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Biomedical subjects

A Shah

Publications and source records attributed to A Shah.

At least 415 records · Page 23Linked to original sources

Nerve conduction in leprosy: in vivo and in vitro study.

Sensory and mixed nerve conduction studies were performed on the distal segments of the radial, sural, median and ulnar nerves of leprosy patients from the entire spectrum of the disease. The values obtained were compared with those of age matched normal controls. All the clinically involved nerves, and about 30% of the clinically normal patient nerves showed a delayed conduction velocity. The conduction velocity difference was most significant (P less than 0.001) for the cutaneous branch of the radial, and sural nerves as compared to the ulnar and median. Five patients nerves that were clinically normal and showed a normal conduction velocity when tested in vivo, were biopsies and studied in vitro to determine the type of early nerve damage. C and A delta fibre involvement was found in all these nerves. It is concluded that leprosy is a diffuse neuropathy and there is early detectable nerve involvement even in clinically normal nerves of leprosy patients.

Adult↗

Prevalence of autism and related conditions in adults in a mental handicap hospital.

The proportions of subjects with severe social impairment and those retaining the features of childhood autism were investigated in a population of mentally retarded adults in a long-stay hospital. The results confirmed the findings of an earlier study of mentally retarded children (Wing & Gould, 1979) that the administrative category of mental retardation includes a substantial minority of people with severe impairment of two-way social interaction. Such social impairment occurred in 38% of the adult population and was very significantly associated with abnormalities of communication and imaginative activities. Muteness, repetitive stereotyped behaviour, including repetitive speech, and a range of behaviour problems also occurred more frequently in the socially impaired group. Two methods of sub-classifying the socially impaired were compared. Classification based on the severity of social impairment gave more statistically significant associations with behavioural and psychological variables than did a method based on the presence or absence of typical autism. The implications of these findings and their relevance for management and planning of services for the mentally retarded were briefly discussed.

Adolescent↗

Multiple myeloma first observed as multiple cutaneous plasmacytomas.

A 62-year-old woman had multiple plasmacytomas of the skin with no roentgenographic or bone marrow evidence of multiple myeloma. Serum IgA-lambda level was increased to 1,000 mg/dL (normal range, 90 to 450 mg/dL). The skin lesions regressed completely when the patient was treated with melphalan. She had recurrence of a skin plasmacytoma and lytic bone lesions ten months later and died of bronchopneumonia 11 months after the was first seen. Solitary skin plasmacytomas are rare, and multiple skin plasmacytomas are even rarer. Occasionally, these lesions may precede roentgenographic and bone marrow evidence of multiple myeloma.

Female↗

Systolic anterior motion of the mitral valve with and without asymmetric septal hypertrophy. Role of left ventricular posterior wall motion.

Abnormal systolic anterior (SAM) motion of the mitral valve without asymmetric hypertrophy of the interventricular septum was observed in 16 patients (group 1). 5 of the 16 patients had no other evidence of heart disease and the remaining 11 had a variety of cardiac disorders. Left ventricular dimensions, septal and posterior wall thickness, left ventricular ejection fraction, the mean velocity of circumferential fiber shortening, and the mean velocity of the posterior wall and septal contraction was measured by echocardiography in all patients in group 1. These measurements were compared with similar measurements in 14 patients with idiopathic hypertrophic subaortic stenosis (group 2) and in 11 normal subjects (group 3) to evaluate the role of the left ventricular contractility with particular reference to the left ventricular posterior wall motion in production of SAM. All patients with SAM (groups 1 and 2) showed significantly higher indexes of left ventricular contractility, particularly posterior wall velocity, and normalized mean posterior wall velocity, when compared to the normal subjects. The significantly higher posterior wall and the normalized mean posterior wall velocities in all patients with SAM suggest that the exaggerated systolic anterior motion of the left ventricular posterior wall plays an important role in production of SAM in the presence or absence of asymmetric septal hypertrophy.

Adult↗

Echocardiographic features of cardiac compression by mediastinal pancreatic pseudocyst.

Echocardiogram of a patient who had retrocardiac compression by pancreatic pseudocyst is described both before and after drainage. Mass of echoes behind the anterior leaflet of the mitral valve and its disappearance after drainage of a pseudocyst have not been described in available literature. These findings mimic left atrial myxoma, and we discuss their differentiation in this case report.

Drainage↗

On the pathogenesis of mitochondrial myopathies. An experimental study.

The intra-arterial injection of 2-4 dinitrophenol, an uncoupler of oxidative phosphorylation, resulted in the production of ragged red fibers. The ultrastructure of these fibers showed intramitochondrial paracrystalline inclusions, laminar and fingerprint bodies. Antimycin A and oligomycin injection (which inhibit mitochondrial respiration) only caused swelling and disruption of the mitochondria. An increase in muscle lactic acid, decrease in ATP, glycogen and phosphocreatine was observed after the injection of all these agents. This indicates that lactic acidosis has no significant role in the pathogenesis of mitochondrial pathology. It is concluded that mitochondrial changes are a morphological expression of uncoupled but intact mitochondrial respiration.

Animals↗

Incidence of mitral valve prolapse in subjects with thoracic skeletal abnormalities--a prospective study.

