PubMed Health⌕ Search

Biomedical subjects

P K Rohatgi

Publications and source records attributed to P K Rohatgi.

At least 19 recordsLinked to original sources
PubMed2001

Sarcoidosis: the value of exercise testing.

STUDY OBJECTIVES: To evaluate exercise testing for the assessment of the extent of pulmonary disease in patients with sarcoidosis. DESIGN: Retrospective analysis of consecutive patients with sarcoidosis referred to the Pulmonary Physiology Laboratory between 1992 and 1997, who completed at least 6 min of progressive bicycle exercise. Resting and exercise pulmonary function measurements were compared to radiographic stage of disease. SETTING: Pulmonary Physiology Laboratory at Washington, DC, Veterans Affairs Medical Center. PATIENTS: Forty-eight outpatient veterans with biopsy specimen-proven sarcoidosis. RESULTS: Across all radiographic stages of sarcoidosis, total lung capacity, resting diffusing capacity, and exercise gas exchange measurements had a significant variance with radiographic stage. Across the early radiographic stage disease (stages 0 to 2), the change in alveolar-arterial oxygen pressure gradient between rest and exercise, normalized for oxygen uptake, was the most significant measurement in its variation with radiographic stage. CONCLUSIONS: Changes in gas exchange with exercise may be the most sensitive physiologic measurements to assess the extent of disease in early radiographic stages of sarcoidosis.

Adult↗
PubMed1998

Interpretive algorithms for the symptom-limited exercise test: assessing dyspnea in Persian Gulf war veterans.

Interpretation of symptom-limited exercise testing requires analysis of a large body of simultaneously recorded cardiopulmonary data. Karlman Wasserman has recommended an algorithmic approach to interpretation (WA) that leads to a dichotomous choice between pulmonary and cardiovascular impairment. An alternative algorithm published by William Eschenbacher (EA) provides for concurrent assessment of cardiovascular and pulmonary exercise impairment. We analyzed a group of 29 individuals referred to the Pulmonary Physiology Laboratory at the Washington Veterans Affairs Medical Center for evaluation of dyspnea following service in the Persian Gulf War to assess the concordance of the two algorithms in determining the cause of dyspnea and exercise impairment in these individuals. They each performed a progressive, ramped, symptom-limited exercise test on a bike for a minimum of 6 min. Exercise measurements were analyzed by both interpretive algorithms. Concordance was found in 28% of tests. The greatest discordance occurred in identifying pulmonary limitation. Eleven had pulmonary limitation by EA; of these, WA found 1 to have pulmonary limitation, 5 to be normal, 4 indeterminate, and 1 musculoskeletal limitation. Of the 11 with pulmonary limitation by EA, but not by WA, 5 had abnormal resting pulmonary function measurements. Analysis of the differences between these two interpretive approaches is given. The EA algorithm may be more sensitive for detecting exercise impairment of pulmonary origin, but its specificity remains to be determined.

Adult↗
PubMed1995

Herpetic bronchitis with a broncho-oesophageal fistula.

Tracheobronchitis and oesophagitis due to herpes simplex virus (HSV) are rare. Tracheo-oesophageal fistula due to HSV oesophagitis has been described in the immunocompromised host. A case is reported of a broncho-oesophageal fistula which developed secondary to herpetic bronchitis in an apparently immunocompetent patient.

Aged↗
PubMed1993

Pathogenesis and therapy of pulmonary emphysema.

Emphysema is characterized by permanent enlargement of the respiratory air spaces distal to the terminal bronchioles accompanied by destruction of their walls and without obvious fibrosis. We present a review of this disease, discussing its classification, pathology, and therapy.

Humans↗
PubMed1992

Acute miliary tuberculosis of the skin in acquired immunodeficiency syndrome.

In human immunodeficiency virus-infected persons the clinical and radiographic appearance of pulmonary tuberculosis is frequently atypical, and extrapulmonary involvement is more frequent. We describe what we believe is the first case of a human immunodeficiency virus-infected person with acute miliary tuberculosis of the skin.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Pseudotumor of left kidney due to sarcoidosis.

