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Biomedical subjects

R Mokka

Publications and source records attributed to R Mokka.

At least 37 records · Page 2Linked to original sources
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↗
PubMed1983

Haemodynamic comparison of dopamine and dobutamine in normovolaemic and hypovolaemic dogs.

The haemodynamic effects of dopamine and dobutamine in doses of 1-106 micrograms/kg/min were compared in dogs, first in the normovolaemic state and then after bleeding (10 ml/kg). In normovolaemia, dopamine caused a dose-dependent rise in systolic, mean and diastolic aortic pressures, while dobutamine caused a rise only in systolic pressure. In hypovolaemia, a rise in all three aortic pressures, was caused by both drugs, but to a lesser extent by dobutamine. Heart rate and cardiac output were similarly increased by both drugs, as was pulmonary artery pressure with high doses, in both states. Renal blood flow and diuresis increased in the middle-dose area. Both inotropic drugs caused an elevation in Paco2 and a drop in Pao2 and O2-saturation in both normovolaemia and hypovolaemia. The results agree with current opinion on the dose-dependent alpha-sympathomimetic action of dopamine and the relatively pure beta-action of dobutamine.

Animals↗
PubMed1982

Comparison of metronidazole with clindamycin-gentamycin combination in the prevention of infectious complications after elective colonic surgery.

The efficacy of metronidazole, active only against anaerobes, and clindamycin-gentamycin combination, covering both anaerobes and aerobes, in the prevention of infectious complications after elective colonic surgery was compared in a prospective randomized trial over a three-year period. A total of 130 patients were accepted for the trial, 67 receiving metronidazole intrarectally and 63 receiving clindamycin-gentamycin combination. The prophylactic treatment was started on the evening before the operation and continued for 24 hours. One patient out of 67 receiving metronidazole (1.5%) and two patients out of 63 receiving clindamycin-gentamycin (3.2%) developed a wound infection. An intra-abdominal infection occurred in two patients in both groups (3% and 3.2%, respectively). There was no statistically significant difference in postoperative infections between the groups. The authors conclude that metronidazole is as effective as the clindamycin-gentamycin combination and should be preferred to broad-spectrum antibiotics because of its fewer side effects and lower potential of developing resistant bacterial strains.

Adolescent↗
PubMed1980

Experiences with the EEA stapling instrument for colorectal anastomosis.

Early experiences and results with the EEA stapling instrument for colorectal anastomosis are reported. 39 patients underwent anterior resection or left hemicolectomy with end-to-end anastomosis performed by means of the EEA stapler. Two patients had a clinically recognizable anastomotic leakage, both of which healed spontaneously. One patient died from pulmonary embolism, but at autopsy the anastomosis was intact. No significant problems in the control of anorectal function developed. On follow-up sigmoidoscopic examinations two patients showed a distinct narrowing of the anastomotic site, but both of these stenoses were spontaneously dilated by six months. It seems that an anastomosis performed with the EEA stapler is at least as reliable as a hand sutured one and apparently more so. With this instrument an anastomosis can be achieved at a lower level than would be feasible with conventional hand suture techniques. In addition, it is much more easily and rapidly performed, especially in patients with a narrow pelvis or other anatomical difficulties.

Adult↗
PubMed1977

The in vitro oxidative metabolism of benzo(a)pyrene in human liver measured by different assays.

The specific metabolism of benzo(a)pyrene (BP) in adult human liver samples was studied by using triated BP and thin-layer chromatographic separation of metabolites and by using the conventional fluorometric assay. The incubation in vitro of BP with human liver homogenates yielded the usual pattern of metabolites, including several dihydrodiols, phenols and quinones, as well as products bound convalently to protein. Interindividual variation in the production of different metabolites were very large, several ten-fold. The over-all metabolism was inhibited by aminopyrine and SKF 525A but not by 7,8-benzoflavone. The formation of dihydrodiols was inhibited by several epoxide hydratase inhibitors with consequent accumulation of phenols and an unidentified metabolite (possibly BP 4,5-oxide). Radiometric measurement of phenols, total dihydrodiols and individual dihydrodiols correlated well with the fluorometric assay of BP hydroxylase activity.

Adult↗
PubMed1977

Management of injuries of the large intestine.

