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Biomedical subjects

K R Reddy

Publications and source records attributed to K R Reddy.

At least 181 records · Page 10Linked to original sources
PubMed1977

A sibship with hypervalinemia.

During routine screening of amino-acid disorders, we detected hypervalinemia in two sibs (a girl of 4 and a boy of 3 years of age) of a consanguineous marriage. There was no excess accumulation or excretion of leucine or isoleucine, which presumably indicates the absence of valine transaminase.

Amino Acid Metabolism, Inborn Errors↗
PubMed1977

Familial incidence of L-xylulosuria.

During a survey for genetic disorders, L-Xylulosuria, an autosomal recessive condition, was found to affect three cousins in an inbred family. There were no clinical symptoms.

Carbohydrate Metabolism, Inborn Errors↗
PubMedDate not supplied

Electron microscopic evidence of non-A, non-B hepatitis markers and virus-like particles in immunocompromised humans.

Characteristic pathological alterations of the liver in chimpanzees inoculated with non-A, non-B hepatitis sera have been described, but no corresponding findings have been reported in humans. Electron microscopic studies of the liver biopsy specimens of two homosexual patients with acquired immune deficiency syndrome, one without hepatitis (Patient 1) and one with chronic active hepatitis in remission (Patient 2), revealed the cytoplasmic tubular structures which are characteristic of chimpanzee non-A, non-B hepatitis. A cluster of 23 nm double-shelled particles was also seen in the cytoplasm of a hepatocyte in patient 1 who had received a blood transfusion 8 days before the biopsy. These particles were smaller than the Dane particles, Epstein-Barr virus, cytomegalovirus or herpes simplex virus, and different from hepatitis A virus particles; the antibodies to all of which are found in high concentration in acquired immune deficiency syndrome patients. These observations may reflect the morphologic findings for non-A, non-B hepatitis infection in humans.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Hepatic encephalopathy and orotic aciduria associated with hepatocellular carcinoma in a noncirrhotic liver.

A 40-yr-old man presented with encephalopathy and was found to have hepatocellular carcinoma without cirrhosis. A large vascular hepatic mass was defined by CT scan and angiography; laparoscopy with biopsy confirmed the absence of chronic liver disease. A definitive tissue diagnosis of hepatocellular carcinoma was made at laparotomy; the tumor was unresectable. Peripheral arterial and selective portal and hepatic venous ammonia levels were high, and this finding suggested that the encephalopathy was nitrogenous and hepatic in origin. The proposed mechanisms of the encephalopathy are generation of ammonia from tumor breakdown and portosystemic shunting, a result of partial tumor occlusion of the hepatic veins. An unusually high urinary excretion of orotic acid was found similar to that seen in hereditary orotic aciduria.

Adult↗
PubMedDate not supplied

The use of two new coagulation probes for control of hemorrhage in laparoscopic liver biopsy.

Two new prototype probes, BICAP and Heater, were assessed to determine their effectiveness in controlling post-biopsy bleeding during laparoscopy. A total of 88 patients with a wide spectrum of liver diseases were studied. Both probes were equally effective in stopping bleeding in all patients. We recommend the use of either of these devices in controlling post-biopsy bleeding.

Adolescent↗
PubMedDate not supplied

Laparoscopic and histologic findings in patients with the human immunodeficiency virus.

Hepatic dysfunction frequently develops in patients infected with the human immunodeficiency virus (HIV). This retrospective study was undertaken to determine the laparoscopic and histologic findings in a group of HIV-seropositive patients with or without the acquired immune deficiency syndrome (AIDS). Fifty-four patients, 44 with AIDS and 10 HIV-positive, underwent laparoscopic examination and visually guided biopsies for the assessment of clinical or biochemical evidence of liver injury. Significant abnormalities were detected in 31/44 (70%) AIDS patients and 3/10 (30%) HIV-positive patients. Overall, specific laparoscopic findings were described in 25/54 (46%). The most common findings were peritoneal involvement, massive intra-abdominal adhesions, focal lesions of the liver or spleen, and diffuse nodularity of the liver; these were usually related to opportunistic infections or neoplasms such as non-Hodgkin's lymphomas and Kaposi's sarcoma. No procedure-related deaths occurred. Laparoscopy is a safe and accurate method to detect underlying disease in a selected population of HIV-seropositive patients.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

Visceral protothecosis mimicking sclerosing cholangitis in an immunocompetent host: successful antifungal therapy.

