A tribute to professor Autar Singh Paintal (1925-2004).
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Animals↗
Biomedical subjects
K Ravi
Publications and source records attributed to K Ravi.
Is herniography useful?
Herniography has been used for 25 years in the diagnosis of occult herniation but has not gained widespread acceptance in the UK, despite studies confirming its high sensitivity and specificity for occult hernias and an excellent record of safety and patient acceptability. The traditional approach in the UK to suspected occult groin herniation has been surgical exploration. This study examined the use of herniography in a single district general hospital to assess its impact in limiting unnecessary groin explorations and allowing discharge of patients without hernias. The case notes of 90 successive patients referred for herniography by the department of general surgery in a single UK district general hospital over an 18-month period were reviewed. Eighty-seven completed examinations were analysed in which 23 hernias were diagnosed in 20 patients. Thirteen patients have undergone hernia repair with resolution of symptoms. There were no false positive examinations, although two inguinal hernias were incorrectly diagnosed radiologically as femoral hernias; there were two false negative examinations where additional hernias were found at laparoscopic repair. There were no reported complications. Twenty-four patients were discharged directly from the surgical clinic after a negative herniogram. Thirty patients were referred to other specialities. No patient had undergone groin exploration after a negative herniogram. Herniography is a useful tool in assessing obscure groin pain and potential occult herniation. It can reliably rule out the presence of a hernia and avoid the need for surgical exploration. Many patients with a negative herniogram can be reassured and discharged, whilst others may be referred on to other specialities safe in the knowledge that an occult hernia has been excluded.
Adult↗
Dorsal plating of unstable distal radius fractures using a bio-absorbable plating system and bone substitute.
This study reports the results of open reduction and internal fixation of 26 unstable, intraarticular, dorsally displaced fractures of the distal radius using a bio-absorbable dorsal distal radius (Reunite) plate and calcium phosphate (Biobon) bone substitute. The bio-absorbable plate has the advantage of being low profile, easily contourable and angularly stable. In the majority of cases, this plate produces functional results comparable with metal plates. The Gartland and Werley score was excellent or good in 21 patients. The theoretical advantage over metal plates is in eliminating the need to remove the plate and hence the need for a second operation if implant-related extensor tenosynovitis occurs. Inflammatory tissue reaction to the degradation products of the plate is a potential concern, although the co-polymer ratio used in this plate appears to have reduced the severity of this reaction, which was seen in two patients in this series. The reduction was lost in five patients with severe dorsal comminution. Following this experience, we do not recommend this plating system for fractures with a metaphyseal gap of greater than 7 mm following reduction.
Absorbable Implants↗
Effect of quercetin supplementation on lung antioxidants after experimental influenza virus infection.
In the mice, instillation of influenza virus A/Udorn/317/72(H3N2) intranasally resulted in a significant decrease in the pulmonary concentrations of catalase, reduced glutathione, and superoxide dismutase. There was a decrease in vitamin E level also. These effects were observed on the 5th day after viral instillation. Oral supplementation with quercetin simultaneous with viral instillation produced significant increases in the pulmonary concentrations of catalase, reduced glutathione, and superoxide dismutase. However, quercetin did not reverse the fall in vitamin E level associated with the viral infection. It is concluded that during influenza virus infection, there is "oxidative stress." Because quercetin restored the concentrations of many antioxidants, it is proposed that it may be useful as a drug in protecting the lung from the deleterious effects of oxygen derived free radicals released during influenza virus infection.
Animals↗
Effects of gadolinium chloride on slowly adapting and rapidly adapting receptors of the rabbit lung.
