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Biomedical subjects

P Puri

Publications and source records attributed to P Puri.

At least 235 records · Page 13Linked to original sources
PubMed1992

Effect of coingestion of paracetamol on glycaemic response.

Rate of gastric emptying is a frequently measured variable in glycaemic response studies. One of the indices employed for measurement of the gastric emptying rate is the blood level of paracetamol at frequent intervals of time following coingestion of paracetamol with the meal. But the effect of paracetamol itself on glycaemic response is not known. The present study was performed on ten healthy and five NIDDM subjects. Each subject underwent two meal tolerance tests in random sequence. On one occasion the meal was white bread; on the other occasion, the meal consisted of the same quantity of white bread and 1.5 g paracetamol. The postprandial glycaemica following the two meals was not significantly different. Thus the results validate the use of the paracetamol technique for gastric emptying in glycaemic response studies.

Acetaminophen↗
PubMed1991

Glycaemic response to maize, bajra and barley.

The postprandial glycaemic response to maize (Zea mays), bajra (Pennisetum typhoideum) and barley (Hordeum vulgare) was studied in a pool of 18 healthy volunteers and 14 patients having non-insulin-dependent diabetes mellitus (NIDDM). In response to maize, none of the variables examined was significantly different as compared to white bread. The glycaemic response to bajra was significantly lower than that to white bread in healthy subjects, but the two responses were indistinguishable in NIDDM subjects. The insulinaemic responses to bajra and white break were not significantly different in either group of subjects. The glycaemic response to barley was significantly lower than that to white bread in both groups of subjects. But the insulinaemic response to barley was significantly lower than that to white bread only in healthy subjects. In NIDDM subjects, there was a tendency for the response to barley to be higher than that to white bread 0.5 h after ingestion. Barley, with a low glycaemic index (68.7 in healthy and 53.4 in NIDDM subjects) and a high insulinaemic index (105.2) in NIDDM subjects seems to mobilize insulin in NIDDM. This makes it a specially suitable cereal for diabetes mellitus.

Adult↗
PubMed1990

Endoscopic correction of primary vesicoureteric reflux by subureteric injection of polytetrafluoroethylene.

91 children (143 ureters) with primary vesicoureteric reflux (VUR) treated endoscopically by subureteric injection of 'Polytef' (polytetrafluoroethylene) paste were followed up for 2 to 5 1/2 years. 94% of the patients were treated as day cases. Reflux ceased in 113 (79%) of the 143 ureters after a single injection of polytef paste. 20% of ureters in this series required more than one endoscopic injection of polytef paste to correct reflux. Nearly 80% of the 113 ureters corrected after a single injection of polytef required less than 0.3 ml of paste per ureter to correct reflux. 88% of ureters continue to show absence of reflux 2 to 5 1/2 years after endoscopic correction. More than half of the recurrences were only of grade I or grade II severity and required no treatment. 7 ureters had recurrent grade III or IV reflux and were reinjected without any difficulty. The correction of vesicoureteric reflux by endoscopic injection of polytef paste is an outpatient procedure that requires 15 min of anaesthetic time. It is safe, simple, and effective in correcting all grades of reflux. Best results are obtained when the paste is injected precisely into the floor of the submucosal ureter.

Adolescent↗
PubMed1990

New insights into the pathogenesis of appendicitis based on immunocytochemical analysis of early immune response.

