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Biomedical subjects

P Puri

Publications and source records attributed to P Puri.

At least 253 records · Page 14Linked to original sources
PubMed1986

Endoscopic correction of primary vesicoureteric reflux.

One hundred and three children with primary vesicoureteric reflux treated by endoscopic injection of Polytef paste between March 1984 and February 1986 have been followed up for periods ranging from 3 to 23 months. Seventy-five per cent of refluxing ureters showed absence of reflux after one injection of Polytef paste; 14% of ureters required two to four sub-ureteric injections of Polytef paste for the correction of vesicoureteric reflux; 8% of ureters showed improvement in the grade of reflux after the initial injection of Polytef paste. Duplex systems were more difficult to correct and recurrence of reflux was much higher than in primary reflux. Follow-up intravenous urograms showed no evidence of ureteric obstruction in the treated ureters. The procedure is safe, simple and effective in correcting all grades of vesicoureteric reflux. To obtain best results, attention should be paid to minute details of the technique and the injection made with pinpoint accuracy.

Adolescent↗
PubMed1985

Small bowel tumours causing intussusception in childhood.

In a series of 292 children with intussusception ten (3.5 per cent) were caused by small bowel tumours. The average age of these patients was greater than in idiopathic cases; seven of the ten being older than 2 years. Intussusception due to Peutz-Jeghers hamartomas was jejunojejunal whereas other small bowel tumours causing intussusception were in the terminal ileum. The majority of these intussusceptions were either irreducible or gangrenous and all required resection of bowel. There was only one death in the entire series of 292 patients, and this was a child with lymphosarcoma.

Child↗
PubMed1985

Prepubertal testicular torsion: subsequent fertility.

Eighteen patients were reviewed 7 to 23 years after prolonged unilateral testicular torsion. They had all undergone surgical untwisting with replacement of the nonviable testis in the scrotum during prepubertal period. Five patients were now married and had fathered one or more children. Thirteen patients were unmarried. There was absence of testis on the affected side in 14 of 18 patients. Four patients had severe testicular atrophy on the affected side (testicular volume less than 1 mL). The contralateral side showed either a normal testicular volume or a compensatory hypertrophy (testicular volume greater than 25 mL). Seminal analysis was done in 13 unmarried men and it was completely normal in 10 patients. Two patients had low sperm density but normal semen volume and motility. One patient had pathologic semen analysis. IgG and IgA specific mixed agglutination reaction (MAR) test did not show evidence of sperm autoantibodies in any patient. Our clinical experience shows that, after prepubertal torsion, the contralateral testis undergoes normal development. Furthermore, torsion in the prepubertal male does not cause autosensitization and diminished fertility in adult life.

Adolescent↗
PubMed1985

Multiple gastrointestinal atresias in three consecutive siblings: observations on pathogenesis.

Three consecutive siblings with innumerable membranous gastrointestinal atresias, beginning at the prepyloric region and ending in the rectum, are reported. Microscopic examination of the small and large intestine showed multiple, tiny lumina each surrounded by a separate mucosa and muscularis mucosae but by a single muscular layer at the periphery. The pathological findings and hereditary character of these atresias suggest that a defect in recanalization during a solid stage of development involving the whole of the gastrointestinal tract may be the cause of these atresias.

Female↗
PubMed1985

Identification of rectal ganglion cells using monoclonal antibodies.

A monoclonal antibody has been developed that reacts specifically with ganglion cells of the myenteric and submucous plexuses of the gastrointestinal tract. This antibody also recognizes an axonal antigen that is distributed throughout the circular muscle of normal colon and rectum. Aganglionic segments of colon and rectum from patients with Hirschsprung's disease showed no specific antibody binding using a fluorescent labelled assay. The use of monoclonal antibodies should provide further insights into the pathophysiology of Hirschsprung's disease and allied disorders.

Antibodies, Monoclonal↗
PubMed1985

Augmentation of pokeweed mitogen-induced immunoglobulin production by cord T-cell supernatants.

Adult mononuclear cells were stimulated with pokeweed mitogen (PWM) in the presence of supernatants from cord T cells which had been previously stimulated with PWM for 24 h. Increased IgM, IgG and IgA production, as measured by ELISA, was observed with the addition of increasing concentrations of cord T-cell supernatants. The most significant increase in immunoglobulin production was observed with IgM (p less than 0.001). Cord T lymphocytes appear to be capable of producing soluble helper factors which augment immunoglobulin production by adult lymphocytes.