Effects of gadolinium chloride, an inhibitor of stretch-activated channels, on the responses of slowly adapting receptors (SARs) and rapidly adapting receptors (RARs) to hyperinflation were investigated. The increase in activity of RARs resulting from sustained elevations of left atrial pressure (LAP) was also assessed with gadolinium chloride application. Action potentials (AP) of SARs and RARs during hyperinflation were recorded from the vagus nerve of anesthetized New Zealand White rabbits before and after application of gadolinium chloride (20mM) directly on the receptor area of the nerve endings. There was a significant reduction of activity in SARs (n = 9) and RARs (n = 7) after application of gadolinium chloride. Activity of RARs (n = 6) increased when the LAP was elevated by 5 and 10 mmHg. This effect was abolished after gadolinium chloride was applied to receptor endings and the activity was restored when gadolinium chloride was removed. This suggests that stretch-activated channels play a role in SARs and RARs activity.
Action Potentials↗
Role of nitric oxide in the reflex diuresis in rabbits during pulmonary lymphatic obstruction.
The role of nitric oxide in the reflex diuresis in response to pulmonary lymphatic drainage was examined in anaesthetized, artificially ventilated New Zealand White rabbits. Pulmonary lymphatic drainage was obstructed by raising the pressure in a pouch created from the right external jugular vein. Pulmonary lymphatic obstruction resulted in a significant increase in urine flow from an initial control value of 8.9 +/- 0.5 ml (10 min)(-1) to 12.1 +/- 0.6 ml (10 min)(-1) during lymphatic obstruction (mean +/-s.e.m.; n= 17, P < 0.001). This increase in urine flow was accompanied by a significant increase in the excretion of sodium. Additionally, renal blood flow remained unchanged during the increase in urine flow caused by lymphatic obstruction. Intravenous infusion of L-NAME, a non-selective inhibitor of nitric oxide synthase (NOS), abolished the reflex diuresis. Furthermore, intraperitoneal administration of the relatively selective neuronal NOS blocker, 7-nitroindazole also abolished the response. It was observed that infusion of a more soluble neuronal NOS blocker, 7-nitroindazole sodium salt (7-NINA), into the renal medulla also abolished the reflex diuresis. These findings suggest that the increase in urine flow in rabbits caused by pulmonary lymphatic obstruction is dependent upon the integrity of neuronal NOS activity within the renal medulla.
Animals↗
Anti-diabetic activity of Eugenia jambolana seed kernels on streptozotocin-induced diabetic rats.
The present study evaluated the hypoglycemic activity of different parts of Eugenia jambolana seeds such as whole seed, kernel, and seed coat on streptozotocin-induced diabetic rats. Administration of the ethanolic extract of kernel at a concentration of 100 mg/kg of body weight significantly decreased the levels of blood glucose, blood urea, and cholesterol, increased glucose tolerance and levels of total proteins and liver glycogen, and decreased the activities of glutamate oxaloacetate transaminase and glutamate pyruvate transaminase in experimental diabetic rats. Whole seed showed a moderate hypoglycemic effect, and seed coat did not show any hypoglycemic effect. The hypoglycemic efficacy was compared with that of glibenclamide, a standard hypoglycemic drug.
Alanine Transaminase↗
Hypoglycemic effect of Aloe vera gel on streptozotocin-induced diabetes in experimental rats.
In the present study an attempt has been made to evaluate the presence of hypoglycemic activity in the alcoholic extract of Aloe vera gel. Effects of oral administration of A. vera extract at a concentration of 200 and 300 mg/kg of body weight on (a) normal fasted rats, (b) oral glucose-loaded rats, and (c) streptozotocin-induced diabetic rats have been studied. A. vera extract maintain the glucose homeostasis by controlling the carbohydrate metabolizing enzymes.
Administration, Oral↗
Hypoglycemic activity of inorganic constituents in Eugenia jambolana seed on streptozotocin-induced diabetes in rats.
Medicinal herbs used in indigenous medicines for the management of diabetes mellitus contain both organic and inorganic constituents. Some of these inorganic trace elements possess antidiabetic properties, which accounts for the activity of medicinal herbs. The aim of this study was to analyze the inorganic trace elements present in Eugenia jambolana seeds and to evaluate the hypoglycemic activity of the inorganic part of E. jambolana seeds on streptozotocin-induced diabetes. The seeds of E. jambolana seeds were reduced to ash and the inorganic elements present were assayed. The hypoglycemic efficacy of the inorganic part was tested by the glucose tolerance test on streptozotocin-induced diabetes. Elements such as zinc, chromium, vanadium, potassium, and sodium, possessing hypoglycemic activity, were present in the seed. The E. jambolana seed ash-treated diabetic rats exhibited normoglycemia and better glucose tolerance. The conclusion that the inorganic constituents might play a important role in the antidiabetic nature E. jambolana seeds was reached.
