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Biomedical subjects

K K Jain

Publications and source records attributed to K K Jain.

At least 19 recordsLinked to original sources
PubMed1994

Cutaneous vasculitis associated with granulocyte colony-stimulating factor.

BACKGROUND: Several cases of cutaneous vasculitis have been reported in patients treated with granulocyte colony-stimulating factor (G-CSF). OBJECTIVE: The purpose of this study was to determine the prevalence of cutaneous vasculitis in patients receiving G-CSF therapy, causal relation to the drug, and possible pathomechanisms. METHODS: Review of the literature, retrieval of cases from the safety database of the manufacturer of G-CSF, and global assessment of the causal relation of the drug to adverse drug reactions were done. RESULTS: Eighteen cases of cutaneous vasculitis were found, of which only three have been published. A skin biopsy was done in 12 and showed leukocytoclastic vasculitis. Although cutaneous vasculitis was rare in patients treated for neutropenia associated with malignant disease and chemotherapy, it occurred in 6% of the patients with chronic benign neutropenias. Cutaneous vasculitis usually followed the increase of absolute neutrophil count (ANC) and subsided after the decrease of ANC. There was no recurrence if ANC was kept below 800/mm3. The course of G-CSF was completed in most patients. CONCLUSION: Cutaneous vasculitis should be recognized as an adverse reaction to G-CSF with low morbidity. It can be managed by reduction of dose or discontinuation of G-CSF therapy and use of topical steroids.

Granulocyte Colony-Stimulating Factor↗
PubMed1994

High-pressure neurological syndrome (HPNS).

High-pressure neurological syndrome (HPNS) is a condition encountered in diving beyond a depth of 100 m. Manifestations include headache, tremor, myoclonus, neuropsychiatric disturbances and EEG changes. Convulsions are seen only in experimental animals. Most of the changes are reversible on surfacing but some such as memory disturbances may linger on for long periods. Excessive atmospheric pressure is the most important factor in the pathogenesis of HPNS. Neurotransmitter changes occur of which serotonin appears to be a more likely mediator because of the resemblance of HPNS to serotonin syndrome. Anesthetics and anticonvulsants have been used in experimental animals but are unsuitable for use in human divers. Breathing gas mixtures such as heliox have enabled the extension of depth of diving without HPNS. Use of 5-HT1A receptor antagonists may provide an interesting approach to prevention of HPNS.

Animals↗
PubMed1986

Incision of the brain with the Varipulse carbon dioxide laser: a preliminary study for potential application in neurosurgery.

Incisions were made into the rat brain using the Varipulse carbon dioxide laser; they were compared with those made by using an equal amount of energy in the continuous mode of the same laser. Histological examination of the cross sections of the incisions was done. The Varipulse CO2 laser, in comparison with the continuous wave CO2 laser, caused less damage to the tissues surrounding the incision. A 500 Z (peak power, 500 watts) NIIC carbon dioxide laser (Cooper Laser Sonics, Santa Clara, California) equipped with a microcomputer was used with a pulse repetition rate of 200 to 400 and a pulse width of 0.1 second. A focused spot of 0.2 mm and a constant speed of incision of 5 mm/second was used for both types of lesions. The potential usefulness of the Varipulse CO2 laser in neurosurgery, as well as the precautions to be observed during its use, are discussed.

Animals↗
PubMed1985

A prospective randomized comparison of epirubicin and doxorubicin in patients with advanced breast cancer.

Fifty-four patients with advanced breast cancer who had failed prior non-anthracycline combination chemotherapy were randomized to treatment with either epirubicin 85 mg/m2 or doxorubicin 60 mg/m2 intravenously every three weeks. Of 52 evaluable patients, 25% (six of 24) treated with epirubicin, and 25% (seven of 28) treated with doxorubicin experienced major therapeutic responses. The median duration of response to epirubicin was 11.9 months compared to 7.1 months with doxorubicin. Cardiotoxicity was monitored by serial multigated radionuclide cineangiocardiography performed at rest and after exercise. Laboratory evidence of cardiotoxicity was defined as a decrease in resting left ventricular ejection fraction of greater than 10% from the baseline value, or a decrease of 5% or greater with exercise compared with the resting study performed on the same day. Fifteen patients treated with epirubicin and 18 patients treated with doxorubicin had at least two determinations of left ventricular ejection fraction and were evaluable for laboratory cardiotoxicity. Using methods of survival analysis, the median doses to the development of laboratory cardiotoxicity were estimated to be 935 mg/m2 of epirubicin and 468 mg/m2 of doxorubicin. Four patients treated with epirubicin and five treated with doxorubicin developed symptomatic congestive heart failure. The median cumulative dose at which congestive heart failure occurred was 1,134 mg/m2 of epirubicin compared with 492 mg/m2 of doxorubicin. Fewer episodes of nausea and vomiting were observed in patients receiving epirubicin. Epirubicin is a new anthracycline with reduced cardiac toxicity, but preserved efficacy in the treatment of patients with advanced breast cancer.