Although appendicitis is the most common condition requiring emergency surgery, the pathogenesis of this disease is poorly understood. In this study, local immune responses in acute appendicitis were investigated, using an experimental rabbit model, as well as in different grades of appendicitis in humans. Polymorphonuclear leukocyte (PMN) and plasma cell isotypes infiltration was measured in 24 New Zealand-bred white rabbits following experimental obstruction of the appendiceal lumen for periods ranging from 30 minutes to 24 hours. Significant infiltration of PMNs, IgM, and IgG plasma cells was noted at 30 minutes following obstruction, and IgA plasma cells were noted at 2 hours after obstruction. The immunopathological features observed in the study of human appendicitis clearly demonstrated the role of plasma cell infiltration in the immunopathogenesis of appendicitis. IgA and IgG plasma cells were significantly increased in the lamina propria of both focal and acute suppurative appendicitis, compared with controls (P less than .001). In focal appendicitis, in which the focus of inflammation is confined to only a few serial sections, the increased IgA and IgG plasma cell infiltration was present throughout the entire length of the resected organ. The possibility, as seen in this study, that antigen stimulation of the effector immune system could give rise to appendicitis, provides new insights into the diversity of inflammatory responses contributing to diseases of the intestinal tract. This previously unrecognised concept in the pathogenesis of appendicitis requires further elucidation of the stimulating agent, and in particular the T-cell recognition process.

Animals↗
PubMed1990

Semen analysis in patients operated on for impalpable testes.

Semen analysis was performed on 48 men who had undergone orchiopexy, 40 for unilateral impalpable testes and 8 for bilateral impalpable testes. Patients with unilateral impalpable testes had varying sperm analysis; 18 (86%) of the 23 patients with unilateral impalpable canalicular testes had normal sperm analysis. All patients with bilateral impalpable testes were azoospermic. The subsequent quality of the semen is dependent upon the original anatomical positions of the undescended testes.

Adolescent↗
PubMed1990

Relationship of primary site of testis to final testicular size in cryptorchid patients.

Testicular volume was examined in men who had undergone orchiopexy at or after 7 years of age; 159 men with 187 cryptorchid testes were available for estimation. The mean age at orchiopexy was 9.8 years (range 7-13.6) and the mean age at follow-up was 24.3 years (range 18-41). The data showed that surgically treated cryptorchism was associated with testes that are significantly smaller than normal. The most important factor in relation to subsequent testicular size was whether or not the testes were palpable. Testes found in the superficial inguinal pouch were approximately 85% of normal testicular volume. Contralateral testicular volume in unilaterally cryptorchid patients was not significantly different from that of controls.

Abdomen↗
PubMed1989

Fertility following perforated appendicitis in girls.

A study was undertaken to determine fertility status in a group of adult females who as children had been operated on for perforated appendicitis between 1957 to 1975. The 389 girls operated on for perforated appendicitis were reviewed. Their ages ranged from 10 months to 13 years at the time of appendicectomy. Of these girls, 276 were now 20 to 43 years old, and they were contacted by means of a mail questionnaire, and personal interview wherever necessary. It proved possible to contact 181 women; 102 of them were married and 79 were unmarried. Eight-four of the married women (82%) had one or more children. Nine unmarried women also had one or more children. Eighteen married women who have no children were studied in detail. Five women were on contraceptives, two desired pregnancy but had not conceived, and one patient was separated from her husband. Two patients had conceived and aborted, and two were married to infertile men. Of the remaining six patients who had been investigated for infertility, no demonstrable cause of infertility was found in three. Of the other three patients, one showed evidence of bilateral tubal occlusion secondary to pelvic inflammatory disease, one has had a right ectopic pregnancy followed by two abortions, and the third patient was found to have a pituitary adenoma. Our data show that perforated appendicitis before puberty has little if any role in the aetiology of tubal infertility.

Adult↗
PubMed1988

Semen analysis of patients who had orchidopexy at or after seven years of age.

Semen analysis was performed in 142 men who had undergone orchidopexy at age 7-13 1/2 years, 119 for unilateral cryptorchidism and 23 for bilateral cryptorchidism. Fertility potential was related to the original position of the testes: most men who had had unilateral cryptorchidism or bilateral undescended testes in the superficial inguinal pouch produced normal or acceptable semen, whereas those who had had bilateral canalicular or abdominal testes were azoospermic.

Adolescent↗
PubMed1988

Diagnosis of allied functional bowel disorders using monoclonal antibodies and electronmicroscopy.

