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Biomedical subjects

R Mokka

Publications and source records attributed to R Mokka.

At least 19 recordsLinked to original sources
PubMed1992

Morphological effects of photodynamic therapy on rabbit bladder using Photofrin II and Photosan intravesically and intravenously.

Photodynamic therapy (PDT) has proved effective against superficial papillary bladder tumours and focal and diffuse carcinoma in situ. Effective topical administration of the sensitiser would be a welcome improvement. The morphological effects of PDT on the normal bladder were examined in 13 rabbits when 2 photosensitisers (Photofrin II and Photosan III) were applied intravesically (5 mg/kg for 1 h) and compared with intravenous administration (3 or 5 mg/kg). Four animals served as controls without a sensitiser. Intravesical red light (630 nm) from an argon dye laser was used to activate the photosensitiser, using light doses of 12 or 24 J/cm2. The animals were sacrificed either 1 or 5 to 7 days after the laser treatment. Intravenous dosage induced bladder wall oedema/haemorrhage and total necrosis of the epithelium. There was no difference between the effects of the 2 sensitisers. Intravesical application induced superficial epithelial necrosis. The control animals treated with laser light alone showed slight superficial injury to the cell layer.

Administration, Intravesical↗
PubMed1991

Chronic prosthetic vascular graft infection visualized with technetium-99m-hexamethylpropyleneamine oxime-labeled leukocytes.

Technetium-99m-HMPAO labeled leukocytes demonstrated chronic femoro-femoral prosthetic vascular graft infection several times during an 18-mo period in a 77-yr-old man. The intensity and distribution of the uptake in the graft were fluctuating in different imaging occasions possibly indicating the strength and location of the infection. Gallium-67-citrate imaging showed negative results twice. The reason for negative 67Ga results remained obscure. The infected graft was removed and the patient did well 5 mo postoperatively.

Aged↗
PubMed1990

Septic Haemophilus influenzae polyarthritis demonstrated best with Tc-99m HMPAO labeled leukocytes.

A 5-year-old girl with fever and tenderness in her left wrist and right ankle was hospitalized. Bone scanning and Tc-99m labeled leukocyte imaging showed increased uptake in these joints and also in her left knee. These radionuclide methods helped determine the diagnosis and were superior to plain radiography and CT scanning. Uptake was greater on leukocyte imaging than it was on the bone scan. The patient had infectious polyarthritis caused by Haemophilus influenzae, which is a very rare cause of acute polyarthritis in children older than 2 years. The patient fully recovered with antibiotic therapy, and no surgical procedure was needed.

Ankle Joint↗
PubMed1990

Renorrhaphy with a polyglycolic acid mesh.

In recent years resorbable polyglycolic acid mesh has been successfully used in the treatment of splenic injuries. The use of a resorbable mesh seems promising also in the treatment of renal injuries and in the rare ruptures of renal allografts. The authors report their own experience in the use of resorbable polyglycolic acid mesh in the treatment of a renal injury.

Child↗
PubMed1989

Delayed diagnosis of rupture of the main bronchus.

A case of a bronchus rupture with delayed diagnosis is reported. The symptoms of tracheobronchial lesions are discussed. With this case report the authors wish to bring attention to a rare but increasingly common injury in patients with multiple trauma.

Adolescent↗
PubMed1989

99mTc-leukocyte scintigraphy in prosthetic vascular graft infections.

The aim of this study was to determine the diagnostic value of scintigraphy with 99mTc-HMPAO-labelled leukocytes for the detection of prosthetic vascular graft infection. 51 scans were recorded in 19 patients with suspected vascular graft infection and 8 control patients. Three-phase scanning was used at 0.5, 3-6 and 18-24 h. 13 vascular graft infections (10 early, 3 late) were found. 12 of these healed with antibiotics and only one patient with late infection had to be reoperated. None of them died during the follow-up period. The sensitivity was 100% and the specificity 96%. 99mTc-leukocyte scintigraphy seems a useful tool to detect vascular graft infection and to differentiate it from infections elsewhere. The results suggest that the incidence of vascular graft infection may be greater, and the mortality rate lower, than supposed before.

Aged↗
PubMed1988

Comparison of 123I monoclonal granulocyte antibody and 99Tcm-HMPAO-labelled leucocytes in the detection of inflammation.

