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Biomedical subjects

R Carachi

Publications and source records attributed to R Carachi.

At least 55 records · Page 3Linked to original sources
PubMed1992

Short-bowel syndrome: a collective review.

Neonates can now be expected to survive with very short lengths of bowel because of advances in pediatric neonatal care and in parenteral and enteral nutrition. Most pediatric surgeons have only a few patients with this problem under their care, so individual experience is limited. This collective survey, carried out by postal questionnaires to pediatric surgeons in the British Association of Paediatric Surgeons in the United Kingdom with an interest in the gastrointestinal tract, documents current techniques of management, the complications encountered, and reviews the clinical and economic consequences of prolonged total parenteral nutrition. We conclude that within the limitations of resources and our understanding of prognosis, neonates, especially if less than 35 weeks' gestation, with remaining jejunoileal segment of greater than 20 cm with an intact ileocecal valve (ICV) or greater than 30 cm without an ICV, should be considered salvageable.

Enteral Nutrition↗
PubMed1991

Inactive renin levels in recurrent nephroblastoma.

A prospective study of four children with nephroblastoma has demonstrated elevation of plasma inactive renin levels at the time of detection of recurrent disease. Three of the four children had been shown to have elevated inactive renin levels at their initial presentation with primary nephroblastoma. These levels returned to normal following operation and chemotherapy. The observation provides further evidence that plasma inactive renin may be a useful tumour marker for nephroblastoma.

Child↗
PubMed1991

Use of a collagen coated vicryl tube in reconstruction of the porcine esophagus.

This experimental study assessed the use of a collagen-coated vicryl mesh tube to reconstruct the esophagus in growing piglets. Initial experiments, in which a segment of thoracic esophagus was excised and replaced by this prosthetic tube, resulted in all the animals succumbing to mediastinitis within the first 3-4 days. This was shown, at post-mortem, to be due to leakage of the prosthesis, secondary to acid reflux, resulting in dissolution of the prosthesis. The collagen-coated vicryl mesh was thereafter treated with glutaraldehyde and in-vitro studies showed that the glutaraldehyde-treated material exhibited a higher resistance to 0.01 M HCl at pH 2.0, when compared with untreated material. In addition, the glutaraldehyde-treated material also showed an increased resistance to digestion by bacterial collagenase. Further experiments to reconstruct the cervical esophagus in growing piglets were performed using the revised glutaraldehyde cross-linked collagen coated vicryl mesh tube. All the animals survived the procedure and the prosthesis were leakproof immediately post-operatively. The animals, however, developed severe stenosis at a mean of 11 days post-operatively. Attempts at neo-epithelialization of the graft were seen histologically. There was considerable granulation tissue and scar tissue formation on the mediastinal aspect of the graft. It is suggested that collagen coated vicryl mesh tube may find applications in the treatment of esophageal atresia only if the problem of stenosis of the prosthesis can be solved.

Anastomosis, Surgical↗
PubMed1991

Neonatal primary hyperparathyroidism--a case report and review of the literature.

Primary Hyperparathyroidism in the neonate is exceptionally rare and is almost invariably fatal unless a prompt diagnosis is made and urgent surgical intervention instituted. The first case was reported in 1947 by Prat et al (30) and since then 35 cases have been published. The true number is probably greater due to the diagnosis being missed both clinically and at autopsy and it has been suggested as a possible contributor to a small number of cases of the Sudden Infant Death Syndrome (17). The authors report on a case presenting in a female neonate, review the world literature and discuss the clinical manifestations, investigators findings and the management options available.

Female↗
PubMed1991

Encephaloceles: a review 1971-1990.

Fifty-two patients with an occipital encephalocele were managed at our institution between 1971-1990 inclusive. The case notes of fifty-one patients were available for review. Thirty-four of the patients presented in the first decade of the study. Fifty-seven per cent (29) developed hydrocephalus and 18 of these required shunting. The overall one year mortality was 23% (12) but only one patient died within the last decade. Of 23 patients followed up by postal questionnaire to general practitioners; 14 had no obvious deficit and 9 had a combination of deficits. Only one death occurred after one year of life in a child with a very severe handicap.