There are a number of conditions that clinically resemble Hirschsprung's disease despite the presence of ganglion cells on rectal biopsies. These conditions have been described under various names. There have been no systematic studies to date to distinguish these conditions from one another. We examined biopsy and surgical specimens from 19 cases of allied functional bowel disorders in an attempt to establish the most appropriate diagnostic procedure. Suction rectal biopsy and full thickness surgical biopsy specimens were examined by enzyme histochemistry (AChE), immunocytochemistry (monoclonal antibody D7), silver impregnation, and electronmicroscopy. Monoclonal antibody D7, which was produced in our own laboratory, is a good marker of autonomic nervous system. This unique antibody allowed us to distinguish various neuronal abnormalities of the bowel except the abnormalities of the argyrophil plexus, which were diagnosed by silver staining. Eight of the 19 cases had a smooth muscle disorder that was only diagnosed on electronmicroscopy. Our data suggest that the vast majority of allied functional bowel disorders can be diagnosed by examining a full thickness rectal biopsy by immunocytochemistry (D7 monoclonal antibody), silver impregnation, and electronmicroscopy.

Acetylcholinesterase↗
PubMed1988

New observations on the pathogenesis of multiple intestinal atresias.

It has been suggested that multiple intestinal atresias result from multiple ischemic infarctions of the intestinal tract. We have studied surgical material from 59 neonates with intestinal atresias seen at our hospital between 1975 and 1986. Forty (68%) patients had single intestinal atresias and 19 (32%) had multiple atresias. There were seven cases of hereditary multiple atresias seen in three families and 12 cases of nonhereditary multiple atresias. All hereditary cases had numerous type I or type II gastrointestinal atresias but none had type IIIa atresia. Six of the seven hereditary cases had multiple atresias in the small as well as large bowel. The 12 patients with nonhereditary atresias had various types of atresias but mesenteric or intestinal interruption was observed in only two patients. All patients with hereditary multiple intestinal atresias showed identical microscopic appearances in the small and large intestine, consisting of sieve-like multiple lumina, each surrounded by its own mucosa and muscularis mucosae but sharing a common muscle coat. There was no evidence of lanugo, bile pigments, or squames within the lumen distal to atretic segments in any of these patients. Six nonhereditary cases who had multiple septal atresias affecting only the small bowel demonstrated essentially similar lesions on microscopic examination as seen in hereditary cases. There was no evidence of arterial occlusion in the mesentery and lanugo, bile pigments, and squames could not be found distally in the intestinal contents in any of these cases. These pathologic findings suggest that all cases of hereditary multiple intestinal atresias and some cases of nonhereditary multiple intestinal atresias are a consequence of a malformative process of the gastrointestinal tract rather than an ischemic process.

Abnormalities, Multiple↗
PubMed1988

Technical refinements in endoscopic correction of vesicoureteral reflux.

Subureteral polytetrafluoroethylene (Teflon) injection (the Sting) was used for endoscopic correction of vesicoureteral reflux in more than 400 patients since March 1984. The basic principle involves injection of 0.2 to 0.8 ml. of polytetrafluoroethylene paste the intravesical portion of the affected ureter. The refinements of the technique and the various types of equipment used are described. A protocol for followup is outlined.

Endoscopy↗
PubMed1988

Inflammatory response in enterocolitis in the piebald lethal mouse model of Hirschsprung's disease.

Mucosal immune defense responses in two clinical forms of enterocolitis complicating congenital megacolon in the piebald lethal mouse model of Hirschsprung's disease were investigated. Significant histological and immunocytochemical differences were seen in the ganglionic segment of colon between piebald mice with early clinical onset of acute illness and piebald mice with late onset enterocolitis. The number of IgA-containing plasma cells infiltrating the lamina propria of the gut in the former group were significantly increased (p less than 0.001) compared to the latter group of mice and healthy controls. This study suggests that the two forms of enterocolitis complicating congenital megacolon in piebald mice have different etiologies.

