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Biomedical subjects

J Radhakrishnan

Publications and source records attributed to J Radhakrishnan.

16 recordsLinked to original sources
PubMed1992

Evaluation of a computer program for teaching laboratory diagnosis of acid-base disorders.

A computer program was evaluated as a tool for increasing the diagnostic acumen of medical housestaff and students in identifying acid-base disorders. The participants were randomized into two groups; group A (N = 20) was encouraged to use the software, and group B (N = 19) was denied access. Pre- and post-tests were administered to delineate the groups' ability to identify correctly an acid-base disorder from laboratory data (electrolytes and arterial blood gas). During 6 weeks, group A used the computer for a mean of 2.83 h (range 1 to 6). The mean +/- SE number of correct answers out of 20 questions, prior to use of the computer program, were 5.7 +/- 0.8 (95% confidence interval 3.9 to 7.5) for group A and 5.2 +/- 0.6 (95% confidence interval 3.9 to 6.5) for group B. These results were not statistically different. Correct responses increased significantly in group A to 10.3 +/- 0.9 (P < 0.0001, 95% confidence interval 8.4 to 12.2) but did not increase significantly in group B. The data suggest that this software program was effective in increasing the diagnostic capabilities of medical housestaff and students for identifying acid-base disorders.

Acid-Base Imbalance↗
PubMed1992

Postoperative apnea in infants.

This is a review of 127 neonates evaluated for postoperative apnea and bradycardia (A&B) after inguinal surgery. The patients could be divided into three groups based on postconceptional age (PCA) at operation. Ten of 29 patients operated on at PCA of 33 to 39 weeks developed episodes of A&B. Preoperative assessment was not reliable in their identification. In the second group of 54 patients at PCA 40 to 44 weeks, 8 developed A&B, whereas in the third group of 44 patients at PCA of 45 to 60 weeks 1 patient developed A&B. In the latter two groups preoperative assessment identified all patients at high risk. We conclude that after PCA of 40 weeks patients at risk for A&B can be identified preoperatively. Patients operated on up to 39 weeks PCA should all be observed in the hospital.

Age Factors↗
PubMed1991

Colonic strictures following successful medical management of necrotizing enterocolitis: a prospective study evaluating early gastrointestinal contrast studies.

This is a prospective study of 50 patients with neonatal necrotizing enterocolitis (NEC) treated successfully by medical means. They were all screened with an upper gastrointestinal (GI) contrast study after 14 days of healing and prior to establishment of feeding. Thirty-six patients (72%) with normal upper GI examinations responded well to a graduated increase in feeding. Another 5 (10%) with questionable areas on their upper GI examination had a normal follow-up contrast enema. Feeding was successfully established in this group of infants also. The remaining 9 patients (18%) had demonstrable strictures in both contrast studies. After elective resection of strictures with restoration of intestinal continuity, they were also fed successfully. No delayed strictures were seen in any of the patients. We propose that this method of evaluation is safe, efficient and reliable in the diagnosis of strictures that develop in patients recovering from NEC.

Colonic Diseases↗
PubMed1991

Button gastrostomy obstructing the ileocecal valve removed by colonoscopic retrieval.

A 16-year-old male with profound developmental disability acutely developed retching, irritability, and abdominal distension. He had undergone a fundoplication and placement of a feeding gastrostomy 6 months earlier. A button gastrostomy tube was subsequently placed, but was noted to be missing from the stoma when the patient was awakened by his mother one morning. Within 48 hours he developed signs of abdominal obstruction. Abdominal radiography confirmed the presence of the gastrostomy button at the ileocecal valve. After a trial of decompression and medical management failed, the button was successfully removed endoscopically, resulting in prompt resolution of the obstruction. Gastrostomy buttons are a newer alternative to conventional catheters, but can become dislodged and migrate, as illustrated by this case. Refinements in the outer wing design may be needed.

Adolescent↗
PubMed1991

Granulocytic sarcoma of the ileum treated by bone marrow transplantation.

An 8-year-old boy with a granulocytic sarcoma of the proximal ileum metastatic to mesenteric lymph nodes was placed into complete remission with surgical excision of the primary tumor and conventional induction chemotherapy with daunorubicin and cytosine arabinoside. He was then treated with high dose cytosine arabinoside, fractionated total body irradiation, and allogeneic marrow transplantation from his 22-month-old brother who was completely matched at the major histocompatibility complex. Methotrexate was given following the transplant to prevent graft-versus-host disease (GVHD). His post-transplantation course was complicated by a transient autoimmune hemolytic anemia related to an ABO blood group incompatibility and hepatic fungal microabscesses which responded to Amphotericin therapy. Four years following the transplant the patient remains in complete remission. The prognosis for patients with granulocytic sarcoma has been poor although, perhaps, improved over the past decade. This is the first published case report of successful treatment of a granulocytic sarcoma of the ileum by allogeneic marrow transplantation.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1990

Perianal abscess and fistula-in-ano in children.