Adult↗
PubMed1984

Correction of experimentally produced vesicoureteric reflux in the piglet by intravesical injection of Teflon.

Vesicoureteric reflux was produced in eight piglets by opening their bladders and slitting the anterior intravesical wall of the ureter. Cystography confirmed the presence of bilateral reflux in six piglets and unilateral reflux in two. Six to eight weeks later the bladder was again opened and Teflon paste injected in the space behind the intravesical ureter, thereby creating a support for the submucosal ureter. Cystography four to six weeks after injection of Teflon paste showed absence of reflux in all animals. Intravenous pyelography showed obstruction at the vesicoureteric junction in only one of the 14 treated ureters and this was later confirmed at necropsy. Animals were followed up from one to six months and then were killed. Gross examination of the vesicoureteric region showed a well circumscribed subureteric Teflon mass of firm consistency, retaining its shape and position at the site of the injection. Histological examination showed encapsulation of the implant by a thin layer of fibrous tissue and a foreign body granulomatous reaction with histiocytes and giant cells within the implant. Hence it is technically feasible to correct experimentally produced vesicoureteric reflux in the piglet by intravesical injection of Teflon paste--a relatively inert material. It may now be possible to treat vesicoureteric reflux in man by endoscopic injection of Teflon behind the intravesical ureter.

Animals↗
PubMed1984

Treatment of vesicoureteric reflux by endoscopic injection of Teflon.

Thirteen girls with grade III-V vesicoureteric reflux were treated by endoscopic injection of Teflon paste behind the intravesical ureter. Fourteen of the 18 treated ureters showed complete absence of reflux after one injection of Teflon. Three ureters required a second injection of Teflon for successful treatment of the reflux. One ureter with grade IV reflux was converted to grade II reflux. Properly carried out, this procedure corrects reflux. It takes less than 15 minutes, may be done as a day procedure, and avoids open surgery. There have been no complications.

Child↗
PubMed1984

Lethal nonpulmonary anomalies associated with congenital diaphragmatic hernia: implications for early intrauterine surgery.

Recently, interest has been expressed in the correction of diaphragmatic hernia in utero as a solution to the problem of high mortality from this condition. Before such a procedure can be adopted in the human, studies aimed at establishing the contribution such advanced techniques would make in reducing mortality are required. Between 1973 and 1982, there were 36 cases of congenital diaphragmatic hernia among 75,512 births--an incidence of 1 in 2097 births. there were 11 (31%) stillbirths and 25 (69%) livebirths. the liveborn patients were divided into two groups: group A included 15 patients who died prior to transfer to the referral center; group B included ten neonates who arrived at the referral center and were operated upon. Twenty (56%) cases of diaphragmatic hernia (11 stillbirths and 9 liveborns who did not live long enough to be transferred to the referral center) were found to have lethal nonpulmonary associated anomalies at autopsy. In view of the high association of lethal anomalies it appears that fetal surgery would have a limited role in reducing mortality in congenital diaphragmatic hernia.

Abnormalities, Multiple↗
PubMed1984

Inguinal hernia in infants: the fate of the testis following incarceration.

In the years from 1971 to 1980 inclusive, 511 infants under 1 year of age presented with inguinal hernia. Of these, 158 (31%) (149 boys and 9 girls) had incarcerated inguinal hernia. In 151 (95.5%) infants the incarcerated inguinal hernia was reduced by taxis and herniotomy performed 48 to 72 hours later. Seven infants (4.5%) required emergency operation. Of the 142 boys whose incarcerations were reduced by taxis 87 (61%) were contacted and examined. They were aged 10 months to 10 years, 9 months at the time of follow-up. Two boys had testis in the groin presumably hitched up at operation. Testicular volume was assessed in 87 boys using Prader's orchidometer. Two boys had unilateral testicular atrophy. In the remaining 85 boys testicular volume was not different from that of age-matched controls. Our data show that the danger of testicular infarction from an incarcerated inguinal hernia, although real, has been much over-emphasized.