Actuarial Analysis↗
PubMed1985

Complications of use of the neodymium: yttrium-aluminum-garnet laser in neurosurgery.

Review of the clinical records of 32 patients who underwent operation for brain tumors with the use of the neodymium:yttrium-aluminum-garnet (Nd:YAG) laser during a 4-month period revealed 5 cases of complications related to laser use. One death was presumed to be due to intratumor explosion (the popcorn effect) after excessive Nd:YAG laser application. The other death was due to heat necrosis of the brain stem after radiation of an ependymoma of the 4th ventricle. Two patients suffered neurological deficits. One had facial palsy after radiation of the site of attachment of a meningioma to the petrous bone. The other suffered aphasia and hemiparesis due to heat damage to the cerebral cortex after laser coagulation of the overlying dura mater. The fifth patient suffered postoperative hemorrhage in a residual necrotic chromophobe adenoma after a transsphenoidal approach using the Nd:YAG laser. These complications are preventable. Suggestions are made for the safe use of this laser.

Adenoma, Chromophobe↗
PubMed1984

Laser surgery.

Explore the source record for details and available documents.

Humans↗
PubMed1984

Cerebral protection during carotid endarterectomy--EEG monitoring as a guide to the use of intraluminal shunts.

The authors have reviewed the literature concerning measures for cerebral protection during carotid endarterectomy, with particular reference to the controversy regarding the use of an intraluminar shunt. The authors use preoperative EEG analysis during the carotid compression test as well as intraoperative EEG monitoring, and insert a shunt only when signs of cerebral ischaemia appear. This approach was used in 100 patients during a 4 year period and an internal shunt was required in only 10% of these patients. The mortality was 1% and morbidity 1% in this series. The authors believe that EEG monitoring is a reliable technique in detecting signs of cerebral ischaemia before irreversible changes occur and that an intraoperative shunt should be used only when necessary, and not routinely, as it may contribute to operative and postoperative complications.

Adult↗
PubMed1984

The treatment of extragonadal seminoma.

Primary extragonadal seminoma (EGS) is a rare tumor of young adults that often presents with bulky primary tumors and metastatic disease. Long-term survival is inadequate with conventional therapy consisting of radiotherapy with or without surgery. The charts of 21 patients with EGS treated initially either with conventional therapy (group I) or with multimodality therapy including initial chemotherapy with high doses of cisplatin followed by either radiotherapy or surgery or both (group II) were reviewed. Five of the ten patients in group I developed recurrent disease and four of them eventually died of disease. Only one of 11 patients in group II died of metastatic disease and the remaining patients are free of disease with 19+ to 46+ months of follow-up. Of the six patients from group II who underwent surgical resection of apparently residual disease after chemotherapy but prior to radiotherapy, five were found to have completely necrotic tumor and one had microscopic disease on histologic examination, proving the efficacy of chemotherapy. Combined modality therapy including initial chemotherapy containing high doses of cisplatin provided rapid reduction in tumor burden and the results appeared superior to treatment that did not include initial chemotherapy.

Adult↗
PubMed1983

[Lasers in neurosurgery].

In recent years neurosurgeons have shown an increasing interest in lasers. An understanding of the basic laser mechanism and tissue effects is important. CO2 laser is an excellent no-touch tool for excising and evaporating brain tumors. It has several other uses in neurosurgery both with free hand technique and with microscope attachment and micromanipulator. Nd: YAG and Argon lasers are more effective for coagulation of blood vessels and dealing with vascular neoplasms. Advantages and disadvantages of this technique are discussed and compared with other methods like bipolar coagulation and CUSA. Indications for the use of the different laser types in neurosurgery are summarized and a prospect of laser in neurosurgery is given.

Brain Diseases↗
PubMed1983

Lasers in neurosurgery: a review.

In recent years neurosurgeons have shown an increasing interest in lasers. An understanding of the basic laser mechanism and tissue effects is important. CO2 laser is an excellent no-touch tool for excising and evaporating brain tumors. It has several other uses in neurosurgery both with free-hand technique and with microscope attachment and a micromanipulator. It is easier and more precise to manipulate a laser beam than any of the conventional instruments. Nd:YAG and argon lasers are more effective for coagulation of blood vessels and for dealing with vascular neoplasms. Microvascular anastamosis has been achieved with the use of Nd:YAG laser in experimental animals and has potential for practical application in extra-intracranial bypass operations. There are many advantages and some disadvantages to the use of lasers in neurosurgery.

Argon↗