The authors present a retrospective review of 40 pediatric patients with perianal abscess and/or fistula-in-ano. The total patient population could be divided clinically into 2 broad groups. The first group consisted of 22 infants younger than 2 years of age, all of whom were males, and 10 of whom presented with recurrences after previous incision and drainage. Of the 14 infants presenting with an abscess, in 12 (85.7 percent), a fistula-in-ano was discovered at surgery. In contrast, in the group of 18 children older than 2 years of age, there were 7 females and 11 males, and fistulas were identified in only 7 of 13 patients (54.8 percent) who presented with abscesses. Surgical treatment consisted of examination under anesthesia and a diligent search for a fistulous tract. Abscesses were primarily saucerized and fistulotomy and cryptotomy of the confluent crypt was performed if a fistulous tract was identified. The only recurrences with this form of treatment occurred in the two immunocompromised patients.

Abscess↗
PubMed1990

Obstructive uropathy in the newborn.

The three common causes of urinary obstruction in the newborn are ureteropelvic obstruction, posterior urethral valves, and ureteroceles. Considerable controversy exists regarding their embryology and treatment, yet the basic principles are clear and consist of relief of urinary obstruction, prevention of infection, and maintenance of renal function. Subsequently, total reconstruction can be implemented.

Humans↗
PubMed1988

Lipogenic activity and brown fat content of human perirenal adipose tissue.

The incorporation of 3H2O and/or 14C-glycerol into lipids and the specific activities of the enzymes acetyl CoA carboxylase and lipoprotein lipase were measured in the perirenal and subcutaneous adipose tissue of human subjects. The perirenal adipose tissue of younger subjects with higher brown adipocyte content had higher rates of lipogenesis and enzyme activities per gram tissue than the corresponding subcutaneous tissue. However, in individual specimens, the perirenal/subcutaneous ratios of all but one of the above parameters failed to show a correlation with the brown adipocyte content of the perirenal adipose tissue. One parameter, namely 3H2O incorporation into fatty acids per adipocyte, did relate to the brown adipocyte content of the perirenal adipose tissue in four normal-weight patients only.

Adipose Tissue↗
PubMed1986

Computed tomography in the assessment of pediatric abdominal trauma.

A retrospective review was conducted to determine the clinical reliability of computed tomography(ic) (CT) in the initial evaluation of pediatric blunt abdominal trauma. Sixty patients underwent CT with infusion over the two-year study period. Seventeen injuries were identified by CT scans in 12 patients. Injuries included splenic hematoma, hepatic injury, duodenal hematoma, traumatic pancreatitis, retroperitoneal hematoma, renal pelvis laceration, and perinephric hematoma. Three patients required abdominal exploration and CT findings were confirmed in these cases. Other diagnostic studies (nuclear imaging, ultrasonography, upper gastrointestinal tract studies) that were obtained in some patients also confirmed the CT findings. Patients who had normal CT scans had unremarkable hospital courses, and none required reevaluation for missed injury. Only two CT scans were inadequate due to motion artifact.

Abdominal Injuries↗
PubMed1979

Choledochal cyst with cholelithiasis: 15-yr follow-up.

A 15-yr-old boy, who had had surgery for a choledochal cyst in infancy, was worked up for recurrent right upper quandrant pair. Intravenous cholangiogram and ultrasound demonstrated a choledochal cyst with stones. Angiogram showed only a distorted branch of the gastro-duodenal artery. These findings were confirmed at surgery.

Adolescent↗
PubMed1979

Bronchial carcinoid tumor.

Bronchial carcinoid tumor occurring in an 11-yr-old boy is described. Pertinent diagnostic and therapeutic considerations are discussed briefly.

Bronchial Neoplasms↗
PubMed1979

Observations on the gubernaculum during descent of the testis.

The mechanisms that influence the descent of the testis are not clearly understood. The gubernaculum is a structure worthy of scrutiny inasmuch as it is conspicuous during descent, but virtually disappears after descent is complete. Early in gestation, the rat gubernacular bulb consists of loose mesenchymal cells that develop into fibrillar cells. These later thicken into rhabdomyoblasts that, near the end of gestation, differentiate into spiral striated muscle bundles, and eventually migrate outward into the abdominal/scrotal wall. The rhabdomyoblasts of the female gubernaculum do not differentiate further but rather undergo fatty degeneration. It is possible that spiral contractions of the attached gubernaculum produce tension on the testis and induce descent. The gubernaculum as the receptor organ for testicular descent may be responsive to local testicular hormones. Likely candidates are testosterone, dihydrotestosterone, or Mullerian Inhibiting Substance. A thorough knowledge of the sequential differentiation of the gubernaculum during embryonic development sets the stage for the study of its response to hormonal manipulation both in vivo and in vitro.

Animals↗