Biomedical subjects

L Nambirajan

Publications and source records attributed to L Nambirajan.

5 recordsLinked to original sources

PubMed2002

Fertility and unilateral undescended testis in the rat model III: ultrastructural changes in the contralateral descended testis.

Fertility is decreased in rats with experimentally-created unilateral undescended testis (UUDT). Although light microscopy has shown changes in the UDT, it has consistently failed to demonstrate any significant damage in the contralateral descended testis (CDT) of these animals in previous experimental studies utilizing the same model. To study the ultrastructural details of the CDT and the ipsilateral UDT using transmission electron microscopy (TEM) in rats with experimentally-created UUDT, in Wistar albino rat pups UUDT was experimentally created in accordance with the model described previously. Ten rats with UUDT were compared with 10 control rats. The UDT and CDT were harvested at 135 days of age and sections from specimens studied by TEM for changes in the seminiferous tubules, Leydig cells, and extracellular matrix. All observations were graded and analyzed for statistical significance. TEM of the testes of control rats was normal, while both the ipsilateral UDT and the CDT showed significant changes. Significant changes in the CDT included thickening of the basement membrane ( P=0.001), a decrease in spermatogenic cell lines ( P=0.02), vacuolation ( P=0.0001) and other features of degeneration ( P=0.02), single cell apoptotic figures ( P=0.02), and an increase in Sertoli-cell numbers ( P=0.01), size ( P=0.01), and endoplasmic reticulum ( P=0.01). Another significant feature was the occurrence of morphologic sperm abnormalities in the form of tail denudation ( P=0.02). The surgically-created UDT showed changes of gross degeneration and atrophy. TEM studies thus revealed gross ultrastructural damage to the UDT and similar subtle but significant changes in the CDT. These may explain the decrease in fertility in rats with UUDT.

Animals↗

PubMed2001

Pericardial foreign body.

The authors describe the case of an inhaled foreign body unusually located in the pericardium. An initial chest skiagram was misinterpreted leading to a negative bronchoscopy. Correct anatomic localization of the foreign body only was established at surgical exploration, despite preoperative computerized tomography scan of the chest. Recognition of the propensity of sharp foreign bodies to migrate is essential in treating these patients. A tracheobronchial foreign body migrating to the pericardium has not been reported previously in the literature. J Pediatr Surg 36:936-938.

Bronchi↗

PubMed1998

The value of early postoperative oesophagography following repair of oesophageal atresia.

The aim of the study was to examine the relationship between anastomotic leaks and the development of symptomatic anastomotic strictures after primary repair of oesophageal atresia (OA) with or without tracheo-oesophageal fistula (TOF) and the prognostic value of the anastomotic appearance on postoperative oesophagography. The records and X-ray films of 49 patients with OA with or without TOF admitted between January 1990 and June 1995 were reviewed retrospectively. Of these, 37 had a primary repair (34 immediate and 3 delayed) and a postoperative contrast swallow was done between day 5 and day 30 (median day 7). Radiological leaks were documented. In addition, the maximum transverse diameters of the upper pouch and anastomotic region and the length of the anastomotic narrow segment were measured; the ratio of upper-pouch diameter to that of the anastomosis was calculated (anastomotic index, AI). The need for dilatation of symptomatic anastomotic strictures and for repeat dilatation as a separate episode were documented. Of the 37 patients, 4 developed an anastomotic leak (11%), 3 radiological and 1 clinical. A symptomatic stricture occurred in 55% of patients. There was no correlation between a leak and later development of a symptomatic stricture, although the small number of patients with leaks precluded definite conclusions. No radiological leak progressed to a clinical leak. There was no correlation between the AI or the length of the anastomotic narrow segment and the need for dilatation, the need for repeat dilatation, or the number of dilatations. In this study, the presence of a leak, the AI, and the length of the narrow segment on early postoperative contrast swallow did not correlate with the later development of a symptomatic stricture. A radiological leak was of no clinical significance. Since major leaks are apparent clinically, an early routine contrast study did not influence management and is not necessary.

Esophageal Atresia↗

PubMedDate not supplied

The liver in choledochal cyst.

BACKGROUND/PURPOSE: Hepatic changes due to choledochal cyst have not been given due emphasis in the published literature. In this study the gross and microscopic appearance of the liver in patients with choledochal cyst have been correlated with clinical features, liver function tests and postoperative complications. METHODS: A retrospective evaluation of patients treated for choledochal cysts between January 1989-December 1998 was undertaken. The case records were reviewed and liver biopsies taken at surgery were analysed. RESULTS: The case records of 22 patients were reviewed (16 girls, 6 boys; mean age 4.6 years, range 1 month-10 years). The presenting features included jaundice (59%; 85.7% in < 1 year), abdominal pain (59%; 86.7% in > 1 years) and fever in 40.9% cases. A palpable abdominal mass and hepatomegaly was present in 32% cases. A type IV cyst was present in 1 case; all others had type I cysts (14 cystic and 7 fusiform). The liver looked grossly 'normal' in 16 and 'cirrhotic' in 6 cases. Liver biopsies were available for review from 5 of the 'cirrhotic' and 7 of the 'normal' looking livers. All the liver biopsies showed varying degrees of bile duct proliferation, cholestasis, parenchymal damage, inflammatory cell infiltration and pericentral fibrosis. Histological features of cirrhosis were evident in 6 cases (4 'cirrhotic' and 2 'normal' looking livers), 4 of these cases were infants. Liver function tests were deranged in 5 cases with histological features of cirrhosis and hepato-biliary scintigraphy showed obstructive features in 3 of these cases. There was an increased risk of postoperative complications in the cases with histological features of cirrhosis, 2 died from hepatic insufficiency and one each had transient ascitic and biliary leak. CONCLUSION: Liver histology showed significant changes in all the cases of choledochal cyst in whom it was studied; even normal looking livers showed evidence of significant changes. Presence of cirrhosis, more common in infants, correlated with jaundice, deranged liver function tests, obstructive features on hepatobiliary scintigraphy and a greater risk of postoperative complications.

Child↗

PubMedDate not supplied

Spontaneous neonatal gall bladder perforation.

A full term neonate was operated for diaphragmatic eventration through the chest. Postoperatively the baby developed gastric outlet obstruction. Ultrasonography and barium meal examination were suggestive of extrinsic compression in the region of the pylorus. At laparotomy a gall bladder perforation was found producing a biloma just abve the pylorus. Drainage of the bilioma and temporary cholecystostomy cured the gastric outlet obstruction.

Female↗