PubMed Health⌕ Search

Biomedical subjects

S D Shetty

Publications and source records attributed to S D Shetty.

22 records · Page 2Linked to original sources

Measurements of serum gamma-seminoprotein and prostate specific antigen evaluated for monitoring carcinoma of the prostate.

We have compared the concentrations in serum of gamma-seminoprotein (gamma-SM) and prostate specific antigen (PSA), two antigens of prostatic origin that are synthesized independently of prostatic acid phosphatase (PAP, EC 3.1.3.2), to assess their potential in monitoring prostatic cancer. At presentation, 27/30 (90%) patients with metastases had a PSA concentration greater than 10 ng/mL, and 29/30 (97%) a gamma-SM concentration greater than 10 ng/mL; 21/61 (34%) with disease but without metastases had an abnormal content of PSA, and 23/61 (38%) an abnormal gamma-SM. Concentrations of PSA and gamma-SM were significantly correlated (r = 0.68, p less than 0.001). In 20 patients without metastases followed longitudinally, the median concentrations of gamma-SM, PSA, and PAP in the 13 patients who developed bony metastases or showed signs of local spreading of the tumor were 58 ng/mL, 34 ng/mL, and 2.1 U/L, respectively. The corresponding median values in the seven patients who remained clinically stable were 2.5 and 3.9 ng/mL, and 2.3 U/L. We conclude that either PSA or gamma-SM can warn of disease progression when PAP activities are still within normal limits.

Acid Phosphatase↗

Small-bowel perforations. A study of 32 cases.

We studied 32 consecutive cases of small-bowel perforations treated in a single surgical unit during the last three years. Clinical features are typical and diagnosis is not difficult. Suprapubic peritoneal paracentesis in head-high position is the most accurate diagnostic investigation. Ultimate results are not related to cause, but are directly proportional to the degree of contamination of the peritoneal cavity, delay in manifestation, antibiotic resistance of the contaminating organism, and the method of treatment of the perforation. There were two deaths in the 16 patients who had exteriorization of the suture line (12.5%), compared with seven deaths in the group of 16 patients who did not have exteriorization (43.75%). Exteriorization of the suture line (16 cases) is a superior method of treatment and significantly lowers the mortality.

Adolescent↗

Selective transplenic decompression of oesophageal varices by distal splenorenal and splenocaval shunt.

The usefulness of selective transplenic decompression of oesophageal varices by distal splenorenal shunt and splenocaval shunt was evaluated in the control of gastrointestinal haemorrhage in patients with portal hypertension of varied aetiology. (Decompression was successful in 69 out of 78 cases.) It was shown that it is superior to total portosystemic shunts, as the incidence of encephalopathy was very low compared with the data from our series of portocaval shunts. The operative mortality has been progressively lowered and has now reached levels comparable with portocaval shunt. Distal splenorenal shunt when performed as an emergency procedure to arrest bleeding has limited usefulness but when performed as an elective or prophylactic procedure its results are comparable with those of portocaval shunt without the untoward complications such as encephalopathy. A modified selective decompression of varices has been described in which the distal end of the splenic vein is anastomosed to the inferior vena cava. Though no long term follow-up studies are available, we believe that this shunt is likely to prove superior to distal splenorenal shunt as it has both the advantages of the distal splenoral and the haemodynamic advantage of end-to-side portocaval shunt. We conclude that in patients with portal hypertension of varied aetiology, who have not had a haemorrhagic episode but in whom varices have been demonstrated or who have had one episode of haemorrhage from varices, the splenocaval shunt when feasible or the distal splenorenal shunt offers the optimal method of management at present in India.

Adolescent↗