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Biomedical subjects

J C Patel

Publications and source records attributed to J C Patel.

At least 73 records · Page 4Linked to original sources
PubMed1993

Alterations in the concentration of an apolipoprotein E-containing subfraction of plasma high density lipoprotein in coronary heart disease.

The concentrations of high density lipoprotein (HDL) subfractions in 100 healthy male subjects were compared with 100 newly presenting patients with myocardial infarction (MI) within 12 h of the onset of chest pain. A subfraction of HDL enriched in apolipoprotein E (apo E), separated by heparin-Sepharose affinity chromatography, was present in lower concentrations (P < 0.001) in the plasma of the coronary patients than in the control subjects. This finding was confirmed by a lower content (P < 0.02) of apo E, measured by ELISA, in the total HDL fraction isolated from the coronary patients. Gradient gel electrophoresis of the total HDL demonstrated that the coronary patients had a significantly decreased concentration of the large HDL particles, HDL2b, of mean diameter 10.57 nm and a higher concentration of the smaller-sized HDL3, especially HDL3c, of mean diameter 7.62 nm. The coronary patients had a lower concentration of HDL cholesterol than the control subjects, attributable to the HDL2 fraction, with no difference in HDL2a between the two groups. There was no difference in the concentration of plasma cholesterol or triglyceride. The distribution of apo E phenotypes was similar in the two groups. HDL2b produced the highest discriminant power between the two groups, followed by apo E-rich HDL, HDL2 and HDL3c Plasma cholesterol correlated strongly with apo E-rich HDL for control subjects but not for MI survivors. This study demonstrates that the inverse relationship between HDL cholesterol and coronary risk shown in epidemiological studies is attributable to the large, apo E-containing HDL subspecies which under some circumstances are implicated in cholesterol removal by reverse cholesterol transport. This study also suggests that the concentration of the large, apo E-containing HDL may provide a sensitive predictor for subjects at risk of developing coronary heart disease.

Adult↗
PubMed1993

Computed tomography (CT) appearances of acute pancreatitis presenting as polyarthropathy with subcutaneous fat necrosis.

A case of severe acute pancreatitis presenting with polyarthropathy and subcutaneous nodules but no abdominal pain is described. Abdominal CT showed multiple subcutaneous soft tissue densities which on histological examination were identified as areas of fat necrosis consistent with pancreatic disease. Such CT appearances have not been described previously.

Acute Disease↗
PubMed1993

The role of intravenous cholangiography in pre-operative assessment for laparoscopic cholecystectomy.

With the advent of laparoscopic cholecystectomy, pre-operative identification of calculi in the common bile duct has become increasingly important. In patients without clinical or biochemical evidence of common bile duct calculi, debate continues as to the value of intravenous cholangiography (IVC) as a screening modality for the detection of unsuspected choledocholithiasis. In a prospective series of 180 patients, IVC was used to assess the common bile duct in 113 patients at low risk of choledocholithiasis, 51 patients at high risk underwent endoscopic retrograde cholangiography (ERC) and sphincterotomy if indicated, and in 16 patients, for a variety of reasons, no pre-operative cholangiography was performed. 31% of those who had ERC and two (1.8%) of those who had IVC had duct calculi. These data do not support the routine use of IVC in patients with no evidence of common bile duct calculi and its routine use has been discontinued.

Adolescent↗
PubMed1993

Levels of lactic acid in normal Indians & its relation to food, glucose, cholesterol, raised blood urea.

1. The level of lactic acid was found to be between 5mg 25mg percent in 95 percent in 186 normal Indias. There was no difference due to sex and age. 2. Level of lactic acid was estimated in blood of normal persons and diabetes type II patients to observe the effects of food and glucose. The effect of food and and glucose was to take the levels of lactic acid to higher level than normal in about 25 percent of persons examined. 3. Hyperglycemia of over 300 mg raised the blood lactic acid in 25 percent of patients. 4. Lactic acid was not affected by hypercholereteremia but was raised in 60 percent of cases with high blood urea.

Adolescent↗
PubMed1993

[Qualification in general surgery. Experience of the National Commission with the first action by the Counsel of licensure of physicians].

The french board of qualification in general surgery examines requests from physicians who have neither a University French diplome of surgery, nor a similar diplome of a country of the European Community. From 1989 to 1991, 184 requests were submitted to the board, coming from military surgeons (n = 18), residents of university hospitals (n = 37) or general hospitals (n = 10) or from other physicians (n = 119). These latters originate mainly from non European foreign countries, and are naturalized as French citizens afterwards. The board gave 54 favourable recommendations (29%), ranging from 100% for military surgeons, to 8% for other physicians who had not been resident. Out of these requests, 18 were applied by physicians who were appointed as staff surgeon, usually in small public hospitals. Rather to appoint physicians without any surgical qualification to artificially provide jobs it would be cheaper for the care insurance system, and more secure for the patients, to close or transform hospitals which cannot find qualified surgeons. However, it is a difficult political challenge as, in France, mayors are systematically President of the administrative board of the public hospital.

France↗
PubMed1993

[Crohn's disease of the small intestine: place of surgery in 1992].