A healthy 39-year-old man who had clinical findings consistent with sclerosing cholangitis was found to have systemic protothecosis at surgery. Severe granulomatous inflammation and palpable nodules were found in the gallbladder, on the surface of the liver, and in the duodenum. Prototheca wickerhamii was detected in biopsied specimens and stool; the titer of indirect fluorescent antibody to this organism was 1:2,000. The patient recovered after a short course of treatment with amphotericin B and 3 months of oral therapy with ketoconazole. He had no other concurrent illness and had no abnormality in his immune system. This is the second reported human case of systemic protothecosis. An elevated IgG level, an elevated erythrocyte sedimentation rate, eosinophilia, and abnormal levels of enzymes in the liver were found in both cases. Protothecosis should be considered in the differential diagnosis of hepatic and biliary inflammatory diseases of uncertain etiology.

Adult↗
PubMedDate not supplied

Fulminant hepatic failure secondary to previously unrecognized cardiomyopathy.

Fulminant hepatic failure is infrequently seen as a consequence of acute congestive heart failure. Recognition of this entity is important as treatment directed towards heart failure should help resolve the liver failure. A case of fulminant hepatic failure due to previously unrecognized cardiomyopathy is presented. A liver transplantation was being considered for fulminant hepatic failure until hemodynamic monitoring studies demonstrated that, in fact, the patient had severe cardiomyopathy. Treatment directed at his cardiomyopathy resolved the liver failure. Therefore, prompt recognition of such a phenomenon would enable early institution of appropriate therapeutic measures with the hope of clinical benefit to the patient.

Acute Disease↗
PubMedDate not supplied

Ibuprofen protects platelet cyclooxygenase from irreversible inhibition by aspirin.

Previous investigations have shown that ibuprofen inhibits the second wave of platelet aggregation and blocks the conversion of 14C-arachidonic acid to thromboxane. However, the influence of the drug on platelet function and cyclooxygenase is transitory, lasting only 24 hours. The present study has taken advantage of the short-lived influence of ibuprofen to study its interaction with the long-term effects of aspirin. As expected, both aspirin and ibuprofen suppressed platelet cyclooxygenase activity and function, but addition of aspirin to ibuprofen-treated platelets did not increase the degree of inhibition in vitro. Platelet function and prostaglandin synthesis recovered completely 26 hours following ingestion of ibuprofen, but remained compromised 26 hours after taking aspirin. When 650 mg of aspirin was administered after ibuprofen, platelet function and cyclooxygenase activity recovered as completely at 26 hours as did platelets which had been exposed to ibuprofen alone. Thus, prior exposure to ibuprofen in vivo completely protected cyclooxygenase from the irreversible effects of aspirin. Our findings indicate that ibuprofen-like indomethacin and other nonsteroidal antiinflammatory drugs react with the heme group of cyclooxygenase to prevent arachidonic acid conversion. Since ibuprofen completely blocks the effects of aspirin in platelets in vitro and in vivo, aspirin's primary influence on inhibition of cyclooxygenase must also be through action on the heme portion of the enzyme, rather than acetylation of the protein.

Animals↗
PubMedDate not supplied

Controlled-release, pegylation, liposomal formulations: new mechanisms in the delivery of injectable drugs.

OBJECTIVE: To review recent developments in novel injectable drug delivery mechanisms and outline the advantages and disadvantages of each. DATA SOURCES: A MEDLINE (1995-January 2000) search using the terms polyethylene glycol, liposomes, polymers, polylactic acid, and controlled release was conducted. Additional references were identified by scanning bibliographies. STUDY SELECTION AND DATA EXTRACTION: All articles were considered for inclusion. Abstracts were included only if they were judged to add critical information not otherwise available in the medical literature. DATA SYNTHESIS: A number of systems that alter the delivery of injectable drugs have been developed in attempts to improve pharmacodynamic and pharmacokinetic properties of therapeutic agents. New drug delivery systems can be produced either through a change in formulation (e.g., continuous-release products, liposomes) or an addition to the drug molecule (e.g., pegylation). Potential advantages of new delivery mechanisms include an increased or prolonged duration of pharmacologic activity, a decrease in adverse effects, and increased patient compliance and quality of life. Injectable continuous-release systems deliver drugs in a controlled, predetermined fashion and are particularly appropriate when it is important to avoid large fluctuations in plasma drug concentrations. Encapsulating a drug within a liposome can produce a prolonged half-life and a shift of distribution toward tissues with increased capillary permeability (e.g., tumors, infected tissue). Pegylation provides a method for modification of therapeutic proteins to minimize many of the limitations (e.g., poor stability, short half-life, immunogenicity) associated with these agents. CONCLUSIONS: Pegylation of therapeutic proteins is an established process with new applications. However, not all pegylated proteins are alike, and each requires optimization on a protein-by-protein basis to derive maximum clinical benefit. The language required to describe each pegylated therapeutic protein must be more precise to accurately distinguish each protein's differential pharmacologic properties.

Adjuvants, Pharmaceutic↗