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Biomedical subjects

H S Shukla

Publications and source records attributed to H S Shukla.

At least 37 records · Page 2Linked to original sources
PubMed1989

Clinicopathological studies of carcinoma oesophagus with special reference to changes in surrounding epithelium.

A total 17 cases of carcinoma oesophagus were studied in a period of 2 years. Ten patients (58.82%) were males and rest were females. Maximum cases (64.70%) were seen in 5th and 6th decades. Majority of the patients belonged to low socio-economic group (47.05%) followed by middle socio-economic group (41.17%). Dysphagia was present in all cases, followed by weight loss 52.94% and other symptoms. Cancer was equally distributed in middle third and lower third of the oesophagus (41.18% in each group) only in 3 cases it was in upper third of the oesophagus. Histologically 70.5% tumours were squamous cell carcinoma, 17.64% were adenocarcinoma and 11.76% were undifferentiated carcinoma. Surrounding epithelium in 17.64 per cent cases showed chronic oesophagitis, 4 cases (23.52%) showed acanthosis and dysplasia, and two cases revealed carcinoma in situ. Hence findings of oesophagitis, acanthosis, dysplasia, carcinoma in situ suggest that oesophagitis and acanthosis may be considered as precancerous lesions.

Adenocarcinoma↗
PubMed1988

Tubercular fistula in ano.

Of 122 patients with fistulae in ano operated upon in a 5-year period, 19 (15.6 per cent) were found to have tubercular fistulae on histopathological examination. There was no characteristic clinical picture and concomitant pulmonary tuberculosis was present in only three patients. Histological examination of the excised fistula is mandatory for the diagnosis of anal tuberculosis. There were no cases of Crohn's disease of the anal region.

Adolescent↗
PubMed1987

Role of rectus abdominis myocutaneous flap in surgery for breast cancer.

Rectus abdominis myocutaneous flap has been used in four different therapeutic situations after mastectomy for breast cancer. These include (1) to obtain skin cover after radical mastectomy with liberal skin sacrifice for locally advanced cancer in 14 cases, (2) for skin cover to obtain primary wound healing in 10 cases treated by preoperative radiotherapy, (3) for delayed breast reconstruction in three patients and (4) for immediate postmastectomy breast reconstruction in 25 patients. Prosthesis was not used for breast reconstruction. The operative morbidity was minimal but 1-2 units of extra blood transfusion was required. Administration of adjuvant treatment, including chemotherapy and radiotherapy was not affected. Reconstruction was satisfactory.

Adult↗
PubMed1986

Long-term (5-11 years) follow-up of general immune competence in breast cancer. I. Pre-treatment levels with reference to micrometastasis.

General immune competence was measured before treatment in 185 breast cancer patients. They were then followed for 5 to 11 years to determine its relationship to recurrence and its clinical value in predicting prognosis. The tests of immune competence used were immunoglobulins IgG, IgA, IgM, leucocyte counts, percentage and total lymphocyte counts and Mantoux and DNCB skin hypersensitivity tests. None of these tests was strongly predictive of recurrence on an individual basis, a finding similar to our results at 2 years. The longer period of follow-up now reported has provided no findings of unequivocal statistical significance, but suggests a biphasic host response to early tumours. The patients who developed recurrence within 5-11 years due to micrometastasis had higher lymphocyte counts in their preoperative assessment than patients who remained recurrence free. This suggests that small tumour volumes do not stimulate immunity and that large volumes depress it; tumours in between these groups are associated with higher levels. Examination of studies by a number of authors reveal parallel findings which have not been previously noted. It is not possible to confirm the significance of these findings from this study because of the heterogeneity of human breast cancer. However, if they indicate a general principle of a dynamic host-tumour interplay they have important implications for assessing immune competence at any single point of time and for the theory that cancer may arise during an anergic state. We hope that these findings will stimulate other workers to examine host-tumour interaction from this point of view.