Thirteen patients with a suspicion of bacterial infection or inflammatory disease were studied with 99Tcm-HMPAO-labelled leucocytes (99Tcm-WBC) and 123I-labelled monoclonal antibodies against granulocytes (123I-MoAb-gc) within 5 days of the first study. Images were obtained at 30-40 min, 3-5 and 20-24 h. The quality of 99Tcm-WBC images was superior to that of the 123I-MoAb-gc. Eight cases were negative with both agents. Six inflammatory or infectious sites in five patients were clearly positive with 99Tcm-WBC even at 30 min, becoming moderately or strongly positive at 3-5 h but only three of them were weakly positive with 123I-MoAb-gc. One cause of the poor result with 123I-MoAb-gc may be the quite low activity in granulocytes and high plasma activity. We cannot recommend 123I-MoAb-gc as a primary imaging agent for inflammatory or infectious diseases for which 99Tcm-WBC seems very useful.

Adult↗
PubMed1988

Problems of cancer diagnosis in thyroid nodules.

During a ten-year period from 1977 to 1986 75 thyroid malignancies were found. The most common carcinomas were papillary (43%), follicular (39%) and anaplastic forms (7%). All 66 thyroids imaged with 99mTc-pertechnetate showed at least one cold nodule. Two or more cold nodules were seen in 52% of thyroids. In 63 of 66 cases the carcinoma was located in a cold nodule. The location of the carcinoma was not possible to find out accurately in the remaining three cases. 40% of frozen sections obtained at surgery showed benign and 60% malignant finding. Fine needle aspiration biopsy showed benign finding in 10 of 20 patients, suspicious for malignancy in 6 and malignant finding only in 4 cases.

Adult↗
PubMed1988

Early laparotomy wound dehiscence: a randomized comparison of three suture materials and two methods of fascial closure.

Early fascial disruption occurs in 1 to 3 per cent of abdominal operations. It is a serious complication with 15 to 20 per cent mortality. In this study 195 laparotomy patients were randomized into three categories without regard to the preoperative diagnosis. The fascia was sutured either with polyglycolic acid, polyglyconate or polypropylene suture. The polyglycolic acid suture was used in an interrupted fashion, whereas the polyglyconate and the polypropylene sutures were inserted continuously. The incidence of acute fascial disruption was 1.4 per cent in the polyglycolic acid group, 4.8 per cent with polyglyconate and 11.3 per cent with polypropylene. According to this study, there is no significant difference between using a continuous running polyglyconate suture or an interrupted polyglycolic acid suture. Polypropylene was less ideal.

Fasciotomy↗
PubMed1988

Recurrent varicose veins--is there a role for varicography?

Recurrent varicose veins are a common problem. Ascending phlebography has been used to identify possible incompetent perforating veins. The method is accurate in the leg, but much less so in the thigh. In this study, thirteen patients with recurrent varicose veins were examined with varicography, i.e. direct injection of contrast medium into a dilated varicosity. The method is especially valuable in the thigh. In this study 12 of 13 of the patients with recurrent varicose veins had incompetent perforating veins in the thigh, which would have been missed with a more simple procedure.

Adult↗
PubMed1987

Radionuclide venography and uptake imaging using 99Tcm-fibrinogen in the detection of venous thrombosis and its correlation with contrast venography.

Thirty-eight patients (76 legs) with suspected deep vein thrombosis were examined with 99Tcm-fibrinogen study (Tc-F), which consists of three parts: (1) radionuclide venography (RNV) of both legs after injection of 150 MBq of 99Tcm-fibrinogen into the dorsal veins of each foot, (2) blood pool imaging (BPI) at 5 to 20 min and (3) uptake imaging (UI) at 4 to 6 and 17 to 26 h. The clinical diagnosis was deep vein thrombosis in 27 legs. Twenty-nine patients (with 18 thrombi) were also studied with contrast venography (CV). Comparison of RNV with BPI suggests that the time-consuming and laborious RNV could, without affecting the diagnosis, be substituted by BPI, which is possible to perform after a single antecubital injection. When all patients were taken into consideration the sensitivity of Tc-F to detect fresh thrombosis was 100% but the specificity was lower (73%) because of the false positive findings in RNV/BPI. However, the specificity of UI was 100%. Previous anticoagulation did not prevent the uptake of fibrinogen within thrombi. There was good agreement of RNV/BPI and CV in the popliteal, femoral and iliac veins but the calf veins were better delineated in CV. Seventeen of the 18 thrombi examined both with Tc-F and CV were positive with RNV/BPI, 14 with UI and 13 with CV. Sensitivity, specificity, accuracy, positive predictive value and negative predictive value (%) were with RNV/BPI: 83, 73, 86, 90, 83, with UI: 78, 100, 86, 100, 74 and with CV: 73, 100, 83, 100, 69. Our results suggest that Tc-F could be used not only as a screening test but also instead of CV in the detection of venous thrombosis.