Animals↗
PubMed1987

Immunohistochemical characterization of abnormal innervation of colon in Hirschsprung's disease using D7 monoclonal antibody.

Innervation patterns in normal and aganglionic colon were studied using a panel of antineuronal cell antibodies. One antibody, D7, which recognizes a subset of neuronal cells of the peripheral and central nervous system reacted strongly with nerve fibers in the circular muscle of the normal colon. Immunohistochemical scanning of the entire resected specimen of colon from three children with Hirschsprung's disease demonstrated large numbers of D7 immunoreactive nerve fibers in the circular muscle of the ganglionic colon, few fibers in the transitional zone, and no immunoreactive fibers in the aganglionic segment of bowel. While the absence of D7 immunoreactive fibers paralleled the absence of myenteric ganglion cells in the aganglionic segment, a critical region of colon was identified wherein D7 reactive fibers were evident ahead of the appearance of ganglion cells. These findings indicate that the fundamental pathology in Hirschsprung's disease is not only the absence of ganglion cells of the myenteric and submucuous plexuses but also the absence of D7 immunoreactive fibers in the circular muscle of the colon.

Antibodies, Monoclonal↗
PubMed1987

Endoscopic correction of grades IV and V primary vesicoureteric reflux: six to 30 month follow-up in 42 ureters.

Between March 1984 and March 1986, 31 children with 42 ureters with grades IV and V primary vesicoureteric reflux were treated by endoscopic subureteric injection of Polytef paste. Reflux ceased after a single injection in 28 ureters, after the second in six, after the third in three and after the fourth injection in one. Two ureters showed improvement to grade II reflux after two injections and no further treatment was given. Two ureters showed no change in grade of reflux after three and four injections, respectively. Twenty-seven children with successfully treated ureters have now been followed up for periods ranging from 6 to 30 months. All 38 ureters had a negative micturating cystogram following endoscopic correction. At follow-up there was no reflux in 32 (84%) ureters and recurrence in six (16%). The procedure is simple to perform and without significant complications. The follow-up results show that the endoscopic treatment is reliable and effective in correcting higher grades of vesicoureteric reflux.

Adolescent↗
PubMed1986

Endoscopic correction of primary vesicoureteric reflux: results in 94 ureters.

Sixty one patients with primary vesicoureteric reflux were treated by endoscopic injection of Mentor Polytef paste. Seventy six of the 94 treated ureters showed complete disappearance of vesicoureteric reflux after one injection. Eight refluxing ureters required a second injection, one required a third, and one a fourth. Six ureters showed improvement in the grade of reflux after the first injection. Two ureters did not show any change in the grade of reflux after endoscopic injection. The amount of paste injected to correct reflux in the 94 ureters varied from 0.1 to 1.0 ml (mean 0.33 ml). Patients were followed up for three to 25 months (mean 13.4 months). Follow up micturating cystograms in the 94 ureters showed absence of reflux in 83. Eleven ureters showed recurrence of reflux. Recurrence of reflux was attributed to early technical difficulties and to insufficient amounts of polytef paste used in some cases. Follow up urograms did not show evidence of ureteric obstruction in the treated ureters. Endoscopic injection of polytef paste is a safe, simple, and effective procedure for primary vesicoureteric reflux and averts the need for open operation.

Adolescent↗
PubMed1986

Endoscopic correction of vesicoureteric reflux secondary to neuropathic bladder.

Eleven patients with vesicoureteric reflux secondary to neuropathic bladder were treated by endoscopic injection of pyrolised polytetrafluoroethylene (Polytef) paste. Thirteen of the 15 ureters treated showed disappearance of reflux after one injection. The amount of Polytef paste injected varied from 0.2 to 0.9 ml (mean 0.45 ml). There were no complications, except in one ureter where distension of the collecting system was slightly increased compared with the pre-operative urogram.

Adolescent↗