Blunt trauma accounted for 1/3 of the 32 patients operated upon for injuries of the large intestine and penetrating wounds for 2/3. Most of the blunt injuries (9/10) were caused by traffic accidents, and more than half of the penetrating ones (12/22) were stab wounds. The transverse colon was most commonly affected, followed by the ascending, descending and sigmoid colon, rectum and mesentery. Perforation of the small intestine was the most frequent associated intra-abdominal injury, occurring in 11 patients (34%). Most patients (22/32) underwent simple suture, 6 patients suture with proximal colostomy, 3 primary resection and one exteriorization, combined in all cases with broad-spectrum antibiotic coverage and drainage of the abdominal cavity. Injuries to the right and transverse colon were managed mainly with simple suture, and those to the left colon and rectum with suture and proximal colostomy. 50% of the patients had complications, most frequently wound infection and intra-abdominal abscess. The patients with simple suture had fewer complications than the others. In the absence of complicating factors injuries to the colon are best managed with simple suture, whereas in the presence of complicating factors and in injuries of the rectum, suture or resection with proximal colostomy, especially in cases of severe tissue destruction, remains the treatment of choice.

Accidents↗
PubMed1976

Spontaneous rupture of liver tumours.

Five geriatric patients with spontaneous rupture of the liver caused by hepatic malignancies were operated upon without mortality. Liver resection seems to be the treatment of choice, but in selected cases with unresectable tumours ligation of the hepatic artery alone is preferable to an attempt to control haemorrhage by packing and suture.

Aged↗
PubMed1976

Prolonged recovery after extended right hepatic lobectomy in a patient with severe blunt liver injury and laceration of the vena cava. A report of case with special references to autotransfusion and complications of biliary decompression.

A patient with severe blunt liver injury and laceration of the vena cava who underwent a successful extended right hepatic lobectomy is reported. The use of autotransfusion unit saved the patient from exsanguination. His postoperative course was complicated by renal and hepatic failure, bile leakage, and persistent jaundice due to cholangitis. Prolonged choledochal drainage via T-tube obviously acted as a source of infection. The use of autotransfusion, choledochal drainage and the proper timing of its removal, the treatment of vena cava lesions and jaundice due to cholangitis in patients with severe liver trauma are discussed.

Acute Kidney Injury↗
PubMed1975

A critical analysis of the cystic duct remnant.

The cystic duct remnant can be an etiologic factor for distress after cholecystectomy, justifying reoperation and excision of the stump. In connection with cholecystectomy, it is not justified to leave any cystic duct stump unless there is a special reason for it. Stones in the cystic duct remnant, overlooked or newly formed, scar tissues and cystic duct syndrome of whatever cause--inflammation and stasis of the bile, a poorly healing stump end and neuroma--can also be factors producing the discomfort. Unresorbable suture material which provokes foreign body granulomas should be avoided in operations upon the biliary tract since, together with even a normal nerve under pressure, it may cause biliary distress. For the same reason, special attention should be devoted to careful trimming of the cystic nerve in cholecystectomy, and ligation or cautery of nerve tissues should be avoided. The cystic duct remnant is more often visualized in peroperative cholangiography than in an intravenous examination but even then not unfailingly. The cholangiographic finding alone does not justify surgical intervention, since in a number of patients troubles deriving from elsewhere in the biliary tract or from adjacent organs persist and not all cystic stumps apparently produce discomfort.

Adolescent↗
PubMed1975

Severe liver injury. Surgical treatment of eight consecutive cases.

A series of eight consecutive patients with severe liver injury is presented. Surgical treatment consisted of liver resection in four patients, one hepatic artery ligation and suture and drainage in three patients. Six patients survived. There were about three complications per patient, infection, and bile leakage being the most common. Of three patients who required hemodialysis for renal failure, only one survived. It is strongly recommended that an autotransfusion device should be ready to hand when a patient with severe liver injury is to be operated. In a case of massive bleeding from a lesion of the vena cava or major hepatic vein, autotransfusion could save the patient's life.

Abdominal Injuries↗
PubMed1975

Spontaneous rupture of the liver and the spleen: report of a successfully treated case with immunopathologic reaction.

A patient with a spontaneous rupture of the liver, followed by a spontaneous rupture of the spleen and gastrointestinal bleeding, is reported. The patient was operated for both ruptures and survived. We could not find any corresponding reports in the literature. Histological findings both in the liver and in the spleen were suggestive of an acute immunologic reaction and the symptoms of the patient resembled those of an autoimmune disease. Attention is drawn to the possibility that the ruptures of the liver and the spleen might have represented an allergic reaction reminiscent of the general type of Schwartzman reaction. This also could explain the other systemic manifestations of the disease. In the present patient steroid therapy eliminated all symptoms, and this possibility should be kept in mind when treating obscure ruptures of the liver and the spleen.

Autoimmune Diseases↗