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Biomedical subjects

S Sharma

Publications and source records attributed to S Sharma.

At least 73 records · Page 4Linked to original sources
PubMed1991

Cardiac involvement in nonspecific aortoarteritis (Takayasu's arteritis).

Fifty-four patients (18 males and 36 females, ages 2 to 37 years) with nonspecific aortoarteritis (NSAA) were studied. Evaluation revealed hypertension in 35, congestive heart failure (CHF) in 24, mild to moderate mitral regurgitation in six, and mild aortic regurgitation in two. Erythrocyte sedimentation rate was raised (greater than 35 mm in the first hour) in 38 patients. The arterial lesions included type I in seven, type II in eight, and type III in 34. Pulmonary artery involvement was present in 4 (type IV) of the 20 patients in whom it was studied. Selective coronary angiography was done in 11 patients and revealed 90% left main stenosis in one patient. Hemodynamic data revealed raised (greater than 7 mm Hg) mean right atrial pressure in nine, raised mean pulmonary artery pressure (greater than 20 mm Hg) in 29, and raised left ventricular filling pressure (greater than 12 mm Hg) in 27 patients. Radionuclide ventriculography revealed reduced (less than 45%) left ventricular ejection fraction (LVEF) in 27 patients. The myocardial morphology as evaluated on right ventricular endomyocardial biopsy revealed normal histology in nine, features of inflammatory myocarditis in 24, and nonspecific changes suggestive of dilated cardiomyopathy in six patients. Marked right ventricular endocardial thickening was present in three. All patients with CHF had some histologic abnormality. We emphasize that myocardial involvement including myocarditis is common in NSAA and may precipitate CHF in these patients.

Adolescent↗
PubMed1991

Experience with a potent LH-RH agonist, buserelin, alone and in combination with testosterone for antispermatogenic activity, reversibility and toxicity in langur monkey.

Chronic intermittent treatment of LH-RH superagonist Buserelin alone or in combination with testosterone enanthate were given to adult male langurs for 90 days to evaluate antispermatogenic activity of alone and combination therapy, maintenance of normal androgenicity, possible toxic effects of agonist treatment, related side effects of testosterone supplementation and complete reversibility of the procedure. A gradual decrease in sperm count was recorded in both treatment groups, along with reduced motility and vitality of the spermatozoa. In the combination group, oligospermia was achieved in 4 out of 5 animals, whereas, only 2 animals became oligospermic in the agonist alone group. Significant decrease in serum testosterone levels along with impaired libido and other testosterone withdrawal symptoms were observed in the Buserelin alone group, conversely normal testosterone levels and libido were observed in the combination group. An elevation in haematological variables and serum total protein concomitant with a slight gain in body weight of the animals were recorded in the combination group; these changes were not encountered in the agonist alone group. Reversibility of all the altered parameters to control range was observed in both treatment groups following 75 to 90 days of treatment withdrawal.

Acid Phosphatase↗
PubMed1991

Noninvasive preoperative localization of an intracardiac bullet.

A 40-year-old patient with intracardiac gunshot injury is reported. The bullet was localized preoperatively within the pericardium at the junction of the right atrium and the inferior caval vein and was removed successfully at surgery. The role of various imaging techniques in the preoperative localization of intracardiac missiles is discussed.

Adult↗
PubMed1991

Probe angioplasty through an intracoronary probing catheter in lesions which are difficult to cross.

The clinical records of the first 17 consecutive patients (20 lesions) in whom percutaneous transluminal coronary angioplasty was done using the ultra-low profile "balloon-on-wire probe" passed through an intracoronary probing catheter were reviewed. All patients had high-grade "difficult" lesions. In 15 lesions (12 patients) other balloon systems (over-the-wire low profile balloons (n = 9), and balloon-on-wire used alone, (n = 6)) had failed to cross the lesion. Acute ischemia due to complete occlusion at the site of the lesion during attempts to cross was seen in 3 of these patients. The intracoronary probing catheter was used to deliver the probe across the lesion in all these cases. Successful dilatation was achieved in 14 lesions (93%). In 5 lesions (5 patients) this combination was used as the initial strategy. Three of these had chronic total occlusions. Successful dilatation was achieved in 3 lesions (60%) using this combination and in 1 lesion over-the-wire balloon finally succeeded. There was 1 failure. The intracoronary probing catheter in combination with probe balloon wire offers a promising method to increase the success rate in patients with high grade "difficult" lesions. This combination is especially useful in situations where other balloon systems fail to cross the lesion.