Presence of granulomas in the kidney have been reported in up to 40 percent of patients with sarcoidosis. However, granulomatous infiltration producing renal enlargement with distortion of the normal renal contour, and mimicking renal "pseudotumor" is exceedingly rare and is the subject of this case report. Radiographic, scintigraphic, and histologic findings are presented.

Adult↗
PubMed1990

Disseminated Mycobacterium fortuitum successfully treated with combination therapy including ciprofloxacin.

We report a case of disseminated Mycobacterium fortuitum in a 76-yr-old male with no identifiable predisposing factors except chronic interstitial lung disease. Recurrent, progressive pulmonary symptoms and radiographic findings were followed by the development of multiple, culture-positive peripheral lesions. The patient responded rapidly and completely to combination therapy consisting primarily of ciprofloxacin, minocycline, and surgical drainage. Our experience supports the cautious use and further study of fluorinated quinolones for M. fortuitum infections caused by susceptible isolates.

Aged↗
PubMed1990

Clinical role of bronchoalveolar lavage in adults with pulmonary disease.

BAL remains a powerful investigative tool. In a short span of 20 yr, it has helped tremendously in understanding some of the aspects of the pathogenesis of diseases involving the lower respiratory tract. To realize its full potential in the diagnosis and management of diseases involving the lower respiratory tract, there is a great need for standardization of the technical aspects of BAL as well as processing and analysis of the BAL cellular- and fluid-phase components. Despite these hurdles, BAL has been found to be diagnostic in several infectious and noninfectious diseases involving the lower respiratory tract, and it provides valuable information that may be helpful in characterizing the prognosis and response to therapy in certain interstitial diseases of the lung. It is expected that with future research, in particular long-term prospective epidemiologic and clinical studies in pneumoconioses and in other interstitial lung disease, BAL will prove more valuable in the diagnosis and management of such disease.

Bronchoalveolar Lavage Fluid↗
PubMed1990

Multicentric endobronchial granular cell myoblastoma.

Granular cell myoblastoma (GCM) is a rare benign neoplasm involving the tracheobronchial tree. It is believed to arise from the Schwann cell. Four cases of tracheobronchial GCM, all of which were multicentric, are presented and a conservative therapeutic approach is suggested.

Adult↗
PubMed1988

Metastatic pulmonary calcification in sarcoidosis.

A patient with sarcoidosis with elevated 1,25-dihydroxy vitamin D levels, hypercalcemia, nephrolithiasis, and moderate azotemia is presented because of development of metastatic pulmonary calcification which was diagnosed by radioisotope scanning and tissue biopsy.

Biopsy↗
PubMed1987

Extrapulmonary localization of gallium in sarcoidosis.

This paper describes the spectrum of extrapulmonary localization of gallium in patients with sarcoidosis. The usefulness of Ga-67 scintiscans in detecting clinically occult lesions, in directing clinicians to accessible sites for biopsy, and in following the course of extrapulmonary sites of involvement with therapy is emphasized.

Bone Diseases↗
PubMed1986

Endoscopic removal of a bronchial lipoma with the Neodymium-YAG laser.

A 56-year-old man presented with right middle and lower lobe pneumonia with empyema. Bronchoscopy and endobronchial biopsy revealed a lipoma in the bronchus intermedius. Removal of the lipoma was achieved with the Neodymium-Yttrium-Aluminum-Garnet (Nd:YAG) laser through a fiberoptic bronchoscope. The present case represents the first report of endobronchial lipoma with the Nd:YAG laser in the United States.

Bronchial Neoplasms↗
PubMed1986

Assessment of activity in chronic sarcoidosis: usefulness of serum angiotensin converting enzyme and gallium scan.

Gallium scan and serum angiotensin converting enzyme (SACE) activity were performed in 39 patients, who were not receiving corticosteroids and had histologically proven chronic sarcoidosis of at least 2 years duration. Results of these investigations were compared with clinical assessment of disease activity. In patients with radiographic evidence of pulmonary parenchymal disease, the positive and negative predictive values for gallium scan and/or SACE were 96 and 100% respectively; however, in patients with no radiographic evidence of parenchymal disease the positive and negative predictive values were 50 and 100%, respectively. These findings suggest that SACE and gallium scan are useful in assessing the activity and hence the need for therapy in patients with chronic sarcoidosis with radiographic evidence of parenchymal disease.

Adult↗