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Biomedical subjects

R Sinniah

Publications and source records attributed to R Sinniah.

At least 73 records · Page 4Linked to original sources
PubMed1981

Acute heat stroke deaths.

Ten cases of death due to heat stroke are described. They were all young men who collapsed during running exercise or route march and died in hospital later. Post-mortem examination was carried out in all cases. Death was due to disseminated intravascular coagulation with widespread microthrombus formation and coagulative necrosis involving many organs. Meteorological studies showed that at the time of the collapse the environmental temperature was higher than average although it may have been in the morning or evening.

Adolescent↗
PubMed1978

Unusual small intestinal obstruction in adolescent girls: the abdominal cocoon.

Ten cases of small intestinal obstruction seen over a period of 6 years (1971-6) in young girls within the narrow age range of 13-18 years are described. The patients were all within 2 years of menarche. In all these cases the obstruction was due to a membrane encasing the small intestine in the manner of a cocoon. There was no previous history of abdominal operation, peritonitis or prolonged drug intake. The clinical features, operative findings and management of the cases are presented. Possible causes of the condition are discussed. In view of the similar clinical presentation in all these patients, their conditions can be grouped as a clinical entity--'the abdominal cocoon'.

Adolescent↗
PubMed1978

Henoch-Schoenlein syndrome: a clinical and morphological study of renal biopsies.

Twenty-four patients, 12 children and 12 adults, with the Henoch-Schoenlein syndrome had their renal biopsy specimens studied by light and electron microscopic and immunofluorescent antibody techniques. The principal glomerular lesion was a focal and segmental proliferative glomerulonephritis in 15, a diffuse proliferative glomerulonephritis in 6 and a animal or minor change lesion with mesangial hypertrophy in 3 cases. The proliferation of the cells was mainly mesangial. Renal biopsies taken earlier in the course of the disease showed a greater number with a focal lesion. Electron dense deposits with cellular proliferation and increased matrix were seen in the mesangium. Less frequent subendothelial and occasional subepithelial deposits were found. Capillary loop changes were seen more frequently in the later stages of the disease. Heavy deposits of IgA were found in the mesangium in all cases, and less intense deposits of IgG in 60%. beta 1 C globulin and fibrinogen were found in 80% and IgD and IgM less frequently. Complement activation was via the alternate pathway as early complement components C1q and C4 were absent. Overt allergies, streptococal infections and the HBsAg could not explain the pathogenesis of the disease. Henoch-Schoenlein syndrome is a chronic disease of the mesangium; only 5 patients showed complete recovery, 15 had persistent microscopic hematuria and 3 died or developed renal insufficiency within 8 years. The prognosis was worst with diffuse proliferative glomerulonephritis, widespread focal glomerulonephritis or epithelial cresents formation.

Adolescent↗
PubMed1977

Glomerular lesions in patients with asymptomatic persistent andorthostatic proteinuria discovered on routine medical examination.

The incidence of asymptomatic proteinuria in young healthy men entering the army service in Singapore was 0.94%; 0.56% had intermittent orthostatic proteinuria and 0.38% with persistent proteinuria. Renal biopsies from 45 cases with persistent proteinuria and 10 cases with orthostatic proteinuria were studied by light microscopy, electron microscopic and immunofluorescent antibody techniques. Three cases with orthostatic proteinuria showed a minimal lesion ('Nil'), and 7 a minimal lesion with increased centrilobular mesangial matrix and mild focal and segmental mesangial hypercellularity. Focal and segmental capillary loop changes were seen in two cases. No immunoglobulin deposits were found in orthostatic proteinuria. A raised anti-streptolysin O titer was found in 3 cases. 13.3% of cases with persistent proteinuria showed a minimal lesion ('Nil'); 66.6% a minimal lesion with increased centrilobular mesangial matrix and mild focal and segmental mesangial hypercellularity: Focal global sclerosis, focal segmental sclerosing glomerulonephritis and diffuse proliferative GN (mesangial hypercellularity) were each found in 6.7% of patients in this group. Focal and segmental changes in capillary loops were found in 30% of cases. Changes in visceral epithelium such as the appearance of cytoplasmic swelling, vesicles and dense aggregates, and areas of focal foot process fusion were common findings. Mesangial deposits of IgA were found in 34.3%, with an IgA-IgG-beta1C globulin combination in 28.6% of cases. IgM-beta1C globulin was present in 5.7% of cases with persistent proteinuria. Early complement components, C1q and C4, and IgA secretory piece were absent. A raised antistreptolysin O titer was found in 25% of cases. The changes inthe glomeruli may represent the end or healing stages of an early bout of glomerulonephritis. Changed hemodynamic responses on assuming an upright position may play a role in the loss of protein across the glomerular basement membrane in patients with orthostatic proteinuria.

Adolescent↗
PubMed1976

Glomerular lesions in asymptomatic microscopic hematuria discovered on routine medical examination.