Angioplasty, Balloon, Coronary↗
PubMed1991

Coarctation of aorta with unusual association of diverticulum of the left ventricle and double orifice mitral valve.

We describe a case of coarctation of aorta with two unusual associated anomalies, namely, a diverticulum of the left ventricle and double orifice of the mitral valve. Echocardiography and colour flow mapping precisely diagnosed the bridging tongue of leaflet tissue responsible for the double orifice of the mitral valve. Balloon angioplasty for coarctation produced dramatic benefits which are sustained at follow-up. The other two lesions caused no haemodynamic abnormality.

Adolescent↗
PubMed1991

"Anatomically corrected malposition": a rare case with bilateral absence of a complete subarterial muscular infundibulum.

A unique case of anatomically corrected malposition of great arteries with a bilateral absence of a complete subarterial muscular infundibulum is presented. The other unusual feature of the case was absence of any complex associations and interestingly an intact ventricular septum. The presenting lesion was valvar pulmonary stenosis and balloon valvotomy could not be achieved because of abnormal relationship of the great vessels.

Adult↗
PubMed1991

The morphology of coronary arterial dissection occurring subsequent to angioplasty and its influence on acute complications.

We reviewed the records of 402 patients undergoing percutaneous transluminal coronary angioplasty to identify factors predicting an ischemic event with arterial disruption during an otherwise uncomplicated angioplasty. Major dissection of the coronary arteries without immediate occlusion was found in 25 patients, who exhibited 28 dissected lesions. Dissections were classified into 2 types: those producing a continuous extraluminal and parallel filling tract, and those with a continuous parallel filling tract extending into and compromising the lumen. Ischemic complications (defined as myocardial infarction, the need for repeat angioplasty, or coronary arterial bypass surgery) occurred in 6 patients (24%) within 24 hours of the completion of the procedure. The remaining 19 patients had an uncomplicated hospital course. Acute ischemic complications following dissection correlated with the percentage of luminal compromise 50 +/- 0% in those with complications as opposed to 17 +/- 21% in those without: P less than 0.001) and the development of dissection producing a filling tract which compromised at least half the lumen (100% in those with complications versus 9.1% in those without: P less than 0.001). There was a trend towards an increase in ischemic complications in patients with proximal and eccentric lesions. We conclude that patients who develop dissections which produce significant luminal compromise after an otherwise uncomplicated angioplasty are at a high risk of developing an acute ischemic complication within 24 hours of the procedure.

Acute Disease↗
PubMed1991

Intracranial arteriovenous malformation masquerading as a cardiac disorder.

In this report, we describe an adult with a large intracranial arteriovenous malformation which mimicked a cardiac lesion. The patient presented with predominant cardiac symptoms, a prominent continuous murmur and signs of arterial run-off. The diagnosis was confirmed by digital subtraction angiography. We report the case to highlight the rare presentation.

Adult↗
PubMed1991

Comparison of left coronary and laevo-phase pulmonary angiograms in detecting left atrial thrombi in rheumatic mitral stenosis.

We have compared the diagnostic accuracy of left coronary and laevo-phase pulmonary angiograms in detecting left atrial thrombi in 27 consecutive patients with rheumatic mitral stenosis who underwent both these procedures prior to open-heart surgery. In 10 patients, both procedures were 'positive' for thrombus, confirmed at subsequent surgery in all instances (true positive). Both procedures were negative for thrombus in 11 patients, and none of these patients showed thrombi at subsequent surgery (true negative). Left coronary angiography only was positive for thrombus in one patient in whom no thrombus was found at surgery. Laevo-phase pulmonary angiography only was positive for thrombus in five patients, two of whom had thrombus at subsequent surgery. The sensitivity, specificity and predictive accuracy of left coronary angiogram were 83.3% and 93.3% and 90.9% and that of laevo-phase pulmonary angiogram 100%, 80% and 80% respectively. Laevo-phase pulmonary angiograms showed higher sensitivity and left coronary angiograms showed higher specificity for angiographic diagnosis. However, the differences were found to be statistically insignificant. Angiography is a reliable method for detecting left atrial thrombi if both left coronary and pulmonary angiograms are performed and both procedures are positive or negative for thrombus.

Adolescent↗
PubMed1991

Extracranial carotid artery aneurysms following accidental injury: ten years experience.

