Biomedical subjects
Publications and source records attributed to R Kapoor.
An 11-year-old girl with Opitz (BBBG) syndrome presented with a bleeding disorder. Studies showed an immune-mediated qualitative platelet dysfunction in the absence of thrombocytopenia. This is the first report of hemostatic dysfunction in a patient with the Opitz (BBBG) syndrome. This report considers the possible relationship of the platelet dysfunction to the Opitz (BBBG) syndrome and its treatment.
Explore the source record for details and available documents.
Male F-344 rats were fed a choline-free (CF) diet, and changes in phospholipid content, phospholipid fatty acids and phospholipase A2 activity in liver nuclei and microsomes were examined during the first 72 hr. Both nuclei and microsomes showed a decrease in phosphatidylcholine (PC) content. Microsomes showed an increase in PC arachidonate while nuclei showed a decrease. Also, microsomes showed increased activity of phospholipase A2 (PLA2) while nuclei did not. These observations are consistent with the hypothesis that the absence of diene conjugates in liver microsomes in the rats on the CF diet may reflect the increased rate of removal of peroxidized fatty acids by phospholipase A2.
Cine voiding cystourethrogram was performed in 15 normal subjects using T1-weighted Turbo FLASH sequence. It showed the sequence of emptying of bladder, detrusor muscle contraction, opening of the sphincters, and various parts of urethra. It was found to be a good noninvasive test to study the dynamics of lower urinary tract without disturbing the state of the physiology.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Despite the availability of lithotripsy and endourology, clear guidelines on the management of impacted upper ureteric calculi are lacking. In this study, 51 upper ureteric calculi treated with in situ extracorporeal shock wave lithotripsy (ESWL) were classified according to the degree of impaction as indicated by proximal back pressure changes. Patients with mild proximal hydronephrosis (or none at all) had a success rate of 93% but only 35% of those in the impacted group (moderate to severe hydronephrosis) had a successful outcome. A percutaneous antegrade approach to 29 impacted upper ureteric calculi resulted in total clearance in 23 cases; 4 other patients were rendered stone-free following additional procedures, an overall success rate of 93%. The only complication was a ureteric stricture in 1 patient. We recommend the percutaneous approach in the management of impacted upper ureteric calculi.
Explore the source record for details and available documents.
The clinical and electrophysiological features of segmental myoclonus affecting the right arm and upper trunk are described in a patient with multiple sclerosis. Electrophysiological studies suggested that the myoclonus was propagated from a generator site in the cervical cord, where lesions were found using MRI. The spread of electromyographic activity in each myoclonic jerk was slow and variable. These findings are characteristic of propriospinal myoclonus, which has not been associated with multiple sclerosis previously.
Explore the source record for details and available documents.
Functional bladder neck obstruction is often an elusive cause of outlet obstruction in males. If the entity escapes timely diagnosis and treatment, it may progress to acute or chronic retention, terminating in renal failure. The diagnosis can be accurately made by a synchronous pressure flow electromyograph (EMG) study. This is a report on 16 men under 45 years of age encountered during the past 2.5 years. A high sustained detrusor pressure (mean 157 cm H2O) during voiding with poor flow (mean 9.89 ml/s) was observed in all patients. External sphincteric activity during EMG and video study was found to be completely quiescent at the time of voiding. All these patients had inadequate funneling and bladder neck opening. Some of these patients had intermittent bladder neck opening. Three patients presented with renal failure. Following therapy, renal function could be reversed back to normal in 2 patients. Clean intermittent catheterisation, pharmacotherapy using alpha-blockers and endoscopic bladder neck incision were the modalities used to treat this group of patients.