Encephalocele↗
PubMed1991

Congenital neuroblastoma presenting with paraplegia.

A girl presented with paraplegia at birth. A magnetic resonance scan showed an abdominal neuroblastoma with intraspinal extension. Treatment by chemotherapy did not produce any improvement in the neurological signs. Review of previously reported cases suggests the outlook for neurological recovery is poor regardless of treatment.

Abdominal Neoplasms↗
PubMed1989

Use of a bioprosthesis to relieve tension in oesophageal anastomosis: an experimental study.

Collagen-coated Vicryl mesh was assessed as a prosthetic repair material in the oesophagus of growing piglets. In a group of six piglets (group A), a full thickness defect was created in the oesophagus without fully transecting the organ. The removed tissue was subsequently replaced with a patch of collagen-coated Vicryl mesh. Animals were killed at 4 weeks and in the five surviving piglets the prosthesis had been replaced by host scar tissue with a normal epithelial lining. Two further groups of six piglets (groups B and C) were used as controls. In group B the oesophagus was either partly transected (four animals) or completely transected (two animals) and an anastomosis was performed, whereas in group C a 2.5-cm length of oesophagus was removed so that the anastomosis was performed under tension. In group B, all six piglets survived, whereas in group C, where the anastomosis was performed under tension, only two piglets survived. Microscopic and macroscopic examination of all groups showed that the collagen-coated Vicryl prosthesis was replaced by scar tissue; moderate stenosis was observed in only one animal in group A. Collagen-coated Vicryl mesh may be used either to reinforce an anastomosis performed under tension or may find use in tubular form to bridge the gap between the two ends of the oesophagus to be joined. It is envisaged that such a material may find applications in the treatment of oesophageal atresia.

Anastomosis, Surgical↗
PubMed1989

Plasma renin levels in patients with thoracic neuroblastoma.

Plasma renin levels are elevated in neuroblastoma as in nephroblastoma patients. Unlike nephroblastoma, the active component appears to predominate. Patients with thoracic neuroblastoma produce high levels of renin by the tumour, which thus excludes an ischaemic aetiology as the source.

Humans↗
PubMed1989

Hepatocarcinoma in a child: a clinical and experimental study.

An inoperable hepatocarcinoma in a 2-year-old female was treated with chemotherapy. Regression of the tumour allowed complete surgical excision. The tumour was successfully xenografted into athymic rats. Growth of tumour was monitored by external measurement and plasma alphafetoprotein (AFP) assays. AFP levels meanwhile in the patient fell from 2 x 10(6) international units/ml preoperatively to 10 units/ml post-operatively. The value of AFP as a tumour marker in hepatic tumours and the availability of xenograft material for experimentation enabled the measurement of plasma AFP levels as well as assessing the tumour mass.

Animals↗
PubMed1988

Cholelithiasis in childhood: a follow-up study.

Fifteen children with cholelithiasis who were treated at the Royal Hospital for Sick Children, Glasgow between 1973 and 1985 are reviewed. Ten patients had idiopathic gallstones and five had gallstones in association with hereditary spherocytosis. All patients have been followed up for between 4 months and 12 years (mean 4.1 years): ultrasonography has been carried out on 13. Fourteen patients underwent surgery of whom only seven had symptoms from their gallstones. Nine patients had cholecystostomy and removal of gallstones, four patients had cholecystectomy (one had negative exploration of the common bile duct in addition) and one patient with choledocholithiasis underwent choledochotomy with transduodenal sphincterotomy. One patient did not have surgery; she has remained asymptomatic and ultrasound examination confirms that she still has a solitary gallstone in her gallbladder. Clinical review with ultrasonography shows that cholecystostomy with removal of gallstones appears to be an acceptable alternative to cholecystectomy.