Extracranial carotid artery aneurysms secondary to accidental injury are rare. We have seen eight lesions of this type in the last 10 years. The aneurysm was produced by blunt trauma in four patients, penetrating shrapnel injury in two, stabbing and electrical injury in one each. The left side was involved in seven patients. The internal and common carotid artery were each involved in four patients and the lesion was unilocular in five. These lesions often produce non-specific symptoms and may mimic neoplastic or inflammatory masses: a mistaken diagnosis of tonsillar abscess in one patient resulted in incision and drainage before an intravenous digital subtraction angiogram (IV-DSA) correctly identified the abnormality. IV-DSA is ideal for pre-operative assessment of these patients. Awareness of these lesions is essential since definitive surgical repair is possible. All patients in the present study underwent successful surgical repair.

Adolescent↗
PubMed1991

Chest radiographs are unreliable in predicting thrombi in the left atrium or its appendage in rheumatic mitral stenosis.

We have assessed the diagnostic accuracy of a flat or concave left mid-cardiac border (the region of the left atrial appendage) on conventional postero-anterior chest radiographs as a predictor of the presence of thrombi in the left atrium or its appendage in 80 patients with rheumatic mitral stenosis who subsequently underwent open-heart surgery. Forty-six patients (Group I) were found to have left atrial thrombus at surgery whereas 34 patients (Group II) showed no evidence of thrombosis. Only 22 of 46 patients in Group I showed a flat or concave left mid-cardiac border (sensitivity, 48%; specificity, 53%; positive predictive value, 58%). Furthermore in Group 1, the thrombus involved the left atrial appendage in 33 patients. In this subgroup only 14 patients showed a flat or concave left mid-cardiac border (sensitivity, 42%; specificity, 49%; positive predictive value, 37%). The presence of flatness or concavity in the left mid-cardiac border on conventional posterior-anterior chest radiographs in patients with rheumatic mitral stenosis is an unreliable indicator of the presence of thrombi in the left atrium or its appendage.

Adolescent↗
PubMed1991

Mechanism of hypoxia-induced alteration in cerebral arteriolar tone in rats.

We studied the changes in pial arteriolar diameter during hypoxia and 60 and 120 min after restoration of normoxia, using the closed cranial window technique in artificially ventilated and normocapnic rats. Pial arteriolar diameter increased 16 +/- 4% during hypoxia (PaO2 less than 25 mm Hg, lasting 10 min). Although blood pressure (BP), heart rate (HR), and blood gases returned to prehypoxic level when measured at 60 and 120 min after hypoxia, pial arterial diameter decreased significantly (13 +/- 5 and 16 +/- 6% below control levels, respectively). This posthypoxic vasoconstriction was reversed by treatment of the brain surface with L-660,711 (10(-5) M), a specific leukotriene D4 receptor antagonist. These data suggest that leukotrienes may be involved in delayed cerebral vasoconstriction that follows a brief period of hypoxia.

Animals↗
PubMed1991

Enhanced siderophore production and mouse kidney pathogenicity in Escherichia coli grown in urine.

Fifteen siderophore producing urinary isolates of Escherichia coli were compared for aerobactin and enterochelin production in trypticase soy broth and pooled normal human urine. Significant increase in siderophore production (both phenolate and hydroxamate) was observed when organisms were grown in urine. Mouse kidney pathogenic potential of the strains grown in urine was compared with that of bacteria grown in trypticase soy broth in an ascending model of pyelonephritis in female Swiss Webster mice. Organisms grown in urine and instilled into a mouse bladder demonstrated markedly enhanced renal pathogenicity (p less than 0.01). Further information about the influence of urinary constituents on siderophore production could help in understanding the pathogenesis of pyelonephritis.

Animals↗
PubMed1991

Japanese encephalitis virus latency in peripheral blood lymphocytes and recurrence of infection in children.

In a study group of 40 children who had been admitted to hospital with acute encephalitis, the disease was due to infection with Japanese encephalitis virus (JEV). Three children developed recurrence of disease 8-9 months later. No virus had been isolated from these three patients during the acute stage of their illness, but virus was recovered from all during the recurrence phase by co-cultivation of their peripheral blood mononuclear cells in primary mouse embryo fibroblast cultures. Virus was also recovered by co-cultivation of peripheral blood mononuclear cells collected 8 months after their acute disease from three out of eight randomly selected asymptomatic children within the study group but not from similar cultures set up from JEV-seronegative children used as controls. Virus was also isolated by co-cultivation of T lymphocytes of asymptomatic children as detected by indirect immunofluorescence or by inoculation in mice.

Cells, Cultured↗