Hypochlorous acid (HOCl), produced by activated polymorphonuclear (PMN) leukocytes, has been reported to depress cardiac function and contractility. Various mechanisms exist for activation of PMN leukocytes during hemorrhagic shock and reperfusion. In order to determine the role of HOCl in hemorrhagic shock and reinfusion, the authors studied the effects of shock and reinfusion on the cardiac function, contractility, blood lactate, blood gases, and creatine kinase (CK) and MB fraction of CK (MBCK) with and without methionine (quencher of HOCl) in anesthetized dogs. Dogs were divided into two groups: Group I, hemorrhagic shock (two hours) and reinfusion (two hours): Group II, hemorrhagic shock and reinfusion with methionine treatment. Cardiac index, mean arterial pressure, and index of cardiac contractility were similar in the two groups during shock. Postinfusion recovery of cardiac function and contractility was better in group II. Increases in blood lactate were similar in the two groups during shock. The rate of return of blood lactate to preshock values after reinfusion was greater in group II. The increases in serum CK and MBCK of the two groups during shock were similar but not significant. Following reinfusion the levels of these enzymes increased significantly, but the increases in group II were less. These results suggest that HOCl produced by activated PMN leukocytes may play a role in cardiac damage during hemorrhagic shock and reinfusion. Methionine may have beneficial effects in the hemodynamic and metabolic recovery and may reduce cellular damage during hemorrhage shock and reinfusion.
Explore the source record for details and available documents.
A patient is described who presented with cervical cord compression. The imaging and operative findings were typical of a neurofibroma of the right third cervical root. However, histological studies confirmed that the tumour was a B-cell lymphoma. Isolated spinal lymphomas can therefore occur and may present as nerve sheath tumours.
Explore the source record for details and available documents.
Bioavailability of iron from Spirulina was assessed in comparison with whole egg, whole wheat and standard ferrous sulphate using haemoglobin depletion repletion assay. Haemoglobin regeneration efficiency of Spirulina and whole egg was similar and significantly higher than that of whole wheat. The absorption of iron from Spirulina was significantly lower than that of ferrous sulphate and whole egg but significantly greater than that from whole wheat.
Various mechanisms may exist for activation of polymorphonuclear (PMN) leukocytes during hemorrhagic shock and reinfusion. During activation of PMN leukocytes, hypochlorous acid (HOCl) is produced in addition to oxygen free radicals. We studied the effects of hemorrhagic shock and reinfusion on cardiac function and contractility, oxygen free radical producing activity of PMN leukocytes (PMN chemiluminescence), and serum and cardiac tissue malondialdehyde (MDA), a lipid peroxidation product, with and without methionine (quencher of hypochlorous acid) in anesthetized dogs, in order to assess the role of hypochlorous acid in depression of cardiac function and contractility in hemorrhagic shock. The dogs were divided into two groups: group I, hemorrhagic shock (2 hr) followed by reinfusion (2 hr); and group II, hemorrhagic shock and reinfusion similar to group I but methionine (30 mg/kg i.v.) was administered before bleeding, before reinfusion, and after 1 hr of reinfusion in this group. Mean arterial pressure (mAo), mean pulmonary arterial pressure (mPAP), index of myocardial contractility (dp/dtmax), and cardiac function (stroke volume index [SVI], left-ventricular work index [LVWI]) decreased significantly during shock and the decreases were similar in both groups. The indices of myocardial contractility which are independent of pre- and/or afterload ([dp/dt]/IIP and [dp/dt]/IIP/CPIP) were affected to a lesser degree than the other indices of myocardial contractility (dp/dtmax) during shock and reinfusion. However, the systemic and pulmonary vascular resistance increased significantly in both groups. Postinfusion recovery of cardiac function and contractility in group II was greater than in group I. Cardiac function and contractility after reinfusion returned to preshock levels initially followed by a decrease below the preshock values in group I. However, these parameters remained at or above preshock levels after reinfusion in group II. Cardiac tissue MDA levels were higher in group I, as compared to those in control dogs. The tissue levels of MDA in group II were lower than in group I but similar to those of control. The serum MDA did not change significantly during shock and reinfusion in either group. Although there were increases in the serum MDA after reinfusion in group I, they were not significant. While the chemiluminescent activity of PMN leukocyte increased significantly in group I, this activity decreased significantly in group II during shock and reinfusion. Methionine in in vitro studies did not affect the oxygen free radical producing activity of PMN leukocyte. These results suggest that hypochlorous acid is produced during shock and reinfusion. The decrease in the cardiac function and contractility after reinfusion may be due to hypochlorous acid.
Of 340 patients undergoing elective cholecystectomy for gallstone disease, 41 (12%) required an abdominal drain and 22 (65%) required a nasogastric tube postoperatively to control vomiting. Eighty six percent patients were discharged on the third post-operative day; 53% were satisfied with the early discharge. In our opinion, routine use of nasogastric tube and abdominal drain is not necessary and patients can be safely discharged on the third postoperative day after an uncomplicated cholecystectomy.