Animals↗
First contact management of postoperative endophthalmitis. A retrospective analysis.
Records of 37 consecutive patients of postoperative endophthalmitis referred to our centre from North India were retrospectively analysed to study the first contact management profile. Ten (27%) patients had received intravitreal antibiotics as a primary mode of treatment, and 27 (73%) had received only parenteral antibiotics. The outcome was worse in the latter group. This suggests that general ophthalmologists lack the capability to provide adequate treatment to patients with endopthalmitis in Northern India.
Adult↗
Surgical treatment of inguinal herniae in children.
The aim of this paper was to assess if there is a standard technique for the repair of inguinal herniae in children and to establish if the inguinal canal should be routinely opened during this procedure in different age groups. A postal survey was conducted by sending questionnaires to 264 consultant surgeons who were surgical tutors or advisors to the Royal College of Surgeons of England. Information was sought using a multiple-choice tick-box questionnaire. The surgical techniques of surgeons working in specialist units were compared with those working in general units, and comparisons were also drawn between surgeons performing more operations than those doing only a few and also if the technique varied with the age of the patient. The response rate was 69%. Only 23% working in specialist units and 8% from general units performed more than 30 herniotomies per year. Overall, 15% of surgeons always performed the operation through the inguinal canal, 56% performed it superficial to the external ring, and 29% tended to do both. In children under the age of 2 years, most surgeons performed the operation superficial to the external ring, although a higher proportion of surgeons at specialist units opened the inguinal canal routinely. In the older age groups, the tendency to open the inguinal canal and/or divide the external ring was greater. However, surgeons at specialist paediatric units and those performing more than 30 herniotomies in a year were more likely to open the inguinal canal without dividing the external ring in all age groups. There was quite obviously no standard surgical technique for inguinal herniotomy in children in this survey, and there are only trends.
Age Factors↗
Responses of C fiber afferents of the rabbit airways and lungs to changes in extra-vascular fluid volume.
Effects of changes in extra-vascular fluid volume produced by pulmonary lymphatic obstruction and plasmapheresis on the activities of bronchial and pulmonary C fiber receptors and rapidly adapting receptors (RARs) were investigated in New Zealand White rabbits. In intact rabbits, pulmonary lymphatic obstruction either alone or in combination with plasmapheresis did not stimulate pulmonary C fiber receptors. Only the combined stimulus activated the bronchial C fiber receptors. Bronchial C fiber receptors were also stimulated by graded increases in left atrial pressure (+5 and +10 mmHg). In contrast, RARs were activated by lymphatic obstruction either alone or in combination with plasmapheresis. These procedures increase the extra-vascular fluid volume in the carina and bronchi but not in the lungs (alveoli). In rabbits with chronic pulmonary venous congestion secondary to mitral valve damage, bronchial C fiber receptors were not stimulated by these increments in left atrial pressure which were insufficient to increase the extra vascular fluid content of the airways. However, both pulmonary and bronchial C fiber receptors were stimulated when the left atrial pressure was raised to 25 mmHg in these animals to cause pulmonary edema.
Adaptation, Physiological↗
Airway rapidly adapting receptors--sensors of pulmonary extra-vascular fluid volume.
The factors regulating transfer of fluid into the pulmonary extra-vascular space and the role of sensory receptors of the airways in detecting such fluid fluxes are reviewed and discussed. It is concluded that the rapidly adapting receptors (RARs) located in apposition to bronchial venules are highly sensitive to changes in the pulmonary extra-vascular space produced by mild elevations of left atrial pressure, plasmapheresis and pulmonary lymphatic obstruction and their activation causes respiratory stimulation, an increase in tracheal tone and cough. There is a reflex diuresis also following the stimulation of these receptors by pulmonary lymphatic obstruction. It is proposed that the RARs function as a sensory component of the pulmonary defence mechanisms which preserve the 'milieu interior'.