Breast Neoplasms↗
PubMed1986

Long-term follow-up of general immune competence in breast cancer. II. Sequential pre- and post-treatment levels: a 10 year study.

Pre-treatment and sequential post-treatment (at 3 months, 6 months, 1, 2, 3, 4 and 5 years) examination of general immune competence was performed in 185 consecutive breast cancer patients. The patients were followed for 5 to 11 years to monitor the dynamic relationship between host immunity and cancer and to examine the effect of the treatment method. The tests of immune competence used were immunoglobulins IgG, IgA, IgM, leucocyte counts, percentage and total lymphocyte counts and Mantoux and DNCB skin hypersensitivity tests. Serum IgG and IgA showed no change relating to treatment method in recurrence-free patients; but IgG levels were higher when recurrent disease was imminent or established; IgM diminished (P less than 0.001) after treatment and this continued at 5 years in all patient groups. Simple lymphocyte counts showed the most interesting changes. They remained depressed for as long as 60 months following radiotherapy (P less than 0.01). After treatment by surgery, lymphocyte counts rose in patients without recurrence, but fell when systemic recurrence was imminent or established. This effect was not seen in patients with local recurrence only. There was no change in immune competence immediately before recurrence sufficient to be of clinical usefulness, but a low pre-treatment lymphocyte count with a steady rise after surgery carried a good prognosis. Similarly a high initial lymphocyte count with a fall after surgery was indicative of recurrence. Universal and prolonged depression of lymphocyte counts following radiotherapy was confirmed, and the effect was additive to that of tumour load in recurrent disease. Because of the large number of statistical calculations carried out, some of the apparently significant findings may be due to chance. However, the general trends emerging suggest that similar long-term studies, using the more sophisticated measures of lymphocyte function now available, might be rewarding.

Breast Neoplasms↗
PubMed1984

Mammary skin oedema: a new prognostic indicator for breast cancer.

Mammary skin thickening shown on the mammogram was measured in 220 patients with non-inflammatory breast cancer, and the mean skin oedema was derived by taking the mean of five measurements from separate sites on the breast (upper part, lower part, medial part, lateral part, and areola) after subtracting the corresponding figures from the opposite (normal) breast. The prevalence of appreciable oedema (greater than 0.25 mm) was 70% for tumours less than 1 cm and 100% for tumours more than 3 cm in diameter. This measure of oedema correlated positively and significantly with tumour size and lymph node status. In a minimum of 60 months' follow up patients developing recurrence had significantly higher oedema values. The amount of oedema also predicted recurrence better than lymph node status, tumour size, or tumour stage. Oedema and tumour size, information available preoperatively, provide a simple means of assessing prognosis before definitive treatment.

Breast Neoplasms↗
PubMed1984

The rectus abdominis flap for perineal wounds.

The use of an inferiorly based rectus abdominis myocutaneous flap taken through the pelvis is described. It provides rapid healing of large perineal wounds following excision of advanced perineal malignancy or rectal excision in association with radiotherapy. Two cases were completely satisfactory, but the flap was lost in the third case because of delayed venous thrombosis. It is recommended that the rectus muscle below the entry of the inferior epigastric artery is not completely divided to prevent kinking of the vessels.

Abdominal Muscles↗
PubMed1982

Investigation of lymphocyte subpopulations and hypersensitivity skin tests during the menstrual cycle and pregnancy.

Cell-mediated immune responses were examined during the menstrual cycle of 10 healthy females and in 90 pregnant females, 10 for each month of gestation, and in 10 females 2--4 weeks after normal delivery. Lymphocytes and their subpopulations and PPD hypersensitivity skin tests were investigated. The lymphocyte subpopulation T-cells showed statistically significant depression at the time of ovulation (P less than 0.01) and during the entire period of gestation (P less than 0.001) with recovery in the post-partum period. There was borderline PPD skin response during pregnancy which became positive after parturition. These changes were demonstrated to be specific to conception but the exact mechanism of the T-cell depression is not known. There was a corresponding rise in the B-cell count.

Adolescent↗