Adolescent↗
PubMed1988

Neonatal tumours: Glasgow 1955-86.

Fifty one neonatal tumours were diagnosed in Glasgow over a 32 year period. The most common tumours were teratomas (n=19), others being renal tumours (n=9), soft tissue sarcomas (n=8), neuroblastomas (n=7), and others (n=8). Of the total, 31% were malignant. Neonatal tumours pose difficult problems of management, and because of their comparative rarity and the great potential for cure we recommend that all centres dealing with such patients should contribute to and benefit from a Neonatal Tumour Registry.

Eye Neoplasms↗
PubMed1987

Inactive renin: a tumor marker in nephroblastoma.

Renin-containing cells have been identified in nephroblastoma. A prospective study of eight children with nephroblastoma has demonstrated abnormally high levels of total renin. The increase in total renin was due to increased levels of inactive renin (prorenin), rather than the active renin. These high levels decreased to normal after operation. The plasma level of inactive renin could be a useful biochemical tumor marker in nephroblastoma.

Child↗
PubMed1987

Biological properties of a tumour cell line (NB1-G) derived from human neuroblastoma.

The properties of a new tumour cell line (NB1-G) derived from human neuroblastoma by xenografting in nude rats followed by adaptation to tissue culture are described. Studies using a panel of monoclonal antibodies demonstrate the neuro-ectodermal nature of the cells and support the diagnosis of the primary tumour as neuroblastoma. Cytogenetic studies have revealed a human karyotype with several chromosomal abnormalities. Genetic analysis by in situ DNA hybridization has demonstrated the presence of multiple copies of the N-myc gene. Approximately 20-30 fold amplification of the gene is observed on Southern blot analysis. The cell line has been adapted to growth as multicellular tumour spheroids as well as monolayer culture. Radiobiological studies on spheroids show the cells to be radiosensitive with low capacity for sub-lethal damage accumulation and repair. The cell line should be useful for fundamental studies of human neuroblastoma as well as experimental therapy in vitro.

Animals↗
PubMed1987

Plasma alpha fetoprotein reference ranges in infancy: effect of prematurity.

The dearth of plasma alpha fetoprotein reference ranges for preterm infants often impairs the clinical interpretation of plasma alpha fetoprotein data collected from ill babies. This study tested our hypothesis that meaningful plasma reference ranges could be established for preterm infants by a simple correction of patient age at sampling date for gestational age deficit at birth. Using a modified radioimmunoassay kit method, determinations of alpha fetoprotein were performed on capillary and venous blood samples collected from 56 babies aged from birth to 5 months with gestational ages ranging from 26 weeks to 43 weeks. Unmodified plasma alpha fetoprotein values were grouped according to patient age and examined statistically using established normal theory methods, but these yielded excessively wide reference intervals and non-Gaussian distribution parameters. Acceptable reference ranges were derived using logarithmic transformation of plasma alpha fetoprotein values and rearrangement against patient age corrected for gestational age deficit. These provisional reference ranges for plasma alpha fetoprotein in preterm (and term) infants are applied to groups of previously meaningless alpha fetoprotein results and used to test the potential usefulness of plasma alpha fetoprotein determination as a diagnostic marker in biliary atresia, hepatitis, and yolk sac derived tumours.

Female↗
PubMed1987

Renin and inactive renin (prorenin) in the plasma of patients with malignant renal tumours.

Plasma active and inactive renin (porenin) concentrations were measured in 26 adults with renal carcinoma and 8 children with nephroblastoma. In patients with carcinoma, plasma total renin concentration was slightly raised in 8 patients and markedly in one, in whom the increase was due to a more than 10-fold excess of inactive renin. Total renin concentration was raised in 7 out of 8 cases of nephroblastoma, the increase being due to excess inactive renin. It is likely that this represented oversecretion of a renin precursor, as inactive renin from the plasma of a patient with renal carcinoma showed similar biochemical characteristics to pure human prorenin.

Adult↗