performed. Six months later, the patient developed retroperitoneal fibrosis, manifesting as bilateral obstructive uropathy. Our case is unique, as it describes retroperitoneal fibrosis developing in a patient with small bowel retractile mesenteritis, with no evidence of colonic or other anatomical involvement. Furthermore, the patient had no risk factors for this condition. We conclude that the presence of sclerosing mesenteritis should cue clinicians to search for other coexisting inflammatory disorders that can have serious sequelae.

Aged↗

Elevated expression of cyclooxygenase-2 in breast cancer and ductal carcinoma in situ has no correlation with established prognostic markers.

BACKGROUND AND OBJECTIVES: Elevated expression of cyclooxygenase-2 (COX-2) has been established to be a feature of breast cancer. There has been inconsistency in the literature regarding the precise significance of this-some studies have found no clinicopathological relevance at all, whilst others have concluded COX-2 expression is an important biomarker in invasive disease and pre-cancerous lesions, correlating with poor prognostic features. We studied COX-2 expression in invasive ductal cancer (IDC) specimens and ductal carcinoma in situ (DCIS) in order to clarify these issues. METHOD: Archival specimens of IDC and DCIS (n = 39) were stained with a polyclonal antibody to COX-2. Results were correlated with recognised clinicopathological parameters. RESULTS: COX-2 expression occurred in 36.7% of IDCs and 54.5% of DCIS lesions. There was no correlation between increased expression and any clinicopathological features. COX-2 expression did not occur in adjacent non-cancerous tissue (ANCT). CONCLUSION: We have confirmed that COX-2 expression does occur in invasive cancers, in DCIS, and is not associated with established prognostic markers. The presence of COX-2 expression in DCIS and invasive cancers has positive implications for the future prevention and treatment of breast cancer with COX-2 inhibitors. A large proportion of tumours are, however, COX-2 negative and may be poor candidates for COX-2 suppression.

Breast Neoplasms↗

Antidiuretic hormone replacement therapy to prevent or ameliorate vasodilatory shock.

Vasodilatory shock is a syndrome with high mortality. It is becoming evident that depletion of antidiuretic hormone (ADH) after cardiac surgery or during sepsis plays an important role in the pathogenesis of this condition. Established vasodilatory shock responds well to exogenous ADH infusion. It is possible that preventing ADH depletion at an earlier stage may abrogate the onset of vasodilatory shock, or at least reduce its severity. This paper examines the evidence supporting this concept, and the potential areas of concern in considering this particular type of hormone replacement therapy.

Animals↗

Elevated cyclooxygenase-2 expression correlates with distant metastases in breast cancer.

BACKGROUND: Cyclooxygenase-2 (COX-2) overexpression clearly plays an important role in the pathogenesis of breast cancer. In this study, we analysed the relationship between COX-2 expression and various clinicopathological factors in human breast cancer. MATERIALS AND METHODS: Using immunohistochemistry, we analysed archival specimens of human breast cancer (n=29) using antibodies to COX-2, ER, PgR and HER2 and, from medical records, obtained clinicopathological data. RESULTS: We observed a significant association between COX-2 overexpression and distant metastasis. COX-2 expression was not significantly associated with any other clinical or pathological variable. CONCLUSION: These findings lend support to the hypothesis that COX-2 overexpression represents an adverse prognostic event in human breast cancer and are encouraging for proposed strategies of COX-2 suppression to treat the disease.

Breast Neoplasms↗