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Biomedical subjects

M Tatke

Publications and source records attributed to M Tatke.

43 records · Page 3Linked to original sources

Surgical management of cardiac myxomas.

Cardiac myxomas are rare cardiac lesions, though they are the commonest tumours of the heart. Seventeen cases of cardiac myxomas have been operated during the last one decade. Exertional dyspnoea, palpitation and chest pain were the main presenting symptoms. Echocardiographic assessment was the only definitive diagnostic investigation required prior to surgery. Early surgical excision was planned in all the cases. Irrespective of the exposure techniques, removal of the tumour with wide excision of its base was practised. There was one early death due to low cardiac output in a patient brought in a shock like state. Follow up study has revealed 14 patients in NYHA class I and two patients are having class II symptoms. Periodic echocardiographic follow up study has not revealed any recurrence till date. It is concluded that an early diagnosis and surgery gives excellent long term results in these cases.

Adult↗

Immunological alterations following open heart surgery.

Immunological changes in thirty patients undergoing various cardiac surgical procedures (twenty patients undergoing open heart surgery with either the bubble or the membrane oxygenator and ten patients undergoing closed surgical procedures) were studied. There was an activation of suppressor T cells and secretion of lymphokines in patients undergoing open heart surgery with activation of the classical complement pathway. The immunological alterations were similar in all patients irrespective of the type of oxygenator used.

Adolescent↗

Endomyocardial biopsy--its evaluation in cardiac disorders.

Endomyocardial biopsies (EMBs) of 47 patients with various cardiac disorders were analysed. Clinically 26 patients were diagnosed as having dilated cardiomyopathy (DCM), 9 myocarditis, six restrictive heart disease and six as Duchenne muscular dystrophy. EMB showed normal histological picture in six cases of DCM and findings consistent with DCM in rest of the twenty cases. None of these biopsies showed evidence of myocarditis. Diagnosis of myocarditis could be confirmed on EMB only in three out of nine clinically diagnosed cases. Cases with restrictive heart disease showed normal biopsy in two, infarction in one, findings consistent with endomyocardial fibrosis in one and amyloidosis in two cases. EMB on six cases of Duchenne muscular dystrophy showed nonspecific histological changes. To conclude, in this series, cases of DCM did not show evidence of underlying myocarditis in endomyocardial biopsies.

Biopsy↗

Intestinal metaplasia--its association with gastric cancer.

Endoscopic gastric biopsies from 230 patients and post gastrectomy specimens of 18 patients were evaluated for the presence of intestinal metaplasia (IM) and its association with the gastric lesions. There were a total of 78 malignant and 170 benign lesions. IM was present in 53% of patients with gastric carcinoma (GC) and in 10.6% with benign lesions of the stomach. The IM in association with GC was of type 1 (Small Intestinal) in 58.8%; type II (mixed gastric and small intestinal) in 11.8% and type III (Colonic) in 29.4%. In patients with benign lesions the IM was predominantly of type I (94.5%) except in 1 patient who had type III metaplasia. Our findings indicate that type III IM was significantly more frequent in patient with GC than with benign lesions (29.4% Vs 5.5%; p < .005). Therefore we conclude that patients with type III IM should be kept on surveillance for GC.

Biopsy↗

Nucleolar organiser regions in different colonic epithelia.

The argyrophilic technique (AgNOR) was applied to paraffin sections of 10 acute self-limited colitis, 15 ulcerative colitis (UC), 5 ulcerative colitis with indefinite dysplastic change, 10 adenomatous polyps, 20 colorectal adenocarcinomas and 10 normal colorectal mucosa. The mean number of nucleolar organiser regions (NORs) per nucleus ranged between 1.62-2.00 (95% CI 1.77-1.93) for normal colon, 2.47-3.80 (95% CI 2.71-3.21) for acute colitis, 1.66-2.75 (95% CI 2.13-2.44) for UC, 3.60-4.00 (95% CI 3.67-3.94) for UC with indefinite dysplasia, 3.00-4.04 (95% CI 3.41-3.81) for adenomatous polyps and 3.59-6.70 (95% CI 4.04-4.72) for colorectal adenocarcinoma. The differences observed were statistically significant. There was a significant difference of AgNOR counts between adenomatous polyp and UC with indefinite dysplasia in comparison to those observed in regenerative epithelium of acute colitis and UC without dysplasia. Hence the technique may be used as an adjunct to routine histology for delineating dysplastic changes in colonic epithelium.

Colon↗