Child↗
PubMed1984

Immunosuppressive effects of anesthesia and surgery in the newborn: I short-term effects.

We examined short-term effects of anesthesia and surgery on the lymphocyte response of neonates and older children to a range of mitogens using a whole blood mitogen stimulation assay. Following induction of anesthesia, both neonates and older children demonstrated significantly decreased lymphocyte transformation to phytohaemagglutinin (PHA; P less than 0.005) and Con A (P less than 0.025) compared with preanesthetic values. Immediately, postsurgery, older children recovered fully their responsiveness to both PHA and Con A, while there was significant depression in their responsiveness to PWM (P less than 0.005) and SPA (P less than 0.05). In contrast, neonatal responsiveness to all mitogens was significantly reduced (P less than 0.005) immediately after surgery compared to preoperative values. At 24-hour postsurgery, neonatal responsiveness to PHA had returned to preoperative levels but Con A, PWM, and SPA responses continued to decline (P less than 0.005). These results suggest that the newborn is particularly susceptible to the immunosuppressive effects of anesthesia and surgery.

Anesthesia, General↗
PubMed1983

Megacystis-microcolon-intestinal hypoperistalsis syndrome: a visceral myopathy.

Two newborn infants with megacystis-microcolon-intestinal hypoperistalsis syndrome are described. Review of the literature revealed twenty previously reported cases of this syndrome. Electron microscopic examination of the ileum and urinary bladder showed vacuolar degenerative changes in the smooth muscle cells with abundant amount of connective tissue between the muscle cells. These ultrastructural findings suggest that a degenerative disease of smooth muscle may be the cause of megacystis microcolon intestinal hypoperistalsis syndrome.

Abnormalities, Multiple↗
PubMed1983

Significance of elevated IgA antibody levels in neonates with gastrointestinal conditions.

Four groups of patients, 21 neonates with gastrointestinal anomalies, 8 with necrotizing enterocolitis, 5 with low anorectal anomalies and 15 with spina bifida were studied for the development of IgA and IgA subclass immunoglobulin levels. A highly significant increase in IgA levels (p less than 0.001) was seen in neonates with gastrointestinal anomalies and necrotizing enterocolitis while patients with low anorectal anomalies and spina bifida had normal or undetectable IgA levels. Estimation of IgA sub-class distribution in neonates with raised total serum IgA did not demonstrate any striking correlation between either IgA1 or IgA2 sub-classes and the clinical conditions but rather they reflected the level of total IgA. The levels if IgA, correlated closely with those of total IgA (r = 0.93) in all patients implying that in these patients total serum IgA is composed principally of IgA1 immunoglobulin.

Digestive System Abnormalities↗
PubMed1982

Transient hypothyroidism associated with short gut syndrome.

Two consecutive short gut babies with a residual small intestinal length of 44 and 46 cm, respectively, were managed initially by total parenteral nutrition and oral feedings begun around the fifth week postoperatively. Uncontrollable diarrhea, malabsorption, and failure to thrive made the early management of these babies a difficult problem. The two infants developed clinical features of hypothyroidism at the age of 4 and 6 mo, respectively. Hypothyroxinemia was confirmed by repeated detection of low serum levels of T4. Hormonal treatment resulted in clinical recovery and normalized T4 values. Thyroid function has remained normal after discontinuation of treatment, underlining the transient nature of hypothyroidism. Early recognition and therapy of this previously unreported association is essential in order to prevent mental retardation.

Child, Preschool↗
PubMed1982

Total parenteral nutrition in the newborn using peripheral veins: role of I.V. nursing team.

During a six-year period, 109 consecutive neonates were fed intravenously via peripheral veins. This report compares two groups of neonates, group A when conventional approach of I.V. therapy was utilised, i.e. when junior medical staff erected all infusions, and group B when I.V. team nurses were responsible for erecting over 90% of infusions. Neonates in group A lost 1528 hours (63.7 days) or 8.8% of total infusion time. In contrast, patients in group B lost 1303 hours (54.3 days) or 3.8% of total infusion time (x2 = 23.31; p less than 0.001). On completion of course of total parenteral nutrition, 71% of the infants in group A maintained or gained weight and 29% lost weight, while in group B 88.2% of patients maintained or gained weight and 11.8% lost weight.

Bacterial Infections↗