Renal biopsies from 145 patients with asymptomatic microscopic hematuria were studied with light microscopic, electron microscopic and immunofluorescence antibody techniques. The predominant lesions were a diffuse proliferative glomerulonephritis (mesangial hypercellularity) with focal epithelial crescents and focal segment and/or global sclerosis in many of them; and a minimal lesion with increased mesangial matrix and mild mesangial hypercellularity. Focal and segmental glomerulonephritis, diffuse mesangio-capillary and membranous glomerulonephritis were less common lesions. IgA deposition with other immunoglobulins was seen in over 50% of cases, with an IgA IgG-Beta1C-globulin combination being the common lesion. IgA secretory piece and HBs antigen were not found in the glomeruli and early complement components C1q and C4 were absent. Changes in the mesangium, basement membranes of capillary loops and mesangial osmophilic deposits reflect the pathogenesis of this disease. In addition to the above 145 patients, thirty-five cases of persistent microscopic hematuria classified as symptomatic, with a past history of "acute nephritis", lumbar pain and other complaints; and 11 patients with macroscopic hematuria, painless or associated with "acute nephritis" had similar glomerular lesions. Raised ASOT levels suggest the role of an upper respiratory infection in the exacervation or precipitation of this lesion. The IgA depositon may be associated with deposition of other antibodies in a picture of chronic glomerulonephritis, post-streptococcal or otherwise. 6 of the 145 patients with asymptomatic microscopic hematuria have gone into chronic renal failure in 3.5 years.

Adolescent↗
PubMed1976

Lupus nephritis: correlation between light, electron microscopic and immunofluorescent findings and renal function.

Percutaneous renal biopsies from 56 patients with systemic lupus erythematosus were studied to determine the relationship between renal function and the light microscopic, electron microscopic and immunofluorescent antibody findings. The glomerular lesions were classified into 5 major groups: diffuse membranoproliferative glomerulonephritis (34%), diffuse proliferative glomerulonephritis (26.8%), membranous nephropathy (12.5%), minimal lesion ('nil') and minimal lesion with increased mesangial matrix and/or cells (21.4%) and focal and segmental glomerulonephritis (5.3%). Minimal lesions and focal and segmental glomerulonephritis were invariably associated with normal renal function. Patients with moderate to severe renal involvement and the nephrotic syndrome had predominantly diffuse membranoproliferative and diffuse proliferative glomerulonephritis. Membranous nephropathy was associated with moderate renal involvement and the nephrotic syndrome in 50% of cases. Patients with pure mesangial electron dense deposits had normal renal function or mild renal involvement when the deposits were heavy. Moderate and heavy subepithelial, and intramembranous/subepithelial deposits were associated with moderate to severe renal involvement and the nephrotic syndrome. Renal involvement was most severe with heavy subendothelial deposits. Cytoplasmic tubuloreticular structures measuring approximately 18 to 20 nm in diameter and 80 to 100 nm in length were found in 93% of all biopsies, but bore no relationship to the renal function of the patients. Anti-Hu-IgG fluorescent deposits were found in all the renal biopsies; in 81.3% these were associated with less heavily stained deposits of immunoglobulin IgA, IgD and IgM. Early complement components Clq and C4 were utilized in the complement pathway of activation. Pure mesangial fluorescent deposits were associated with normal renal function or mild proteinuria. Diffuse granular and lumpy deposits along the capillary loops were usually associated with moderate to severe renal involvement and the nephrotic syndrome. In the present series of cases, there was a good correlation between renal function of patients with systemic lupus erythematosus and the glomerular lesions as determined by light, electron microscopic and immunofluorescent microscopic findings.

Adolescent↗
PubMed1975

Lupus cor pulmonale with electron microscope and immunofluroescent antibody studies.

A case of systemic lupus erythemaosus with an unusual complication of pulmonary hypertension leading to cor pulmonale is reported. Lung biopsy showed an interstitial pneumonitis with pulmonary vascular narrowing causing pulmonary hypertension. These changes appeared to be immunologically mediated by the utilization of IgG and C3. Microtubular virus-like particles were present in the endothelial cell cytoplasm of both lung and kidney.

Adult↗
PubMed1973

The effect of pancreatectomy and other agents on iron absorption and storage in the rat.

Evidence from both animal and human studies had been presented by various authors to suggest that reduction of pancreatic function increased iron absorption. The present experimental studies in rats showed that there was increased radioiron ((59)Fe) absorption after pancreatectomy, but this appeared to be due to the operative procedure as there was a similar increased absorption in animals who had sham operations performed. There was no certain evidence that pancreatic enzymes or extract had a specific inhibitory effect on the absorption of iron. But with increased doses of pancreatic extract, above the normal doses, the amount of radioiron absorption was greatly enhanced.A significant increase in hepatic storage iron was found in the groups of rats who had been fed a diet supplemented with dl-ethionine. All these animals showed extensive damage and atrophy of the pancreas, with degeneration and considerable regenerative activity in the liver. The absolute increased hepatic storage iron was not due to the liberation and laying down of haemosiderin from the damaged cells or to decreased liver mass. Rats who had carbon tetrachloride-induced liver cirrhosis without pancreatic damage showed no increased hepatic storage iron. It was observed that in liver damage with considerable cellular proliferation there was increased liver iron content. As this was found only when there was associated pancreatic injury, it is suggested that decreased pancreatic function in the presence of liver cell injury with cellular proliferation leads to increased iron absorption and storage. The relationship of liver injury with cellular proliferation and pancreatic damage to increased hepatic storage iron merits further study.

Absorption↗