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Biomedical subjects

A Rastogi

Publications and source records attributed to A Rastogi.

59 records · Page 4Linked to original sources

Stones associated renal pelvic malignancies.

BACKGROUND: The clinico-pathological characteristics of renal pelvic malignancies associated with stones were retrospectively analyzed. AIMS: The main objective was to define the biological behavior and prognostic factors for these malignancies. SETTINGS & DESIGN: The tumors were classified according to the pathological types. The clinical data, imaging features and pathological features were analyzed with relation to prognosis. MATERIAL AND METHODS: Eighteen cases of malignancies associated with stone disease were retrospectively studied. The institute review board permitted the study. RESULTS: High incidence (15/18) of squamous cell carcinoma (SCC) was noted. The prognosis in this group of patients was uniformly poor. The median survival time was 3.6 months in the SCC group, 7.5 months in the Transitional Cell Carcinoma (TCC) group and 24 months in the Adenocarcinoma (AC) group. Infectious and systemic symptoms were noted in the majority of the patients. Preoperative Imaging techniques revealed tumor in only 2 cases. Both underwent radical extirpation and the median survival is 18 months till date. In the other 16 patients, where the initial diagnosis was made only on histological analysis of incomplete nephrectomy specimens, the survival was 3.56 months. All patients had prolonged history of staghorn stone disease with associated non-functioning kidney. We found that the main prognostic factor was the stage of the disease. CONCLUSIONS: Malignancies associated with stone disease have insidious onset of clinical symptoms and need a high degree of suspicion to identify them pre-operatively. The grave prognosis associated with incomplete excision makes it imperative to diagnose them earlier.

Adenocarcinoma↗

Modified canaliculo-dacryocystorhinostomy.

The management of cases with common canalicular obstruction poses a difficult problem. Nineteen patients presenting with common canalicular obstruction of unknown cause or in association with trauma, encysted mucocoele and previous sac surgery, were operated on by the modified canaliculodacryocystorhinostomy technique. The surgery involves a microsurgical dissection at the site of the common canalicular obstruction followed by anastomosis to the sac or nasal mucosa with silicone tube intubation of the passage using an improvised metallic introducer. The procedure was successful in 13 of the cases in a follow-up period varying from 4 months to 15 months. The complications included extrusion of the tube and nasal bleeding. The indications of the procedure, the precise technique and precautions to avoid intra and post operative complications have been elaborated in the paper.

Adolescent↗

Effect of heparin-binding growth factor-1 on bronchial healing in canine lung allograft transplantation.

Failure of airway healing complicates lung transplantation. Local application of heparin-binding growth factor-1 induces neovascularization in vivo. To determine the effect of direct application of heparin-binding growth factor-1 on bronchial healing, we performed single left lung allotransplantations in 12 dogs, and wrapped the bronchial anastomosis with Gelfoam impregnated with either recombinant heparin-binding growth factor-1 (100 micrograms, n = 6) or saline solution (n = 6) in a blinded fashion. After 21 days, the bronchial anastomosis was studied by gross examination, light and electron microscopy, bromodeoxyuridine uptake, measurement of bronchial breaking strength, and high-speed computerized tomography to assess bronchial cross-sectional area and distensibility. The transplanted lung was examined histologically for concomitant lung rejection. No significant difference was found between the two groups in histologic bronchial healing scores, proliferation index, bronchial breaking strength, cross-sectional area, anastomotic distensibility, or local blood flow as estimated by high-speed computerized tomography scan. In the growth factor group, both increased neovascularization and lung rejection were found at histologic evaluation. We conclude that, although the use of heparin-binding growth factor-1 increased perianastomotic neovascularization, it did not contribute to improved bronchial healing, possibly because of increased lung rejection.

Anastomosis, Surgical↗

Hepatitis B--potential of perinatal transmission in India.

To estimate the frequency of perinatal hepatitis B virus (HBV) infection, 850 pregnant females were tested for HBsAg and HBeAg using RPHA kits. Frequency of HBsAg positivity was 4.6% by RPHA and 6.34% by micro-ELISA. HBeAg was detected in 18% of the HBsAg positive pregnant females. Presuming a perinatal HBV infection rate of 90% amongst infants born to HBsAg and HBeAg positive pregnant females and 17% amongst infant born to HBsAg positive but HBeAg negative mothers, we estimated that 1.17% to 1.64% infants out of 24 million births occurring annually in this country would be infected with HBV. In other words every year 2.8 to 3.9 lakh infants are being infected by HBV perinatally, 90% of whom will eventually develop chronic HBV infection. Urgent control measures are necessary to circumvent this problem.

Adult↗