Fibrinogen↗
PubMed1987

Adsorption of bile acids by sucralfate, antacids, and cholestyramine in vitro.

Sucralfate, one of the newer drugs shown to be effective in the treatment of peptic ulcer and esophagitis; cholestyramine, a known bile acid binder; and commercial antacid preparations of pure aluminum hydroxide, pure magnesium hydroxide, and a combination of aluminum hydroxide, magnesium hydroxide, and magnesium carbonate were tested in vitro for bile acid-binding capacity. Cholestyramine was found to be the most effective bile acid binder, with more than 90% of bile acids adsorbed at all of the pH values studied. Sucralfate proved efficacious at pH 4, 6, and 8, adsorbing about 50% of the bile acids, but its binding capacity decreased at pH 2. Pure aluminum hydroxide was the most effective of the various antacid preparations; it adsorbed about 90% of bile acids at pH 2, although this percentage was significantly reduced at pH 6 and 8. Sucralfate was significantly more effective as a bile acid absorbent at pH 4 than either the magnesium hydroxide or aluminum-magnesium hydroxide plus magnesium carbonate antacids, as effective as the aluminum hydroxide antacid, and significantly less effective than cholestyramine.

Adsorption↗
PubMed1987

Comparison of gallium-67 citrate and technetium-99m glucoheptonate in the evaluation of pulmonary malignancies.

Sixty-five patients with suspected or proven pulmonary malignancy were examined with [67Ga]citrate and [99mTc]glucoheptonate ([99mTc]GH) scintigraphy. In the final diagnosis 39 had primary lung carcinoma, four metastases in lung, mediastinum, and pleura from carcinomas elsewhere, and 22 benign pulmonary diseases. The sensitivity in the detection of pulmonary malignancies was 91% with 67Ga and 95% with [99mTc]GH. The intensity of uptake was somewhat greater with 67Ga than with [99mTc]GH in almost all malignant lung tumor groups. The specificity to detect malignant tumors was 82% with both radiopharmaceuticals. Irradiation and chemotherapy seemed to decrease 67Ga uptake but not [99mTc]GH uptake. Only four of 22 benign diseases showed accumulation of both 67Ga and [99mTc]GH. The intensity of uptake in benign processes was almost equal with that in malignant diseases, but most malignant processes were better delineated than the benign lesions. There were many differences between 67Ga and [99mTc]GH uptake, which suggest different mechanisms of accumulation of these agents. It is concluded that some 67Ga studies could be replaced by cheaper and more practical [99mTc]GH.

Diagnosis, Differential↗
PubMed1987

Detection of inflammation with 99mTC-HMPAO labelled leucocytes.

20 patients were studied with 99mTcHMPAO labelled leucocytes for detection of inflammation. 14 patients had positive uptake. 6 patients were examined also with 67Ga-citrate and 5 with 99mTc-nanocolloid. The 99mTc-HMPAO images were superior to other methods. Abscesses, osteitis, inflammatory bowel disease and graft infection were positive. Abscesses were positive at 30 min images and became more positive at 4 h. The 99mTc-HMPAO labelled leucocyte scan can be used also to follow up healing of inflammation.

Adolescent↗
PubMed1986

Radionuclide angiography in the assessment of lumbar sympathectomy.

Nuclear angiography was used in the assessment of the effects of lumbar sympathectomy in 16 patients. Computed nuclear angiographic study was performed before and after sympathectomy. 7 patients had a good clinical course and 9 had a poor prognosis. Visual observation and computed analysis gave almost equal information. Shortening of arrival time (ATdecrease) and increase in input rate ratio (IRratio) were the most suitable parameters in computed analysis. A good clinical course was probable if ATdecrease was greater than or equal to 5 s and IRratio greater than or equal to 1.3. Smaller values predicted poor prognosis. Preoperative Doppler ankle/arm systolic blood pressure index (API) greater than or equal to 0.50 predicted good and less than or equal to 0.50 poor clinical response. Postoperative API provided no additional information and was not able to measure the effects of sympathectomy. Radionuclide angiography was found to be a safe, noninvasive reliable method in the evaluation of peripheral circulation in the follow-up of sympathectomy.

Adult↗