Crohn's disease (CD) is a chronic pan-enteric inflammatory disease of unknown etiology. Although treatment of CD of small intestine is at present principally medical, in the majority of cases surgical intervention is unavoidable, essentially to treat complications such as occlusion, intra- and/or extra-abdominal abscess, certain fistulae, intraperitoneal perforation, profuse hemorrhage and neoplastic degeneration. Surgery may also be indicated during acute episodes of corticotherapy resistant CD, and as a valid alternative to only partially effective long term corticoid treatment of an active chronic disease. Experience has shown that surgery should be as conservative as possible, "stricturoplasty" being the treatment of choice for stenotic lesions. Postoperative follow-up conditions have still to be formulated because of the marked variations in manifestations of recurrence of the disease.

Abscess↗
PubMed1992

Correlation of microproteinuria and histopathological changes in kidney in diabetes mellitus.

Single attempt kidney biopsy was successful in 60 cases of diabetes mellitus out of 83. Histopathological evidence of nephropathy was found in 30 (50%) out of 60 (4 of IDDM and 56 of NIDDM). Microproteinuria was a sensitive indicator of histopathological evidence of nephropathy (by biopsy) and should be used as a non invasive method of evidence of kidney involvement in diabetes mellitus regardless of duration of the disease. Routine renal function tests--commonly used indicators of kidney disease in the presence of hypertension were of no value and should not be relied upon. Duration of diabetes mellitus was important correlation with the evidence of the disease and and its severity but nephropathy was found in newly detected cases of diabetes mellitus (NIDDM). Nephropathy was present in case of DM who had retinopathy and is a better factor of correlation.

Adult↗
PubMed1992

Hereditary spherocytosis: experience of 145 cases.

145 patients were diagnosed to have hereditary spherocytosis (HS) over a period of 25 years. Jaundice (66.9%), fever (65.5%), weakness (44.8%), and abdominal pain (35.8%) were the commonest complaints. 94.5% had splenomegaly (JP-17 cm) and 71.7% had hepatomegaly (JP-6 cm). Spherocytes were detected in the peripheral smears of all patients at presentation on careful examination. 67 patients had been investigated elsewhere and spherocytes missed in 86.6%. Gall stones were seen in 20 of the 54 patients investigated. Family history suggestive of HS was available in only 16.6% of cases, whereas examination and investigations revealed HS in almost all families. Splenectomy was done in all symptomatic patients. In the 39 patients followed up for 1-9 years after splenectomy.

Adult↗
PubMed1991

A complex pattern of H2A phosphorylation in the mouse testis.

Phosphorylation of H2A histones in mouse testis was examined using testis tubule cultures labeled with 32PO4. Histones were analyzed by two systems of two-dimensional polyacrylamide gel electrophoresis, followed by autoradiography of the gels. Of the 32PO4 detected in histones, 95% was incorporated by certain modified forms of the H2A variants H2A.1 and H2A.X. Phosphorylation sites were mapped to N- and C-terminal regions of the modified variants by SDS gel electrophoresis and autoradiography of peptides generated by cleavage of in vitro-labeled proteins with N-bromosuccinimide. Incorporation rates differed for N- and C-terminal regions from different modified forms, demonstrating a complex pattern of H2A phosphorylation in the mouse testis.

Animals↗
PubMed1991

[Role of emergency subtotal colectomy in neoplastic obstructions of the left colon].

From 1984 to 1990, 60 patients underwent emergent surgery for a neoplastic obstruction of the left colon. We performed 19 colostomies without initial exeresis and 41 immediate tumoral resections. In the latter group, five subtotal colectomies (S.T.C.) were performed, including four with immediate mechanical anastomosis. Two patients had synchronous cancers and three had pre-perforating cecal lesions. Three patients had an associated general peritonitis. Three of the patients treated with STC died. These were these patients with general peritonitis, two of whom also had hepatic metastases. The data found in the literature on neoplastic obstructions of the left colon treated with STC with immediate anastomosis (227 cases are published) show an overall mortality rate of 8.4% with 24% morbidity, a complication of the anastomosis occurring in 4.5% of all cases.

Aged↗
PubMed1991

[Antropyloric lithiasic obstruction. A variant of Bouveret's syndrome].

We report about one case of cholecystoduodenal fistula complicated by antropyloric lithiasic obstruction, which was treated surgically with gastrotomy and extraction of the calculus, in an 82-year-old woman. This case represents an anatomic variant of Bouveret's syndrome, which is classically defined as a duodenal lithiasic obstruction. On the basis of this case, the authors discuss the diagnostic and possibly therapeutic merits of digestive endoscopy and define the main clinical, anatomical and evolutive characteristics of this unfrequent complication of biliary lithiasis.

Aged↗
PubMed1990

[Surgical treatment of infectious aneurysm of the popliteal artery. Description of a case caused by Campylobacter jejuni and a review of the literature].

The authors describe a case of mycotic aneurysm of the popliteal artery secondary to Campylobacter jejuni-derived infectious endocarditis treated by excision and in situ femoro tibial venous bypass, and take the opportunity to review 14 literature cases of infectious aneurysm of popliteal artery. This diagnosis is most frequently evoked by the development in an infectious setting of a throbbing inflammatory mass in the popliteal fossa. Management is aimed at controlling the infection and insuring proper distal vascularization. Eradication of the infection rests with the excision of the aneurysm and adequate antibiotherapy for at least 6 weeks. Distal vascularization is best provided (2 cases) by extra-anatomical bypass. However, in situ bypassing (9) is possible provided apyrexia and negative blood cultures have been obtained by preoperative antibiotherapy. The material used must be a venous autograft, whenever possible.

Adult↗