Animals↗
Influence of metal-artery ratio on the dose reduction due to stent.
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Journal Article↗
Yb-169: a promising new isotope for intravascular brachytherapy.
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Journal Article↗
Effect of stent on radiation dosimetry in an in-stent restenosis model.
Purpose: Intravascular brachytherapy is the leading modality being evaluated for treatment of in-stent restenosis. Stent struts may have an effect on the dose distributions of various radiation sources. We evaluated dosimetry in a stented coronary artery model using a variety of beta and gamma sources and stent materials.Methods: We determined the dose distributions with and without stent in the in-stent restenosis model. Three beta-particle emitting radionuclides, 90Y (2.3 MeV), 144Pr (3.0 MeV), and 106Rh (3.5 MeV), and two gamma-ray emitters, 192Ir (380 keV) and 125I (30 keV), were studied. Stent materials included stainless steel, nitinol, and tantalum. Monte Carlo dose calculations were performed in a stent model of multiple stent struts placed at 1.5 mm from the source. Isodose curves were generated and the ratios of dose rates with and without stent, the stent factors, were evaluated. A stent factor of greater or less than unity represents dose enhancement or reduction in the presence of a stent.Results: For the three beta radionuclides, dose reduction was found on the adventitial side of the stent strut and dose enhancement was noted on the luminal side. On the luminal side, the maximum dose enhancement ranges from 7% to 29%, and the dose reduction on the adventitial side ranges from 13% to 43%. Both the reduction and enhancement effects were most pronounced for the high atomic number material, tantalum. For a given stent material, the dose reduction and enhancement are similar for the three beta radionuclides. For the gamma sources, the stent had no effect for the high-energy 192Ir, but for the low-energy 125I, drastic dose reduction on the adventitial side was observed (up to 86% for tantalum stent), and about 10% dose enhancement on the luminal side was also noted. The dose reduction with 125I was more pronounced than that seen with the beta sources.Conclusions: The presence of stent struts significantly affects dose distributions of 90Y, 106Rh, 144Pr, and 125I. The maximum dose reduction can be as much as 86%. 192Ir was unaffected. These factors need to be considered in choosing radionuclides and dose prescriptions in treating in-stent restenosis.
Journal Article↗
Role of vagal afferents in the reflex effects of capsaicin and lobeline in monkeys.
Reflex effects of pulmonary C-fiber receptor stimulation by right atrial injections of capsaicin and lobeline were investigated in conscious monkeys (n=17). Capsaicin injection (15.0+/-1.4 microg/kg) produced apnea mostly (n=15, latency-1.7+/-0.2 s) and bradycardia, which were abolished by vagotomy (n=4). Lobeline administration (142+/-6 microg/kg) produced either apnea (n=7, latency -2.0+/-0.3 s) or excitation of breathing (n=8, latency -3.5+/-0.3 s) and no change in heart rate. After vagotomy (n=4), the apneic response was abolished, but the respiratory excitation persisted. Neither capsaicin nor lobeline produced cough. In the anesthetized monkey also (n=7), lobeline injection (50-150 microg/kg) did not produce any cardiovascular response. However, it produced excitation of breathing, which persisted after vagotomy but was abolished by carotid sinus denervation. It is concluded that in the non-human primate, it is capsaicin that produces reflexes typical of pulmonary C-fiber receptor stimulation, and cough is not a part of this reflex.
Afferent Pathways↗
Adult small bowel Dieulafoy lesion.
A 47 year old woman presented with melaena and haemodynamic instability. Preliminary investigations failed to locate the source of bleeding. At laparotomy an arteriovenous malformation was identified in the distal ileum. Histology revealed this to be of the Dieulafoy type. This is the first published case of a histologically proved ileal Dieulafoy lesion in an adult.
Arteriovenous Malformations↗