The incidence of mitral valve prolapse (MVP) in 80 patients with various thoracic skeletal abnormalities (TSA) was examined prospectively using compete history and physical examination, chest x-rays, electrocardiography, phonocardiography, and echocardiography. There were 76 males and four females, ranging in age from 18 to 80 years. Thirty-four patients had narrow anteroposterior diameter of the chest (asthenic habitus) (Group 1), 13 had straight back (Group 2), and 33 had pectus excavatum (Group 3). Twenty-five of the 80 patients (31 per cent) had evidence of MVP, 22 by echocardiographic criteria and three by phonocardiographic criteria. The incidence of MVP in this predominantly male population was substantially higher than that reported in the general adult population. Thoracic skeletal abnormality is an important nonauscultatory feature of mitral valve prolapse syndrome. The association between TSA and MVP may be a manifestation of a single connective tissue defect during embryonic development of the bony thoracic cage and the atrioventricular valves. All patients with TSA, even when asymptomatic, should be screened for MVP by noninvasive investigations. The recognition of MVP in patients with TSA may be of potential value in prevention of life-threatening endocarditis and cardiac arrhythmia.

Adolescent↗

Substituted 3-amino-1,1-diaryl-2-propanols as potential antidepressant agents.

Following the discovery that 3-(dimethylamino)-1,1-diphenyl-2-propanol hydrobromide (1) possesses potent reserpine-prevention activity in mice, a series of analogues of 1 was synthesized and evaluated as potential antidepressant agents. Several routes to analogues of 1 were evaluated, the most generally applicable of which was the regiospecific ring opening of a suitably functionalized 1,1-diaryl-2,3-epoxypropane (obtained in three stages from the corresponding benzophenone) with the appropriate amine. The more interesting compounds of the series were evaluated for their propensity to cause undesirable peripheral anticholinergic effects, all compounds tested being markedly less active than imipramine on this parameter. On the basis of its good activity in biochemical and pharmacological animal models of depression, together with its relative lack of anticholinergic side effects, 1-(3-chlorophenyl)-3-(dimethylamino)-1-phenyl-2-propanol hydrochloride (20, BRL 14342) was chosen for further evaluation.

Animals↗

Complications due to cloth wear in cloth-covered Starr-Edwards aortic and mitral valve prostheses--and their management.

Five cases of complications due to cloth wear in cloth-covered composite-seat Starr-Edwards aortic and mitral valvular prostheses are described. The complications of cloth wear were recurrent systemic emboli in three patients, two with aortic and one with mitral prosthesis, and severe hemolytic anemia in two patients with aortic prosthesis. The over-all incidence of clinically significant complications due to cloth wear in aortic and mitral valve prosthesis was 2.5 per cent. The diagnosis of cloth wear is impossible before reoperation and it was made by exclusion of other causes of recurrent transient cerebral ischemic attacks or systemic emboli and by exclusion of other causes of hemolytic anemia. Clinical and laboratory findings suggestive of cloth wear are described. Aggressive management of complications of cloth wear by reoperation is likely to prevent disabling or lethal consequences. Porcine xenograft aortic and mitral bioprostheses were used in these patients to replace the cloth-covered valvular prostheses. The symptoms due to cloth wear were abolished in all patients by reoperation, and all patients are off anticoagulants postoperatively. The operative mortality rate for reoperation in this small group of patients was zero.

Adult↗

Thoracotomy as adjuvant to chemotherapy in metastatic osteogenic sarcoma.

This is a review of the experience at Memorial Hospital using chemotherapy combined with surgical excision for control of pulmonary metastases in osteogenic sarcoma. Effective multiple drug chemotherapy was able to control small deposits of osteogenic sarcoma in the lung, making surgical resection of residual visible nodules worthwhile. Surgical resection was most successful for solitary nodules or where multiple nodules were shrunk or at least prevented from growing by chemotherapy. Eight percent of these patients with pulmonary metastases initially or subsequently showed bilateral lung disease. When two or more nodules were found at th oracotomy, they were never confined to one lobe. For these reasons, wedge resections or segmental resections were the most commonly indicated procedures. Results justify an aggressive surgical approach to these lesions including multiple wedge resections of all lesions found at thoracotomy, chest wall resection and multiple bilateral thoracotomies. Chemotherapy alone cannot be expected to cure metastatic osteogenic sarcoma of the lung, but combined with surgical resection of residual disease the results are encouraging.

Adolescent↗

Complications of selective coronary arteriography by the Judkins technique and their prevention.

Complications encountered during 351 selective coronary artery and coronary artery bypass examinations performed by the Judkins technique are reviewed. The over-all incidence of cardiac and peripheral vascular complications was 3.13 per cent. The cardiac complications included four ventricular fibrillations and one acute myocardial infarction. Peripheral vascular complications included three femoral artery thromboses, two peripheral emboli, and one probable cerebral embolus. There was one death. The incidence of cardiac complications was not significantly different from that reported in the literature with the Sones technique and local arterial complications were significantly lower than those reported with the Sones technique. The causes of individual complications are analyzed and measures to minimize these complications are described. The Judkins technique is a simple, reliable, quick, and safe method of selective coronary arteriography. The incidence of complications can be kept at an acceptably low level by stringent observation of every minor detail of the technique.

Adult↗